Care Concerns in the Nursing Home? A Simple Lesson in Getting Results

Call the Director of Nurses!

Entrusting your fragile, dependent loved one to strangers upon whom she will depend for the most basic and intimate necessities of life, most likely for the rest of her life, is a difficult process. There are oodles of layers and dynamics of all kinds which complicate our best intentions to be effective advocates: Guilt? Sadness? Helplessness? And oh so, so many more issues.

Nobody likes to complain, and some folks are downright intimidated by the process. Fears of retaliation, even when entirely unfounded are powerful drivers of inaction… “I don’t want to make waves or upset anybody…it might come back on Momma.”

 “I hate to bother them…it’s such a little thing…” Instead of the direct communication route, some families will step in and take care of issues or needs themselves with nary a whimper. The intent is to be understanding/ forgiving/ helpful because staff [always] seems so overworked. Or a more irritated and righteous “Never Mind, I’ll do it myself!” approach may be adopted. There’s also pouting, sarcasm and silent suffering or just plain wimping out. Befriending staff, offering tips, or bringing goodies in hopes that this will curry special favor and result in more or better attention for loved ones will not succeed.

Complaining to the CNA’s, other families, or your neighbors and friends about the terrible care is yet another ineffective approach to addressing care concerns.

 So where does the rubber meet the road? The Director of Nurses.

Nursing Home Administrators are of course very interested in your concerns. But to address those issues, they’re gonna call the DON! So start there. Yes, these are very busy people indeed. Worried about bothering them with what might be a kinda petty complaint? Don’t! There is really no such thing. My experience has been that folks tend to save up the little stuff. While the intent is to overlook/ “understand” and/ or forgive, in truth those items are stored.  Then, when enough of these “little things” occur, and /or add a big thing or a different thing happens later, that first lil ol’ thing is marched out too. This usually takes place in the wake of a now massive wave of unhappiness.

 Unfortunately, the lil-now big-thing is past history, and evidence and accountability may be inaccessible. This is extremely frustrating to all those highly motivated to address the problems.

 It is great to bring goodies. Don’t expect a thank you note, and don’t expect better care. Show respect to care providers –but remember: you aren’t a hostage. As in any relationship, finding the good and blowing on those coals will help to warm the room, and encourage better care from the staff.

 You may also contact the facility Ombudsman. Information on how to do this is provided on admission and posted prominently in all facilities. However, the Ombudsman is gonna say: “Have your spoken to the DON?”

 Here’s the thing: We have a limited number of nursing homes in our community. While some are fancier than others, the rules and regulations and expectations for care are exactly the same for them all. And whether fancy or plain, they all face the same challenges as healthcare providers to a fragile, vulnerable population with very complex needs.

 When care does not meet expectations reporting those problems must be as prompt as possible. Remember how the Sheriff always liked it best when the trail was warm? This enables more effective fact-finding and accountability.

 I like putting my concerns in writing. This documentation formalizes your expectations for accountability and provides a tidy way to keep track.

 Ultimately, ”success” takes a spirit of being on the same side. Remember: It is in everyone’s best interest that the nursing home staff succeeds. This means timely, direct, respectful communication. Start with the Director of Nurses.

A book we have found to be really helpful that we provide to our Life Care Plan clients is called 20 Common Nursing Home Problems and How to Resolve Them, by Eric Carlson, Esq., available through the National Senior Citizens Law Center. Mr. Carlson recommends: “Be the Squeaky Wheel!”

Kumbayah!