I have an extremely close relationship with my mother.
You can often find me sitting at the kitchen table, talking, and watching her cook. Not to mention, our tradition of watching all the new Netflix releases together. We are a close knit pair, joined at the hip. Although it pains me to think about it, one day, mi mama will someday reach the point where she will no longer be able to adequately care for herself. It is a reality that will one day come to fruition.
Alzheimer's and dementia are two neurological diseases that run in my family. My great grandmother was affected to the point in which it contributed to her death in a car accident. It was a story I heard my relatives tell in hushed whispers when they believed no prying eyes were watching.
In her final days, my abuelita (grandmother) could not recognize my mother's voice. I painfully remember the days I caught my mother with silver lining her eyes after a phone call with her own mother. My grandmother eventually died after having a terrible fall in her home. An accident that could have been prevented, but atlas, I cannot change the past. I can only choose between potential futures.
As a Mexican-American woman, it is expected of me to care for my parents when they retire. Based on my career plans, I do not feel I will be able to sufficiently care for my parents. An option I must consider (despite the cultural taboo) is placing my parents in a nursing home.
If I had to choose a few "must haves" in a nursing home. I would make sure to include the following:
1. Location
Finding a short commute.
It is important for me to be able to visit my loved ones. I would want to spend the most time possible with my mother and father. It would be difficult to do so if I had to drive two hours just to go talk to my mother or play checkers with my father.
Besides the potential long commute, I would like my mother to be in place where she could connect with others. A home where there are fun events and people she could interact with when I am not with her. My mother has always been an extremely sociable person. She can walk right up to someone and immediately make new friends (which has created some awkward dinners for me). My father, albeit less of an extrovert, would also benefit from having companions.
2. Service
Looking for care that meet specific needs.
In my mother's case, I would have to make sure the facility she resides in can fully meet her needs. If she is diagnosed with one of the before mentioned neurological diseases, she would need special care.
Demand for elder care will also be driven by a steep rise in the number of Americans living with Alzheimer’s disease, which could more than double by 2050 to 13.8 million, from 5.8 million today.
My mother is also allergic to penicillin and is lactose intolerant. I would need to confirm that the nursing home could provide options for her special dietary needs.
Questions to keep in mind:
Can the staff help residents during mealtime?
Will meals be taken together or separately?
How are residents treated during mealtime?
How much autonomy are residents given?
One of the biggest pieces of advice I found during my extensive research, was to visit the home during mealtime to get a better feel of the place. It's important to be attentive to how the residents are treated. The best homes allow their residents to select which activities they wish to partake in. It's important for the older adults to be able to make their own choices and retain an amount of autonomy in their lives. Things as simple as what they eat, clothing, or when they go to sleep can substantially improve their overall mood, happiness, and quality of life.
3. Staff
Observe staff.
It is essential to pay attention to whether staff members interact closely with residents and know their names. This is a sign that the staff cares about their residents and enjoys their job. A large portion of what makes a resident comfortable living in a nursing home is its atmosphere.
Questions to consider:
Is the home sufficiently staffed?
Does the staff have access to continuing education and training programs at the nursing home?
Are there any staff with any record of mistreat or neglect in the nurse aide registry?
Is there a licensed nurse 24/7? Is there a registered nurse at least 8 hours a day?
Is there a lot of turnover, especially in the administrative area?
90% of US nursing homes have staff levels too low for adequate care. One nurse's aide may care for up to 30 people.
4. History
Research meticulously for ANY red flags!
Examples of red flags: violations and infections.
Severe Violations
It is common to find a few minor violations when searching for nursing homes, but it is imperative to consider the severity of each violation. They could range from as severe as allowing a president to wander off the campus to having a cobweb in one of the rooms.
An estimated 21 percent of Medicare beneficiaries experienced adverse events during their nursing home stays, according to a 2018 report from the Office of Inspector General of the U.S. Department of Health and Human Services.
Infections
There is a high rate of infection in nursing homes. In some states, nursing homes are required to report unusual occurrences of infectious diseases to the local public health agency. This is not the same procedure in every state. Due to the close proximity among residents, new patients can being infections with them. One such example is Clostridioides difficile, which causes extreme diarrhea that can lead to death. Influenza is also quickly spread through homes. Any sign of infection, bacteria, or viruses could lead tp serious health problems.
One in 11 people older than 65 who contracted a health care–associated C. diff infection died within a month of diagnosis, according to the Federal Centers for Disease Control and Prevention.
A home that is frequently sanitized is the safest, best choice. Infections like C. diff are spread by tiny spores left on bedside tables and other surfaces. The risk of contagion makes thorough cleaning an essential factor to look for in any nursing home.
In June 2019, Sens. Bob Casey and Pat Toomey, a Democrat and a Republican, respectively, who represent Pennsylvania, leaked a so-called federal “secret list" of more than 400 nursing facilities with persistent records of poor care.
Medicare.gov offers a very helpful search tool that provides reports on different nursing homes based on ZIP code. They rate these facilities on factors such as staffing violations, health inspections and more. If the nursing home you’re interested in isn’t showing many stars, you should take a look at the home’s full report. There are many other great search engines like those provided by ProPublica and US News that can be very helpful tools for choosing the right nursing home in your area.
5. Opinion
How do you and your parents feel about the home?
When visiting any home, it's important to ask plenty of questions. When purchasing a home or a car, a prospective buyer must examine every aspect of the deal. A nursing home where my parents could possibly reside in is more important than any car or house. It's important to take enough time to get to know the community and its staff.
In 2007, there was an average of 20 complaints per nursing home, which equated to 257, 872 complaints related to quality of care, facilities, staffing, and other factors.
If you get a bad feeling, or "vibe" of the place, then the nursing home is probably not the best place for you. Choosing a nursing home is a very important matter that takes time and attention.
In my parent's case, I know I will have to take extra care in selecting a community that feels like home to them. A comfortable place where they can live out the rest of their days in peace and without any incidents.
If I cannot change the past, I will choose my future.
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