News, Information and Ideas on how to deal with hearing loss in a hearing world. Plus a few other topics!
You've tried to get information on what is going on with your Elder. You've sent emails, made phone calls and still aren't getting the information that you are asking for. What do you do?
This is a tough one. As consumers, we know that we should be looking up the State History of these facilities. But, when you look at the ways these places are inspected and licensed, it's another game of bureaucracy and wasted time from our point of view. Add in all of the paperwork that these facilities are now required to fill out and in their defense, would a complaint with more paperwork really help them to fix the problems?
Let's look at where some of these places are located. If you are lucky enough to live in a major metropolitan area, chances are, there are a multitude of places to look into. If you live in a more rural area, several factors come into play.
Major Cities have tons of resources as well as qualified personnel to staff these facilities. Add in the fact that the pay is pretty competitive and it's pretty easy to weed out the 'not so good' ones. Rural areas don't have it as easy. You have limited personnel, few facilities and it becomes a situation of 'he said, she said' on just how good some places are. It's also a family thing! If Great Grandma stayed at a place in her later years, odds are that other family members are also going to carry on that family tradition.
Here's the way that we made the decisions that we did with Moms' input. None of us lived in the same town/state that she did. One of us could actually take the time from work to go down there and stay an unlimited number of days as needed. Add in the costs of hotels, meals, gas, ect. and you now have a situation of one part of the family getting slammed financially, emotionally and physically. Yet, someone has to be there to check on things and see Mom. You've reached the point in this process where she can no longer do this on her own.
Over the last 6 months, we've seen a multitude of places and talked to numerous Directors of 'something'. We've also seen the difference between those places that take Medicaid/Title 19 patients and those that only take private pay. If you are meeting with an Admissions Director and the first question they ask is, 'How much money do you have?', think twice about going any further. If the prices aren't posted and they are writing the 'costs' on a piece of paper for you, odds are they are making it up as they go along if they know how much money is involved. You need to remember that this is a game for some of them to see how much money their facility can lock in to. I know that sounds harsh, but reality sometimes is.
Let's say that you've now reached the point where you are spending your nights fretting over the lack of information you are receiving on just what is going on with your Elder. You've tried the 'being nice' route. Sent emails and made phone calls. Yet, you are still not getting the level of communication you are looking for. At these prices, someone should be answering your questions!
We've heard so many stories from other families on this subject and yet, the facilities still don't get it. We've had situations where some of the medical professionals affiliated with places have told us or other families to file a complaint with the state and seriously look at moving their Elder to another facility. When you hear something like that, it certainly doesn't help to ease your stress.
All states have different rules on filing complaints and the timing of them. The decision that you have to make is do you really want to expend valuable time doing this? Is it going to help your Elder? Is it going to fix the problem? Try and get the facilities' chart notes to see what they are saying that they are doing when it comes to the family requests. You may be surprised to see that their story is totally different from yours. You are dealing with a business that knows how to play the game. You don't even know all of the rules of the game yet.
All that it takes is for one person at a facility that is 'in charge' to decide how to handle situations. When that person is wrong and it ends up affecting the care of your Elder, you need to act. Filing a complaint takes time and if what is happening is not healthy for your Elder, you need to step in and get the ball rolling to make other arrangements. You will also run into this problem when a facility that verbally told you upon admission that 'they can handle any type of medical situation or need' decides that your Elder is now too much for them to handle. If you are in an Assisted Living situation, one of the clues that you may have a problem is if they now ask that you hire a private CNA for 1 or more shifts due to the needs of your Elder. This is one way for them to 'price' you out of the place and get you to move your Elder someplace else.
Remember how friendly everyone was when you initally came in the door asking about availability? It's just like buying a car. Once you sign on the dotted line, they've got you. There are many ways as well as reasons these things just don't work out. Finding a good fit for the Elder as well as the family is not a one stop deal. The unfortunate thing is that you really don't know what you are getting into until your Elder has moved in.
Ask to talk to other family members of residents. There should be a Resident and/or a Family Council at the facility. Go to one of the meetings. I know that in most of these situations, you don't have the extra time to do all of this stuff. But, go into these places with your radar up and listen to that little voice in your head if you are seeing red flags. I went into one place for a meeting with the Admissions Director and the first thing she said to me was, 'Can you smell anything? See, we pass the smell test." Wow. You may pass the smell test, but how good is your quality of care?
By all means, take the time to look at the State Complaints. Ask the person that you are meeting with how they addressed these. How did their last few inspections look? Why were they fined? How did they 'fix' the deficiency? If a facility has no complaints on it, don't assume that means that they are that good. Depending on where they are, it may be a situation of no one complaining because there's no other place to go. Some States have lots of complaints via their websites, others, very few. It all depends on how many staff they have and what the state budget is for their office.
The best thing to do in any case is to take your time, show up at odd times and watch what is going on with the residents, what happens at night? Look at their staffing levels. Keep in mind that most inspections by the State are pre-arranged with the facility. Of course, they are going to have their fancy duds on. They were expecting company!
Knowing that you are putting an elderly person into a place is a lot like dropping your child off for their first day of school or daycare. The elderly person may not have the capacity to verbalize what is going on. Putting your trust in strangers is probably the biggest leap you have to take in this situation. Trust your instincts and pay attention to what's going on. If you have a doctor that is affiliated with the place, ask them what their opinion of it is. Look at the how long the staff stays employed there. Lots of state websites have this information on them. If there's high turnover of staff, that's a big red flag.
Take the time to google/search the facility on the internet. If you enter complaints followed by the name of the facility, this will usually take you to the best information. With the advent of the internet and websites, anyone can make a place look great. Pictures of pretty rooms and smiling faces are plentiful and can be posted with ease. What's the real story? Do all of us a favor and if you do find that 'perfect' place, tell the rest of us! There are some true gems out there. You just have to get through the pile of rocks to find them sometimes.
Have a great week!
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