Nursing Home Problems

If Nursing Home Problems Occur
Understanding how the nursing home system works, how to solve problems, where to go for help, and the residents' rights are important in getting good care in a nursing home.
Communication Is Key
There are many reasons why nursing home care is not always good. At the first sign of a problem, it is best to discuss it with the nursing home staff. Friendly, open communication and relationships with nursing assistants, charge nurses, the director of nursing, the social workers, the administrator and other staff help keep small problems from becoming big. When a problem comes up or is ongoing, chances are that other families (and residents) are also concerned.
Communication among the families of residents is so important that Medicare and Medicaid nursing homes are required to allow families to form family councils. These councils can meet privately in the facility. Ideally, the council is a place for families to talk freely among themselves. They can present concerns or complaints to staff. Find out if there is an established family council already meeting. If not, start one. Communication is always the best step to avoiding or solving problems.
Periodically, nursing homes must hold care planning meetings. During these, residents' needs and any changes the nursing home should make in their care are discussed. It's important that residents and their families participate in these meetings. The meeting should involve a team of staff members, not just nurses. Ask about the next care planning conference. Ask who will be attending and feel free to request that other staff attend as well (including nursing assistants). The long-term care ombudsman, a member of the clergy or a close friend could also come to the meeting to provide support.
How to Solve Problems
Often families fear that if they complain, someone will take it out on their loved one. Sometimes, out of fear, residents ask family members not to speak up. This is the primary reason families hesitate to complain about poor nursing home care. Nursing home workers themselves say that families who call attention to problems get results. Try the following suggestions to confront problems:
Use the care planning conference to discuss problems with staff. This meeting creates a natural setting to address concerns without raising them to the level of a complaint.
When making a complaint about a staff member to a supervisor, share any concerns about retaliation.
Work with the family council to address problems in the nursing home.
Solving problems can be more affective when working in a group.
If the nursing home is poorly staffed or poorly managed, it may not give good care until residents or their families take the concern to a higher level. If working with the nursing home is not getting the problem solved, never hesitate to take a complaint outside the facility The purpose of your complaint should be to get better care for a loved one and the other residents. It should not be to hurt the facility or its employees. A written record can be very helpful when filing a complaint. Keep track of when the problems(s) occurred and who was involved. These are some places to go for advice or investigation of complaints dealing with nursing homes:
Long-term care ombudsman
Citizen advocacy groups
Legal services
State licensing and certification agency
When the Nursing Home System Fails
If nothing you try improves the care a loved one is receiving, join a citizen advocacy group. If none exists, form one. Ask the family council group for help, and check with the local AAA or ombudsman program about how to get an advocacy group started in your area.
Protecting Rights and Dignity
Too often people lose even the simplest rights when they become nursing home residents:
Privacy when they sleep, bathe, and dress
Freedom to go wherever and whenever they want to visit with friends and relatives
Choice of what they eat or wear
Control of their money
The right to choose their own doctor or make decisions about medical treatment
The Nursing Home Residents' Bill of Rights helps people can keep their privacy and dignity. It protects rights as basic as whether or not staff knock on the door before entering a resident's room. These rights apply to all residents who live in Medicare or Medicaid certified nursing homes.
Neglect and Abuse
Good care is everyone's basic right in a nursing home. Poor care is usually from the nursing homes' failure to have enough qualified licensed nurses and nursing assistants. It is understandable to sympathize with overworked nursing staff, but expectations for good care should not be lowered. Nursing homes must keep an adequate number of qualified staff.
Providing poor quality food, not keeping residents clean and dry, and ignoring a change in a resident's condition are all signs of neglect. Sometimes poor care and neglect may result in dangerous medical conditions. Some signs to watch for are:
Dehydration
Malnutrition
Bedsores (or pressure sores)
Physical restraints
Chemical restraints (Drugs used to control a resident's behavior)
Contractures (Muscles that are becoming too stiff to move easily)
Abuse sometimes happens in nursing homes. Sometimes residents are hurt physically or psychologically. Do not accept behavior toward a loved one that is abusive, including rough treatment or unkind words during or in between care. If supervisory staff do not act immediately to fix a problem, contact one or more of the following authorities:
The long-term care ombudsman
The local adult protective services agency
The police
Nursing homes should be a place where loved ones get the care they need. Working together, families can make nursing homes better.
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