How Do I Know If My Parent is Receiving Good Care in a Nursing Home?

A young woman holding hands with an elderly woman - good care in nursing home concept

With the holidays recently concluded and the new year beginning, many of us have just been to visit loved ones in nursing homes and in assisted living facilities. These visits may have sparked some concerns and left you wondering if your loved one is receiving good care in the nursing home.

Unfortunately, all too often nursing homes neglect and abuse their residents. Many times when that occurs they do not disclose that abuse to the resident's family members. Recently, the owners and the operators of The Montefiore Home nursing home sent a letter to residents' families indicating that a number of their residents had tested positive for COVID and those positive results had been concealed and reported as negative, putting the staff and the other residents at grave risk. Given the fact that nursing homes are not always forthcoming with respect to abuse and neglect that takes place at these nursing homes, how do you know if your loved one is receiving good care?

Is My Loved One in the Correct Facility?

If your loved one is in an assisted living facility, one of the main things to ask yourself is, are they suitable for assisted living and are they receiving sufficient care? Some entities are paid more for the care of their residents in assisted living. These entities have a financial incentive to keep the person in assisted living as opposed to transferring them to a nursing home where they might not be paid as much for their care.

If your loved one cannot walk safely on their own, they are likely not a good candidate for assisted living. Most assisted living facilities do not provide 24‑hour supervision of their residents. Nursing homes are legally obligated to provide every single resident with adequate supervision to prevent accidents and maintain a safe environment. If your loved one is not independent, (not able to walk on their own, not able to take themselves to the bathroom, etc.) you may want to consider a nursing home instead of an assisted living facility.

Can Falls Be Prevented?

Oftentimes nursing homes like to tell people that not all falls can be prevented. They also like to say that residents have a right to refuse care. As an attorney who represents clients in nursing home abuse and neglect cases, I have yet to meet a resident who is in their sound mind that wants to fall and run the risk of suffering a serious, if not fatal, injury. Falls can be prevented in the nursing home.

Nursing homes are legally obligated, under federal law, to provide each and every one of their residents with adequate supervision to prevent such accidents. There are many things that can be done to prevent falls. Does the nursing home where your loved one resides use alarms? If they don't, how do they provide the residents with adequate supervision? In my experience, I have never had an appropriate response to this question. It would be nearly impossible for a nursing home to provide adequate supervision to its multiple residents in the middle of the night when they are all asleep in their rooms. A typical nursing home has a nurse and a couple of aides keeping an eye on 20 or 30 residents in a hall. How could those three staff members possibly know if every single one of those residents is safe in their bed?

Nursing homes like to say that alarms don't prevent falls. This is technically true, the alarms themselves do not prevent falls. However, when alarms are used properly, they alert the staff that the resident has tried to get up or is beginning to get up on their own. If the nursing home is properly staffed, they are able to respond to that resident before they get up and would be able to prevent the fall. Falls are one of the leading causes of injuries and death of nursing home residents and are often fatal. The mortality rates for nursing home residents after a fall are incredibly high. When considering if your loved one is receiving good care in their nursing home, consider what they are (or are not) doing for fall prevention. Falls must be prevented in older people as much as absolutely possible.

Can Bed Sores Be Prevented?

Some bed sores are not avoidable. However, these are typically in very extreme cases. If your loved one has profound circulatory problems, peripheral vascular disease, advanced diabetes, etc., they may very well have a medical condition that makes preventing skin breakdown impossible. One of the questions to ask yourself, is does my loved one have a history of skin breakdown? If they don't, then if the nursing home is providing good care, it's possible to prevent skin breakdown regardless of their other medical conditions.

What typically happens is that a person is living independently at home and they suffer a fall. This typically leads to hospital time, perhaps surgical procedures, and now they have been discharged to a nursing home and they are not able to be ambulatory on their own like they were prior to their fall. They are now dependent upon the nursing home staff to turn and reposition them.

If the nursing home is not properly staffed, and the resident is not turned and repositioned as they are supposed to be, that is when bedsores occur. The key is to monitor the condition of your loved one, which can be a challenge. Bed sores often form on the coccyx or the sacral area of an individual or on their buttocks. Any location on their body where it makes contact with a surface and is subject to pressure, or any place that they lay and/or sit on. Most people do not inspect the buttocks or the sacral area of their loved one when they visit them in the nursing home. And, if you have a loved one who is not able to communicate with you, this can be an even bigger challenge.

One solution is to have frequent communication with the nurses. Ask them directly about the condition of your loved one and if they have any skin breakdown. If you're not comfortable inspecting your loved one from head to toe then ask a nurse or an aide who recently bathed them what the condition of their skin is.

When Am I Visiting My Loved One?

Another tip is to visit your loved one at all different times. Visit them at mealtime, early in the morning, and late in the evening. Visit them in the middle of the day. Does the staff get them out of bed first thing in the morning and bathe and dress them? Do they take them to the dining room for meals? When they're in the dining room, if they need assistance with their meals do they get assistance with their meals, do they supervise them during their meals? Our firm has handled numerous cases where residents have choked simply because they were given improper food and were not properly monitored or supervised during the meal.

Is My Loved One Receiving Good Care in Their Nursing Home?

When you have a loved one in a nursing home, or assisted living facility, it is important to stay vigilant and attentive to their condition. Asking yourself questions like the ones mentioned in this article can help you determine if action needs to be taken to ensure the nursing home is providing them with good care.

If someone you love has been neglected or abused in a nursing home, we would be happy to talk with you and help you in any way that we can. Please call 1-800-OHIO-LAW and ask to speak with me, Blake A. Dickson. I am the founder of this firm and it would be my pleasure to speak with you about your concerns.