I appreciate the fact that we have nursing homes. The people working in them work hard, have lots of rules to follow, and are unappreciated most of the time. Knowing that you’re working with people who are, for all intents & purposes, waiting to leave this Earth… I wouldn’t want to do it.

Lockport NY ~ Chase-Hubbard-Williams House~Historic House
Onasill ~ Bill Badzo via Compfight

Having said that, there are things that are inherently wrong with many of them. These are things that most people have no idea about when they put their loved ones in one. Sometimes, no matter how much vetting you try to do, you’ll never get to everything that can happen and does happen.

That’s why I’m only doing 5 things, those things I believe are the most important. I give those with the recommendation that, if you have a loved one in a nursing home, you should try to visit at least once a week, alternating the days so no one knows exactly when you’re coming. The things you’ll see and learn about could help to make your loved ones end of life more comfortable.

1. Sometimes the patients come in worse off than you know.

Years ago we put my grandmother in a nursing home directly after a hospital stay. Very early, we questioned the diet and medication they put her on. We found out that when they first examined my grandmother she had a hole in her back, the result of the hospital not rotating her and protecting her from bedsores. Because my grandmother didn’t have the ability to communicate her discomfort, no one knew until she was at the nursing home.

2. Nursing homes are woefully understaffed.

The cost of running a nursing home is extreme. Reimbursement mainly comes from state Medicaid offices because, even though many assets need to be whittled down, there are rules and laws to protect living relatives, property, and a host of other things.

So, many aides get paid relatively low, but it’s still never enough to go around. There’s lots of paperwork and oversight that’s supposed to take place, and of course you must have nurses and doctors and they don’t come as inexpensively.

Volunteers can help a lot, and you don’t have to have medical training for it. Companionship and some other duties could help a lot and free up some time for employees to do a few more things.

3. Not all aides are properly trained to notice behavior, changes or not.

My mother was visiting my grandmother every single day. Some days my grandmother wouldn’t open her mouth to say anything. Within a few days my mother figured out it was because my grandmother not only wasn’t eating, but she was holding food in her mouth. The aides thought she was just being stubborn in not opening her mouth to take food without realizing she wasn’t consuming what they were giving her.

So my mother took over feeding her during lunch, but couldn’t be there all day. Many times when she came in for lunch she’d see food in my grandmother’s mouth that had been there all night. We both complained and were told the issue would be address… but it never was. We recognized she was slowly leaving us, but that was no excuse for no one noticing or informing us it was happening beforehand.

4. Not all aides are evaluated mentally to see if they should be aides.

Because I lived out of town, whenever I came up and my mother and I went to see my grandmother the time wasn’t always the same. This ended up being beneficial because we caught this one afternoon when we weren’t expected to be there.

This one aide was literally screaming at my grandmother because she wouldn’t drink the juice the woman was trying to give her, and there were tears on my grandmother’s face. You can imagine how incredulous I was and my insistence that the woman immediately leave my grandmother’s room. I don’t know if she lost her job but I never saw her again on any of my later visits.

I acknowledge it’s a tough job, and can be frustrating at times. That’s how a lot of health care works. However, you can’t ever let people abuse those who can’t take care of themselves, no matter what the issue is.

5. You should look into hospice early, even if the nursing home doesn’t tell you about it.

Most people know hospice for taking in patients who have been diagnosed as having less than six months to live. Some hospice personnel visit patients in their homes. Turns out they’ll also visit patients in nursing homes.

This is a kind and courteous thing for them to do. They not only offer companionship but, because they’re well trained, they will notice when things aren’t going properly and will advocate for your loved one. Because they’re not part of the nursing home, they have nothing to hide. And, because if approved Medicare pays for it, obviously it’s worth it.

As I mentioned early on, it’s wise to check on your loved one often and consistently, but not always at the same time so they can predict when you’ll show. Not all nursing homes are bad but never take their care for granted as being the very best.

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