STORY BYIt happens. Your aging mother can't care for herself like she used to. Simple, everyday tasks she took for granted like bathing and cooking become virtually impossible. But before you shudder at the thought of nursing home care, think again. By doing your homework, you can ensure that your loved one will receive good care.
"Just because you'll be assuming a different role in your parent's life doesn't mean you stop being a caregiver," says Diane Persson, Ph.D., director of the Long-Term Care Ombudsman Program at the Center on Aging at The University of Texas School of Nursing at Houston. "Get as much information as you can before you visit a nursing home. Be sure to visit with your nose, eyes and ears and talk to other families there to find out what they think."
Persson says it's a good idea to find out how many people work there and what the usual staffing pattern is. "That's a real challenge. Most states don't have a mandated ratio that says for every 10 residents, you must have one nurse aide. You just need sufficient staff to care for the residents. That's pretty subjective," says Persson.
Another good idea, Persson says, is to visit the nursing home at different times of the day and form a good relationship with the certified nursing aides who provide the bulk of the hands-on care. "If there is a urine spill, look for a housekeeper. If you see a call light that keeps ringing or the resident is not eating her food or missed their bath, talk to the nurse aide about it first," Persson said. "If it doesn't get resolved, go to the director of nursing. They may be busy with paperwork, but keep looking. If that fails, go the administrator. That's where the buck stops."
It's no secret that long-term care is expensive. Around half of all nursing home residents pay nursing home costs out of their personal savings. If you're worried that you or your loved one can't pay for nursing home care, shop around for nursing homes that are certified for Medicare and Medicaid. About one in four nursing home residents receive assistance from Medicaid. Medicare does not pay for long nursing home stays-only up to 100 days. But, it will pay for short periods of skilled nursing facility care when a patient has been in the hospital and needs continued care.
Medicare
provides information about Medicare and
Medicaid certified
nursing homes throughout the
United States on its Web site.
The site includes information on payment and patient
rights,
as well as an interactive nursing home
comparison page and
checklist to help you rate the
nursing homes that you visit.
To find out more, log on at http://www.medicare.gov/
If your loved one is a resident in a nursing home that accepts Medicare, it will pay for his or her care during any period he or she is eligible for the benefit. Medicaid does pay for long nursing home stays for those whose income and savings can't cover the cost.
Persson says, as your parent's advocate, you should know your rights when it comes to selecting a good nursing home or assisted living center. "It's important for families to get as actively involved as they can," she says.
Effective January 1, 2003, the Centers for Medicaid and Medicare passed a law to make available to the public a nursing home's most recent annual survey conducted by state government agencies to decide if nursing homes meet state licensing requirements and federal standards. The survey covers nutrition, quality of life and residents' rights. "Even if it's a little outdated - say eight months - it's generally a good indicator of what was found the last time," says Persson.
You also have the right to visit your loved one as often as possible. It's good for both of you. Studies have shown that nursing home residents whose family and friends visit them tend to get better care. "Sadly, more than half of residents don't have anyone to visit them on a regular basis for whatever reason," says Persson. "These residents fair much worse than their less isolated counterparts."
Community resources such as religious organizations, social workers and nursing home professional associations can provide you with general advice when choosing a nursing home. Citizen advocacy groups are effective, too. One such program called the Long-Term Care Ombudsman Program was established by the federal government in 1987 to serve as a community "voice" for nursing home residents. An ombudsman is a specially trained and certified volunteer who advocates for quality nursing home care. "Ombudsmen visit residents regularly, mediate disputes and serve as the eyes and ears for those folks who really don't have anyone in their corner," says Persson.
Are you patient, sensitive, fair, diplomatic, tactful with
good judgment, common sense, a sense of humor and
reliable transportation? Then you probably qualify as a
certified Long-Term Care Ombudsman.
The U.T.
Health Science Center at Houston Center on
Aging needs
adult volunteers for training as advocates
for the elderly.
Qualified volunteers will be asked to visi
a nursing home
facility at least two hours a week. Some
of the responsibilities
include listening to residents'
concerns and resolving
their problems and complaints,
educating residents and
their families on their rights,
and providing information
on the Ombudsman program
and other available resources.
Since you won't be in the nursing home around the clock with your loved one, you'll probably still worry. You're not alone. Realizing the concern, Medicaid and Medicare nursing homes allow families to form family councils that meet privately in the facility.
"A family council can help everybody concerned," says Persson. "These councils arrange educational programs on reducing stress and even plan holiday events involving the nursing home staff. One council I know recognized a deserving nurse aide and also sponsored a garage sale to pay for a new garden for the residents."
Persson adds that a family council can show new families the ropes and be a constant source of support. "Many council members have asked their fellow members if they could check on a loved one while they're out of town."
Now that you've done all the leg work and your mother is settled into her new residence, does it stop there? "No," says Persson.
"We can't ignore nursing homes. We all have to be advocates for bigger changes at the state and national levels," says Persson. "Get involved with groups that deal with advocacy issues at a policy level, like AARP (American Association of Retired Persons), nursing home reform citizens' groups and local aging agencies. No one chooses to go into a nursing home. But sometimes, a nursing home can provide the best care that we need. We have to open the doors and go inside and make it better for everyone."
UPDATED: 12-02-2002
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©2000-2006 Office of Institutional Advancement, UT-Houston
Dr. Diane Persson is director of the Long-Term Care Ombudsman Program at the Center on Aging at The UT School of Nursing.
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