Issue 6, September, 2007
FEATURE ARTICLE - Maximizing Income and Assets for the Spouse at Home
HEALTHLINE - Medication Safety
LEGALLINE - Report Criticizes "Free Lunch" Seminars Aimed at Seniors
CAREGIVER HELPLINE - The Caregiver as Advocate

The Caregiver as Advocate

The Caregiver as Advocate

When a loved one can no longer be taken care of at home, a nursing facility may be the next step in the "caretaking continuum." Although the actual day to day needs of your loved one will be met by others, there is still a need for you to monitor and manage the care provided to make certain your loved one is receiving the best possible care. Although facilities may try to manage the care of their residents in the best way possible, problems can and do erupt. Some of these include:

a) unanswered call bells
b) use of restraints
c) toileting problems
d) bed sores and other preventable infections
e) malnutrition and/or dehydration
f) sexual assault/physical abuse/emotional abuse
g) medication errors
h) lack of meaningful activity
i) inadequate or unqualified staffing
j) bed transfer issues

Residents can feel helpless when staff does not respond to requests for assistance, and call bells should be answered right away. It is illegal to use physical or chemical retraints for staff convenience; they must be ordered by a physician, with the length of time specified. Residents' individual needs for toileting should be accommodated, as much as possible, to prevent incontinency or urinary tract infections. Soiled bedclothes and linen can contribute to bedsores. The proper amount of fluid should be provided, and assistance given, if necessary to consume it. Dehydration can be a dangerous health risk. Poor nutrition can be caused by several factors, including depression, unappetizing food, and difficulty cutting food. Bed sores can be avoided with proper nutrition, hydration, cleanliness, and change of position of the resident every two hours. Abuse in a facility can occur from a staff person, another resident, a family member, or a friend. Bruises, scratches, and signs of neglect need to be addressed. Giving the wrong medication or the wrong dosage can have dire consequences for a resident. Lack of activity can foster depression and diminish quality of life. Staffing problems can be a major concern in providing the best overall care to residents. A resident must receive notice of a pending transfer to another bed or room, but has the right to refuse.

You should have realistic expectations about a facility and learn how to partner with the staff to ensure a high quality of care. However, any time that you place a loved one in the care of others, there is always the possibility of disagreement, no matter how sensitive and caring the staff. Some disagreements may be a simple misunderstanding or difference of opinion which can be resolved by discussion with the appropriate staff member or their supervisor. Other problems may be severe and require attention and advocacy at a higher level, or in the worst case, turning to the authorities for resolution.

It's important that you know your loved ones legal rights in connection with care in a long term care facility.

The Federal Nursing Home Reform law, as well as state law, outlines certain rights for all residents of nursing homes. A facility must post these rights in a highly visible area within the nursing home. Each state is required to have an "ombudsman" assigned on the county level. The facility should display the contact information to reach the county ombudsman's office. An ombudsman is a resident advocate who can act as a link between the resident and the facility and plays a vital role in promoting the rights and needs of the nursing home resident.

Ombudsmen are trained to resolve problems in ways that prevent retaliation against the resident. They advocate for the residents and monitor compliance to laws and regulations in the facility. They investigate and resolve complaints made about the nursing home and provide information about recent nursing home surveys and current licensure status. In Pennsylvania, the Pennsylvania Department of Health is responsible for surveying nursing homes to ensure they are following regulations. Surveys now include information from residents, family members, and the ombudsman. You can also file a complain with the Pennsylvania Department of Health, if the ombudsman is unsuccessful at resolving your problem.

If you feel that your loved one's situation has not been adequately managed by the nursing home, the ombudsman, or the Department of Health, you may choose to contact an attorney to pursue protection of your loved ones' rights.

Copyright © 2004-2009 Levandowski & Darpino, LLC. All rights reserved.

The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for individual advice regarding your own situation. Copyright © 2009 by Levandowski & Darpino, LLC. All rights reserved. You may reproduce materials available at this time for your own personal use and for non-commercial distribution. All copies must include this copyright statement.