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Making the decision to put your loved one in a nursing home is hard enough, but with the current rash of stories detailing abuse of senior citizens it's almost impossible to feel safe and secure about the facility your loved one is in. But by following a few simple rules and keeping your eyes open you can reassure yourself that all will be well when you walk out that door at the end of your visit.
The first thing to do is examine the home's credentials, hopefully before anyone is admitted. Check for elevator safety certificates; fire alarm routines and various other safety-oriented goals before you even head for the nurses station. Emergency procedures should be posted clearly and easy to interpret for the reader along with various escape routes should one be blocked. Most if not all of these are required by law, so if they are not posted it's best to inquire where they are and why they aren't visible to the public.
Now that you're past the front doors, stop and take a deep breath. There should be NO odor of urine or unclean materials in the general corridors of any home. Dirty laundry should be separated from the patients quickly and efficiently, placed in the room specifically designated for that purpose. Patients should also be cleaned quickly if they have soiled themselves, and if you are smelling anything other than cleaner it's not a good sign. The scent should be clean and comfortable to yourself and your family; not an ammonia smell.
Look down at the floors and at the walls. Most homes have pictures on the walls of some sort in an attempt to make the atmosphere less threatening to their patients. If the walls are bare and the floor dirty, it's not a good sign and a breeding home for infection. The floors should be dry and clean, without pools of water anywhere other than perhaps where emergency repairs are needed - and then they should be clearly signaled and closed off from the general public and patients. Any dirt on the floors or walls should be viewed with suspicion, as it signals a problem with housekeeping.
View the nurses carefully in your first visit. If they are overworked and frantic, it's a good bet that they are understaffed and your loved one might have to wait for attention - hardly a good thing at the best of times, much less if your patient is in need of medication or physical assistance. The nursing station should be clean and tidy, with charts clearly labeled and stored appropriately; not lying about for others to see or to be misplaced. The general mood is important too - do these people like being here, or are they miserable to start with? It's a hard decision to make on a single visit, but it's a good bet that the mood of your nursing staff and the doctor on call will determine the attitude towards your loved one.
Observe the patients in the public areas. Are they clean and well-kept; hair tidy and clothing suitable? Are they left at a single table for hours with dried food on their fingers or are they cleaned up promptly and encouraged to participate in activities? It's hard to judge a home based on a few patients, especially if they also include Alzheimer sufferers in their group, but a good look at most of them will give you an idea of how much attention is paid to the average occupant.
There should be an activities board set up in a main area for the patients - check it out and see what is offered to keep their minds active. Most places offer bingo and other mental games as well as swimming and physical therapy for those patients who can participate. If there's no board, ask at the nurses station what is available for those patients who can still function normally. There's nothing worse than being forced to sit in front of the television set all day if you can still move about; or being at a loss for things to do if no one else will do them with you.
Finally, check in on how often the doctor visits and the rules regarding transportation to a local hospital if needed - along with emergency procedures and how they will react if your loved one is hurt. A regular visit from a doctor or a nurse practitioner will help make sure that adequate medical care is being given, as well as observation of any potential life-threatening disabilities.
Lastly, visit and visit often. Perform the same checks on every visit as well as monitoring your loved one's physical and mental condition. If there are any new injuries such as bedsores or bruises, inquire how it happened and how they are being treated. Most homes now document every scratch and bump to an individual to make sure that all the bases are covered in case of a lawsuit, so don't be afraid to ask how and what happened.
By staying alert and staying aware your loved one can make the transition to a nursing home with a minimum of mental or physical stress. For both of you.
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