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Old 04-12-2010, 02:54 PM   #1
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What to ask in the nursing home? How to choose it?

Today I officially started looking for a nursing home for MIL.
We'll have an official incapacity certificate in a couple of weeks, giving us the right to put her into a nursing home for free (from now on, everything about her health and care are gonna be paid by the state).
We heard a lawyer and we know (something not many people know) that we have the right to choose any nursing home we want.

Today I visited a couple and I realized I had no idea what questions to ask. I thought it was natural to ask about the medical staff... visitation "rights" for family members and friends. Didn't really care about the social activities, because MIl won't be able to do any of them.

The first one I liked... a little bit. I thought I hated until I went to the second one...
I feel so heartbroken now, and thankfully I was the one going, because I know if fiancé goes to any of those places, MIL will stay for good at home and never moving out...

In the first one the lady answered all my questions and gave me a couple of advices. I liked the fact that even when I perfectly explained MIL situation she said they could handle her, take her out of the bedroom in a wheel chair and spend some time with the other grandpas, even without doing the activity itself.
I also was lucky to get in the lunch time, so I could see the staff handling them and I liked it. They were gentle and really caring. I didn't like the fact that NO ONE talks with them. They just sit them next to the table. Once the table is full, the food comes in. In the meanwhile, they just stood looking the air. Maybe they don't speak anymore, who knows.

The second one... OMG... it was in the middle of one of the most VIP neighborhoods in town, thought it'd be great... and it was awful... it was dark, the staff was rude with the patients... the director was the one talking about their services and she seemed out of a Tim Burton movie...
The place was super clean, the beds were perfectly normal... everything "seemed" fine. But while I was waiting I was able to watch around, and a very old lady was falling out of her chair and no one seemed to notice or even care about it.
Then, another nurse was walking a lady to the lunch area and she simply stopped to gossip with another nurse and didn't care the old lady was standing next to her...

I understand that we can get tired of doing this... but that was HORRIBLE to watch. After they fed them, they just took them to a couple of sofas... not even a TV... NOTHING...

Uff... I predict this is gonna be really hard!

Sol
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Old 04-12-2010, 03:44 PM   #2
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Re: What to ask in the nursing home? How to choose it?

Solcita. My advice would be to take time to visit unannounced and at different times of the day. You will then know which is the right place for your MIL. It's also my understanding that there are no 'visitation rights' set down....I was able to visit any time night or day. My mum could not take part in activities, but she did enjoy the atmosphere. A good activity programme shows staff interest . Are staff pleasant and interested in you? A couple of times I needed mopping up.

 
Old 04-12-2010, 05:28 PM   #3
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Re: What to ask in the nursing home? How to choose it?

You can check the rating of your local nursing homes online. Look them all up...then start asking people...anybody and everybody. Know any nurses? Call them up if you do... ask ask ask.

And yes, visit them. We visited about 5 places and were happiest with the first one we saw...it was also the one that had been suggested to us by the people we asked.

You could even call visiting nurse businesses. Heck, don't be shy.

My mom lives in an Assisted living place and not all of her neighbors speak so it is not unlikely that the ones you saw sitting quietly just don't speak...or had nothing to say at the moment.
My mom...she never stops talking.

Also, where mom lives they try to keep people out of their rooms and in the common areas so that they can be with other people. Most of them sit there and go to sleep but at least they are out amongst others. The director where mom is said it used to be one of his pet peaves to go into a place and see people sleeping in their wheelchairs but has since changed his mind. He said it is their "living room" and if they want to sleep, then so be it. He said he goes home and sleeps in his living room.

So, do some online research, ask others, and then visit and see for yourself.

Love, Meg

 
Old 04-12-2010, 05:29 PM   #4
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Re: What to ask in the nursing home? How to choose it?

The way the staff treats patients is at least as important as the cleanliness and atmosphere. A less well decorated place can be better than one that looks perfect but the staff seem indifferent. In many cases their job at the lunch table is to make sure the patients eat enough, which is often a problem in old age. Maybe talking to a patient would distract him from eating, which is what they had to concentrate on. But a friendly word at any other time of the day is so important.

Where my Mom was, the nurses and aides told her repeatedly how nice she looked, how pretty she was, etc. One thing to absolutely look for is any patient sitting in a smelly diaper. In the NH where Mom was, this never happened. Within a minute one of the aides came and took the person to her own room to clean her up.

They also made a point of getting everyone up in the morning, sitting them in a wheelchair or in the living room if they could , not staying in bed all day. Their feeling was, once they want to lie in bed all day they don't last long.

My Mom was unable to follow a TV show, but always enjoyed music, radio or TV or CD player .. music always cheered her up and for a long time she was able to sing along with songs she knew.

Good luck; I hope you find the right place. Having it all paid for is an impossible dream for us here, unless the patient has already spent all that they own on their own care ... I guess we're not as advanced yet as in your country!

Your English is just fine!

Love,
Martha

Last edited by Martha H; 04-13-2010 at 04:56 AM.

 
Old 04-12-2010, 09:58 PM   #5
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Re: What to ask in the nursing home? How to choose it?

Great suggestions here. I would say that the care they receive from the staff is the MOST important factor. I would rather have a less appealing place with caring attentive staff then a mansion facility with staff that didn't care. So as was mentioned. Visit more than once. Visit at different times. Visit during a meal and during at least first and second shift. I went to the facility Mom and Dad are in no less than 5 times before they moved in.

