There is a wide variation in the quality of care that people can find in Nursing Homes. Even within the same Home, there can be a difference. Homes that have terrible reputations can be turned around, and good ones can go downhill.
Quality of care is dependent on many factors. Key is the Administrator and Director of Care (Nursing Director). Their attitude and approach influences the atmosphere and provision of care throughout a Home. If you have a rigid, authoritarian administration, that is what will be reflected in the home. If you have a commitment to true psycho-social, resident focussed care, that is what will come through in the home. If you have people who act through a medical model, then that is what you will have reflected.
Some residents receive better care because they are easier to take care of. This does not mean whether they complain or not, it means their needs may be less complicated, they are not as sick, they are on fewer medications, etc. Residents who can speak for themselves can be easier to provide care for, because they can more easily indicate their needs.
Great care does not equal expensive care. Some of the best care can be found in publicly funded Homes;some of the worst in places that charge $5,000.00. The reverse is also true.
Family members can have a strong influence on quality of care. It takes some work and dedication. Here are some suggestions:
- Understand the physical conditions that your loved one has. Become an expert to the extent you can ask questions and participate in the care decisions about the condition.
- Understand and monitor the medications your loved one is on. Medications that are prescribed for mood, agitation, anxiety, or behaviours can be too easily prescribed; once someone is one them, they are not quickly enough discontinued.
- Make sure there is agreement and understanding between you and the Home about the concerns that need to be addressed and the steps that will be taken to address them. This is called the Care Plan.
- Care conferences, in which staff and family get together, should happen at least yearly, and ideally within one month of admission. This is where the Care Plan is developed and discussed.Make sure you speak up and ask the questions you need to. Do not let yourself be intimidated by abbreviations and medical terminology with which you are unfamiliar.
- Make sure the Home knows what you expect, and you should know if those expectations can be met or not. This includes when and for what issues you wish to be called.
- Visit regularly at different times, both weekends and weekdays.
- Get to know the staff and their roles. Remember different staff, on at different times, see different aspects of a resident.
- Learn the signs of abuse and neglect, and then learn when those signs mean something totally unrelated to abuse and neglect.
- Learn to handle your anxiety and sadness in a way which is healthy and is not directed in anger, and inappropriately, at the staff.
- Find the support you need to take care of yourself emotionally and that can care for your loved one.
- Be positive and develop a vision of what a good Nursing Home is about. Read some resources. Respectfully work with the staff to help make it a reality.
Skills for Family Members
- Visit creatively.
- Listen with empathy.
- Touch and hold.
- Note and tell the staff when they have been helpful.
- Get the information you need before you form an opinion.
- Bring in kids, dogs, babies.
- Meet other families and residents.
- Bring in the skills you use outside to help you cope inside.
Resources for Getting Good Care
- “Nursing Homes: the Family’s Journey,” Peter Silin, MSW, RSW (http://www.nursinghomesbook.com)
- “Old Age in a New Age: An Urgent Call to Action” Beth Baker. (www.pioneernetwork.net)
