The doctor said it’s time – your mother either enlists 24-hour nursing care or she could hurt herself, left alone at home. How can you find the right nursing home in North Carolina? If your mother continues to live alone, a stove burner left unattended could prove fatal. Walking around the house or negotiating stairs could result in a broken hip and a permanent convalescence.
Shepherding children to school and sports activities, plus a full-time job with a long commute leaves you no time to care for your mom at home. Now what? You’ve heard the woeful tales of nursing homes – residents found unconscious in their rooms after staff had failed to check on them; senior residents wandering away half-clothed and ending up miles away; residents sexually abused, beaten and robbed by staff.
When searching for a nursing home, carry the checklist below created by our Raleigh nursing home abuse lawyers:
- CARE LEVELS – Make sure the facility offers independent assisted living and nursing care. As your loved one ages, their needs increase. The transition is easier when they can move “within” a facility rather than “out” of one.
- ODORS – Incontinence typically develops as we age. Urine odors should be contained within an apartment or bathroom. The smell should not permeate hallways, elevators or lounges.
- DINING – Eat a meal in the cafeteria. Be certain the food is served hot and the contents are nutritious. If your loved one has Type I or II Diabeties, the food service manager should provide meals low in sugar and carbohydrates. Look to see the self-serve food line, is it easy to negotiate? Would walking with a tray be cumbersome?
- BATHROOMS – Are there handles on the walls near toilets, sinks, tubs? Is the area well-lit? Does the toilet have a seat supplement? If the seat is too low, one may have trouble rising from it. Is there a call button nearby in case one becomes stranded?
- OUTDOOR AREA – Are there benches? If so, are they in the shade? Are the wrought iron feet of the benches anchored into the concrete? If those feet are not, they may slide and cause falls. Is the green space landscaped? Is there a separate area for smokers?
- STAFF – Do staff attendants appear to be doing their jobs or is there excess socializing? Are there enough staff? Are employees fluent in English, Spanish, or the language your family needs? It’s hard enough for the elderly to hear, but if a staffer can’t communicate in English, care may be compromised. Trail an aide down a residence hallway and listen in when the staffer is inside a room with a resident. Make sure there is two-way communication. Is the staff attendant helpful? Speaking loudly is ok, berating or admonishing isn’t. Make sure the nursing home has bonded staff. Some people take jobs in nursing homes to prey upon the elderly.
- LISTEN! – Do call alarms ring unanswered? If so, whomever is summoning help isn’t getting it. Walk in an empty room and try the alarm yourself. It should be functional. Hear repeated calls or crying from residents? This behavior can be typical, but make sure staff at least respond. Sit with a magazine near the staff office and open your ears. Is there persistent laughing? Is there loud music? Is there arguing? Remember, people should be working.
- PUBLIC LOUNGES – Are furniture and carpeting clean? Is there a television or radio on for the residents? If there is music playing, make sure it’s appropriate for senior citizens. Are there windows? If there is a door to a courtyard, make sure it doesn’t lock from the outside. Again, is there a bench in the shade? Sitting in the summer sun isn’t ideal for the elderly.
- HALLWAYS – Are they well-lit? Are there railings on both walls? Are room numbers clearly marked?
- ELEVATORS – Is the button panel easy to read? Does the door remain open long enough for someone with a walker to exit? Does the elevator car floor stop level with the hallway? Are there railings inside the car? If there is music playing, is it appropriate?
- PHYSICAL THERAPY: Are there therapists on staff? Does the PT room accommodate many patients simultaneously? Does the equipment seem old or broken? Are the foam-rubber tables clean? Is the floor free of debris? Again, is the room well-lit? Do therapists seem patient when working with the residents? They should be. Being firm is fine; barking is not.
- DOCTORS – How often does one visit the nursing home? Introduce yourself to this doctor to see if you approve. Conduct a background check on the doctor online. It costs as low as $25 but you will receive a comprehensive complaint report, if one exists.
