Nursing Home & Assisted Living Centers - Know What to Expect

Are you currently considering a nursing home stayeverything, and I do mean EVERYTHING else, is of
for either yourself or a loved one? In either case,lesser importance. What makes this statement all the
you would expect to receive the best care,more outrageous is that it may actually sound
especially for the very expensive prices nowadays,naïve to some, in today's corporate controlled
wouldn't you? Unfortunately, locating a facility thatworld. "Of course it's about money, what else could it
provides genuine quality care may be tantamount tobe about?"
finding the proverbial needle in the haystack. KnowIt should be mentioned the examples given above
the truth about nursing home or assisted livingare extreme and may not necessarily occur in all
facilities before you decide.nursing centers. However, the Centers for Medicare
I have been involved with health care for more thanand Medicaid Services (CMS) on February 5, 2008
15 years as a Combat Medic in the United Statesnamed 4,037 nursing homes whose pressure sore
Army, a Certified Nurse Assistant, Physical Rehaband/or physical restraint rates it says have targeted
Aide and Occupational Rehab Aide in California andthem for "improvement". Thus, anyone who is
the suburbs of Illinois. My wife is a Registered Nurseconsidering a nursing home or assisted living facility
with more than 11 years of experience, and likestay, for either a loved one or themselves, should
myself, the majority of the experience is in nursingconsider and understand the reality of these facilities
home or assisted living centers.and the possible measures that can be taken to
1989 was the year I became employed in my firstpromote better care.
nursing home. One of the many duties of a CNA, orSo, what can you do if you believe extended
certified nurse assistant, is to help the residents ofassisted living or nursing care is needed for you or a
the nursing home with their morning routine. Whileloved one? Here are some suggestions and options
assisting a certain resident, I noticed the sliding doorsyou might want to consider.
of her closet were broke and one of them wouldn't- If distance is not a major concern, you may be able
open without forceful tugging. After getting herto locate a decent facility via the Senior Housing site.
clothes together, I opened a drawer for some socksAfter choosing a place, if you have the means,
and a few roaches crawled out from the haphazardlyresearch the facility. Find out what you can about it
bundled clothing. I later discovered most of thebefore you visit it. Perhaps you can check for recent
rooms in this particular facility were in the samecomplaints, or any history of lawsuits, with the Better
appalling condition.Business Bureau online. If this is not an option,
Mysterious injuries to some of the mentallyarrange a visit and ask the residents about the care,
handicapped residents also created rumors of abuse.their rooms, the food, etc.
Yet, no one seemed to know anything about it.- Notice if you can detect urine when you enter the
Through the Medicare and Medicaid programs, thefacility. If there is no one in the immediate area and
federal government is suppose to conduct on-sitethe odor is very noticeable, we suggest that you
inspections of nursing homes participating in Medicareturn around and leave. It is a telltale sign of poor
and Medicaid and to recommend sanctions againstsanitation and or possible neglect of bedridden
those homes that are violating health and safetypatients.
rules. Yet, this particular facility, on several occasions,Most assisted living centers are modeled impressively
somehow received a Five Star rating afterto give a beautiful "Home-like" appearance and most
"inspections".new residents agree it is much better than the
I assumed I made a bad employment choice and thesterile-looking hospital appearance of many nursing
next nursing center would be better. I was wrong.homes. However, do keep in mind; it is not
Within three months of employment at a differentnecessarily an assurance of superior care. In other
facility, a couple of senior residents confided that awords, appearances can be deceiving.
certain nursing assistant was handling them roughly.- Ask about the training background of the CNAs
Being the young newbie to the status quo, I(certified nursing assistants) or caregivers, they will
hesitated to act. I was aware the elderly could bebe assisting you or handling your loved one the
quite fragile, so perhaps the manhandling theymajority of the time. Many assisted living centers do
described was a misunderstanding. Then I witnessednot require their caregivers to be certified assistants,
this same assistant "person" placing a soiled diaperchoosing to hire untrained or inexperienced caregivers
onto the face of a resident several times in a teasingwho are then asked to attend an in-service or two.
