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Even in a Nursing Home, Caregiving for a Loved One Continues
Part II of III

Last week, we started the conversation about nursing homes, the costs, concerns and what you should, and shouldn’t, bring when you visit a resident. Today, we will discuss some of the things to look out for, and what to do, if you encounter a problem with the care your loved one is receiving.

Listen. When you talk to the nursing home resident, take special note of what is said about the nursing staff and their level of concern about any problems that arise. If the resident doesn’t feel that his/her physical needs are being met, don’t hesitate to direct your concerns to the nurse in charge.

Observe. Sometimes, a resident will experience symptoms unrelated to any medication. He/she may be having a physical problem (like constipation or urinary difficulty) and cannot tell you what is wrong. An increase in thirst, fidgety behavior, listlessness, jerky body movements, unsteady gait, or a change in facial features and expressions are all things to watch out for.

Pain. Do not accept that your loved one is not experiencing pain, even if you are told that by a staff member. Only the individual can relay such information, and sometimes he/she is unable. Pain has become a hot-button topic because of the abuse of opioid medications. Psychotropic drug usage in nursing homes has also declined in prevalence due to the side effects, which included falls. Nurses often know ways to reduce certain types of pain without medication. Discomfort can be caused by poor body alignment. Arthritis is also common amongst the elderly. Sometimes, pain issues can be corrected with neck braces, pressure-relieving mattresses, special pillows, massage or whirlpool therapy, or the use of electrical nerve stimulators. Keep in mind that if a resident is coherent, he/she has the right to accept or refuse any medication or treatment.

Speak Out. If there is a problem or concern, make sure to speak with a “charge nurse” or supervisor. When the need arises, many nursing homes employ agency nurses who may not be as familiar with your loved one’s particular requirements or condition. If a supervisor is not available, or doesn’t provide the assistance you seek, go directly to the facility administrator. If a problem is not urgent in nature, nursing homes usually have staff/family care planning meetings, and most issues can be addressed at that time. If you have made several attempts to communicate a problem, and your concern is still not being addressed, the ombudsman for your area can act as a liaison between the nursing home staff and family. If all else fails, the problem should be documented with your state’s Office on Aging and the Department of Licensing and Certification.

For our final installment, we will address meals, facility cleanliness and staffing. Once again, I want to thank Joanne Meshinsky for assisting me with this three-part series. Before her retirement, Joanne spent three decades as an R.N. in long-term care and assessed medical records for quality of care at nursing homes in the state of Maryland.


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