When a family member moves into a nursing home, you quickly learn that your role as a caregiver changes significantly. Instead of monitoring daily details of your loved one's life, you become an advocate, a voice to help ensure the quality of care. In the course of this, you may hear complaints from your loved one that she isn't happy or getting what she needs. But how do you distinguish things you can fix from the ones you can't, or which ones aren't even justified? To help mitigate problems — and to solve them — follow these five rules.
1. Investigate before you complain to the staff or administration.
Some complaints have relatively straightforward solutions. Three common ones are:
- Roommate conflicts. Most nursing homes will try to accommodate room changes when problems between roommates can't be resolved, so a simple request should do the trick. Keep in mind, though, that unless the nursing home has private rooms, and you can afford one, dealing with a period of adjustment is normal.
- Food issues. Nursing home food may never measure up to Mom's standards, particularly if she is used to ethnic foods or has particular preferences. Many older people lose some sense of taste, so even well-prepared food just doesn't taste right to them. Keep an eye out for signs of malnutrition. Ask the nursing home staff whether you can bring your mom's favorite foods when you visit. Make sure you don't bring foods that are banned from her special diet or that may cause choking. Try to visit at mealtimes; Mom may not miss the food as much as the family eating together.
- Lost items. Make sure you have insurance that covers loss; hearing aids, eyeglasses, dentures and other devices do get easily lost. Your mother may insist that they have been stolen, but it is more likely that they got bundled up with the sheets and sent to the laundry.
2. Work to establish good relationships with the nursing aides.
If the aide knows to look out for hearing aids when changing the bed, she'll be more apt to find one that would otherwise go missing. Get to know the aides as individuals and help them understand your loved one's quirks, habits and preferences. Be appreciative of the hard job they do. You can also help your family member better understand the aide, who may speak with an accent or have other unfamiliar characteristics.
3. Get involved in the nursing home.
Offer your own or others' talents — music, arts, storytelling, computer instruction — to the residents. Try to visit as often as possible and at different times of day and evening. Make yourself a familiar and welcome presence. If you are a part of the community, your family member may be more likely to participate in activities, which wards off another common resident complaint: boredom.
Being present not only is a way to help Mom stay engaged, but also is essential for monitoring her care, leading us to the next rule.
4. Don't miss important meetings.
Attend the annual or quarterly staff review of your family member's care plan. You can use this opportunity to raise concerns and questions with the people who care directly for your family member. Aides spend more time than anyone with residents, so be sure to listen to what they say about what your family member needs. Make sure the staff knows that you want to attend the reviews and need advance notice for meeting times.
However, you need to raise a red flag if you find a serious problem.
5. Observe, note and report serious lapses in care.
Your family member may be unaware of or unable to communicate the most serious problems — those about quality of care. Many common examples are apparent, such as bedsores, neglect of personal hygiene, weight loss and lack of attention to an illness or obvious deterioration. If your family member is in physical restraints or seems overmedicated, those, too, are alarming signs.
You should first speak to the nurses and doctor if there appears to be a problem. If you are not satisfied with their responses, call the nursing home ombudsman in your area. Ombudsmen are trained to resolve problems in quality of care, as well as suggest ways to manage other non-life-threatening issues. Any sign of physical, sexual or verbal abuse should be reported immediately to the nursing home administration, an ombudsman and your state's department of health.