Beyond that please do talk to other family members and not in the walls where they think they might be heard. I approached many family members in the parking lot or in the court yard where we could talk out of hearing range of staff.

Talk to the staff, not just the administrators or sales managers. Ask how they like their job and how long they have been there. One of the questions I would ask the administration is what the turn over rate is for their employees. If you have long term employees then you probably have a good facility. Good workers in a good facility will stay. If there is a lot of turn over then there is usually a problem.

Check the facility out with whatever governmental agency is over them.

Follow your gut. If there is something that bothers you about the facility then steer clear. But also remember that these are all patients with major health problems. Many will not be able to carry on a conversation or follow a TV. They do tend to sleep in the middle of the day. Others wander aimlessly. It is just what they do and they are entitle to continue the activities that their health dictates. Sometimes those "sleeping" are kept in the open so they can be observed more closely by the staff. I also agree that talking to a patient during meal time distracts them. When I sit with Mom at meals I am quiet because if I speak she will focus on me and not her food. The purpose of meal time is to get them to eat Just don't expect them to be "like home".

Just take your time, ask questions, and ask some more questions You will know when you find the right one.

Love, deb

 
Old 04-14-2010, 06:00 PM   #6
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Re: What to ask in the nursing home? How to choose it?

Thank you all for your kinds words and helpful advices.

Today I visited other 4 places.
I fell in love with one. That's the place where my ex boss' mother has lived for the last 10 years (she's 94 right now). He really likes this place and always told me he felt his mom was safe there.
I loved the fact that the lady who spoke with me gave me a lot of information about how to take care of MIL while she's still with us.
I also loved the fact that they have an entire medical staff. A cardiologist, a psyc, a clinic doc, etc... every single day. They even have physical therapy from Monday to Saturday... not even in my wildest dreams!
They even have a really nice "beauty salon". Obviously MIL won't be able to enjoy it much... but I really liked the atmosphere there. The staff seemed happy to work there.
I will take your advice of going in different time frames and to talk to staff outside their work place.

One of the other places was really nice too, but they have no vacancies. They also have medical staff in house.

And the third one was a nightmare... I thought the one I saw the other day was ugly... this won the award... OMG... I wanted to cry.

The last one was... mmm... not ugly, not ok either.

Anywya, I'm happy to know I have a couple of choices I did like... I'll keep looking, because we never know. MIL will be able to be moved in a few days, so we better keep looking just in case...

Thank you again, I'll keep you posted.

Sol
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Old 04-14-2010, 08:02 PM   #7
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Re: What to ask in the nursing home? How to choose it?

Good for you! !

Love, Meg

 
Old 04-14-2010, 09:20 PM   #8
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Re: What to ask in the nursing home? How to choose it?

Solcita, I am so glad you found at least a couple of places that would be suitable. The words of your boss are worth listening too. The recommendations of family members outside of the facility is what you need to hear. Check out all of the facilities in your area, comparethem, find out who has available beds, and then make the best choice for MIL.

Please let us know how it goes. I wish the best for you and your MIL.

Love, deb

 
Old 04-14-2010, 10:56 PM   #9
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Re: What to ask in the nursing home? How to choose it?

Advice from people you trust and respect is a help for sure. Please keep us posted as your search continues. We like to hear happy endings as well as the troubled times. My dad is at home with good home care right now, but my SIL and I are still researching nursing homes just in case---so we will be ready. No need to apologize for your English---it is fantastic! Bright Blessings! Lynne/Blue
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Old 04-18-2010, 02:23 PM   #10
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Re: What to ask in the nursing home? How to choose it?

As most NH's take Medicare - just go to this government website - 'CMS Nursing Home Ratings.' The site will provide you with 1-5 star ratings on local NH's - also a checklist for what to ask. The lower the star rating - the higher the number of complaints and violations.

To me, after my spouse was in a NH for two years, it is not the variety or number of physicians that matters as much as the number and dedication of the CNA'S (certified nursing assistants) - they are at the bottom rung of the NH latter - but at the top in providing resident care. These are the people who are held responsible for diaper changes, checking for sores or infections, giving baths/showers, taking vitals, feeding if necessary, dressing them in the AM, undressing them at bedtime, ensuring that the bed positions are right for the resident, that water pitchers and glasses are easily reachable -- the list is infinite. Just walk a mile in their shoes.

Whichever NH you choose - get to know the CNA's. You may not be able to tip them - but you can leave donuts, cookies, candy at their nursing station or in the resident's room (with the CNA's name on it). I didn't consider it a bribe - but more so - a gift of appreciation. The CNA will be the primary caregiver 24/7/365.

 
Old 04-18-2010, 05:11 PM   #11
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Re: What to ask in the nursing home? How to choose it?

I agree with you totally Rekem. The CNAs are the front line in any care facility and they determine the level of care that is afforded our loved ones. I too leave gifts of appreciation. I will take Mom pound cake, oops there is a while cake and Mom can only eat a slice so enjoy the rest. I leave canisters of cookies and candies in her room and the caregivers know they are welcome to have a treat any time they are in her room.

I would also suggest that when you observe a potential facility that you hang around the unit you are interested in and watch the caregivers. See how they interact with the residents. This will be the best indication of what kind of care your loved one will receive. Pretty furniture and wall paper is nice but it is the caregivers that make a facility!!

Love, deb

 
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