The Courageous Process of Evaluating Nursing Homes for Your Older Relatives

Glamaris Valentín Cameron migentegrande.com

Before starting this piece, I did something I never do. As I was sitting, I started looking at the floor and touched the chair’s fabric, as if searching for the bravery, strength, and courage to write the first line. 

We can find ourselves terrified or paralyzed when considering the topic of choosing a nursing home for our older relatives. But this is exactly the opposite of what we should feel. Let’s look at it bit by bit.

The Reality of Becoming Caregivers

As caregivers (at least in my family), we are quite proactive when it comes to our older relatives. However, we avoided the decision of choosing a nursing home.

And I will tell you why. In our home, my parents enjoyed their health and independence until my father became ill at 80 years old. At that moment, my mother was 75 years old, very healthy, active, and still drove her car. So without even thinking it over or talking about it as a family, mom became dad’s caregiver. My father suffered from Lewy body dementia, a neurological condition that presents both Alzheimer’s and Parkinson’s symptoms. This condition limited his movements until he was bedridden. Therefore, mom had to assist him with all personal tasks 24 hours a day. I became his other caregiver, supporting my mom for over 5 hours, 6 days a week. But it was never enough. We both felt tired, and oftentimes I seriously doubted that we were following the proper techniques required for his care. This insecurity did not allow us to sleep properly, which is a pretty common cycle among caregivers that is very difficult to get out of.

Caregivers Aren’t Robots

At 75 years old, mom became my dad’s nurse, therapist, and nutritionist, among many other things. So, taking care of mom, as a breast cancer survivor who suffered from thyroid and neuropathy issues, became my second most important goal (after making sure my dad enjoyed a good quality of life). Even as she was used to going to the gym three times a week, there came a time when she could no longer do so and her health deteriorated. Our concern grew and we thought, “If mom becomes ill, who will take care of dad?” I knew it was my responsibility to become the main caregiver, but I needed to work, and the worst part was that I did not have the skills my mother had developed quickly. 

Marta Luz’s Father

When my mother remembered that her friend Marta Luz went through the same situation with her father, we felt a bit hopeful. Marta’s father became violent and she had to admit him into a nursing home. However, she visited him every day, bringing and giving him a freshly made (and mashed) lunch during these visits. Mom would frequently take her friend Marta to the nursing home and confirmed its hygienic conditions and the patients’ quality of life. Unfortunately, Marta Luz’s experience was not enough to calm us as wife and daughter, respectively.

Jeannette’s Mother 

Marta was not my only source of inspiration. My friend Jeannette is an only child, and her mother developed Alzheimer’s at a very young age. Without siblings, with a small child of her own, and a complicated job, Jeannette had to admit her mother at a nursing home, where she resided for decades. Unlike other people, Jeannette spoke about her mother all the time and shared her plans with the companions who worked at the nursing home where her mother lived. She was the person that would visit the home with a cake every time one of the residents had a birthday and made sure they enjoyed those moments of recreation. Her commitment to the nursing home was confirmed when a powerful hurricane passed through Puerto Rico. Jeannette dedicated herself to searching for energy generators, fuel, and food for the home’s residents. She became the friendly helping hand of the nursing home’s owner.

Even with Marta and Jeannette as examples, we spoke little of the topic at home and we never encouraged ourselves to visit a nursing home to evaluate it. I confess that this kept me in constant fear for my mom when, as dad’s main caregiver, she faced health concerns. And however much she avoided it, the moment had come. She needed a knee replacement.

Being Unable to Continue Providing 24/7 Care

As part of the preparation process for mom’s operation, I asked the health professionals hundreds of questions about mom’s recovery time. For the first time, we asked ourselves how to take care of my bedridden father. We decided that I would assist mom during her hospital stay and my brother would take care of my father at the house.

During the process, I talked with a mental health professional about the topic and they told me that: “Did you know the majority of decisions regarding older adults are made in the middle of an emergency and without time to properly evaluate every option?” Well, of course I knew; in our case, we faced problems because we did not ask the correct questions when making delicate decisions. 

