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Posted by on Aug 10, 2012 in Caregiving, Elder Abuse, Hero Spotlight, Long-term Care, Senior Health | 0 comments

My Father’s Story: Choosing the Right Nursing Home Matters

Community nursing home rights advocate, Marian Hollingsworth, shares the personal story of her father’s rapid decline upon entering his nursing home.  Marian thought she could put her trust in the nursing home to provide the highest quality of care to her father.  Had she known more about the medications commonly used and the laws that exist to protect patients, her family’s story may have had a different ending.  She now shares the lessons she learned with others to ensure that those with ailing parents are better informed of their rights and are able to ask the proper questions when deciding on a nursing facility.

I thought that I had done everything right when I chose a home for my father for what was meant to be a short rehabilitation period.  My husband, brother, and I “shopped” a number of facilities.  I looked at online reviews and spoke to friends.  The home we chose for my father appeared nice and clean.  It had a rehab room where my father would get daily therapy.  The plan was for him to get well enough to be able to bring him home.

Three weeks later, I was sitting next to my father in the ER.  He had suffered seven falls in the preceding 12 days.  His kidneys were failing due to dehydration, his mental state was deteriorated, his eyes were bright red and filled with pus from a raging MRSA infection, his nails were caked with fecal matter and he was wearing someone else’s shirt.  We lost him shortly thereafter and were left with many questions.

What in the world had happened?  I visited him every day and called regularly, so how did his rehab turn into a fight for life?  I had entrusted people to care for my father and everything had gone so wrong.  I began researching my father’s case by requesting his medical records and investigating the laws that are supposed to protect patients and ensure high standards of care. 

My father’s medical records showed that over the last three weeks of his life in the nursing home, he had been given powerful antipsychotic drugs, Risperdal and Haldol, without our knowledge or consent – drugs that carry an FDA warning of an increased risk of death in the elderly and those with dementia.   My father was also given twice the senior dose of AmbienCR, a sleeping pill known to be especially potent in the elderly.  The MRSA infection, my father’s unhygienic state, mismatched clothing, and persistent falls, all spoke to the facilities substandard basic caretaking practices.  Had I known what questions to ask of the medical staff, what warning signs to looks for, and the dangers of antipsychotic drugs and infections, my father may not have deteriorated so quickly. 

Now I offer the following key pointers to anyone looking to place a loved one in a nursing home.  I hope my story can protect just one family from the heartache of losing a parent or loved one in such an undignified, unexpected manner.

  • Visit the facility at different times of the day.  How busy do the residents seem?  Are the rehab and activity rooms in use?  During mealtime, are residents given help with their meals if needed?  Does the meal look appetizing?  In the evening, are the majority of patients sleeping or groggy?  If so, the facility could be giving unnecessary sedatives which may have harmful side-affects.
  • Talk with the staff you see throughout the facility.  Are nurses and CNAs congregating at the nurses’ station or are they busy helping patients?  Do they take the time to speak with you?  Are they able to communicate easily with your loved one in his or her primary language? 
  • Chat with the other patients.  Are they happy with the care?  Do they have to wait long after pressing the call button?  Have they seen a doctor recently?  Do you get the sense that they are relaxed and having their needs met?
  • Look for signs of abuse.  Do the residents look and smell clean?  Are their clothes and hair in order?  Do any of them have bruises on their faces or arms?
  • Speak to the actual Administrator of the facility, not the trainee administrator or the admissions person.  Ask how he/she ensures patients’ rights are followed.  Ask about the facility’s policies following CA State laws on sedatives and consent for antipsychotic medications.
  • Ask about the infection rates for MRSA and C-diff.  These infections may prove deadly.  Do they isolate patients with these conditions? 
  • Investigate the facility’s track record with health and safety regulations.  Will the administrator give you the results of the facility’s most recent survey from the CDPH – California Department of Public Health?  Has the facility recently received any citations or deficiencies?  If so, what were the violations?  Compare the answers to the official results on the CDPH website, or go to your local CDPH office and ask to see the facility’s file.

Finally, ask this trick question:

  • Ask about visiting hours.  Under CA State law, family members are not subject to the same visiting hour limits of the general public, meaning you should have 24/7 access to your loved one.  If the facility insists on strict visiting hours for family then go elsewhere.

For additional resources and information on patient’s rights see:

Your Right to Visit

Your Rights as a Nursing Home Resident

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