As your loved one considers moving into a nursing home, it’s important to look for a facility that offers needed services in a clean, safe, friendly environment.

Nursing Home Quality Of Life Issues

Nursing home residents should have the freedom and privacy to attend to their personal needs. That means several things: from managing their own financial affairs to decorating their rooms with personal belongings. It also means being able to participate in the planning of their treatment.

In the 1980s, several studies identified some problems with the quality of care that the nation’s nursing homes provided to Medicare and Medicaid residents. In October 1990, important new nursing home reforms took effect designed to strengthen both the quality of life and quality of care for residents. The reforms call for the provision and enforcement of certain rights of residents to dignity, choice, self-determination, and quality services and activities.

Knowing some of the key details of the law can help you make a better decision about selecting a nursing home for your loved one. It can also better prepare you to know what to expect, and what to ask for if your loved one is not receiving the care and services to which he or she is entitled.

Under the law, nursing homes must train their nurse aides. Facilities must also conduct a comprehensive assessment of resident needs within two weeks of admission. The law also requires that nursing home residents have the right to choose activities, schedules, and health care that are consistent with their interests and needs. Facilities are expected to provide a safe, clean, comfortable homelike environment.

Residents must receive the necessary care and services that enable them to reach and maintain their highest level of physical, mental, and social well being. For example, married residents should be assured privacy for visits from spouses. If both husband and wife live in the home, they should be able to share a room, if possible. All residents should have freedom and opportunity to make friends and to socialize.

Residents and their relatives must be able to talk to administrators and staff about questions, problems and complaints without fear of reprisal. Administrators should be courteous, helpful, and frank. They should treat residents and their requests with respect. Staff members should respond quickly to calls for assistance and treat residents with courtesy, respect, and affection. Warm, professional relationships between staff and residents are an essential ingredient to quality care.

Residents should not be transferred or discharged arbitrarily and should be given reasonable advance notice if they must be moved.

Many of the specific items you should be aware of are part of the regulations concerning residents’ rights. These are rules that Medicaid and Medicare certified nursing homes must follow. The law applies to referrals, admissions, accommodations, room assignments and transfers, policies regarding financial matters, care services, physical facilities, residents’ privileges, and the assignments of medical staff and volunteers. In addition, civil rights law ensures equal access to all nursing home, regardless of the prospective resident’s race, color, or national origin.

What To Look For In Nursing Home Medical Services

Medical and nursing care are crucial to your loved one’s welfare as a resident of the nursing home. It pays to spend extra time to ensure that his or her needs will be met in this important area.

It’s good to find out:

• How often the nursing home’s physician visits the facility and reviews resident’s medical records.
• If the physician and nursing staff meet with residents and their families to develop plans for treatment.
• How many residents, on average, each nurse’s aide or direct care nurse is assigned to care for.
• If licensed nurses are not on duty around the clock, is there 24-hour access by telephone?
• Will the confidentiality of your loved one’s medical records be assured?

The importance of having answers to these questions often depends on the medical needs of the resident. Still, it pays to know the answers in case your loved one needs medical treatment.
 
Restraints

The law strictly limits circumstances under which facilities can physically restrain residents in beds or chairs. Residents can never be restrained simply for the convenience of staff. All physical or chemical (medication) restraints must be ordered by a physician. Many nursing homes are making progress in finding other safe ways to care for residents without restraining them. If you see residents with restraints, you should carefully question the staff about the nursing home’s philosophy on the use of restraints. Ask what kind of activities and rehabilitation are used to keep residents restraint free.

When a medication is used, facility staff must check the resident to make sure there are no adverse side-effects. When a physical restraint is used, the resident should be monitored frequently to see that all is well, and to take care of any physical needs such as toileting.

Remember that federal law states that nursing home residents have the right to be free from any restraints administered for purposes of discipline or convenience, and not required to treat medical conditions.

In addition, the law says a resident will have the right to be free from any type of abuse—verbal, sexual, physical, and mental. That includes corporal punishment and involuntary seclusion.

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Adapted from Your Guide to Choosing a Nursing Home, United States Department of Health and Human Services Health Care Financing Administration.