My mom is on Medicaid and has been in a nursing home for over a year. It's perpetually understaffed and the food is pretty awful. However, it's close by and seems halfway decent to me, overall. She wants to move someplace new, but options are limited due to being full or only taking private pay before accepting Medicaid. I've looked on the Medicaid site at health ratings, etc., and asked friends for recommendations. Is there something specific I should be asking or looking for when visiting a potential new facility? Or should I try to convince her that it's not going to be any better anywhere else?
I would ask specifically about staff turnover rates. I would ask how many new CNAs and nurses are working at the nursing home now out of a staff of how many. I would ask how many positions are currently open. I would ask if they have a difficult time retaining good employees. If they squirm, you know the answer.
I would ask if they have student nurses completing clinical rotations there which, in my opinion, would be a good thing because students want to learn.
I would ask if their food and nutrition services is run by a registered dietician. I would ask for a menu and then pick a day to show up and tour during lunchtime.
I would ask the director how long he/she has been working there, and where were they prior to coming there. And I would ask the same about other key personnel.
That said, some people stay at a job for the wrong reasons. If key personnel have been there since the stone age and seem unenthusiastic and lazy, leave.
Frequently I visit this nursing home, which has a rehab section as well as a LTC residential side. My sister has been living there now in LTC since end of June 2019, and I’ve found this home to be full of caring, helpful nurses, CNA’s, and even the chef and maintenance people are kind. Yes, occasionally a smell can erupt but it passes. The home holds
126 patients so something is bound
happen with peoples bowels etc., however I’m continually surprised and impressed on what I visually see and experience, so if you choose to read reviews my advice would be not to take it as gospel.
Many people have very high expectations Of nursing homes, and
think workers should be at there every beck and call. That’s just not realistic.
However it is a chronic complaint by many seniors that they want 'better' to live - what is 'better' is another question - who at age 50-60 said "I want to end up in a nursing home" - many are ostriches who keep their heads in the sand to avoid making proper choices that effect both them & their kids
Said as one who took care of both parents to age 92 & 94 [basically sis was a no-show] & I'm 70 now [the first line of my autobiography will be "At the age of 69 I became an orphan"] - I personally will buy a first class ticket to wherever I can control my own health so that I come back in a coffin in the belly of an airplane
Your mom isn't super happy where she is, but will she be any happier if she moves - probably not so ask her what she isn't happy about - this might be the fact that nurses check on her during the night or that she doesn't control her own meds anymore - it is very important that your know not only that your mom is unhappy but why .... if you can't fix the 'why' then don't move her HOWEVER if you can fix the 'why' with a move then look into it with educated eyes to solve her issue
My MIL is also in a nursing home on Medicaid. For the most part it is good - not perfect- but good. That you live close by is a big plus. If she is being well cared for, and you like and trust the staff, I would not be in a hurry to try to move her. On the other hand if you witnessing neglect or seeing something you don't think is right contact your state's Department of Health. I work in an upscale retirement community that includes a nursing home. It is strictly private pay big $$$$ and it is no better in terms of care (maybe even not as good) as where she is on Medicaid.
I've found it helpful to stop by at different times. This lets the staff know that you are an involved family and also puts them on notice that you may drop in at any time.
My mom is very soft spoken and will not speak up for herself. After almost 4 years I have learned to pick my battles carefully and not complain about every little thing. I am respectful when issues arise. I have lost it a couple times, but the situation was very unusual and I wanted to be very clear that it was unacceptable and would not be tolerated no matter what their excuse was.
They have care plan meetings with me every 3 months, but I don't wait until then to discuss issues unless they are relatively unimportant. I chat with the charge nurse and have her occasionally "remind" caregivers of the care plan in effect for my mom if I notice things not being done on a regular basis. They are very busy and if they can cut corners at times, they will. Staff also changes and may not have been informed of all aspects of mom's care. Most caregivers in these settings are very caring and certainly are not in it for the money, but nursing homes are like any other place of business; they have exceptional employees and they have those who do the bare minimum to get by. It certainly doesn't hurt to let them know you are watching!
The food is acceptable, but not great all the time. I bring take-out from mom's favorite restaurants occasionally to break up the boredom. I give mom manicures occasionally, put lotion on her face, arms and hands, give her a shoulder massage, brush her hair and clean her teeth. Her caregivers do these things too, but it's not always consistent. It's important for her to feel the touch of a loved one. She loves it when I do these things and talks about it for days! I talk to her......a lot. LOL She won't carry on a conversation with me, but loves when I and others talk to her. She likes to just listen.
Now if that is what’s driving the I wanna move conversation, (& it’s not an awful level of care issue), I’d suggest you go a meet 1-on-1 with the activities director of the NH. Tell activities director what your mom is like & may find of interesting. Find out what’s on the calendar and you volunteer to help with activities. Believe me there’s Halloween, Thanksgiving & Xmas on the horizon as well as football right now that activities will have stuff planned for. Pick a couple you can be at and get there early to get your mom all ready and you take her to the activity. Once there you help the activities director behind the scenes, you do NOT helicopter over mom. This will let you see how accurate mom is in “nobody talks to me” & also how she is in relation to what the other residents can or cannot do. You do this a few times & you’ll get to know the staff way way better & the residents & who mom might be pals with. AND you yourself become pals with other residents families. You know their names & can make it a point to chat by name however briefly w/them & their elder. Believe me doing this will pay off for both you & your mom.... & what your likely going to hear is OMG your 5 minutes away how beyond lucky is your mom.
Personally I am not the sorority social chair type.... but I got involved with helping the activities gal at my moms NH & scheduled trips over when there was a bigger event planned (I live in another state). It was a wonderful & often beyond funny experience.
