Written by Mark San Juan.
When one places a family member in a nursing home, the emotions felt are likely complex (on both sides). There’s a sense of relief that the family member is being taken care of and is safe, yet there is a sense of melancholy/abandonment, knowing that the person is advanced in years and will not be in the home they’ve been living in for years.
And if we’re being completely frank, most people don’t want to live in a nursing home, so you’re worried about whether the person you just left there is unhappy. The point is, even in the best case scenario, where the facility is top-notch, this takes some adjusting and getting used to before everybody’s okay with the new situation.
When rooms aren’t that clean, meals seem… Not too edible, and the staff is indifferent? This is why you, as a family member, have to be able to recognize red flags.
We’ll show you all the subtle (and not-so-subtle) signs to look out for and what to do if you think there’s reason to worry.
What Standards to Expect from Nursing Homes
In all honesty, the standards you should expect from a nursing home aren’t anything over the top; you want it to be clean, safe, your loved one to feel respected, and for the staff to do their job. Nothing crazy, so you’d think all nursing homes can stick to this.
Sadly, the reality is different, so let’s get into more details on the standards.
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Cleanliness and Safety
There’s a reason why cleanliness/safety takes the number one spot on this list. The nursing home has to be clean (and safe, of course).
The rooms should be kept in an organized manner without any clutter; bathrooms should be hygienic while use of common hallways should not be obstructed by any clutter and should not have any unpleasant odors. This means, the rooms have to be maintained and tidy, the bathrooms have to be hygienic, and common areas can’t be cluttered or smelly.
Linens, bedding, and clothes (this goes for both the staff and the residents) have to be clean, too, and everything has to be washed on a regular basis.
Safety is another top concern. You want all the proper procedures in place (e.g., handrails, lighting, anti-slip flooring, etc.) throughout the entire facility.
Each room should have emergency buttons and safety features (grab bars, entrances accessible by wheelchairs, etc.).
Beyond just “everything needs to be clean and safe”, there’s a deeper reason for the extra caution. And that is to avoid possible infections. The reason is that old people (usually) have weakened immune systems, and are more prone to getting infected.
This is why the COVID-19 protocols actually did a great job in securing such facilities. Hand sanitizers, frequent surface sanitation, staff hygiene, frequent hand washing, gloves, and masks (when necessary).
Not only does this help minimize the chances of an infection, but it also helps minimize the spread of microorganisms.
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Sufficient Staff
If the facility is understaffed, the residents don’t get quality care because they just can’t get enough attention from their caregivers. This impacts the seniors’ quality of life, so it’s non-negotiable. It NEEDS to be up to standard.
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Resident Rights and Dignity
Quality care also means that all residents are treated with respect. Their privacy needs to be protected and they need to feel dignified.
Those in charge of caregiving should knock prior to making an entry to any of the resident rooms (privacy is important), observe the areas occupied by the patients, and allow them to make their own decisions concerning their everyday activities such as what to eat and what to do.
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Proper Management and Procedures for Administration of Drugs-Prescription
In most cases, patients residing in a nursing home are required to take medications within certain intervals of time, which implies that there have to be established procedures that’ll ensure all the medications are taken at the right time without fail (people forget, even refuse, take the wrong dosage, etc. – it needs to be controlled).
Another important thing is for the staff to review the medications every once in a while so that there’s no unnecessary prescriptions, especially with psychoactive drugs.
6 Red Flags
Now that you know what standards every nursing home has to meet, make sure not to compromise on any of them.
But apart from being informed on the standards, you also need to know what red flags to watch out for; let’s take a look.
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Sudden Changes in Health or Behavior
Big changes in physical or mental health is usually a sign that something is wrong. If the resident is losing weight quickly, seems depressed, or has bruises or injuries they don’t have a normal explanation for, it’s probably due to neglect.
Pressure sores are another surefire sign of neglect because they occur because of prolonged immobility, so it means that the staff didn’t reposition the resident enough.
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Overworked, Tired Staff
Take a look at the staff; do they seem happy and energetic or tired and cranky? If ‘tired & cranky’ is the situation, then the staff members likely under great pressure and stress as a result of being overworked, and if that is the case, then it’s almost certain that they cannot adequately care for their residents.
So, even though this might not be the fault of the employees, it is still the residents who will be the most affected anyway.
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Hight Staff Turnover Rate
This is not something that will be obvious, but it is more of something that you’ll find out as time passes. Naturally, if there are a lot of caregivers being streamed through the facility, that means that (most likely) something is wrong. To be fair, it could mean nothing. But, in most cases, it is a call for caution.
High turnovers are usually the result in poor management, poor working conditions, inadequate training, or simply low salaries/high amount of hours. It could also be linked to the previous point, overworked, tired staff.
All of those things, while at first seemingly don’t look like it is YOUR problem to deal with, it actually is. The residents of the facility are going to be the ones that get the short end of that stick. Low morale in workers, means poor living conditions for the residents.
Talk to the current workers (not management) and see how long they’ve been there. If they are new, try finding out why the last person left. You might get no information, or misinformation in the form of gossip/rumors, but nonetheless, you’ll know more than before. You could also talk to some of the residents and ask them if they are happy with the staff, and work from there.
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Missing/Misplaced (Personal) Items
If any personal items are being misplaced, or have completely gone missing – this is a huge concern. It could indicate that there’s a lack of organization and security in the facility, or that personal items aren’t being respected.
Regardless of whether the culprit is a staff member, or another resident, personal items should be dealt with respect. It is an issue, and it is not on the victim’s hands to try and deal with it.
If it’s a staff member that’s at fault, management should resolve the issue. If we are looking at another resident/residents, then again, it’s the management or the staff directly who should ensure this isn’t happening.
If the issue persists, then definitely consider contacting an attorney who has experience in this area.
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Restrictive Visiting Policies
If a nursing facility (usually) has restricted visiting hours, this could point toward some underlying problems, like understaffing or an unwelcome attitude towards family involvement. Or something worse.
Either way, be wary of such restrictions, and think about how that would affect your elderly loved ones in the long term.
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Negative Evaluations and/or Low CMS Ratings
Should the institution fall short of expectations in the ratings system, such as that of the Centers for Medicare & Medicaid Services (CMS), those will be a clear indication to keep away from that establishment.
A few negative comments can always come from an angry customer that didn’t get their way (even though they were in the wrong). But too many negative comments are (usually) a giant red flag.
Just look at the case of Casa Real Nursing Home failure to meet health standards and you’ll see how low ratings are usually tied to big deficiencies. Casa Real has received repeated citations in basic care areas, and consistently low CMS ratings are one of the biggest red flags ever.
If you’re in a position where your elderly are in a similar nursing home, and you’ve found yourself powerless to take action after your pleas/concerns about any of the red flags were all ignored. Then, you can contact a law firm that specializes in such specific situations.
Conclusion
Everybody deserves to be cared for properly, but especially our fragile seniors.
Unfortunately, they’re easy to take advantage of and if their family isn’t involved or doesn’t visit often, the staff can see that as a chance to not work properly, which leads to neglected, depressed, possibly even sick residents.
Make sure to visit a lot, ask questions, and observe everything around you to see if there’s anything you should be concerned about.
Author’s Bio
Mark San Juan is a distinguished author and health care professional with a passion for transforming health care delivery through innovative approaches. With over two decades of experience in the field, Mark has established himself as a leading voice in health care reform and patient-centered care.
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