We have had two experiences with nursing homes-different companies, different states-but neither of them was positive. Before we placed Frank's uncle in a nursing home for rehab after a bad fall, I was given two very important pieces of advice by a co-worker:
1. drop in at odd times to check on your relative-the staff never knows when you might be in so they will be more attentive
2. be nice to the staff-gifts at Christmas. etc.
We did these things and still did not receive good quality care. One time we dropped in after 11 a.m. on a Sunday, when many residents have visitors, to find that his uncle had not had breakfast, not been bathed and had not been checked by the staff. I immediately went to the nurse's station to inquire about what was going on and someone came to the room right away. I also called the facility's director the next day to inform her of the problem. She apologized and said they had been having some staffing problems. Nothing improved but we continued to have someone stop by at odd times during the day to check on him.
Last summer, I had a similar experience when my father was taken to a rehab facility. He kept trying to tell the staff that he wasn't able to swallow and that the food was stuck in his esophagus-he has a problem with food emptying so he knew what he was talking about. He called me and said he needed to go to the hospital. I called the head nurse to find out what was going on and then rushed over to see him. I could see that he was in obvious distress.
When I went to speak to the nurse, she said she had spent 2 hours with him and that he was fine. I determined that the facility's staff doctor would be in that night and I said I wanted him to be seen. The doctor said he needed to go to the hospital. Needless to say, we cleaned out his room that night and said he would not be returning.
When he left the hospital, he had sores because he wasn't properly watched and, while he did get good physical therapy, he did not progress nearly as quickly as he did when we got him home.
I know that many people have good experiences with these facilities and we actually may be facing the possibility of finding a facility for my mother because she needs more intensive care but I'm not convinced that she will get that care from a staff that has to care for many patients. There are certainly questions that I think people need to ask:
1. What is the patient/nurse/aide ratio?
2. How often are patients checked by the staff?
3. Who are your doctors? Some facilities have their own doctors; others allow the patient's doctor to provide the care
4. What kind of communication is there with the family?
5. Do they accept insurance? This care is not cheap-but neither is home care. Round the clock care for my father cost $15,000/month. Medicare only covers a tiny portion of that cost but will cover the total cost in some facilities. For obvious reasons, those facilities do not have many beds available.
6. Check websites that various groups run that show evaluations of facilities as well as family comments-getting figures about health violations is important when making this decision.
7. Walk around the facility and take a good look at the patients. Brochures often show happy people playing cards, singing, etc. The reality might be very different.
I would love to hear suggestions from others who have gone through this. I spent several hours this afternoon checking out facilities for my mother and haven't found anything that looks better than what she already has but know that we are going to have to make some tough decisions because of cost considerations.
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