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john65pennington's avatar

Do you trust nursing homes?

Asked by john65pennington (29182points) July 10th, 2010

With all the bad publicity surrounding nursing homes, it makes me wonder if its safe to keep my mother in one. so far, she has received the best of care. also, should nursing homes be on just one floor level, instead of a high-rise type building? my mother’s nursing home is on one level. for safety, in case of a fire, her being on one level brings me peace of mind. Question: today, are nursing home “standards” much better than in the past?

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34 Answers

PandoraBoxx's avatar

My mother has Alzheimers and has been in several homes, ranging from assisted living to a dementia care unit. I think that, like day care for children, there is a wide range of facilities out there, and you have to do due diligence in selecting a facility.

There are more regulations in place with regards to oversight of facilities. However, as facilities get larger, cost reduction takes the form of staff reduction, and that affects care levels. The one that we’ve been happiest with is part of a family owned chain, located in a small rural community. The facility was lovely, the staff who worked there had all been there for 5— 10 years or more. Working at the nursing home was considered a good job in the local community. Staff turnover rate is a good indicator of quality for daycare centers as well.

The center that my mother’s currently in is a two floor facility, with the lower level being a walk-out level at the back. I would lean towards a single floor facility rather than a high rise for the reasons you stated.

Kayak8's avatar

It really depends upon your state. I work for the health dept in my state and another unit inspects nursing homes. When my mom needed a temporary place after a broken hip, I talked to them and learned all sorts of things about nursing home inspections. Most of this is a matter of public record, so all you need to do is make a public records request of the entity in your state who inspects nursing homes and you can learn a great deal.

I have a tendency to lean toward Catholic nursing homes run by nuns. The caregivers aren’t in it for the money and there is a definite sense of sincere loving care . . .

jca's avatar

i would not trust them – i would not feel secure with the workers. you never know if you get a mean worker that might do something to the patient and maybe the patient can’t tell anybody, can’t advocate for themselves. i have heard nurses (i know a lot of nurses) who have said they’ve seen people in nursing homes get slapped (if the patient is verbally abusive, which may be part of their dementia). i know one nurse who worked in a nursing home in westchester NY who told me the aide was wiping the patient and did so roughly, so the patient was red and sore. some times the homes rely on that other workers will look out for abuse and tell on their coworkers, but some workers don’t want to rat on their colleagues and so will say nothing.

nursing homes also are chronically short staffed. my grandfather was in a great one and he said he would sit on the toilet and ring the bell and wait a half hour for them to come help him. he would fall asleep waiting. also, for safety, they will keep people in wheelchairs so as not to have to walk them and deal with their possibly falling, so the people then gradually lose the ability to walk.

CaptainHarley's avatar

Actually, it’s not a matter of “trusting” nursing homes so much as it’s a matter of trusting family more. Even the best-intentioned non-familial caregiver cannot give the sort of quality care a family can.

Now, having said that, some people are actually better off in a nursing home than they would be subjected to the tender mercies of unloving family members. For those of us who love our seniors, or those of our family members who require special care, the price of quality care is constant vigilance, whether at home or in an extended care facility.

PandoraBoxx's avatar

Not everyone has a family member that is available to care for an elderly family member in the home, or the financial bandwidth to pay for in-home care. We tried with my mother for awhile, but it was expensive and extremely stressful.

CaptainHarley's avatar

@PandoraBoxx

Which is another reason why I have tried to live as simply as possible these past few years. Yes, it can be stressful in the extreme. Yes, it can get expensive. In-home care is not for everyone.

lynfromnm's avatar

The key to health and safety in a nursing home is the participation and advocacy of the family members. Residents who get bed sores, aren’t bathed and groomed and have bruises are usually those who don’t have family regularly visiting who check on things. Be sure to ask your mother what she’s been eating, how often she gets to go out for fresh air, how long she waits in bed before someone comes to help her to the toilet. See whether her clothes are keep clean and linens look fresh, look for sores and bruises and listen to her.

