Nursing Home Conundrum

                This is a decision I do not want to make, but I know, at some point, my parents may need the services of a nursing home.  My parents divorced when I was six years old and live in different states.  I am the primary caregiver for my father and my brother is supporting our mother.  Both are in their 80’s and struggle with a myriad of ailments.  They both fear nursing homes and distrust the level of care they would receive.  They both consider these places simply as a place to die.

                It is estimated by the Centers for Disease Control (CDC) that there were 1.2 million nursing home residents in 2016.  This number will continue to grow as the “Baby Boomer” generation ages.  Nursing homes serve a vital role within the healthcare system yet are feared by the elderly and their families.  In a survey taken by Clarity and The EarFoundation, 89% of want to age within their current living conditions.  82% of family members fear that their loved ones will be mistreated in nursing homes.  There have been a lot of news worthy stories of elder abuse in nursing homes.

                The decision to place a loved on in a skilled nursing facility is huge for families.  It involves a recognition that the loved one has deteriorated to a point where the person and their family cannot adequately care for the needs of the patient.  There’s a sense of defeat and as previously stated, fear for everyone involved.  Once this realization had settled, the next choice is to choose an appropriate and affordable home.

                I will not get into the details, but the financial end of choosing a nursing home can be a unique struggle in its own right.  Navigating Medicare and Medicaid can be daunting.  According to A Place for Mom, engaging an Elder Care attorney may be the best course of action.  These advocates can help a family navigate the uncertain waters for their loved ones and create the best possible outcome.  This person can also help when abuse or error is suspected.

                When choosing a nursing home, it is important to do your homework.  It is best to seek quality ratings for nursing homes in your area.  One useful website is https://www.medicare.gov/nursinghomecompare/search.html? Which provides a ranking of facilities by zipcode or address.  A simple search here can quickly help rule out facilities that do not measure up.  Once you have a list of potential choices, make appointments with the facilities and tour them noting the cleanliness and condition of the patients that you might encounter.  Talk with the administrator about your concerns and your loved one.  See if the activities offered by the nursing home match up well with your needs.  Talk about the conflict resolution process they have in place and discuss any special requirements like food allergies or preferences.

                The staff must be well trained and vetted.  Accidents, falls, and any process that causes bruising or marks must have appropriate records and follow up by the administration.  There should be a notification process in place when an incident occurs.  All in all there should be a clear line of communication between the staff and the family about the care of the loved one.

                Once a facility is chosen, be engaged in the care of your loved one.  Every nursing home must create a customized plan for each patient.  According to Strom & Associates, it is important to not only be involved in the creation of the plan, but to be part of its enforcement.  There is no doubt that an engaged family advocate will ensure the best possible care. 

                Personally, as I see this day coming for my 86 year old father, I have a number of concerns that I want to be sure to address.  Beyond his ongoing medical conditions, these include medications, avoiding bed sores, engagement with others in the facility and his diet.

                My father takes a variety of medications at different parts of the day.  We have developed a routine for which he is quite comfortable and can manage.  When my mother-in-law experienced a short stay in a rehabilitation wing of a nursing home, this was a real struggle.  Medications were given at the wrong times or not given at all.  We were in constant conflict with the nursing staff over this topic and it challenged our wellbeing everyday.

                Recently my father had an extended hospital stay and he developed a bed sore.  This was very painful for him. For sedentary seniors, this is a huge problem that can be avoided with proper care and attention.  Unfortunately limited staff and lower quality bedding often create a situation where bed sores are prevalent.

                I would want my father to have some social contact that was meaningful and enriching.  The facility I would choose for him would have activities to engage the residents and stimulate physical and emotional wellbeing.

                Finally, my father has a number of food allergies that would need to be addressed by the staff.  The skilled nursing facility would need to be prepared to ensure that my father was receiving a proper diet while at the same time avoiding foods that cause him difficulty.

                It is a difficult decision for families to put an elderly loved one in a nursing home.  Having a plan, conducting research and staying involved in the day to day care of your loved one can make all the difference.