By A. J. Pompano
Just as their nest empties and the kids can take care of themselves, more and more Baby Boomers are finding themselves with a challenge they might not have planned on. The care of aging parents can become a major responsibility as those who once nurtured you gradually lose their ability to cope with day to day activities. Even if they enter a nursing home or assisted living facility, they still need critical support from you.
Many people, new to the experience, assume that when a parent enters a nursing home or assisted living facility the hard job is over - professionals will take over and you can assume the role of cheerful visitor and perhaps financial conservator. Unfortunately, this transition really means that you must learn to embrace a new role as advocate. As I have found out the hard way, this new role is a critical and sometimes difficult challenge.
Case in Point: from DNR to Walking on Stage to Receive a Special Award
There are several issues which crop up in nursing homes. One of the biggest is medications and interactions with doctors. The family has the right to know what meds are given and why. Ask what the side effects of each medicine are. Some meds make the patient unsteady and at risk of falling.
A case in point is my father, who resides in a highly rated nursing home. When the staff alerted me that he may have had a stroke, they had me speak on the phone to the covering physician. He never saw my father, but as he reviewed the records he told me, “He has a do not resuscitate order and suffers from Alzheimer’s. Considering quality of life, if he had a stroke the nursing home is the best place for him.” He didn’t recommend any treatment or further evaluation. I insisted my father be brought to the emergency room. When I got off the phone, a nurse who overheard said “Good for you, I would have done the same thing.”
Not all, but some, doctors may look at “quality of life” from a more academic (or possibly realistic) point of view than family members do. Don’t be afraid to stand up to the doctor. If you don’t agree, say so.
At the ER they had a similar attitude but said we could “put him through” a brain scan if I insisted. I did. The conclusion was no stroke, and a medication adjustment was needed. Four days later he was stable enough to walk on stage to receive a World War II Service Award from the Connecticut Secretary of State, which gave him a great deal of pleasure. The point is, quality of life is relative.
Interactions with Staff
Nursing homes periodically have care plan meetings. Go to them. Besides medical treatment, other issues that can be discussed include hygiene and safety.
If after bringing up concerns you are still not satisfied, it may be time to bring in an ombudsman. The Long Term Care Ombudsman Program was established by the federal government in 1973. The program looks into complaints and assists residents in resolving concerns with nursing home staff. In Connecticut you can find more information about the program at the CT.gov website. http://www.ct.gov/ltcop/site/default.asp
Pick Your Battles
A word of caution; just as with our children, it can be difficult to be objective in dealing with issues concerning our parents' care. Be sure to pick your battles. If you complain about every little thing, you will be tuned out. Use common sense and then speak up if you think something is not right. If done in the proper manner, most nursing homes actually encourage this. Remember, your parent is not the only patient and even in the best of nursing homes things can be overlooked. If your parent needs an advocate, it’s up to you to be visible and vocal.
Thanks to A. J. Pompano for his insight on this important topic. His website is ajpompano.com
By Families, For Families Guide to Assisted Living