In the previous two columns, we touched on topics like: what to bring to a nursing facility, the importance of listening and observing when you visit your relative, and how to communicate concerns. Today, we will focus on cleanliness, mealtime, staffing and volunteerism.
Next to Godliness. Cleanliness is of the utmost importance! When you enter a nursing home, there should be no unpleasant smells. If you detect an odor in your relative’s room, make a thorough check of his/her skin for any open areas or sores. An infection can cause a foul odor. Take special note of the pressure points on the body, including the heels, elbows and back. (There are special mattresses that can help alleviate the breakdown of skin. You can request that one be ordered.) Keep in mind that infections and viruses can happen in the cleanest of nursing homes. When there is an outbreak in the surrounding community, influenza can be transmitted to the home’s residents. Shingles, yeast infections, and pneumonia are just a few conditions that can also develop. If an outbreak occurs, ask the facility what they are doing to reduce the spread.
Mealtime and Staffing. If your loved one is on a special diet, ask to assist at mealtime. Generally, there is a flurry of activity during serving and feeding. This is a good time to observe the interaction between the staff and residents. Is there an adequate staff to feed everyone while the food is still hot, or are trays left sitting for long periods? Are the nursing assistants feeding two people at once? Do they speak to the residents with animated tones and have pleasant expressions, or are they quiet and simply going through the motions?
The attitudes of the staff can directly affect the well-being of your loved one! Do they appear to be committed, concerned and compassionate, or uninvolved, distant and uncaring? Nurses, and nursing assistants, undergo intense questioning and background checks before being hired, but, occasionally, an employee has to be dismissed because he/she is not qualified to provide loving care to long-term residents.
Volunteer. I mentioned the wonderful work done by volunteers in Part I of this series. If your schedule permits, volunteering is an excellent way to gather information about a nursing facility: Are medications being delivered in a timely manner? Does the maintenance staff respond to “clean-ups” quickly? You’ll be there, so you will know! If you can’t volunteer, or visit very often, remember, other visitors can be a great source of information on past and present quality of life, and care, at the nursing facility. Strike up a conversation!
Again, my thanks to Joanne Meshinsky for assisting with this series. Joanne spent three decades as an R.N. in long-term care, and assessed medical records for quality of care at nursing homes in Maryland. In the early 1990s, she authored the book, How to Choose a Nursing Home. She is now retired from medicine and resides in Scottsdale, Arizona with her husband, John.
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