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Start off with the attitude that you and the staff at the facility are a team. Treat each facility worker with respect and gratitude. Sometimes people forget that these workers are people too and not "the hired help" or "my personal staff".

Ask the aides about any problems they are having with managing your loved one. Ask for their suggestions for solutions. Also offer a few suggestions as well. Feel free to elevate any problems you notice to the nurses - the ones who can call doctors and get medications or treatments.

Some facilities allow occasional gifts and others don't. Ask if you can bring treats individually wrapped from the store or simple meal like delivery pizza or sub sandwiches.
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SandyB66 Aug 2021
Excellent answer! I just put my mom in a facility this week

I love the biography idea and will use it!!
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My mum also lives in care. One thing that the staff seem to like is when I know they have done something well/special/or gone the extra mile: I make note of their name and tell management how pleased I am. Being recognized for a job well done is important. I also acknowledge that working during COVID has been very difficult and thank them for their work.
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The staff are your friends, not your adversaries, so treat them kindly. Ask questions, offer to help, be part of the team rather than the "customer."

Also visit often and at different times of day. Attend case management meetings and be ready with questions.

Also, I wrote out a two-page biography of my mother for both her nursing homes and asked that the caregivers read it. My mother was much more than the withered, deaf and blind woman who had dementia. She was a teacher, an artist, and a librarian. In school, she was a real beauty, and she was a remarkably smart woman. I wanted them to have a bigger picture of who she was, not just who she is when they first met her. I also gave a copy to her hospice company, and they were really pleased to get it.

Just be engaged with the staff because you are all a team in your LO's care.
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I found that asking how something was done was better than saying something like "why doesn't my Mom have her socks on". Instead ask, "Is there a reason my Mom has no socks on?". You probably will find out that she doesn't have them on because she takes them off. Never have an accusing tone. You will find a lot of times that its the resident not the staff. By law, they can not make a resident do anything they don't want to. And the staff doesn't have time to talk them into what is being asked of them.

I had a problem with them putting Moms bra on. She couldn't have skin on skin because she got a nasty rash. I even had it on paperwork I gave them. I said something to my daughter, RN, about it. She asked where did I put the bras. I said in the side table with her socks. That was the problem. Aides dress from the top down. By the time they saw the bra, they had Mom dressed. I hung my Moms clothes in sets so she matched. So I started hanging the bras with the sets. After that she always had a bra on.
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With our Papa I showed up different days, different times, even after midnight until I was satisfied he was getting good care, took my lunch break from work, went after work, and we took Papa out on weekends, my holidays, vacations (I still worked full time and took care of my twin sis, who lived with me, several dogs, houses, cars, did it all over the years). Left thank you notes and baked goodies regularly for all shifts of caregivers, housekeeping, maintenance, nursing, office, receptionists. Got to know everyone, ask about their families, ask how I could help them take care of Papa. We were blessed to have chosen such a wonderful facility. He had dementia for 10 years with nine in AL then one in one of their memory care buildings. When he died I had treat baskets made and delivered to everyone who worked there. They were marvelous and we were so thankful for them.
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Visit often and no regular pattern of visits. Observe. Take notes with dates, times, and staff names of things that appear to be 'off'. Note how long it takes to answer a call button, especially when the person has asked for assisted to go to the bathroom. Note if they came, turned off call button and said they would be right back to help - turning off the call button registers as call answered much quicker than actual service rendered.

Ask to see the medicine list at least monthly. Watch for new meds that may indicate why there's a change in behavior or sleep patterns. Are they being taken out of the room to get some physical movement or therapy - if therapy ordered, go and watch to see if patient just sitting in a corner or actually doing something.

When you see something that appears to be any sort of neglect - wrong meds, food tray not placed close enough to bed, moving the tray with phone on it to clean but not putting it back in close reach - discuss with the nurse desk. If it doesn't improve, talk to the director of nursing. Depending on severity of issue, you may need to talk with director immediately. Record all conversations with date, time, name. If there is a fall, make sure it gets recorded in patient record.

Visitors are the eyes for the patient. They can't always speak for themselves to get a resolution. A lot of thank you's to those who appear to do things well and work in this profession because they care about the patients.
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jacobsonbob Aug 2021
In addition to visitors, sometimes roommates can be of help. My mother had a couple who helped this one. Both were much younger and in better shape mentally. When I came in, sometimes they would tell me if something happened overnight or otherwise. One had been an administrator in a nursing home herself, so she would sometimes "go to bat" for my mother if she saw something that wasn't right or if there was an issue with my mother. My sister and I appreciated them both a great deal and let them know it.
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My mom is in a nursing home now. In assisted living it was very easy to talk with staff. In memory care it was harder, but possibly because of covid lockdown. In nursing home I have a lot of trouble connecting with staff. They tend to stay clear of me when I'm visiting my mom, as I'm sure they are busy and they see someone is there with her, so I go to the desk and ask them how she is doing and if there have been changes in her or in the care plan. They sometimes have to go get someone else to answer my questions, but they don't ignore me if I ask directly. The physical therapists are the best at giving me thorough reports, but I rarely run into them, so I call and ask to speak with them if I have a concern or question. I do not ask if there seems to be no issue. They know me because I'm there every day. If they come in her room or do something with her while in the main room, I always thank them and if they seem relaxed enough, without a rushing about attitude, I tell them something interesting or funny about my mom. So far she seems to be getting good care.
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Restless Aug 2021
My mom starts nursing home care for dementia today in facility I'm not a fan of but it's only place with an available bed until she placed on a waitlist for the facility closer to me and has memory care. But she's been in and out of rehabs, hospitals, and short term nursing care for months now and I can already attest to your experience. I had a hard time reaching out to the social workers and nurses. And it was also her Occupational therapist who knew my mom best but I didn't always have easy access to her to ask questions. COVID withheld so much of my access to my mom and her health info in general. And I also tell whoever is working with my mom a quick anecdote of my mom so she can understand her persona. It's scary to know that every time I visit, I have to leave her in someone else's hands, someone I don't know, for her all of healthcare needs. I just wish nursing home facilities would create an app similar to a Patient Gateway health info access like most healthcare facilities do. There, proxies/family can read notes of meds, current care, who's on shift, medical needs, ops for questions, etc. In the meantime, it feels like I'm sending off my mom into oblivion and it kills my soul how vague things have turned now that she cannot be in my direct care any longer. It's good to know your mom is doing well ... that brings some peace in knowing the facility sees and hears your concerns as well. I pray it turns out that way for my mom and I as well. Blessings to you, caregiver!
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Be nice and appreciative… and let them know you respect their work. Small, handwritten notes of appreciation mean alot!
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I would think similar efforts would be appropriate like at the hospital and rehab. I have not dealt with a nursing home yet. My dad did have an extended rehab stay.

Respect and kindness goes a long way. Learn the staff's names who routinely care for your loved one. People love hearing their names.

Be present as often as you can and attend care meetings. Be a team player and nothing is more appreciated than a treat here and there. Something as simple as cookies but remember each shift.

I wrote some things about my dad on the marker board in his room. A little about his family with phone numbers of who to call. Also add if LO is visually impaired or hard of hearing.
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As others have mentioned, please and thank you go a long way. Also I’ve made it a point to learn the names of the staff involved in the care of my DH. Whenever I see them I also say hello using their name. They also know me by name and one staffer addressed me by name with a friendly hi and I had not met her before. At holiday time I sent an individual wrapped tray of chocolates to his floor with a thank you note for their hard work. I think kindness and respect goes a long way.
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