October 2011 Archives

Guidelines to Selecting A Nursing Home for Your Loved One

October 24, 2011

As a nursing home abuse and neglect lawyer, one of the most common questions is, "how do I choose the right nursing home for my loved one?" Unfortunately, there is rarely an easy answer to this question. However, there are some important guidelines listed below that I believe will assist in selecting the most appropriate nursing home for you or your loved one.

Make a List:

Similar to any other big decision in life, there is no substitute for doing your homework and acquiring as much information as you can. Start by making a list of the nursing homes in a community close to relatives, friends and/or people that will visit your loved one while in the nursing home. To obtain a list of nursing homes, you can contact your local California Department of Public Health District Office. Alternatively, California Advocates for Nursing Home Reform maintains an online nursing home guide that is very helpful.


Although mentioned earlier, location cannot be stressed enough. If at all possible, you should always select a nursing home that is convenient for those who will visit your loved one the most. It is a proven fact that nursing home residents that enjoy frequent visitors are happier and healthier. It is also true that your loved one will likely receive better care if there is somebody constantly monitoring the environment.

Medicare/Medi-Cal Issues:

Nursing homes are expensive and ability to pay is often a concern. It is estimated that the daily cost for a nursing home is approximately $6,000.00 per month. As a result, many will need the assistance of Medicare and/or Medi-Cal to help offset the high cost. If this is a concern, either now or in the future, it is important to locate a nursing home that participates both Medicare and Medi-Cal.

More Homework on the Nursing Homes That Have Made Your List:

Every nursing home has a public record maintained by the state Department of Public Health. Contact your Department of Public Health District Office to review the most recent surveys and inspections. While you are there, take a few moments to review some of the complaints that have been lodged and the results of the investigation. Each county has an Ombudsman Program that provides advocacy services for nursing home residents. You may also contact your local Ombudsman for any additional information they may offer about the nursing homes that have made your list.

Visit the Nursing Home:

Now it is time to visit each nursing home on your list. Here are some tips/ideas you may consider during your visit.
• Ask to see the entire facility - not just he lobby and unit they show you.
• Observe staff and resident interactions.
• Observe resident-to-resident interactions.
• Does it appear home-like or like an institution.
• Speak to residents who live there as well as their families.
• Try to visit more than once at different times.
• Visit during mealtimes and observe residents eating in the dining room.
• Look into what activities are offered (ask for an activity calendar).
• Ask how many residents on average each nurse is assigned to.
• Ask about access to emergency care, dentists, podiatrists and eye doctors.
• Make sure they offer the services you require.

As you can likely tell, finding the right nursing home for your loved one is not a simple process. But it's probably one of the more important decisions you will make in your lifetime. All of the guidelines listed above are important to assist you in making such an important decision. Once your loved one is placed in a nursing home it is critical to make personal visits as often as possible. You may strategically choose to visit at different times, so the staff doesn't know when to expect you. If you run into a problem, speak to the Director of Nursing or the Administrator of the facility immediately. If you are unable to resolve your issue within the facility, contact your local Ombudsman office or the Department of Public Health for additional guidance. Just remember, many of our elderly population are vulnerable and you may serve as their only advocate.

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Nursing Home Neglect Continues to Result in Life Threatening Bedsores

October 12, 2011

Contrary to what the nursing home industry wants us to believe, bedsores can be prevented. A bedsore, also commonly referred to as a pressure ulcer or decubitus ulcer, is basically an injury to the underlying tissues of the skin. They most often occur when an individual remains in the same position for an extended period of time, creating prolonged pressure that affects the necessary blood flow and nutrients to the skin.

Residents in nursing homes are often at most risk because many of them have medical conditions that limit their ability to move. The necessary pressure to create a bedsore can result from sitting or lying for a prolonged period of time. People in wheelchairs often suffer from bedsores on the tailbone, spine, and the back of their arms or legs. For those that are bedbound, they often occur on the heels, hips, ankles, shoulders or their head.

The number one key to prevention (and treatment) is relieving pressure. This can be accomplished most effectively by repositioning a person regularly, particularly once a bedsore has developed. A second strategy is to ensure the appropriate support surfaces are utilized. There are all types of special mattresses and cushions that are designed to relieve pressure.

Once you recognize a bedsore, you should contact your doctor immediately. Bedsores can often resolve with appropriate detection and treatment. Aside from relieving the pressure, your doctor will access the severity of the bedsore and likely consider removing any damaged tissue and/or cleaning and dressing the wound. It is also critical that a patient maintain nutrition and hydration to promote health skin tissues.

If you or a loved one reside in a nursing home, detection of the skin should be a routine part of care. Unfortunately, all too often we see patients that suffer from bedsores due to neglect or lack of an appropriate care plan. The following are just a few of the precautions and safety measures that should be taken to prevent the formation of bedsores.

• Periodic reassessment of the patient's risk;
• Appropriate bathing routine;
• Constant nutrition hydration;
• Repositioning to relieve pressure; and
• Use of appropriate support surfaces.

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