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Solving Problems in Nursing Homes

Copyright © 2014 AARP. All rights reserved.

Selecting the best nursing home is critical to your long-term care plan, but your responsibilities do not end there. Since this will be a long stay, it is important to monitor the quality of care and deal with problems that may arise. You and your family member have a right to expect good quality care, respect, and sensitivity to any special issues.

Still, the situation that exists when your family member is admitted may change over time. Your family member's condition may deteriorate, her roommate may become agitated, and her favorite aide may leave and be replaced by a competent but not so friendly person. You should be familiar with residents’ rights in nursing homes and be a vocal advocate for ensuring that they are enforced.

At the same time you have to distinguish between situations that are unacceptable and those that can be the focus of compromise and negotiation. Of course, if the problems involve serious incidents of abuse or neglect, you have to take immediate action.

Steps to take in solving care problems

If the problem does not involve abuse or neglect, is isolated, and can be resolved, your first approach should be a frank but friendly discussion with the staff person who is the source of the problem. For example, your parent doesn't like the shampoo the aide is using because it stings if it gets in his eyes. Maybe a different shampoo or a different technique will solve the problem.

If the problem is more serious, or you see it happening to other residents, but has not risen to the level of abuse or neglect, then speak to the head nurse or the director of the nursing home. Most nursing homes want satisfied residents and family members and will generally try to resolve the problem. Of course, you may encounter some defensiveness or denial.

If these informal approaches fail, then your next recourse is to contact your state's ombudsman, a person assigned to investigate complaints in nursing homes, adult homes, and assisted-living facilities. The Long-term Care Ombudsman Program is run by the U.S. Administration on Aging and has volunteers and staff in every state.

To find your local ombudsman office, call ElderCare Locator (800-677-1116) or your State Health Department. A website map is also available. In some areas you can call Adult Protective Services. Police should be called if the resident is in imminent danger.

Be prepared to document your concerns with dates, names, and specific violations. Try to take pictures of visible violations to further support your claims.

Get familiar with the very comprehensive list of nursing home residents’ rights, which every nursing home is required by law to observe. If you can link the problem to a violation of patient's rights, you will be on stronger ground.

If the problem persists, you can file a formal complaint with your State Health Department. There are other avenues such as private litigation that you might want to investigate.

Another good resource is a booklet by Eric Carlson from the National Senior Citizens Law Center. It presents 20 common nursing home problems and ways to resolve them.

Nursing-home residents’ rights

The 1987 federal Nursing Home Reform Law guarantees residents’ rights and places a strong emphasis on individual dignity and self-determination. A person living in a nursing home has the same civil rights as someone living in the community.

The law states that all nursing homes that participate in Medicare and Medicaid are required to “provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care that . . . is initially prepared, with participation to the extent practicable, of the resident, the resident’s family, or legal representative.”

Among the rights listed are: the right to be fully informed of available services and charges as well as the right to receive information in a language they understand; the right to complain; the right to participate in one’s own care; the right to privacy and confidentiality; the right to dignity, respect, and freedom; right to visits; and the right to make independent choices.

There are also special rights relating to transfers and discharges. For a complete list of the rights, go to: The National Consumer Voice. There is no comparable federal statement of rights for assisted living residents, although some states have statements of rights for these residents.

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