MissCupid's avatar

My gran was in assisted living until she couldn’t look after herself anymore. She was deteriorating fast and my dad had to put her in a home. She was not happy about it. That said, she’s been in there two years now and she’s better than she was 5 years ago! She’s happy because she has routine, she knows everything about all the nurses and she bosses about the other women (she’s 90 so she thinks she’s in charge). The only problem is that her vests/pants go missing sometimes because they wash en mass and even with labels in – things go missing.
But that said – it’s good. I think if you can’t dedicate your life to looking after them yourself, a nursing home – that you’ve checked out and are happy with – is a good option.

jca's avatar

@lynfromnm : i think the problem is with patients who cannot talk or comprehend, due to dementia, then the situation is ripe for abuse and they can’t explain.

the good thing about a nursing home is that if someone’s medical condition is not stable, or they’re on psychiatric medication, they’re assessed daily and the dosages can be altered on a daily basis, if necessary. in the real world, doctor’s appointments are often weeks away, and may consist of a 10 minute observation.

Aster's avatar

No. I don’t trust any of them. I have experience in this. Here are some things you don’t hear about: do they brush their teeth? No.
Do they turn them over by yanking on one of their frail arms? Yes. And it can break resulting in their death. Do they Make Sure they’re hydrated? No. The most they do is continually pour water into a bedside pitcher. They do Not stand there and watch to see if it’s being drunk. Hydration is of utmost importance; they can easily, without exercise, develop an intestinal obstruction. Can you go there often? To do so could save her life. Are the standards better now than in the past? Hard to know. Most have multiple infractions.

BoBo1946's avatar

Yes, there are some good ones and some bad ones! Most important thing, a person has to do their homework and investigate each and rank it on it’s merits. There is one about 20 minutes from here that is excellent. Great staff and a very beautiful and well-maintained facility.

tranquilsea's avatar

I volunteered at old age homes when I was 18, 19 and 20. I would go in and sit and talk with people who rarely had visitors. The home I volunteered in was fairly well run, but I couldn’t wrap my mind around how warehousey it felt. I adored the people I met there and developed friendships with them.

My sister, after her car accident, was in long term care and it was horrible! Our experiences with different agencies are the main reason we pulled her as soon as we could so she could live with family.

Now I know, in today’s day, many people cannot afford to take care of family who need ever increasing amounts of support. That is a sad state of affairs when that is the case. Governments should be providing the funds for people to look after their family in the way that the family wants or needs to. It shouldn’t bankrupt you to do so.

tranquilsea's avatar

I should also say: I had an agreement with my mom that she would never be put in an old age home. Turns out she didn’t need the agreement as she died long before that would be an issue.

gailcalled's avatar

My mother has been in the rehab section of her staged care facility twice. My sis and I dropped in almost every day for the fine tuning. In general, the care was very good and the staff was kind. The food, on the other hand, was terrible, so we brought healthy treats with us.

I noticed that many of the patients did not have family or regular visitors. They seemed clean, nourished, and reasonably cheerful. There is a wonderful therapy department and beautiful grounds for sitting outside when the weather is nice.

Movies, bingo, word games, etc are provided, but very few patients have the energy or the
cognition to participate. There is also a large library of large print books.

I should caution that this is a staged care facility. My mother bought her own apartment 14 years ago in Independent Living. Her (large) monthly maintenance fee contains a percentage which pays for long-term health care when warranted. An intermediate stage of assisted living is also available.

laureth's avatar

A question about trusting nursing homes is like a question about trusting people. Clearly, you can trust some people and not others. I think nursing homes are the same way.

I volunteered in one for a summer when I was 18. I saw there were wonderful people there who did well by the residents. I saw there were also crappy people there who were overly harsh in dealing with the residents. You sort of have to investigate the home you’re thinking about, in order to know if it’s a bad apple or not. Do a lot of the residents have family that come visit? They’re a great resource, because they’ll know a lot more about what’s going on, and probably stick by you and your Ma if things go badly. The families of all the ladies in the room where my great-grandma lived all visited regularly, looked out for each other’s old folks, and kept an eye to make sure no one was mistreated. The more families you can connect and bond with, the more people you have looking out for your Ma.