How I Let Go of Fear on the Subject

From that day on, I decided to evaluate nursing homes. Not only for my parents and family members, but also for myself. After all, every human being will go through this moment. Why not face it already? It is a natural stage of life. We should maintain a positive attitude and develop concrete plans for this stage. Now I look at commercials and I listen without fear to those who speak to me about their experiences with nursing homes. I write down the names of recommended centers, and I have started saving and planning for this moment in my life. I can honestly say that I overcame my fear in relation to this issue. 

Questions that My Heart Brings Up as a Caregiver 

I do not regret feeling scared during my search for a nursing home for my parents. Even though this fear paralyzed me for a while, it helped me figure out my priorities so I could give my older parents a better quality of life. These are the questions I ask myself each time I am told about a nursing home.

Access:

Do they allow visits at any hour? Avoid places with too many restrictions unless it is due to a public health situation, such as a pandemic. We should have the option to see our family members every day.

Budget:

Does the older adult have enough income to pay for residing at the nursing home, medications, and medical services? Do you need other family members to pitch in? It is important that this topic is discussed as soon as possible, even if the adult is in a perfect state of health.

Cleanliness and general aspects: 

Visit at different hours and trust your sense of smell.

Ventilation:

Is it a cool place? Do they have air conditioning for the warm days? Do its windows open easily? 

Food:

Who will prepare the food? Is it fat free and without added sugars? Try out the meals. What is not good for you, will not be good for your older relatives.

Recreation:

Do they have activities for the residents? Do they have space for them to walk or stroll outside their rooms? Can the residents listen to the radio or watch television?

Personnel in charge of attending visitors:

Does the nursing home have an assigned doctor? How often does the doctor visit? Are the formal caregivers nurses? Do they have enough experience? How is the relationship between the administration and the employees? Is it a tense and toxic environment? The human element is always the most important. A motivated and positive personnel will always be more responsible with your older adults. The bonds that our family members create with the formal caregivers help us understand and see old age as a natural stage of life.

Experiences with other caregivers:

What comments have the residents or family members who receive services from these nursing homes written on social media? First, research with the people you know and later search through Facebook to find reviews of each place you are evaluating. Complete research on the nursing home’s owner. Verify with the authorities if the owner has a complaint or any other kind of irregularity under the name of another business.

What the Experts Say

At https://www.medicare.gov, Medicare offers a detailed list for the inspection you must perform before deciding on a nursing home for you or your older relatives. The following are among the most important questions you should consider:

• Is the nursing home certified by Medicare and are their licenses up to date?
• Does the nursing home offer specialized services, such as a special care unit for a resident with dementia or ventilator care?
• Will the nursing home notify me in writing about their services, charges, and rates before moving in?
• Will the nursing home take measures to improve the personnel’s quality or education as necessary?
• Can the residents continue to visit their personal physicians?
• Does the nursing home have policies and procedures to prohibit and report abuse and neglect?
• Is the nursing home taking measures to keep its residents safe from abuse, neglect, cruelty, or exploitation?
• Does information exist on how to inform concerns about the residents’ care and safety?
• Does the nursing home have a fire sprinkler system or smoke detectors as provided for by law?
• Are all the common areas, entrances, and resident rooms designed for wheelchair use?

In the future, I am sure that creative proposals for the long-term care of older adults await us. How does it sound if we all unite to develop a new model for cooperative homes in which every older adult’s health details and quality of life are taken into account? It is a natural stage of life and we have the right to plan and ensure its enjoyment with Mi Gente Grande. 

The author is a journalist, television producer, and editor of the migentegrande.com webpage, which offers advice for the family members and caregivers of older adults in Puerto Rico. She also built a digital directive of health and quality of life services for our elderly. Look for us on Facebook and Youtube as Mi Gente Grande and become part of our community of caregivers. For more information write us at info@migentegrande.com.