The Nursing Home Workbook

This book is written to assist persons who are caring for a frail elderly loved one. I will guide you through the process of choosing the appropriate type of care.  If nursing home care is required, I will guide you through the process of choosing a nursing home.  Next will come the admittance to the nursing home.  I will tell you what the problem areas are in nursing homes and how to deal with each.  I will tell you the processes in place in all nursing homes when an incident occurs, readiness for survey, the politics of nursing homes.  I will tell you why so many of these places are so very bad, and what we all can do to change the system.

Why do I feel I can give you advice?  I have worked in nursing homes for two decades.  During most of that time I was in management positions, ending with Director of Nursing and consulting facilities who were in grave trouble with the state.  I know the system, where the flaws are, and how the public can deal with these facilities.

It is a fallacy that nursing homes are unique.  Each one I worked in operated the same, but with a different cast of characters.  If your nursing home is good, celebrate your good fortune, and praise them daily.  If your nursing home is not so great, you will undoubtedly find a wonderful care giver amongst the chaos, compliment them, they need it badly.

Statistics back up my opinions of nursing homes.  Seventy five per cent of all nursing homes give bad care.  One and one quarter per cent of nursing homes give excellent care.  The rest give average care.  To say nursing homes have huge problems is an understatement.

There are over 17,500 nursing homes in our country.  A million and a half  frail elderly persons are in these places.  A small percentage of these persons is getting the care they are supposed to receive.  Our country can truly be ashamed of this fact.

When an elderly person becomes frail and in need of care, they seem to disappear from view.  They are entering the grey abyss of elder care.  Families scurry around trying to find appropriate solutions for their care and safety, while the elderly person is in fear of losing everything near and dear to them, their home and their possessions.

Home care is the preferred solution.  Many seniors are able to stay at home with the assistance of persons who are hired to do the tasks they can not easily perform.  With planning, this is the best and least expensive choice. 

If staying at home is not possible, a senior residence with meals and transportation, plus available cleaning services is a good choice.  The senior still has a separate private place with their possessions.  I cannot stress often enough how important a home and their stuff is to a senior or to any of us.

The next level of care is an assisted living facility, or board and care.  These places have the same services that a senior residence has, but also assist with bathing, and supervision of medications.  Many of these facilities do not have private apartments or baths and may have two persons in a room.  These places are under the same type of scrutiny as nursing homes, but seem to have many problems.  The care givers in these places do not have to be licensed nurses and most times do not have certified nursing assistants.  Check out these facilities carefully.  The local Long Term Care Ombudsman can show you the way to find out about the facilities in your area.

The profile of a resident in an assisted living facility, is one who can walk out of the building unassisted, or can get into a wheelchair by themselves and leave the facility, in case of an emergency. There seems to be a lot of grey area in this scenario.

Paying the bill in a senior residence which was built using government assistance is good because the rent has to be prorated according to the ability to pay.  On the other hand, board and cares offer no such incentives.  Their prices for care are determined by what care they offer and how fancy the facility happens to be.  You need to check out these places carefully.

Nursing homes offer complete care.  If you look them up in the yellow pages you will find many names listed. How are they different?  They are mostly the same.  The names you will see are Skilled Nursing Facility or SNF., Convalescent Hospital, Extended Care or Transitional Care, which are associated with hospitals, Long Term Care Facilities, any of the above with rehab added to their name, or Alzheimers facilities.  The old term Home fo