Dr. Cheryl Woodson

Straight Talk with Dr. Cheryl- The Nursing Home Decision- Avoiding or Managing Problems

This is the 3rd installment of the excerpt from my upcoming book, To Survive Caregiving: A Daughter’s Experience, A Doctor’s Advice-2nd edition. Sign into the Woodson Network at www.drcherylwoodson.com to get advance notice of publication dates and presentations.
Attend the Quarterly Care Conferences
Nursing home regulations mandate that staff review residents’ care plans at least every three months. The care coordinator must notify the family of the conference time in advance. You can reschedule the conference to a more convenient time, but prepare to be flexible. Bring a list of questions and concerns to the meeting. You may also bring an advocate with you (another family member, clergy, or a geriatric care manager) and you may take notes. Ask about the facility’s policy on recording the sessions. Also ask:
• How will the facility resolve any identified problems?
• How they will monitor the solutions?
• When should you expect an update?
• Which staff members are responsible for each issue?
• Who is your contact person?

In previous generations, nursing home residents did not have intravenous lines, oxygen, or complicated treatment plans. Today, your senior’s condition may be unstable, and you may feel the need for a conference more often than every 90 days. It is not likely that the nursing home will be able to accommodate more frequent conferences with all team members, but you should be able to arrange a meeting with the charge nurse, social worker, a therapist, or your physician when you have a specific concern.

BE NICE! And Don’t Just Be a Squeaky Wheel
Facility staff should not cringe when they see your name on the caller ID. You have every right to raise your concerns, but it’s better to start out being nice. You can always “mean-up” later if need be, but it can be very difficult to recover from an initial interaction gone bad.
Be professional and courteous at all times, remembering that sarcasm and condescension are just as bad as yelling and cursing. Bad behavior makes people notice you, but it also overshadows and minimizes your concerns.
No matter how nice you are, people will become insensitive to your needs if you only complain. Participate in holiday celebrations and special programs. Attend support groups and educational seminars. Bring your talents to the nursing facility (like you did for Parent-Teacher Association [PTA] programs when your children were in school). Most activities departments will gladly schedule your choirs, dance troupes, plays, crafts, and just about anything else to make the residents smile.
Most facilities are also interested in programs for staff development, family, resident, and community education. Contact the activities director or the social worker to schedule a topic of general interest. Contact the administrator if you have a specific skill or area of expertise and want to offer a program for the professional staff. Either way, prepare a brief presentation of your credentials, a description of the session, and three objectives that you want to achieve in the session.

Contact the Ombudsman
Most states assign an advocate to address allegations of mistreatment, safety violations, and other serious problems in the nursing home. Ombudsmen are not nursing home employees. They are independent volunteer investigators and mediators, trained by departments on aging to work with nursing home administrators, residents, and families. The nursing home will have contact information for the ombudsman assigned to the facility, but the department on aging, or the area agency on aging are independent sources for this information.

I think of nursing homes as powerful treatments that offer great benefits as well as negative side effects. Families can honor the spirit of the promise to always give the best care by recognizing their own limitations and learning to be effective advocates for their loved ones. Then, they can avoid crumbling under guilt when a nursing home is the most appropriate care option.

 

Dr. Cheryl Woodson is a geriatrician and author who also cared for an aging parent. The second edition of her popular resource To Survive Caregiving is due out later this year along with a companion book, The Dr. is IN: Answering your Questions about How to Survive Caregiving    ( for example, what do you do when Mom gives all her money to Pookie, or Dad keeps going to the casino, and the seniors ask for your money when you have two kids in college?). Follow her on Facebook and contact her for a presentation, professional or family consultation at www.drcherylwoodson.com

Photo by Dr. Woodson’s sister in law, Dr. Brackette Williams.

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