I will strengthen the house of Judah, And I will save the house of Joseph, And I will bring them back Because I have had compassion on them; And they will be as though I had not rejected them, For I am the Lord their God and I will answer them. –Zechariah 10:6
Happy Wednesday, friends, family, and countrymen! 🙂 Ready to saddle up to the cornbread trough and discuss a challenging topic? Me too… This is a topic we have been weighing for some time now, but especially so since we get so many texts saying that there is a brand stinkin’ new outbreak and that visits will stay outside in the elements, if at all, for another X number of days. The nursing home has extremely low vaccination rates among staff, so it isn’t surprising when the virus appears….but it has been 573 days of Shawshanking since we could come and go as we choose with our loved ones… and the cure (not visiting) is seeming worse than the disease these days. Mom’s time is very limited… Think of this as a chalkboard with plusses and minuses on it and we, as a community, need to fill in. So off we go, and I welcome your take on this too.
When is the Right Time to Change Nursing Homes?
- Time– Mom’s safety was the primary reason we placed mom in nursing care. If one nursing home ceases to be safer than it should be, it is worth considering changing. This is very hard, though, because of the “few bad apples” principle and the staff shortage epidemic. All it takes is a few folks to blow the curve on safety. Here are some links to help compare safety although every nursing home is required to have publicly-available accident reports, often in a binder at the front desk: LINK LINK LINK (Most states have similar). I wish this decision was easier…
- Not time– We were on a waiting list for one of the best memory units in our region…and she finally made it to the top. However, when they called us to tell us the good news, mom was doing very poorly. Unless there is a serious safety concern, moving a patient after they have been used to one place for over a year, can cause significant short-term issues. Remember the 50 articles here in which I have mentioned that routine is critical? Replace everyone and everything they know with brand new versions and expect hardship…and it just wasn’t worth it. This is an individual choice based on unique circumstances…no easy rule here…
- Time– Social isolation in seniors has the negative health consequences as approximately smoking 15-20 cigarettes a day (depending on which source you read…). Bottom line: being alone is bad for us. Very. If your nursing home has few or no activities, is prone to leaving residents in the hall or in their room with no interaction, and is Shawshanking the world out because of Covid-19, it may be time.
- Not time-High turnover is so common, I have a hard time saying high turnover is a solid reason why to move your loved one. A core of staff should be present that is long-term. Leadership should be long-term. There should appear to be opportunities for advancement as best you can tell as well. However, this is a challenging reason to move because, while it stinks, it is desperately common.
- Time– Billing is haphazard- Is your monthly statement challenging? Does it seem accurate? Are they open to discussing it or are they defensive? These issues can rise to the level of needing to move. Medicaid covering everything including overbilling should be a “civic duty” reason why to report them and to move. Not managing money correcly or doing so in an illegal manner likely means care is also at risk at best.
- Not time– Your friend’s uncle that hd a bad experience- While stories can factor in, remember that people come and go and the law of averages states that there will be some with bad experiences/outcomes. Find overviews and bigger trends and compare them… Is it isolated or a recurring theme?
- Time– Med issues- Ugggh….don’t get me started. Medicine accuracy and deployment should be a given. I am certain mom, at times, got wrong medicine. I prevented it a few times back when we could visit. I can only assume the propensity to have that happen with no oversight is higher now with little or no accountability than it was when we were there multiple times per day every day. How can you tell now that you are restricted? Good question. 🙁 Some nursing homes, I feel confident, steal meds while others overmedicate to make their work easier…both very illegal and a solid reason to bail….
- Not time– Guilt- If you move your loved one every time you feel guilty, you will move them every stinkin’ day. Do yourbest to find the right place, be prepared to move them if needed, but then give yourself grace. Guilt is seldom a healthy/stable motivator.
- Time– If leadership and/or staff treats you as a disruption instead of a partner, it may also be time. This may come and go, but you will know when this becomes too much a trend.
- Not time– If a senior spouse, especially if they are already advanced in age and not as healthy as they could be, is the only option for temporary care, please use caution. It is very common for a loved one caring for a patient to become sick themselves.
- Time/Not time-Covid rates vary and, if you search hard enough, you can find the rates per nursing home. Scroll to the bottom of this site to the map and find your nursing home to see how it has done in fighting the pandemic: LINK. It CAN be a sign that a nursing home is lax in sanitation and/or requesting employees are vaccinated if they did poorly, but don’t be too quick on this one because it is so contagious, even among the vaccinated. However, a Shawshank lockdown AND still having cases every week is a bad sign and worth considering moving them…and that is where we are.
These are hard issues. I like many folks at my mom’s nursing home as do you with your nursing home. However, we remain the biggest advocate for our loved one and we have to be willing to lose a friendship in a nursing home in exchange for better care…
What other considerations can you come up with? What am I missing?
Update- Mom was awake a few times yesterday during the short visit. She is becoming more rigid, a sign of the continued progression of the disease… I hate this for her and wish I could fix it. We have considered a hundred times moving her out and we value your experiences and wisdom.
I wish this was a more fun topic…but you can’t gussie it up…it is the poo it appears to be.