If you want to guarantee great nursing home care, you need to understand the importance of the health care proxy, be committed to attending the comprehensive care planning meeting (CCP), visit your loved one frequently, and insist on being the squeaky wheel, i.e. ask plenty of questions!
Four Steps to Guarantee Great Nursing Home Care (as seen in the March, 2014 Courier Life publications)
Families rarely want to place a family member or friend in a nursing home. But when faced with the responsibilities of providing 24-hour care for an aging person who has ever-increasing physical needs, a nursing home frequently becomes the best alternative.
One big fear is that a loved one will not get proper care in a nursing facility. We have all read new stories that reveal nursing home abuses. But remember people are more interested in reading about a nursing home aide being arrested for mistreating a resident than an aide that refuses to leave the side of a dying patient.
Most nursing homes fall between these two extremes. The majority of nursing homes are capable of offering good care but it takes an added ingredient to insure a loved one to get optimum care. That ingredient is you. You, or a person you assign, can make the difference between so-so care and great care. Here are four steps that insure a resident gets great nursing home care.
1. Become Your Loved One’s Health Care Proxy
A healthcare proxy is one of the most important documents you can have to guarantee a family member or friend gets great care in a nursing home. This document offers you legal access to all your loved one’s medical records and allows you to make decisions when your loved one is not conscious, even for just a short period of time.
The health care proxy permits you to stay in the room with your loved one when he is being examined or dressed. This is a very important privilege that allows you to determine if your mom or dad is being treated well. The health care proxy is an easy document to obtain; you do not need a lawyer to activate it, only two adults to witness its signing. You can download it on line or by going to https://www.health.ny.gov/forms/doh-1430.pdf.
2. Attend The Comprehensive Care Plan (CCP) Meeting
Every skilled nursing facility that accepts Medicare or Medicaid funds must develop a care plan for a new resident within the first 21 days after entry. The facility’s major decision-makers typically called the Interdisciplinary Team, work together to develop this plan of care. As the name implies, the team consists of members from all disciplines, including nursing, social services, therapy, dietary, activities, and medical.
Nursing home regulations mandate that the family (and resident, if able) must be involved in the CCP. The Interdisciplinary Team will schedule a meeting to review their recommendations, sending written notification and an invitation to family members (and the resident) to attend. While family attendance at this meeting is not mandatory, it is recommended. Remember, your loved one’s care will be determined at this time.
Before the Comprehensive Care Plan meeting, you should compile a list of questions and issues you wish to address. If you are anxious about the meeting, bring a friend or trusted individual, such as a clergyman, for assistance and support. If English is not your first language, you may request an interpreter.
Take notes during the meeting. You might even consider making a recording if that will make you feel more comfortable. Before the meeting ends, review your notes, and make sure all your questions have been answered. Summarize what you feel has been decided and indicate how you feel about the plan.
3. Visit Often And Vary Your Schedule
You want to make sure your loved one gets the best care at all times, not just when you visit, so be sure to be unpredictable. Don’t come at the same time every day. Keep the staff on their toes! Be sure to visit on weekends, evenings, and holidays, when many facilities are not fully staffed. Come at meal times or in the evening to make sure your family member has not been put to bed too early, is not isolated, and is involved in activities. You don’t have to stay long, just “pop in” and out. When visiting, introduce yourself to all the staff members, so they know you are watching them. Make sure you let everyone know if you are having doubts about your loved one’s care.
If you live in another state or are unable to visit for some reason, you should appoint someone to visit your loved one, either another relative, a friend, or a professional like a geriatric care manager, senior care advisor, or social worker. Make sure you trust the person and feel assured that he will be vigilant in following your loved one’s care.
4. Become The Squeaky Wheel
You know the old adage, “The squeaky wheel gets the grease.” Anytime you have a question about your mother’s care, voice your concern. If you are not sure if your mom is being bathed frequently enough, ask. If you think her clothes are wrinkled, let the staff know. Make sure your dad’s hair is combed, and that he is well shaven and involved in all the activities he is interested in. The more often you make a comment or ask a question, the more likely the staff will think of you as they are caring for your loved one.
The best way to approach staff members is to assume they are professional. Talk with them pleasantly, but firmly. Don’t yell or appear confrontational. No matter how right you are, people do not respond well to accusations. If you attack, they will probably become defensive and return the attack, escalating the situation. Even if you get the desired change in behavior, you will lose your allies. On the other hand, you don’t want to be too conciliatory. You are both adults with a problem that can be solved if you discuss it and come up with a solution.
By knowing your rights and being involved, you can become a pivotal part in insuring a loved one get the best care in a nursing home.
Excerpted from “Almost Like Home: A Family Guide to Navigating the Nursing Home Maze”, now available at http://joannaleefer.com/almost-like-home-buy-now/. Special price for readers $9.95
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