manner. I had seen enough, I brought this to the- How many caregivers or CNAs are assigned to
Director of Nursing (D.O.N).each unit? How many nurses are there to a unit? Is
I was not aware at the time however, that both thethe ratio to patients or residents adequate for
nurse of that shift and the D.O.N were both friendsdependable care?
of the abusive assistant. Therefore, when a meetingIf you must stay at a facility of questionable quality,
was finally convened on the matter about a monthtry to arrange any of the following:
later, you can probably imagine what the outcome- If possible, have a lawyer present when filling out
was. My heated defense of the residents fell onthe admission forms. Some may say it is an
deaf, dumb and blind, ears. The so-called nurseunnecessary waste of money, however, nursing
defended the abuser and the D.O.N merely pointed afacilities abhor any possible legal action against them
finger at this assistant and said, "You were wrong."and a lawyer intimidates much like a wooden cross
and absolutely nothing else followed, not even adoes when held up to vampires.
written reprimand. However, I became known as the- Arrange periodic unannounced visits from family or
"trouble-maker" shortly after the meeting.friends. This serves more than one purpose. First, it
Fortunately, there was some poetic justice; theprovides witnesses to any neglect or problems.
abusive assistant was later fired for getting into aSecond, it helps keep the staff on their toes
"fist-fight" in an elevator with another assistant. Thisregarding your care. Should any incidence of abuse
was a "Holy" facility in the suburbs of Illinois.occur, a quick internet search provides a long list of
A large man with documented psychological problemsnursing home abuse lawyers.
abused other residents at the last facility in which I- If you are a visiting family member and your loved
was employed. Although there were several staffone is in bed most of the time, check for any
complaints and he choked a female caregiver at onebedsores on the heels, hips, buttocks, back or
point, his transfer to a more appropriate facility waselbows. It is your Right to thoroughly question any
continually delayed to maintain the profits of his stay.injuries and be certain they have been properly
It therefore seemed unconscionable to hear the,documented and the doctor has been informed.
oddly high-strung, administrator of this same facility- If it is within your budget, you may choose to hire
was rumored to be embezzling holiday funds thata reliable private sitter to provide one-on-one
were meant for the caregivers.assistance or care within the facility. Many families
When I learned a new policy required completelyprefer this option as it provides not only constant
untrained caregivers to pass medication to thepersonal attention but companionship as well. Facility
residents, I began to update my resume, and when Istaff appreciates it for the relief it can bring during a
learned that there wouldn't be a nurse at all for thehigh census. As an experienced private sitter, I can
night shift, I turned in my two weeks notice. It wasattest that it is much more preferable to care for
an obvious attempt to save money by limiting orone patient than to juggle ten or twelve.
eliminating professional care. These facilities never- Another option that may save you money is to hire
mention to visiting family members that when thea private home sitter. Many patients obviously prefer
patient or resident census is low, the nursingthis because it allows them to stay in their home with
assistance is often cut to save money. This practicea caregiver to assist them. A nurse will often be
can lead to neglect, which tends to create newrequired to make periodic visits as well for any
issues, such as bedsores for the bedridden residents.medication that must be administered. There are
There was a certain focus prevalent among themany agencies to assist you with this.
many facilities in which both my wife and I wereAlthough there are many negative stories about
employed and apparently, nothing has changed. Theynursing facility care, it does not mean you, or a family
all claimed the well-being of the resident is themember, will have the same negative experiences.
primary concern; some even placed impressivelyBelieve it or not, there are plenty of satisfied
framed statements or plaques on the walls with theirresidents, or patients, who do not regret their move
creeds of care. There was no fine print however,into an assisted living or nursing home and who have
that stated the true primary concern above all elsemade new friends.
was Money. Making money and saving money. ASo, now that you have been given some worst-case
single resident brings in five to eight thousand dollarsscenarios, here's hoping you are prepared for the
a month and in "special care units" such as anworst but experience the best.
Alzheimer's unit, it can be $10,000 a month. Thus,