Question: My mother is a new resident at a nursing home and it looks like she is going to be there for a long time. Naturally, we are concerned about her care since we heard so many stories about poor treatment. Can you give us any guidance?
First, it is important to realize that you will almost never hear a story about excellent care; it simply does not make a good news story. However there is good news. I’ve been working with seniors and their families for many, many years and its my practice to ask how they or their parents are being treated at the various area nursing homes. Although its not one hundred percent, for the most part, the reports are glowing.
Having said this, it is important to note that nursing homes are heavily regulated by both federal and state laws. In addition, residents’ rights are contractually protected by the admissions agreement signed by the nursing home and the resident.
Some regulations are extremely specific. For example, one regulations states that "a facility shall ensure that a resident will not develop pressure ulcers" (bed sores). Such a regulation was in response to this on-going and serious problem especially for elderly nursing home residents who spend a good deal of their time in stationary positions often causing them pain, infection and even death. I recently appeared with other attorneys on a panel for a section of the New York State Bar Association. One of the attorneys detailed how he, in fact sued a facility who allowed a patient to develop severe bed sores all over her body. Without going into the grim details of the case, the ability to bring such suits or make complaints to agencies such as the New York State Department of Health pursuant to such regulations, put nursing homes on notice of dire consequences if standards of care are not met.
Nonetheless, no one wants to get to the stage where they are filing complaints with the State or bringing lawsuits against a facility for lack of adequate care for their loved ones. So there are certain steps that you should take. First and foremost, visit your parent or spouse often. Aside from the obvious positive impact this will have on their quality of life, you are placing the facility on notice that you are there watching the level of care they are providing. While most nursing home employees are hard working, well intentioned individuals, their numbers are often limited so that caring for your parent must be a partnership between the facility and you. Key among the staff are the Certified Nurse’s Assistants (CNA’s) who perform much of the hands on care. CNA training programs never seem to bring in enough personnel so that, unfortunately, this is often where the under-staffing lies. Check in often on your parent or spouse and relay your concerns to the CNA’s. Being aware of concerns and knowing that there is a caring family member present, will often bring a better level of care. Attend case meetings with doctors and social workers where they plan treatment and strategies. Do not be shy about speaking to doctors and administrators if items planned are not carried out. If you have the health care proxy and/or power of attorney for your parent or spouse, the facility should make his or her medicare records available to you.
Another resource available to you is the Ombudsman which every nursing home is required to have. There must be notices posted advising you how to contact Ombudsman whose job it to advocate for the residents on a wide range of issues. While he or she can a valuable ally, remember that it is you who must be the primary watchful eye and voice for your loved one to ensure that he or she receives the high level of care which is deserved.