| Important and unusual questions
you should ask about a nursing home:
Does the nursing home automatically put the resident in diapers
when they begin their stay at the nursing home?
Experience: This seems to be either laziness on the part
of the nursing home or lack of staff at the nursing home. One parent who
went into an elder care facility was immediately diapered though she was
not incontinent and was able to walk to the bathroom on her own when she
arrived. She would still have been able to walk to the bathroom with assistance
as years went on, but in a short time she became dependent on the diapers.
Ask about the nursing home policy on this issue.
Does the nursing home help the resident wash their face every
Experience: We would find mother with "sleep" in her
eyes as no one washed her face in the morning. Ask about the nursing home
policy on this issue.
Does the nursing home help the resident brush their teeth
in the morning and after meals or check that they have done it themselves?
Experience: We found that dental hygiene in a nursing
home usually ranks low on the scale of priorities. Ask about the nursing
home policy on this issue.
Does the nursing home provide regular dental checkups?
My opinion: same as about dental hygiene in a nursing
Does the nursing home have a doctor on staff who will attend
a resident who gets the flu or other illness while in the nursing home?
Experience: Though a nursing home may have a doctor on
call, they may not actually call the doctor unless someone, such as family,
encourages them to do so. We had an incident where mother had congestion,
fever, and coughing, but the nursing home did not on its own call for
a doctor to check her or get medication. The family had to request a doctor
visit. Ask about the nursing home policy on this issue.
For a nursing home resident who becomes ill or injured while in the
nursing home, who calls in the staff doctor, and in what circumstances?
Note: Once a person becomes resident in a nursing home,
unless the family or friends can take him or her out of the nursing home
to the regular family physician,or unless their doctor makes "house
calls" to his or her nursing home, you need to rely on the nursing
home's medical staff.
Experience: Mother is now wheel chair bound. Overnight
mother got a swollen bruise on her forehead that stood out the size of
an egg with a scab. (Really more than an inch!) The nursing home could
not explain how it got there. Mother lay in bed "sleeping" for several
days and eventually awoke. During that time we called in the family fearing
the worst. The nursing home told us it would not be fatal. The extended
lump remained there for over two weeks. No medical attention was provided.
We finally requested a doctor visit with family present. We had to ask
the doctor to lance the bump to relieve the pressure. He did so and mother
What kind of clothing should a nursing home resident wear?
Opinion: What a person usually wore at home may or may
not be a good choice of clothing for life in a nursing home. Loose fitting,
easy neck opening clothes are good. If an aid helps dress a person in
a nursing home, be mindful that they have a lot of people to help dress,
and may do it with more haste than you might take in dressing the person
yourself. Rips and tears may occur. And if the person who is being dressed
has little ability to help in the process, it could hurt to have a tight-necked
garment pulled over the head. A shirt or blouse with buttons may need
to be a size larger for someone wheel-chair bound.. If the person is diapered,
you may need to get them size larger pants, as the diapers are quite bulky.
Dresses or even shifts and mu-mus don't seem to work for a ladies day
in a wheel chair, though they may work for a lady who uses a walker and
has the ability to dress herself. Most nursing homes will attend the residents
who need help getting up and dressed each morning - usually no sleeping
in or staying in your pajamas all day! Ask about it!
What do the residents do between scheduled activities in a
Observation: One of the saddest things to encounter in
a nursing home is a hallway lined with wheelchairs and people sitting
and staring at the walls. Many older people do not seem to want to make
new friends with other residents in the nursing home and though they sit
wheel-chair to wheel-chair, they are isolated. Sometimes one does not
hear well or the other is not able to speak well so they can't communicate
easily. Of course it is hard to have something to do or see all the time
for residents, but some options nursing homes of the future should consider
Ask the nursing home what they do with residents between structured activities.
I urge you to suggest these considerations at a nursing home and together
we may change the future of nursing home care. If your nursing home does
provide continuous visual stimulus, give it a gold star. I don't think
all day elevator music counts for much.
- A place for residents to look out of the building at trees,
nature, traffic, or people in the "outside world".
- Provide large-screen really old movies in the cafeteria
or dining room.
- Provide large-screen travel-logs
- Provide large-screen history or nature programs.
- Provide music of the 20's, 30's and 40's over the speakers between
activities or at certain times during the day.
Observation and Experience: We have found in our two
experiences that the nursing home environment encourages the resident
to get lost in thoughts and memories during unstimulated periods during
the day. To some extent, it's nice to reminisce, but long periods of reminiscence
seems to lead to withdrawal from life today. If the resident is not interested
in Bingo, or other programs offered by the nursing home, or refuse to
attend the programs, they are usually left on their own. Ask about this
too. We provided mother and father (different nursing homes in different
years) with a television. We have visited in evenings when mother has
been placed in front of her television in her area of a shared room, but
the television was not on!
How do nursing home residents get around in the wheel chairs
Observation: The wheel-chair shuffle! Older people in
nursing homes have found that using the extra wheel-rim for getting around
is hard on the arms and many people do not have the strength for it. The
practical way to move your wheelchair is to lift up the footplates and
do a little foot shuffle to move about. It really works quite well even
for folks who really can't walk but have some use of their feet.
Does the nursing home move residents to new rooms at will?
Experience: Now that mother is on Medicare after more
than 5 years in the nursing home, the nursing home moves her from room
to room when they feel the need. They do not consult us. We do not have
a choice. She began in a two-bed room at the window. She has been moved
several times (sometimes to a different floor) and we have been surprised
when we came to visit. She is now in a 4-bed room with a roommate who
appears to be quite disturbed from time to time. Ask about the nursing
home policy on this issue.
What is the procedure in a fire?
Experience: We were upset to find that though there are
3 elevators in the building and one fire staircase, the plan is to close
the fire doors on each floor and wait. We observed there was no way the
staff could get all the people out of the upper floors in case of a fire
or other emergency in any reasonable time anyway. Usually elevators are
not to be used during a fire.