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I would be kind and courteous and express your gratitude in ways like giving a nice little gift and try to be there to help once in a while since a lot of these facilities are often overwhelmed with patients with not enough staff to take care of them.
daisygal: Imho, be PREPARED; I must emphasize this because the nursing home that my late mother was in pulled some "fast ones" on me. I was unaware that they would schedule a family meeting as I never got a heads up from the organization at all. They said to my mother "You're too well to stay here." Wrong answer as less than 48 hours later, my mother suffered an ischemic stroke there.
It helps to start out by finding a good facility. The Medicare website has ratings of all the nursing homes, hospices, etc that it pays. Due to circumstances I couldn’t control my brother ended up in two facilities with one star overall ratings and one star resident care rating. It was awful. He has terminal brain cancer so I set him up in hospice, and I had a list of places with at least three star overall, and five star resident care ratings which the hospice social worker called. He has Medicare and Medicaid which makes the pickings a little slimmer, but he got into an excellent facility not far from the hospice office. My niece is able to visit him anytime and the care has been great.
That being said, show your appreciation! I’ll never forget an occasion when I was a CNA on a liver transplant unit. We had an alcoholic patient in very bad shape who came in for treatment. He knew he was no candidate and never would be, for a liver transplant. He asked me to help him order a bouquet of roses for the nurses. I don’t remember any other shows of appreciation from patients. The nurses were amazed, I think particularly because he wasn’t a transplant patient.
Show up unannounced, show care for your LO. Be nice! Given how much people complain and bully these days, even a heartfelt thanks for their care, or a particular action they performed, is very welcome. With the long distance caregiving I’ve done since October, and all the agencies, doctors’ offices, hospitals, and facilities I’ve contacted, I’ve always wanted it to be a positive interaction, interjecting a little humor when appropriate. I’ve gotten a lot of help and information that way. They say manners are a social lubricant and I think it’s true. I saved the frustration for yelling about passwords and then had to apologize to my dog!
I'd also add this tidbit of advice: Ask if the fax machine in the facility is manned 24 hours a day. Where my mom was, the fax machine was in the supervising nurse's office. She left at 5:00 daily. Hence, when my mom's doctor sent in a change of medication about 6pm, the nursing staff didn't get the notice until the next day. In this case, there was no permanent damage done, but I'm sure in some cases, there might have been a major problem. I also agree with the other people who said to vary the time that you visit, if possible. I even wrote a book about my husband and I taking care of my mom with Alzheimer's called, "My Mother Has Alzheimer's and My Dog has Tapeworms: A Caregiver's Tale." I thought of the title when I was driving home form work one day, and I realized that this "broad's" once broad life was reduced to the pressing health concerns of my mom and dog. My mom only stayed in an Assisted Living facility for about a week, and then she came to live with us for 5 years, (until she passed away at the ripe old age of 94), but my mother-in-law was in Assisted Living for about 10 years. Hope these suggestions help.
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.
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.
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.
The phrase "be curious not furious" from radio host Dr Joy Browne has always stuck with me and is a good summary of the top responses here.
Unfortunately I found that even though I had cared for my mom so was intimately aware of her needs and what was involved in her care and was in the nursing home every day being part of the "team" was never my reality. Oh, they listened politely and answered questions (sort of) but always defaulted to their own way of doing things. I had to learn to bow to the reality that facilities are at their core institutions that run on rules, regulations and routines and pick up the slack myself where I could and just cede control in areas where that wasn't possible.
Yes, it is about family adapting to the culture and routines of the facility. Being friendly and appreciative of the care that is provided, even when you have to work hard to find something that is honest and positive. Save complaints and specific questions for the nurse who is on duty, or maybe request a meeting with the nurse manager or a phone call appt. Then you can be calm and prepared, and the staff on the unit won't feel attacked. (They get yelled at by everyone, including residents with dementia who can be very mean, pinch, try to bite, etc.) Small gifts to brighten your mom's room will make others smile, too. And gifts for the staff - no fancy - a bag of tangerines or small candy bars for the break room.... Your ways of giving care were tailored specifically to your mom. They need to have routines that work for everyone within the time allowed, and they do tweak for patient preferences as much as they can.
