During my legal career as Florida nursing home abuse and neglect attorney, I have seen what bad care looks like. I have also seen what causes bad care to occur. This back ground has given me insight into how to spot signs of abuse and neglect. By knowing what to look for, you can reduce the chances of a loved one being abused or neglected. I want to help you ensure your loved one gets the best care possible in a nursing home. But before I can do that, you have to know the cause of most bad care.
I continue to believe that most Florida Nursing Homes provide good care to their residents. In addition, most Florida Nursing Home staff are hardworking people with good moral character. They generally care about the residents and want to do the right thing. However, some smaller Nursing Homes do not have the financial resources to provide necessary care. In addition, some larger Nursing Home chains are too focused on profits over people. There is nothing wrong with making a profit. The profit motive built this country. But sometimes excessive profit can come at the expense of providing quality care. The bottom line is that there is a big difference between making a product and providing health care to sick and elderly people.
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In a Nursing Home, there are some people that are paying to stay at the Nursing Home out of their pocket. But most reimbursement is fixed by government controlled Medicare and Medicaid programs or Long Term Health Care insurance companies. There is simply no way to make more money by raising prices. In fact, the only way most Nursing Homes can increase their profit is by cutting costs. In addition, the largest component of cost in a Nursing Home is the cost of staff. By paying staff less or having less staff on duty each shift, the Nursing Home can substantially lower costs and therefore increase profits.
The problem with this approach is that lower paid staff are often less qualified. Furthermore, having less staff on duty often means the staff has to cut corners or simply not provide necessary care because there is not enough time for the limited number of staff on duty to get everything done. There may not be enough time to bathe all residents, clean incontinent residents, turn and re-position bed-bound residents, get residents that are able to up and out of bed, ensure unsteady residents get help walking, and timely respond to resident call lights. This lack of time means not everyone gets the care they need. Sometimes this means the resident is inconvenienced. Other times it means real harm comes to the resident.
The surest way to ensure your loved one is not the victim of abuse or neglect in a nursing home is to visit often and stay for long periods of time. When your present and there is not enough staff to get to all the residents, the staff will naturally choose to provide the care to your loved one over the resident with no family members present. It’s that old saying “Out of sight out of mind”. In the Nursing Home context, this means that when family does not visit a resident, the staff knows the resident will have no one to advocate for that resident.
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Nursing Homes have 3 shifts. 7 am to 3 pm; 3pm to 11 pm; and 11 pm to 7 am. Each shift will have its own set of regular staff members. If you only visit during the same shift each time, then the staff members from the other shifts will not know you are an involved family member. I know it’s tough. Especially if your working. But try to show up from time to time on all shifts. Also try to visit during meal time.
Its human nature. We all try harder to help people we know and like. Nursing Home staff members are no different. They gravitate to people they see frequently. By getting to know them and showing an interest in them, they will take notice. Engage them in conversation whenever you visit. Take an interest in their lives. Show your appreciation for their hard work and effort. If you do this on a regular basis, they will go out of their way to look out for your loved one.
What works for the staff works for management as well. After all, they are people too. The main management personnel in the building are the Administrator and the Director of Nursing. The Administrator is in charge of the building and all of the staff. This is the person that runs things inside the building. The Director of Nursing is also called the DON. This person is in charge of all of the nursing staff.
There are simply too many people for the Administrator and DON to know every resident and every family member. But if you take the time to get to know them, they will certainly know you and your loved one. And just like the staff they will be more likely to look after your loved one.
Florida law requires every Nursing Home to create an individualized written plan of care for every resident. The plan of care is put into place within days of your loved one entering the facility. During the care plan process, the Nursing Home staff identifies your loved ones risks and needs. Then they come up with a plan to minimize the risks and provide for the needs. In order to do this, they must evaluate your loved one to see what they need. As part of the process there is a care plan meeting. A representative of each discipline caring for your loved one attends the care plan meeting to discuss your loved ones needs. A care plan meeting usually occurs every 90 days and when there is a significant change in condition. You can and should attend these meetings. By going to these meetings, you can provide your input on what your loved one needs. You can also relay any concerns you may have from your frequent visits.
Many Nursing Homes have resident Council meetings. These meetings are resident run events to discuss concerns about the facility, develop suggested changes within the facility, and plan activities. Going to these meetings will give you an opportunity to discuss any concerns you may have about the facility and help develop solutions to your concerns. It will also give you an opportunity to identify other residents that may be
experiencing similar issues.