Archive for Wednesday, June 20, 2001

Seek information when choosing a nursing home

June 20, 2001

Patricia Maben practices what she preaches.

Her children know her wishes concerning end-of-life issues, including her views on nursing homes.

"We've had a very open discussion about what my wishes are," said Maben, who is director of the long-term care program for the state's Department of Health and Environment. "Most people don't do that. I feel a great deal of comfort in that."

She believes that Kansas has some exceptional nursing homes among the 312 homes in the state and 63 long-term care units in hospitals.

"We are considered one of the tougher survey agencies in the country," said Maben, who's worked 12 years for KDHE. "We write about six deficiencies, on average. The national average is 5.5. So you can see, we're pretty strict. I would much rather have a loved one in a nursing home in Kansas."

To people interested in tracking down information about nursing homes in Kansas or other states Maben suggests two federal government Web sites. These sites contain checklists for consumers, as well as information on nursing home inspections throughout the country.

"There is a tremendous amount of information for the consumer at these sites," Maben said.

Maben also offered these tips to people searching for a high-quality nursing center:

Pay a visit. "First, call and get the official tour," Maben said. "They should get information about the rates and basic information about the services this facility offers," she said. During a tour, Maben said, "Look around. Are residents involved in activities? What's the noise level? Is it quiet, subdued? Do people appear to be enjoying themselves? Are staff and residents talking with each other? Is the place clean? Unfortunately, a number of consumers and family members look at the dr, not at what's going on."

Make a second, unannounced, visit. "Sunday traditionally is the lowest staffing in a nursing home," Maben said. "Go at a meal time. Evening meal is what I prefer because that tends to be a lighter meal." Visitors should note whether residents are being assisted with their meals. "Or are they looking at the plate? Are people talking to each other? Are staff talking with each other and not to residents?

"You can tell a lot about a nursing home just by the feeling when you walk in. It's amazing."

Read the reports that the state issues on nursing homes' inspections. These inspections, called surveys, are completed annually. And they're available in each nursing home, as well as on the federal Web sites.

Talk to friends and relatives who've had experience with nursing homes. "It's like any other customer service," Maben said.

Know what your relatives prefer, before a crisis strikes. "In this state, the only person who can sign an admission agreement is the resident, their guardian or their durable power for health-care decisions," Maben said. "It is a very stressful thing. If they say they don't want to go in, you can't admit them. Most families do not sit down and talk about these things. There needs to be some dialogue about how you want to handle end-of-life issues. That needs to be discussed among the family. Designate a person to act as your agent if you can not make decisions. I would select the person to do that, rather than leave it up to chance."

Maben said several nursing homes in Kansas are on the cutting edge in the industry. They are moving to smaller units that contain 12 to 16 residents. Staff members are assigned to the same residents each day.

"There's lower turnover of staff and there is much higher resident satisfaction," she said.

In addition, more and more homes are recognizing the importance that residents attach to having their own space. It's a difficult transition for anyone from their own home to a nursing home, where they must share living quarters with a stranger.

"If this is where you're going to make your home, privacy is a value that is very, very high," Maben said. "We're finding more and more facilities recognize this."

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