"I would rather take poison than ever allow myself to be admitted to a nursing home."
Having been a licensed nursing home administrator, I have had people make that statement to me. I met with families who were faced with suddenly having to place a loved one in a rehabilitation or long-term care center. They had never given a thought to what was involved or what to expect.
What does placement mean? It means that their loved one will either receive intense therapy and go home, or they will receive the skilled nursing care they need for the rest of their lives. It might also provide a respite for a caregiver for a few days or weeks.
The quality of care depends on two things: the attitudes of the personnel who provide the care and the amount of involvement of the family in their loved one's care.
The attitudes of the personnel arise from several sources, including the caring personality of the individual themselves and the environment that has been created by the management and ownership of the nursing home.
The personnel must have been trained and be either certified nursing assistants or registered nurses. Some owners and managers have compassion for their staff and residents. Some do not, and are only concerned about reimbursement and finances. Because the nursing home industry is dominated by for-profit companies, too many times finances take priority over caring attitudes.
If a nurse or a CNA wants to stay an extra 15 minutes to ensure a specific type of care is provided to a resident, but the corporate policy is there will be no overtime, personnel are required to leave on time and this affects the attitude of the staff.
Family attitudes are also important. If the family member is "dumped" in the facility and no interest is shown by the family, then the staff will know this, and some staff will concentrate less on the care that a resident receives. However, if there is a family member in the building every day, and at all hours, then staff will be on their toes to make certain the family has no reason to complain. From the administrator to the laundry aide, they will be more aware of the needs of the resident.
Family should participate in care planning conferences, and monitor the care to make certain it meets the care plan goals. They should monitor meal times, to make certain the resident is being properly nourished. They should check the resident's physical condition regularly, making sure there are no red areas that might become bedsores. When is the resident bathed, dressed and in clean clothes daily?
Family can visit at 3 a.m. or 3 p.m., at the change of shifts, and other times. If caregivers are sitting at the desk, then they are not watching the residents. They should make regular rounds to check on toileting needs, dressing changes and medication administration. The nurse on duty must know the condition of the residents. If the duty nurse cannot answer questions, then a supervisor needs to be notified.
Poison is not necessary, but being involved is. Remember, no one should care more about your family member than you, but the staff, administration and ownership should be equally concerned as you are about your family member.
Retiree Lawrence G. Flannagan Jr. lives in Dunedin. During his career, he was an administrator at hospitals in Washington, D.C., Pennsylvania and Florida.