It also helps if the person in the NH is pleasant to be around. In some cases, particularly when dementia is involved, the personality of the LO may be "set". However, if the LO is capable of doing so, s/he should be encouraged to be pleasant during interactions with the staff.
My mother was usually pleasant with the staff, and they liked her, and sometimes they would give her a big hug when they came in to give her something or attend to her, and they would make comments to the effect that she was easy to get along with--so I don't believe the hugs were simply "putting on a show" just when I was visiting.
When we hired my dad’s in home helper, the first thing she asked me during the interview was “is he mean?” It hadn’t occurred to me before how much worse the job would be if he was, and I found another respect level for hired caregivers. Thankfully he wasn’t mean, just got riled up occasionally after an overdose of FoxNews 🤣
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.
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.
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.
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!
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.
Well, the staff in the NH will either love your LO or they won’t. If they dislike your LO there is not much you can do about it; except bring cookies and treats for them when you visit. Otherwise, you can hope there might one or two staff members who might like your LO and maybe they might keep a protective oversight on your LO.
Oh man, I feel the same for facilities in Boston. So far, my mom had to leave one because the nurses weren't trained properly on how to deal with her who has dementia and personality. They were so impatient and literally argued with my mom about change in meds that even I was unaware of and they took their frustrations it out on me also when I called to see what was going on. It's so wrong ! Some people DO NOT belong in healthcare at all.
These are all good suggestions. My mother, with dementia, often hid or misplaced items. When she could find them she would tell me someone on the staff stole them. I knew her habits so I would first search her room and could usually find the item secreted away. On the rare occasion I couldn’t find it I would talk to the director making it clear I was not accusing the staff just wanted them to be on the lookout when doing laundry and housekeeping.
Smiles and thank you to everyone you see, learn the names, chat with the aids about your parent, tell them bits of information so they have an inside into your parent. Ask about them and their interaction with your parent.
Mom's AL would ask resident's family to put together a photo poster on their birthday to show their life and experiences. Also, we were allowed to make a monetary donation to a general fund each holiday season that was distributed to the staff.
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.
My cousin used to bake goodies for the staff for taking care of her mother and they treated her well. At the beginning it was not so goodl. Sad but true.
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.
I agree that the team approach is best. Try to learn a little bit about the different tasks/responsibilities the staff members have. That way, if something goes wrong or isn't perfect, you'll have a better idea of what happened and how it occurred. Attend the care conferences and ask the staff what their biggest challenges are. Ask what they wish all family members knew. Tell them to call you with even the smallest thing because you value what they have to say - and then be sure you respond to those calls with respect.
I've seen family members approach the nursing home staff with "I'm going to show you who's boss", but trying to control the staff because they are afraid of you is not going to get your loved one better care. Being a bully is not the same as being "proactive." A staff member is not going to go above and beyond trying to please a family if they are afraid it will backfire. You can't make the staff afraid to call you or afraid to make suggestions to you. Plus, if a family member is mean all the time, how will the staff know if they're really, truly upset this time or if they are just being bullied again?
Thanks, all. I've been doing my best to connect with staff but it's been difficult as within less than two weeks of moving mom in, the facility started getting a steady stream of staff covid-positives and so visitation has been restricted for weeks to only 30-minute, pre-scheduled outdoor visits (1 allowed per day). So I can't get in the building and talk to staff face to face as easily.
And I definitely know they are under-staffed. There's been a persistent issue with Mom not getting her showers when they are supposed to happen (3 times a week). I know it must be difficult circumstances for the CNAs, but at the same time, sometime my mom ends up going 5 days without a shower :-( I have communicated with the head nurse about it, and she's been responsive and is trying to address the persistent problem, but it's definitely been frustrating.
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.
When your loved one is kept in nice, clean clothing, hair brushed, nails trimmed, it shows the staff that you care. Not that you can be there every minute to do these things, but make sure it’s done when you visit. Acknowledge the staff, get to know their names, ask about their families and lives, most people enjoy talking about their lives and shows you care. Take an occasional treat to the staff, doughnuts or snack items are welcomed, and be sure to do this for different shifts. Show up at varying times, say thank you for the caregiving, and smile. It often becomes about taking what can be an oppressive environment and making it better
My mother's nursing home did not allow gifts to the staff, even donuts. Their position was that it's ethically wrong and implies you're trying to buy better treatment for your LO.