- BUS/VAN -- Does the facility have one? Does the van make regular trips to a shopping center. If so, make sure the center has a grocery store, card store, bank, drug store and hair salon.
- TAXI – Service should be punctual and discounted for the elderly. Ask your loved one how their ride was. Ask about the driver. If there was a problem, you will have an inkling if something was wrong. But you have to ask!
- STORAGE – Visit the area. Is there sufficient space? Is it well-lit? Does it smell like a musty basement? Is the room locked? Did you feel safe there, alone?
- PHARMACY – If needed, do staff deliver medications to individual rooms? Does the pharmacy call a resident who has failed to pick up required medications?
- FITNESS CENTER – Does one exist? Is there staff to assist residents on fitness machines? There should be. Does the equipment have seat belts? Visit the center to watch how the staff interact with residents. Monitor ‘touching,’ which occurs when one is demonstrating exercise routines. Make sure private space is respected, regardless of the staffer’s sex.
- SECURITY – Are there guards on regular duty? Does entry to the building require a swipe card or call button? Can any “Joe Q Public” just walk in and head toward the elevator? In 2004, a man claiming to be a minister walked in with the Bible in hand. When upstairs, he was found fondling elderly, female residents. Remember, residents can’t fight for themselves. They are afraid to be the whistleblower. So you have to ask probing questions.
- EMERGENCY – Is there a sprinkler system? Is there an intercom? Are fire escape routes posted? If not, that is unlawful. Does every room have a 24-hour call button?
- COSTS – Does Medicaid pay when Medicare coverage expires?
- GIFT SHOP: Is there one? Does it sell stamps and greeting cards? Is there a place to mail letters?
- SNACK SHOP: Does one exist? Do they sell nutritious items such as bananas and orange juice? Are tea and coffee provided?
- LIBRARY: Does one exist? If so, does it carry books with large print? Are the shelves prohibitively high to reach a book? Is there a staffer to help a resident find a book? Make sure the door to the library remains open. Libraries are usually quiet and walking spaces between book stacks can be remotely located from the general public. Again, be vigilant for any wrongdoing.
- SPECIAL EVENT CALENDAR: Most nursing homes have a social coordinator for: Bingo, guest speakers, films, card games, Mass, pet therapy, singing groups, visiting professors from a college/high school are interesting functions. Make sure the facility does background checks on those entering the facility. Again, this is a haven for scam artists who want to steal from or abuse the elderly or disabled.
- IDENTITY THEFT: Look at your loved one’s mail. In 2002, a ‘temporary’ employee at the front desk opened a resident’s mail and stole a Social Security Number. From there, three separate retail accounts were opened. The bills were charged to the resident. Learn who handles the mail. Make sure the person is responsible. Letters contain valuable information that translate to quick cash for a thief.
- THEFT: Do not allow your loved one to keep large amounts of cash. The elderly are often not lucid. Keep track of who have “access” to your loved one’s room. Your loved one is not the only one with a key. Facility by-laws allow a duplicate room key to be kept in a safe location, in case of emergency. Make sure only the responsible have access to that key.
If your loved one’s stay in a nursing home or rehabilitation center is temporary, your watchdog days are not over. Many times, staffers seek to moonlight on an outpatient, caregiver basis. Health aides, nurses and physical therapists are to be watched when working in your loved one’s home. Remember, at home there is zero supervision. Plus, the chances for theft increase dramatically.
If your loved one needs assistance at home, it is your job to interview caregivers. Make sure they are licensed to do their job. Ask for references. Better yet, “drop in” unexpected when this person is scheduled to be working there. Ask your loved one personally if everything is okay with a new caregiver. Demand honest answers. Look around the house to make sure valuables you know of haven’t disappeared. If you have surveillance cameras, watch the tapes. If there is a theft or any form of abuse you will have it on tape, which is solid evidence in court.