Bringing Home the Issue of Care

We are all horrified at stories of abuse and neglect allegedly taking place in nursing homes across the country. People are living through diseases now that used to take their lives; parents are living beyond their children’s ability to care for them. These “children” are often older than 70, in poor health, caring for parents older than 90. Sometimes the only alternative is a nursing home, along with the fear that loved ones will not be given the quality of care and treated with the dignity and respect they deserve. How many of us have heard our own parents say, “Promise never to send me to one of those places”?

Many factors go into making a decision for placement in a facility. Some elderly persons are not physically able to care for themselves. Others have developed dementia and would not be safe living independently. Long Term Care Services of Ventura County and its ombudsman program receive 150 to 200 pre-admission calls per month from people who need an assisted living situation for themselves or others. The calls usually represent a crisis, as most people don’t want to think about long-term care until absolutely necessary, and each person has individual physical and mental limitations as well as medical problems that must be addressed.

There is a shortage of skilled nursing facilities in Ventura County, which brings with it a severe shortage of Medi-Cal beds in existing facilities. Seniors with incomes of $700 to $1,400 per month find limited choices for custodial care, including for those suffering from dementia or Alzheimer’s disease. Secure custodial facilities for seniors suffering from these diseases cost an average of $3,000 monthly in Ventura County. Although some board-and-care facilities accept Supplemental Security Income, or SSI, those in this low-middle income bracket cannot qualify.

Problems can occur in any facility. The purpose of the ombudsman program is to allow family members who have made the agonizing decision to place a loved one in a long-term care facility to feel more assured that the resident’s needs are being met and that a qualified ombudsman is available to intercede if they are not.

Nursing home personnel providing quality care for our very ill and often dementia afflicted elders have demanding duties. The goal of the ombudsman is to work with the residents, their families and facility staff to identify and resolve issues before they become serious problems. Ombudsmen also report to the appropriate licensing agency all complaints that cannot be resolved.

Ultimately, families need much more education about dementia, end-of-life decisions and hospice care. Families must understand the difficult situations that can arise when a frail, elderly relative lives in long-term care. For example, when a person suffers from Alzheimer’s disease, there eventually comes a time when the body begins to naturally shut down. It is difficult for a family member to allow this to happen. However, interference only prolongs the dying process,; it certainly does not prolong life.

Statistics show that one out of four of us will spend time in a long-term care facility. It is up to all of us to become a part of the solution, not the problem, of providing quality care in a skilled nursing or residential care facility.

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Tips for Caregivers

Here are some things to be aware of when choosing a residential care facility:

* Residents, by law, must take part in their initial assessment and care plan, which should be reviewed at least once a month.

* Make sure the grounds, public areas and rooms are clean and well-kept, with no unpleasant odor.

* Make sure there is enough qualified staff.

* Be an advocate for the patient but don’t overdose on his or her complaints. Check out complaints with a caregiver or nurse at the facility.

* Observe whether residents seem to be enjoying the food.

* Observe whether there is adequate privacy for residents.

* Is there a telephone available where residents can make personal calls?

* Are residents willing to answer your questions about the facility?

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Here is a partial list of what caregivers should be aware of when dealing the frail elderly living in a facility:

* Always make eye contact. You are speaking to an adult, not a toddler or infant whose name is “honey” or “dear.”

* Don’t tell someone, “Just a minute,” and not go back for many minutes or not at all.

* Don’t tell a resident, “You’re not the only one,” or, “We’re busy,” or, “We’re short today.”

* Do not touch residents unless necessary and always handle them gently. Don’t make them the brunt of your irritation when something else is bothering you.

* Never leave a resident in a wheelchair in his or her room unable to reach the call button, phone or water.

* Do not speak in another language in a group in front of residents so that when you laugh, they think you are laughing at them.

* Let residents know their appointment times.

* Don’t make a residents wait for medication, to go to the bathroom or to return to their rooms.