A friend once told me that her mother's health was deteriorating rapidly and that her family was considering placing her mother in a nursing home. I remember that several of their questions and concerns needed addressing before they made the decision: How to find out what is available? Do all homes offer the same level of care? Can her mother's nursing home care be subsidized in any way? Is it true that nursing homes are little more than dumping grounds for older people? What rights does a resident have in a nursing home?
For people who are currently in the same situation as my friend once was, your doctor, hospital social worker, the local community health center, friends who may have faced the same problem, and the Yellow pages of your local telephone directory can all provide you with the names and addresses of nursing homes near your place. Once you have a list of homes in your area, you can begin to check them and find out what services each one offers. If you plan to do a thorough job, be prepared to spend considerable time at it and don't hesitate to ask questions. While you may have heard stories of neglect, abuse and exploitation in nursing homes, there are many excellent institutions that are run with care and respect for residents.
Experts say that nursing homes are generally divided into two basic categories: those that offer skilled nursing care and those that offer only residential care. These can be separate facilities, or both levels of nursing care may be housed under one roof.
There are, of course, excellent nursing homes, but there are some that are woefully inadequate. Poor treatment, general neglect, and violations of patients' rights are among the abuses still found in nursing homes. Several reports have been severely critical of some nursing homes and this has led to changes in procedures for inspection and accreditation.
Listed below are recommended guidelines for assessing such establishments, although your choice of an appropriate facility will inevitably also be governed by factors such as cost, availability, and waiting time:
- Check if the nursing home is accredited by the government authorities and if it is eligible for government subsidies.
- Find out if the nursing home restricts your viewing to certain areas, or if you are free to roam.
- Do an inspection of the facilities. Are they clean, and do the residents appear well-groomed?
- Find out if you can talk to the residents and their families. Be sure to call community agencies and doctors to ask for their comments.
- Know if an occupational or speech therapist is attached to the nursing home.
- Check fire safety regulations and look for safety devices, such as grab handles in the bathrooms and lights on stairs.
- Find out if the person who enters the nursing home can use his own doctor, or if one is provided.
- Check if a registered nurse is always on duty.
- Ask about the type of activities available for residents. Are there daily exercises or wheelchair trips outdoors?
- Know where a patient can take complaints and problems. Is there an established procedure to deal with them?
Patients in nursing homes are often made to feel powerless to complain, but this need not be so. State governments provide information pertaining to the rights of patients in nursing homes. In addition, nursing home inspectors are continuously encouraged to report on quality of care and the condition of buildings.
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