In some cases you get what you pay for, but in most cases you get what you work for.

Aster's avatar

@BoBo1946 ”...very beautiful and well-maintained facility.”
Beauty is meaningless. And how do you do research? The only way is to go online and find the website that lists infractions, when they happened and what type. Visiting one tells you very little. One Gorgeous East Texas NH decorated in antique reproductions was double-billing the residents. How? Some residents paid their own bill. The administrator would go into her room: “honey? your bill is due.” Resident: “I thought I paid it.” “Oh, no, honey; not this month.” And she’d write out a second check.
At this luxurious place, it was common knowledge that if you said anything against the NH they would make sure you were served your meals LAST. The residents would Whisper about things, feeling intimidated. There could not be a fancier, more elegant NHome, boo boo. Something else: fire ants came into some of the rooms under the baseboards, crawled into the beds and bit the residents. I know it’s depressing but I was a witness.

CMaz's avatar

When it comes to nursing homes. Trust (sad as it is) is based on money.
The more you pay the better the nursing home and the easier to trust.

Seek's avatar

My mother is a CNA. That is enough to make me leery.

I often volunteered as a teenager, and when I was 18, I took a housekeeping position in a nursing home she worked in – and learned enough to shock me.

The level of care a person receives depends far too much on how often they have visitors. I can’t tell you how many people (with a lifetime of stories and wonderful personalities) are completely ignored by their “caregivers” because their family lives out of state, or they have no living relatives. And if the resident can’t talk? Forget it.

Basically, the more trouble the caregivers can get into, the better the resident will be cared for. The amount of money you pay doesn’t mean much, because the CNAs are paid hourly and their pay doesn’t depend on the resident’s rent.

It says a lot that whenever my mother – the nursing home caregiver – and I fought, I could almost always end the argument with “You know I’ll be the one choosing your nursing home, right?”

BoBo1946's avatar

@Aster go there and see for yourself!

(your comment about visiting tells you very little) Well, by visiting it and talking to the nurses and administration told me enough. Also, their reputation. Plus, it is a rehab/nursing home, and my mom stayed their for month rehabbing her hip, and could not say one negative thing about it! We never had a problem with money, etc…first class place!

@ChazMaz exactly…the one i mentioned is expensive, but you get what you pay for….as you know!

Aster's avatar

@BoBo1946 Try staying a Year and you’ll get a better picture of what they’re like. Do u consider $120 a day expensive?
@Seek_Kolinahr made excellent points. She knows things you cannot find out by doing interviews.

BoBo1946's avatar

@Aster the nursing homes here, that are good, run about $6000 month. As i said, you get what you pay for! When you live in a small community, you learn a lot about their reputation/or lack of!

Doing interviews! ... You seems to be attacking me because of your bad experience. Nursing homes are not the same everywhere. There are the good and bad, like anything!

Aster's avatar

@BoBo1946 Not attacking, no. 6K a month is Very expensive!

BoBo1946's avatar

@Aster yes, it is…but, it is worth it to know that your loved one is getting first class care. My mom is in an assisted care facility now and doing great, but if her health deteriorates, will move her to this facility. She is 87 and has some dementia. Take care!

Seaofclouds's avatar

As others have said, there are good nursing homes and there are bad ones. If you really feel you can’t get a good impression about what the nursing home is really like, go to the local hospital and ask the nurses there about the condition the patients are in when they have to go to the hospital. That is how I learned which hospitals I would be willing to use if necessary and which ones I would never send a family member to. There were some nursing homes that always had patients coming in with bed sores, dehydrations, and a clear lack of hygiene, but there were others where the patient would come in and the only thing wrong would be their illness (usually pneumonia or a UTI).

