Understanding how the nursing home system works, how to solve problems, where to go for help, and residents’ rights are all important factors in getting good care.
There are many reasons why nursing home care is not always good. At the first sign of a problem, it is best to discuss it with the nursing home staff. Friendly, open communication and relationships with nursing assistants, charge nurses, the director of nursing, the social worker, the administrator, and other staff can often help keep small problems from becoming serious. When a problem arises or is ongoing, chances are that other families (and residents) are also concerned.
Communication among families is so important that Medicaid and Medicare nursing homes are required to allow families to form family councils that can meet privately in the facility; Ideally, the family council is a place for families to talk freely among themselves and present concerns or complaints to the staff. Find out if there is an established family council already meeting. If not, think about starting one as soon as possible. Communication is always the best step to avoiding or solving problems.
Periodically, nursing homes must also hold care planning meetings to discuss residents’ needs and any changes the nursing home should make in their care. Residents and their family members can and should participate in these meetings. The meeting should involve a team of staff members, not just nurses. Ask about the next care planning conference, ask who will be attending, and feel free to request that other staff attend as well (including nursing assistants). The long- term care ombudsman, a member of the clergy; or a close friend could also come to the meeting to provide support.
If the nursing home is poorly staffed or poorly managed, it may not give good care until residents or their family takes the concern to a higher level. Never hesitate to take a complaint outside the facility if working with the nursing home is not getting the problem solved. The purpose should not be to hurt the facility, or its employees, but to get better care for a loved one and the other residents. A written record can be very helpful when filing a complaint. Keep track of when the problem(s) occurred and who was involved. These are some places to go for advice or investigation of complaints dealing with nursing homes:
Often families fear that if they complain, someone will take it out on their loved one. Sometimes, out of fear, residents ask family members not to speak up. This is the primary reason families hesitate to complain about poor nursing home care. Nursing home workers themselves say that families who call attention to problems get results. Try the following suggestions to confront problems:
If nothing you try improves the care a loved one is receiving, consider joining a citizen advocacy group. If none exists, form one. Ask the family council group for help, and check with the local AAA or ombudsman program about how to get an advocacy group started in your area.
Too often people lose even the simplest rights when they become nursing home residents:
The Nursing Home Residents’ Bill of Rights was designed to help make sure people can keep their privacy and dignity. It protects rights as basic as whether or not staff knock on the door before entering a resident’s room. These rights apply to all residents who live in Medicare/Medicaid certified nursing homes.
Good care is everyone’s basic right in a nursing home. Poor care usually comes from the nursing homes’ failure to hire or keep enough qualified licensed nurses and nursing assistants. It is understandable to sympathize with overworked nursing staff, but expectations for good care should not be lowered. Nursing homes must maintain an adequate number of qualified staff.
Providing poor quality food, not keeping residents clean and dry, and ignoring a change in a resident’s condition are all signs of neglect. Sometimes poor care and neglect may result in dangerous medical conditions. Some signs to watch for are:
Sometimes residents are hurt physically or psychologically. Do not accept behavior toward a loved one that is abusive, including rough treatment or unkind words during or in between care. If supervisory staff do not act immediately to fix a problem, contact one or more of the following authorities:
Nursing homes should be a place where loved ones get the care they need. Working together, families can make nursing homes better.
