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What to do if you aren't happy with nursing home care

by Carol Bradley Bursack, Editor-in-Chief

Family members have ways to address caregiving issues with nursing homes. Attitude and the chain of command are both important, but every caregiver has someone on their side if they need more assistance. That person is your ombudsman.

What to Do If You Aren't Happy With Nursing Home Care

After spending fifteen years visiting a nursing home nearly every day for one or more loved ones, I learned a few things. One of them was how to be realistic about the care even the most well-run nursing home can provide, and the other is how to work through the chain of command when you have a legitimate issue with the care provided by the home.

Even a well-run home has issues. Also, families have differing expectations. This is where a reality check, plus a good, respectful relationship with the staff, is exceptionally valuable.

Certified Nursing Assistants: The Frontline of Care

If you feel your loved one is not receiving the proper care, or is not getting the attention you feel is appropriate, by all means chat with the staff. You should do best if you avoid an adversarial approach. You could say something like, "I know Mom can be demanding sometimes, and you have a lot of people to care for, but is there a way we could make sure her call light is answered more quickly?"

The first person to talk with would likely be the hands-on caregiver who is with your mom most often. This would probably be a certified nursing assistant, most often referred to as a CNA, though sometimes still called a nurse's aide. These people work hard and give the most direct, non-medical care.

Your loved one may probably find a favorite and may discover that CNAs may have "pets." Don't think that just because your mom is difficult at times that she won't become beloved by one or more of these CNAs. I've seen some marvelous relationships happen between residents and their caregivers.

This is typically not a well paid position, though it should be. That gives you all the more reason to give this person your respect. They are working hard for your loved one, often without earning half of what they are worth. If you chat with them on a personal level and are sure you aren't being unreasonable, but still see no change, then you should talk with the floor nurse or floor supervisor. Again, approach this person in a friendly manner without pre-judging.

Obviously, none of this applies if you see actual abuse. That is for another article. We are talking here of fixing small irritants or getting a better understanding of what can be done.

Resolving Problems: Use Your Ombudsman

If you still get no satisfaction, then it's time to talk with the nursing home administrator. And if you still feel you are having problems and aren't being heard, you have the option of going to your ombudsman. Every state has a long-term care ombudsman. This person is your representative with nursing homes and is not affiliated with any facility. You can go to your state's Web site to find your ombudsman, or you can get information online at the National Long Term Care Ombudsman Resource Center.

When you contact your ombudsman, you can explain your problem and why you need help. These people go into the nursing homes and talk with residents on a regular basis. They are there for you and your loved one, so use them if you need to.

I do recommend that you don't jump right into this approach, however. Try going up the chain of command. You may find that most of your problems can be handled before you need to make a formal complaint to the ombudsman and you should remain on better terms with the nursing home. Generally, they want to make things right.

Again, I want to stress that if you witness abuse, contact the ombudsman, or even your police department. But in most cases, you can start with the CNA, and tweak care plans with cooperative staff meetings. This refined approach helps everyone become happier with the final result.