Dr. Cheryl Woodson

Straight Talk with Dr. Cheryl -The Nursing Home Decision Pt2: Stay in Control of the Care Plan

Stay in Control of the Nursing Home Care Plan.

Your senior is in the nursing home, but you are still the caregiver. You do not give up the rights, nor the responsibility for your seniors’ care, but you can serve their best interests only when you are a strong advocate. These seven steps will help you get the information you need to voice your concerns effectively.
1) Make Friends with Your Loved One’s ROOMATE’s Family. Remember, it takes a village to support a senior, just as it does to raise a child. You need extra sets of eyes when you are not in the facility. Make other families your allies and join forces to watch out for all the seniors.
2) Follow the Chain of Command. Families often face frustration because they ask the wrong people.
a. The  Registered Nurse (RN) assigned to your senior should be the first point of contact about any questions, concerns, or complaints. The RN will also know about medicines, wound care, catheters, and other specific treatments, as well as any changes in health status.
b. Certified nursing assistants (CNAs,) and the nursing aides provide direct care and can give information about the residents’ daily lives: how well do they eat, control bowel and bladder function, participate in activities, and interact with other residents?

c. Physical, speech, occupational, and activity therapists, psychologists, and social workers can report on your loved one’s progress toward independence, and the resources necessary to support them at home, but talk to the nurse first.

d. Administration The Director of Nursing, or the Nursing Home Administrator intervenes to resolve serious, or repetitive problems, or when RNs cannot address the concerns.
3) Get to Know the Nursing Home Staff, Too. Don’t expect security guards, receptionists, dietary, and housekeeping staff to act as spies, but casual conversations can give information about quality of life in the facility.
4) Contact the Doctor at her Office. Contact the doctor through her office, even the doctor has never cared for your loved one there. Don’t leave messages at the nursing station. Only the office staff knows about emergencies and other commitments that can change the doctor’s routine. Also, don’t just wait in your senior’s room, planning to catch the doctor. You can get the time, attention, and answers you need only by scheduling an appointment through the office. Health insurance rarely pays for conferences, but what’s the problem? You pay your attorney don’t you?
5) Attend the quarterly care conferences
Nursing homes must review care plans at least every three months. The nurse or social worker must also notify the family in advance. Write down your questions in advance and be sure to ask about the resolution process: How and when will they follow up? Who’s your contact person?
6) Be a citizen of the facility. Be NICE and don’t just be a squeaky wheel. It’s just like participating in PTA when your kids were in school; the staff should not DUCK when they see your name on the caller ID! Bring in pizza and doughnuts for everyone. Activities directors are always looking for ways to make residents smile and administrators are looking for staff development. Bring your choirs, crafting, vacation slides, and other interesting projects. If you have specific professional expertise, send a program description and at least 3 objectives to the Administrator.
7) Find the Ombudsmen  The state trains volunteers and assigns them to a specific nursing home to investigate problems, facilitate communication, and mediate disputes. The nursing home and the Department on Aging can give you the ombudsman’s contact information.
Nursing homes can be effective tools when used in appropriate situations. To achieve this goal, families must monitor the care as consistent, powerful advocates. Contact me at cew@drcherylwoodson.com with comments and questions. I’d love to hear from you.

Join me next Wednesday for the first in a twelve-week series, “Preparing to Care.” My coach, Monique Carradine requested this topic for the 40-somethings who worry about future caregiving. Each blogpost will offer strategies for proactive care planning while your parents are still healthy.

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