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Nursing home invisibility and caregiver trepidation

by Isabel Fawcett

Many people feel nursing homes are horrible places and they don't want their elders to ever "go there." It is regrettable that there are still some substandard nursing homes, but some nursing homes are very good. Many good nursing homes are not well known to caregivers and others. With aging populations, this just may be the right time for nursing homes to focus on effecting fundamental changes to enhance and sustain their reputation.

Recently, a friend and fellow caregiver raved about a local nursing home where her mother resides. I had never before heard any family member of a nursing home resident speak in such glowing terms about a nursing home or the environment in nursing homes. The family member cares deeply about her mother's welfare. She mourns the loss of her mother to Alzheimer's disease though her mother is still alive. Her unsolicited nursing home testimonial was not lost on me. I listened, seeking a better understanding of one special nursing home.

Good Nursing Homes

She raved about another nursing home resident who reportedly has taken my friend's mother under the her wing. Essentially, the daughter said she worries less with her mother's fellow resident looking out for her mother. Prior to this resident-protector, she said, things had been dicey with an intrusive and aggressive fellow resident who targeted her mother and others.

If my loved one were in a home, another nursing home resident would not be key to my contentment, though one difficult resident in any nursing home can make life a living hell for other residents and direct care staff. So, it makes perfect sense that the demeanor of fellow nursing home residents also works to improve nursing home environments.

However reassuring to some family members, protective residents cannot be guaranteed with nursing home placement. Eventually, all residents will leave their nursing home. Still, caring residents might enhance the initial appeal of the nursing home and retention appeal for potential residents and their caregivers, depending on circumstances. My friend's mother has been a resident in the same nursing home for 2 years.

Musical Chairs

Over the years, four of my friends had loved ones living in different nursing homes in Texas. Each friend has shared his or her individual perceptions, independently of each other, regarding how difficult it has been to find either the right nursing home for their elders, or adequate care.

In a couple of instances, my friends decided to repeatedly transfer their parents to other facilities in their feeble attempts to find a *minimally acceptable level of care for their elders.

*Adequate care resides in the eye of the beholder, who are generally elders, nursing home administration, and governmental regulatory agencies. From each beholder's perspective, minimal and reasonable standards of care include considering incidents of patient abuse and neglect in the nursing homes, facility cleanliness, safety hazards, and staffing ratios, for example.

Nursing Homes Have the Burden of Proof

Individually, and, as an industry, nursing homes might want to step-up to overcome skittish family members' and caregivers' perceptions. Whether such public perceptions are true or not, they have become the nursing home industry's long-standing reality. There are many skittish caregiver profiles. We are not unlike individuals who fear flying.

Many caregivers understand that good nursing homes exist, high profile circumstances of resident abuse and neglect notwithstanding. As in the airline industry, however, where a few airplane crashes are disconcerting to an already nervous general public, so too, a few high profile patient abuse and neglect stories are burned into the public's long-term memory. Regrettably, some elders and their caregivers avoid nursing homes based on fear.

Nursing Home Wake-up Call

Some nursing homes have relegated themselves to be on the social sidelines, silent and invisible. There is innovative work needing to be done in the industry.

  • Nursing homes might consider targeting and wooing primary caregivers and our elders long before we have exhausted in-home options.
  • It might reassure some caregivers to hear from direct care staff about their individual ethical responsibilities, personal commitments, and institutional practices in caring for society's most vulnerable people. Such ads would provide fresh content and could be recycled as video training for new hires and all staff. If done, the ads could feature skilled and caring direct care staff, as supported by the worker's documented performance history.
  • Nursing home administrators and executives could enlighten the general public about ways their businesses aggressively ferret out bad apples. Other progressive public outreach content might include enhanced supervision and operations protocols to detect, prevent, and promptly self-report abuse and neglect of residents, increasing residents' security with electronics, self-identified, internal fast-track safety controls, measurable bed sores management strategies, and other specific areas of concern to family members and elders. Such content would increase the industry's social visibility and help dispel some of its negative perception issues.
  • Nursing home website blogs could be one of many transition venues to nursing home transparency and community-wide engagement. Ask a Nursing Home Professional might be a regular interactive online feature for caregivers and skilled staff, whether as fee-for-service revenue stream, or strictly outreach and transparency return-on-investment.

If my loved one had no alternatives but to be in a nursing home, I would be on board with placement. In the meantime, the industry remains silent and distant.

Nursing Homes Are as Socially Isolated as Elders and Caregivers

Elders and their caregivers are socially isolated. To a large extent, so are nursing homes.

Recently, I have seen televised ads for local nursing homes. The commercials are startling only because, as far as I can recall, they have not been commonplace in recent television advertising history. The ads remind me that many nursing homes have been in self-imposed social isolation and exile waiting for non-targeted and disengaged customers to show up smiling. This may be a perfect time in history to successfully engage potential and tenured caregivers in dialogue and public education. Help us all inch on down the road as we age.

Eldercarelink.com is a good first step connecting caregivers with agencies. With boomers aging, the opportunity for long-term care to open wide its blinds to let the sunshine in has arrived. Marketing to elders is passé. Waiting for eager customers is old-world.

Forging new partnerships with caregivers and local communities is bold and innovative.