Personally, my family members would come live with me as long as I was able to care for them. If it got to a point that I couldn’t do it, I would start investigating nursing homes. I’d ask the nurses questions about their nurse:patient ration, the roles of the nurses vs the roles of the aides, what activities they have, and how they handle various situations (a patient that refuses to eat or take meds, a patient that gets sick, etc). I’d also check with the state to review their past inspections and see if there have been any complaints about them.

perspicacious's avatar

I’ve had experiences with two nursing homes with two family members. It was enough for me to answer NO to your question. I didn’t find them anything other than a place to die. Both of these nursing homes were owned by large corporate entities. I have heard friends say that their own family members were in nursing homes with which they were quite pleased. In those cases, the homes were owned by a religious denomination or privately.

lynfromnm's avatar

Everyone has made very good points, but I still think the best way to make sure your loved one is safe and well cared for is to visit. Even if your loved one cannot communicate well with you, there are a lot of warning signs you can observe. And if they know you are watching your loved one gets better care.

Lampustic's avatar

I don’t trust them and would never live in one. If I can’t have my guns, I won’t live there.

Dutchess_III's avatar

Depends on the home. My mom had Alz too. She wound up in one facility that was nice, but there was one particular lady who picked on her and picked on her. It’s like…..I felt so helpless. But, the final place that she went, where she died, was awesome. She had her own room and everything..

CaptainHarley's avatar

@Lampustic

LOL! ME EITHER! : D

Lampustic's avatar

@CaptainHarley, Hey there, Long time no see. How have you been doing? You know me either as Pustic or 1858 Remington from the old Answerbag.

CaptainHarley's avatar

Wow! How the heck have you BEEN?? : ))

I’ve been ok. Cancer is still in remission, as far as I know. I go Wednesday to have some tests run. My blood pressure is now within normal limits even without meds, which I no longer take anyway. I’ve quit smoking. And the diabetes is under control. So all in all, the report is good! : ))

Jabe73's avatar

How ironic you would ask this question. I was taking care of my grandmother for the last 9 years (she had Alzheimers and was diabetic) but it started to become too much. Me and my mother decided to put her in the local nursing home because I was working alot more and she would have needed fulltime 24hr care. I couldn’t afford to hire someone to take care of her 24/7. It ended up being a bad decision. She had a stroke, they left her lay in her bed for nearly a day and a half. If it wasn’t for me visiting her that day she would died right there. She passed away a short time later at the hospital. I know how long she had the stroke because my aunt went to visit her the day before when she first started having the first symptoms. My aunt told the nursing home staff but they just said it was her “high blood sugar” causing her symptoms. We now have a lawsuit filed against this nursing home for wrongful death. There were many other details and other things that happened as well to which I will not get into here but this happened 8 months ago.

@john65pennington My advice to you would be to look around at different nursing homes and even ask other people who may have relatives in these homes questions themselves (if you know of anyone that is). Nursing homes are driven by profit just like everything else. It is a very tough decision to make, I still never got over the choice I made. I’m not discouraging using nursing homes but to just be careful and another thing that helps is to visit as often as you can. It can be too much of a burden to care for someone at times.

Lampustic's avatar

@CaptainHarley – Hey, I’m glad to hear that you’re doing good, it sounds like you’ve been blessed from up above. I’m doing ok and I could do a lot of complaining, but no one will listen, so I don’t. In the mean time, I’ll keep collecting guns and stock up on ammo. :-)

On a side note here, My Dad passed away back in May and he was a WWII vet and he was among the first American GI’s to go into Hitler’s bunker after Hitler killed himself. He brought home several souvenirs from that bunker, daggers, bayonets, Nazi medals and guns. Right now I have in my possession the daggers and bayonets. My son and his new family are going on a trip this week and they’re stopping at my mothers along the way and he’s bringing me the medals and handguns back with him. I’ve never seen these handguns before, but I do know that my dad had a P-38. My mom was saying that one of the handguns is still in the box with papers.

It’s good to see you again my friend and I wish the best for you. My little bird Pustic is waving a wing your way. (I named him after me)

Pustic

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