My mom is still on the list. It’s a very long list. But I am the daughter that live in AZ. So I’m not her closest advocate. The place she is in is good- she is clean and thriving in end stage Alzheimer’s.
If Hannah B Shaw can do it - more places should be able to. But we all know greed and making money is the bottom line with our health care.
Hugs I hope you find a suitable facility.
what I found was....for a large sum of money (+$5,000 per month) the places looked nice and people were engaged in activities. But, no Medicaid need apply
amoung the Medicaid accepting places I found
most smelled badly of urine.
most had people sitting around in wheelchairs doing nothing
most were understaffed leaving people crying for someone to help
most had people sitting watching a community TV...looking quite obvious to it all.
do not call in advance to announce your visit...just show up and look around. The home director will quickly come and grab you to take you on the approved tour. Not once did I ever see anyone actually in the gym or rec. centers on those “official tours”.
after seeing that (I visited 6 places in this area) I vowed to never allow my parents to be admitted to one.
now...there is one place that looks really nice, interior very clean, seems to be in order. My Mom stayed there for rehab. Zero rehab was actually done for her. She wasn’t permitted to go to the gym or the lunch room. After one week....she checked herself out after waiting more than 24 hours for a meal. (Thanksgiving day...she had nothing to eat).
so..don’t go by the look of the building or the state of the art gym....see what people (staff included) are actually doing
I was a helicopter parent years ago and now I’m a drone daughter. My parents are in NH in same complex. Dad 90 in AL building over a year, and Mom 92
(Alzheimer’s stage 1 to 3) in Nursing building, she went in three weeks ago. I have taken care of both together for a year. Physically I could no longer care for Mom. The parking lot separates them. We have used this NH for rehab for 25 years! It’s not perfect, however, it works for all of us. I address all complaints and COMPLIMENTS in emails for a paper
trail.
I will post a problem with my Mom that I alerted Soc. Worker and staff about and requested another Care Plan Meeting.
The problem “no bed rails anymore” as DHEC found them dangerous! I told unit nurse that my Mom will fall when she tries to sit up. Well she fell Sunday at 11 am. No alarm button. She yelled help, and her roommate got out of bed, yelled down the hall “Dolores fell off bed” and they all came running. She said she didn’t press her bell because it would take them to long to respond. There is more to this I’m addressing in another meeting this week. I got there at 12:30 and Mom wasn’t dressed or washed up! She was in housecoat and depends. Had she been dressed at 8 ish and breakfast in wheelchair in room by 9, she would not have fallen out of bed!
After an X-ray her hip all is well.
I go to see parents at least three times a week with varying days and times. I eat lunch with them too to check out food. It’s actually very good. The majority of the staff is wonderful.
Have a nice day.
I think you also need to look into the doctors that are available. My mother's doctor didn't visit any of the facilities, so I had to choose a new doctor for her. Having to do this made me very anxious. The staff can't refer any of the doctor's, but they can probably tell you who comes in the most to see their residents.
I also used one of her dresser drawers to keep seasonal decorations, word search books, etc. and I stashed cleaning wipes and spray in it. It made me feel better to do a little extra cleaning and helping out.
Try to find out exactly why she wants to move and then see if you can address that with the staff. One little change in her day might make a difference in how she feels being there. Good Luck :)
Talk to the residents if you can. Also the visiting families. Talk to people you know who have placed family members in facilities and ask if they would recommend that facility or have heard of other acceptable homes.
This advice came from a wonderful worker at a nursing home. He saw all the behind the scenes stuff that went on. He went on to say if the workers are spending a lot of time ‘chatting’ with each other in the hallways, then residents were being neglected.
That’s how I selected the nursing home that my mom did rehab in. Was it perfect? No. Is anywhere perfect? No. You just have to look for the best that you can find.
Address an issue politely as soon as it arises. Be kind to the staff. Show appreciation. It’s a tough job. Don’t interfere with their jobs unless it absolutely necessary.
Best of luck to you and your family.
So you'd be giving in to her in this situation. And then you'd be much farther away. Will you also be giving in and spending as much time with her as you do now, but spending MUCH more traveling back and forth? She might SAY it's okay for less frequent visits to the farther place, but when she gets there and keeps calling you to come visit, will you be able to enforce your boundary of less frequent visits if she is farther away?
Just how often do you visit her at the closeby NH?
If the place she is in now is closer and you can visit more often or for longer rather than the place 30 or 40 minutes away, maybe you can not visit as often or for as long.
Ask her what she would prefer.
Has she been to the other place for a visit...talk to the residents and see what they have to say.
Thanks for your advice!
Why does she want to move someplace new?
Is she taken care of where she is? Have there been any injuries or falls?
Most facilities seem understaffed. You could look up the state codes for staff resident ratios. What I found with just a quick look and I do not know if this is just here or nation wide is day time ratio is 1 staff to 5 residents nighttime 1 to 10 and there should be a nurse 24 hours. These are minimum standards.
If it is the food that she does not like despite the food you get on a "tour" I think the food is pretty much all the same no matter where you go.
I think that it would be pretty much the same no matter where you go. Underpaid and over worked staff, food that is meeting minimum standards for nutrition made by staff that is given a minimal budget to buy the ingredients. So that means lots of canned vegetables rather than fresh or frozen. Lots of gravy that contains a lot of fat to stretch the protein further. Not to mention they are working with a variety of diets from a regular meal to soft processed meals.
Keep in mind these facilities are in the business to make money and unless you can find a small independent home type facility or one that is "non profit" they are all the same..and much like unicorns are fantasy. (OK I will admit there are small independent home type facilities but they are rare.)
There is a place about half an hour away that will take her, and I don't think it's a whole lot different, but I have considered moving her there anyway just so she can see what I'm talking about.
Honestly I don't think she'd be happy anywhere other than her own home; unfortunately, that's not an option anymore.