By letting them know that you're on their side, and thanking them often, as most facilities are understaffed, and their workers overworked. A simple "thank you" can go a long way.
I believe that when you are nice to the staff, they will be nice to your LO. My husband can be very grumpy at times and intimidate people, so I let them know I know he is that way sometimes. He complains about everybody, but I tell him to be nice to them so they will be nice to him.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
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You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
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That being said, show your appreciation! I’ll never forget an occasion when I was a CNA on a liver transplant unit. We had an alcoholic patient in very bad shape who came in for treatment. He knew he was no candidate and never would be, for a liver transplant. He asked me to help him order a bouquet of roses for the nurses. I don’t remember any other shows of appreciation from patients. The nurses were amazed, I think particularly because he wasn’t a transplant patient.
Show up unannounced, show care for your LO. Be nice! Given how much people complain and bully these days, even a heartfelt thanks for their care, or a particular action they performed, is very welcome. With the long distance caregiving I’ve done since October, and all the agencies, doctors’ offices, hospitals, and facilities I’ve contacted, I’ve always wanted it to be a positive interaction, interjecting a little humor when appropriate. I’ve gotten a lot of help and information that way. They say manners are a social lubricant and I think it’s true. I saved the frustration for yelling about passwords and then had to apologize to my dog!
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.
Unfortunately I found that even though I had cared for my mom so was intimately aware of her needs and what was involved in her care and was in the nursing home every day being part of the "team" was never my reality. Oh, they listened politely and answered questions (sort of) but always defaulted to their own way of doing things. I had to learn to bow to the reality that facilities are at their core institutions that run on rules, regulations and routines and pick up the slack myself where I could and just cede control in areas where that wasn't possible.
Being friendly and appreciative of the care that is provided, even when you have to work hard to find something that is honest and positive.
Save complaints and specific questions for the nurse who is on duty, or maybe request a meeting with the nurse manager or a phone call appt.
Then you can be calm and prepared, and the staff on the unit won't feel attacked. (They get yelled at by everyone, including residents with dementia who can be very mean, pinch, try to bite, etc.)
Small gifts to brighten your mom's room will make others smile, too. And gifts for the staff - no fancy - a bag of tangerines or small candy bars for the break room....
Your ways of giving care were tailored specifically to your mom. They need to have routines that work for everyone within the time allowed, and they do tweak for patient preferences as much as they can.
But, if a Loved One has to be in a Nursing Home.
Go to visit often and at different times so you can see what really is going on.
People who get visited often do the best.
See if you can have a camera installed in their bedroom so you're able to check on them 24 7.
Be pleasant to the staff and say please and thank you.
My mother was usually pleasant with the staff, and they liked her, and sometimes they would give her a big hug when they came in to give her something or attend to her, and they would make comments to the effect that she was easy to get along with--so I don't believe the hugs were simply "putting on a show" just when I was visiting.
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.
I love the biography idea and will use it!!
Smiles and thank you to everyone you see, learn the names, chat with the aids about your parent, tell them bits of information so they have an inside into your parent. Ask about them and their interaction with your parent.
Mom's AL would ask resident's family to put together a photo poster on their birthday to show their life and experiences. Also, we were allowed to make a monetary donation to a general fund each holiday season that was distributed to the staff.
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.
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.
I've seen family members approach the nursing home staff with "I'm going to show you who's boss", but trying to control the staff because they are afraid of you is not going to get your loved one better care. Being a bully is not the same as being "proactive." A staff member is not going to go above and beyond trying to please a family if they are afraid it will backfire. You can't make the staff afraid to call you or afraid to make suggestions to you. Plus, if a family member is mean all the time, how will the staff know if they're really, truly upset this time or if they are just being bullied again?
And I definitely know they are under-staffed. There's been a persistent issue with Mom not getting her showers when they are supposed to happen (3 times a week). I know it must be difficult circumstances for the CNAs, but at the same time, sometime my mom ends up going 5 days without a shower :-( I have communicated with the head nurse about it, and she's been responsive and is trying to address the persistent problem, but it's definitely been frustrating.
Keep an eye on things, but don't get too bothered right now by things like showers not getting done on schedule.
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.
Best to check with the nursing home first.