Tuesday, June 5, 2012

My Grandmother and Nursing Home Care


            After my grandmother, Estelle, broke her hip just over two years ago, it wasn’t long before talk of finding a suitable nursing home came to be a common topic of conversation between my parents. At 91 years old, she was one of the oldest inhabitants at her apartment community for “active seniors” in West Palm Beach and it was no surprise to any of her friends and neighbors that the time would soon come for her to need more help.

            Just after surgery and a few months in a rehabilitation facility, Estelle was ready to move to a long-term care nursing home. In anticipation of this move, my family had put her name on a waiting list at a few nursing homes in her area; however, when the time came for her to leave the rehabilitation center there were still no open spots available. My family panicked at the thought of Medicare ending payment to the rehabilitation facility and us having to pick up the astronomical bill for a prolonged residency while we waited for a bed to open. The wait was excruciating for both my grandmother and my parents as beds came and went due to management’s confusion and incompetent staff whose correspondence with Medicaid made the wait that much harder. 

            Finally, we decided that my grandmother should move to an Orlando nursing home so we could more easily advocate for her care from a greater proximity. While waiting for an open bed at a local nursing home, the director of the facility kept in constant contact with my family to update us on the status and presumed availability of new beds. The director’s personable nature really helped my family to see the facility as one that really cared about its patients and their families. One day, a staff member alerted my parents to a bed that would be ready in the coming week, yet when the director called to give us more information, we learned that he did not think the roommate would be a good match for my grandmother because the woman had a long history of past roommate troubles. Unlike stereotypical nursing home directors, anxious to fill beds, this director seemed to care more about my grandmother’s well-being. 

            Once a suitable bed opened up and my grandmother entered the facility, we were pleasantly surprised at the quality of care present in the nursing home. The staff always seemed to be friendly and helpful, something Estelle loves. Additionally, a nurse always responds to our calls and concerns in a timely manner. My parents have even had numerous phone conversations with my grandmother’s main doctor over our wishes to provide her with dietary supplements that were not prescribed by one of her doctors. The physician’s willingness to work with us made my grandmother’s transition into the nursing home as easy as could be. 

            What worries me, however, is the quality of care provided to patients who do not have strong advocates, such as parents like mine. Estelle’s roommate, Mercedes, is one of those patients. Although Mercedes’ daughter lives less than an hour away, she is rarely present for Mercedes’ medical appointments and to oversee treatment. Although her quality of care seems to be good, there have been instances where my father has had to step in and speak with a doctor on her behalf due to her inability to know what is best for her. It seems that there should be an advocate, independent of the nursing home, available to provide information to patients and act on their behalf on a daily basis. These advocates would provide assistance to those patients who may have trouble asking for help on their own.  

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