Having a loved one in a nursing home can be a confusing and emotional experience. Understanding the various aspects of nursing home care and learning how to handle your concerns which may arise will greatly contribute to the success of your loved one’s stay.
These 10 tips will help improve your communication with the facility staff and help to clear up common misunderstandings.
1. Have realistic expectations.
It is important to have realistic expectations about the nursing home environment and the amount of care your loved one will receive. Although nursing home care (also known as skilled nursing facility care) is often referred to as “24-hour” care, it rarely means one-to-one care, 24 hours a day. Certified Nursing Assistants will typically each need to care for eight to fourteen residents during a shift. In addition, their extra duties required during meals and at change-of-shifts usually make staff even less available to help your loved one during those times.
Physicians do not make routine daily, often making visits late in the evening or on the weekends after their general practice offices are closed. However, the facility’s nurses are in constant communication with the patient’s physician by phone, reporting on the patient’s status, lab and test results and changes in condition. If you need to speak to your loved one’s physician, ask the facility’s nurse to have him or her contact you.
2. Understand the purpose and extent of the care.
Some residents and family members believe that the nursing home staff should be personal attendants to the residents and do everything for them. This is counterproductive to the goal of rehabilitation, which requires that each resident be encouraged to do as much as possible independently. However, although independence is vital to self-esteem and crucial to meeting rehabilitation goals, safety is always a paramount concern. Therefore, for example, if your loved one is at risk of falling, it will be important that that he or she not try to get up out of bed without the assistance of facility staff.
3. Important tips upon admission
It is very important that you provide the facility with a copy of all of your loved one’s legal documents that relate to his or her wishes regarding health and personal care and that designate an agent for such care.
The facility does not have the time to communicate information regarding your loved one’s care to multiple family members. Therefore, it is important that one person be assigned as the “responsible party” to communicate with the facility.
Do not bring valuable personal property to the nursing home as it may disappear for a variety of reasons, including getting misplaced, being taken by a confused resident, going down the drain in the shower, etc. Also, label with your loved one’s name all of his or her personal items that will be needed while in the facility, including eyeglasses, dentures, and hearing aids. Your loved one’s clothing should all be washable and not require ironing. Document ALL of your loved one’s items that are brought to the facility on the facility’s inventory list and update the list when new items are brought in or items are taken home.
4. Meet with the nursing home staff.
It’s important to be familiar with the Executive Director or Administrator, rehabilitation therapists, and nurses responsible for your loved one in the nursing home. Know what their roles and responsibilities are in relation to your loved one’s care, and by all means, inform them of any special issues pertaining to your loved one.
5. Get to know the Nursing Home Staffs.
For example in Clearwater Care, the staffs are certified nurses and physiotherapists (known as Lovers) provide most of the care to residents. Be courteous to them but be clear about anything your loved one needs. The better the relationship you establish with the particular LOVERs caring for your loved one, the easier it will be to talk with them.
6. Understand dietary precautions.
Always, always check with the LOVERs or nurse BEFORE giving any food or drink to your loved one or another resident. Some residents are on restricted or special diets, or require foods or liquids of a specific texture or consistency to prevent them from choking. Giving a resident the wrong type of food or drink (even water!) can be potentially dangerous or harmful.
Also be aware that what is considered a “diabetic” diet at the facility may not be as strict as the diet your loved one follows at home. Discuss any concerns regarding your loved one’s diet with the head of Dietary Services.
7. Respect your loved one’s rights.
Your role as a family member is to help communicate your loved one’s preferences to the staff. It is recommended that you provide the facility with a written personal summary of your loved one’s daily routine, so that the staff can understand better how to accommodate and meet his or her needs.
However, a resident’s wishes always come before those the family may consider important. For instance, if your loved one wants to return to bed but you disagree because you think he or she spends too much time in bed, the staff cannot violate your loved one’s personal rights and will allow and assist him or her to return to bed.
8. Respect other residents’ rights.
Although a resident should feel at home in the nursing facility as much as possible, it’s important to respect other residents’ rights regarding noise levels, privacy, and visitors. Being considerate of your loved one’s roommate(s) is important to the well being of both your loved one and his or her roommate(s). Know the facility’s visiting hours and be especially considerate when visiting outside of normal visiting hours. It may be necessary to visit with your loved one in another room at the facility if the visit is too noisy or disruptive to the roommate(s). This is especially true during night-time hours when many of the residents are trying to sleep.
If your loved one desires to watch TV or listen to music at a loud volume, especially when his or her roommates are trying to sleep, it may be necessary for him or her to use headphones.
9. Visit and Participate as much as possible.
The best way to monitor your loved one’s care and identify any problems or concerns is to visit your loved one often and participate in the care process as much as possible. Find out when he or she is receiving rehabilitation services and come in to observe them. Your frequent presence helps to reinforce to your loved one and to the staff how much you care.
10. Communicate your needs and concerns.
Voice any concerns about your loved one’s care and life in the nursing facility promptly to the LOVERs. Keep a notebook to remember specifics, especially dates and times, of situations that you want to address. The more detailed you are, the greater the possibility that any problems you identify will be corrected. Act as a problem-solver or option-creator, not a complainer, by answering the following questions: Can I prioritize the issues? What is unacceptable? What do I really want? What can I live with? By doing so, realistic outcomes are achievable. If you do not get a satisfactory resolution after addressing the problem with the staff most directly involved, then go up the chain of command.
However, before complaining about something, be aware of who is being upset by the situation. Is it you or your loved one? For instance, if your loved one’s clothes are not color coordinated, does it matter to him or her? Or, does it really just matter to you? As the old adage goes, pick your battles.
If your loved one does have a complaint (or even a minor concern) ask him or her how he or she wants to deal with the situation. Does he or she simply need to air feelings rather than have you confront the staff? Sometimes, simply listening is the most effective response you can give. Your loved one has to live in the nursing home, so it’s important that his or her wishes be respected.
Finally, and most importantly, be polite and friendly. A nursing home staff is comprised of people doing a very challenging job. Lifting and moving adults who are unable to help themselves is physically demanding. Understanding the needs of residents who may be confused or unable to communicate for a variety of reasons is emotionally exhausting. Recognize that the facility has many residents and the staff is very busy all of the time. Nursing home staff members work hard to do a good job. Thank them for their efforts. You will accomplish more by being polite and friendly, rather than nasty and demanding, when requesting changes or bringing problems and/or concerns to the staff’s attention.
Final Thoughts…
Remember, no matter how good the nursing home, issues may still arise. More than one person will be looking after your loved one, making communications and systems difficult to manage at times. One of the challenges you will face is figuring out the system and how it works, otherwise you will be setting yourself, your loved one and the nursing home up for failure.
Source : Sugai & Sudweeks
