Jewish World Review Dec. 21, 2004 /9 Teves, 5765
Jan L. Warner & Jan Collins
Our fight to improve Mom's care
Q: When our mother was no longer able to care for herself at home due to a stroke and (what her doctor calls) dementia even with caregivers around the clock my brother and I spent a good three months interviewing and visiting various facilities to find the right one.
We made surprise visits to each facility on our list, got the 50-cent tours, checked out references and even looked up each facility on various Internet comparison sites. We looked into their licensing status for violations at the state level and personally met the administrator of each facility. We even enlisted the assistance of a licensed geriatric care manager to help us.
After Mom was admitted to one we approve of, we sighed with relief, but little did we know that finding a facility was not the hardest job. The hardest job has been making sure our mother receives appropriate care. We have had a series of disagreements with the administration about what we consider to be substandard care, less-than-adequate levels of help for Mother, her difficult (for lack of a better word) roommate who keeps her awake all night, a lack of privacy, and what we consider to be disrespect for our mother as a person. The facility refuses to move Mother or to medicate her disruptive neighbor.
We have talked until we're blue in the face. We have written letters and notes. For the more than $5,500 per month my brother and I are paying, it would seem we could buy our mother some type of respect and peace, but it does not. Short of moving her, something we do not want to do because our "inspections" would start all over again and she would be disrupted, do you have any suggestions?
A: As facilities of last resort for folks who don't want to live there, and families that don't want to place their loved ones there, nursing facilities have the daunting task of caring for the sick and chronically ill, while, at the same time, convincing family members that their relatives are receiving the best money can buy.
In truth, however, family members may tend to be overly concerned (not that that's entirely a bad thing) that the facility is not providing ideal care for a loved one. The question becomes when does the care become so substandard and deficient that legal or other types of intercessions are mandated.
Making that distinction is often difficult for a family member basing his or her opinion on subjective factors. So it's best to retain that geriatric care manager (like the one you consulted) to make independent and objective assessments of the facility and the plan of care.
Your mother has both federal and state rights within the institutional setting that protect her from loss of dignity and guarantee her appropriate care. In fact, the federal Nursing Home Reform Law of 1987 mandates that each nursing home resident be provided with services that allow him or her to function at the highest levels possible.
For example, unless authorized in writing by a physician (and, even then, for limited periods of time), the facility can't medicate your mother or her unruly neighbor, for that matter.
And if your mother's health deteriorates or her care plan is expected to change, the facility must notify your mother, her physician and you as her interested family member before a change is made. Then there are her rights to privacy, to assemble with other residents, and to meet with agency personnel and investigators, all without fear of interference and reprisal for exercising her rights.
Based on our experience, being forceful in pointing out problem areas is generally destined to bring good results. But if talking fails and the problems worsen, consider contacting your state long-term care ombudsperson, who has the right and responsibility to get involved and try to secure an appropriate result.
As an advocate for nursing home residents, the ombudsman is trained to head off and resolve problems. Since every state must have an Ombudsman Program, you can go to www.ltcombudsman.org/static_pages/ombudsmen.cfm to find the ombudsman nearest you. Please remember that, if all else fails, you may need to hire an attorney to help resolve the issue.
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JAN L. WARNER received his A.B. and J.D. degrees from the University of South Carolina and earned a Master of Legal Letters (L.L.M.) in Taxation from the Emory University School of Law in Atlanta, Georgia. He is a frequent lecturer at legal education and public information programs throughout the United States. His articles have been published in national and state legal publications. Jan Collins began co-authoring Flying SoloŽ in 1989. She has more than 27 years of experience as a journalist, writer, and editor. To comment or ask a question, please click here.
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© 2004, Jan Warner