Don’t be a statistic: avoiding a Missouri nursing home nightmare

We've all seen nursing home horror stories revealed by news exposes and print reports. We've witnessed the elderly and vulnerable residents of nursing homes and assisted living facilities subjected to unspeakable mistreatment including physical abuse, malnutrition, infections, bedsores, verbal intimidation, lack of personal cleanliness and more.

We've also learned how dangerous it can be if those in nursing homes are left unsupervised or are allowed to wander off the property, left alone to deal with the elements and unable to take vital medications in a timely manner. Tragically, situations or nursing home abuse and neglect sometimes result in the death of the innocent victim, and devastation to the ones they leave behind.

Putting yourself in their shoes

Can you imagine being in that situation? What do you think it would feel like if you had to live with the knowledge that someone you love, respect and care about was forced to endure inhumane conditions that eventually caused their death? The guilt, doubt and indecision associated with such a situation must be terrible.

Now imagine that you could have taken action to prevent that from happening to someone you love. Would you be willing to put in the work necessary to avoid a nursing home nightmare? If so, then keep reading - you will learn five ways in which to find the best possible care for your older or special needs loved one, and how you can feel confident you have done all you can to keep him or her safe.

1. Research: your first - and best - line of defense

As the adage goes, the best defense is a good offense. That's how you should approach the research process before selecting a nursing home, assisted living center or other residential care facility. You are going on the offensive by performing in-depth research into potential facilities. You can learn a great deal about each location with even rudimentary research, including:

· Age of the facility

· Technology used

· Size/number of beds

· Types of patients treated (particularly the level of assistance offered, be it around-the-clock nursing care for the incapacitated or part-time aides without specific medical training who offer companionship and help residents with day-to-day tasks like cleaning, laundry and cooking)

· Reviews from present and former patients and their loved ones

· Staff resumes

· Any previous complaints lodged against the facility

· Whether any news stories or reports have referenced the facility, in particular those involving challenges similar to ones your elderly loved one may have (like a dementia patient allowed to wander away from a facility, or a bed-ridden patient who developed life-threatening bedsores/pressure sores because he or she was left in one position too long)

2. Dig even deeper

To go even deeper, check with organizations like the Better Business Bureau to see if they have records regarding the facility. Should you find, for example, that the BBB has given a particular nursing home a poor rating (a "D" or "F" instead of an "A" or "B") due to past complaints from residents or their families, you might strongly consider a different facility instead. The BBB also offers "accreditation" to businesses that meet certain criteria including, according to their website, those that "build and maintain a positive track record," "advertise honestly," honor promises," "safeguard privacy" and more.

The United States Government also offers their own nursing home-finding service through the Medicare.Gov Nursing Home Compare website. This site lets you research all Medicare- and Medicaid-certified facilities in a particular area, and compare them to help you determine which offers services, programs and benefits that best meets your needs. The site's comparison tool lets you compare up to three facilities at a time, and gives ratings of each based upon factors like:

· Overall quality measures

· Prior health and safety inspection results

· Staffing levels of medical professionals like Registered Nurses, Licensed Practical Nurses and Certified Nursing Assistants

· Number of beds

· Proximity to or affiliation with a hospital or care center

· Safety features (which can include anything from sprinkler systems and door/window alarms to bracelets or necklaces that make residents easily identifiable and requiring identification from visitors)

· Whether the facility is for-profit or non-profit

3. Take advantage of the tools at your disposal

For those of us here in Missouri, the state's Department of Health and Senior Services can help. Their website offers tools to help select a nursing home, compare different facilities and learn more about possible care options (including everything from drop-in Adult Day Care Programs to 24-hour nursing supervision). In addition, state residents have access to the Long Term Care Ombudsman Program, which can help patients make important decisions regarding their care needs, as well as offering an outlet for complaints or issues arising from nursing home abuse or neglect, questionable billing practices or other related concerns.

The state's regulatory authorities also offer inadvertent assistance to those making the difficult decision of choosing a nursing home. Once on site at a potential facility, you can ask to see its most recent "State of Deficiencies Survey," something that every licensed care center is required to maintain and display. These surveys are oftentimes more current than licensing reports maintained by the state, and can be very informative to potential residents and their families.

4. Trust your gut

Once you have narrowed down your choices for possible care providers, you should tour each facility to get an impression of the environment for yourself. While doing that, ask yourself some very important questions to determine if this is the best facility for your loved one. For example:

· Can you see your "Nana Mary" living out her final years here?

· Would your elderly father enjoy the variety of activities offered by this facility?

· Does the staff have the experience and skill necessary to deal with your mother's myriad serious health issues, in particular the dementia and her congestive heart failure?

· Do you feel there an acceptable staff-to-patient ratio?

· Is the facility close enough to a hospital or care center that emergency treatment could be given in a timely manner if necessary?

· Have you asked current residents what they think of the facility? Are their answers positive in nature (for the most part)?

· Do you feel that the staff will be compassionate to the unique challenges these patients pose, or do you fear that mistreatment could be an issue?

· Are any of the current residents being mistreated, abused, neglected or ignored while you are taking a tour of the facility? To that end, do you see injuries like bruises or welts on any of them that give you pause?

· Do you feel like residents are afraid of or intimidated by particular staff members? (This could be an indication of verbal or physical abuse.)

· Can you afford this facility? Have you considered all possible sources of payment like Medicare, Medicaid, long-term care insurance, retirement funds and the sale of your loved one's home or belongings?

· Are staff members taking proper precautions when handling and disposing of medical waste?

· Have you considered how a new living arrangement will impact your loved one's life? Will the change be negative or positive?

· Is the facility tidy? Have surfaces and floors been recently cleaned and sanitized? Are there any noticeable, unpleasant odors?

· Do the residents seem well-groomed and well-nourished?

· Do residents appear engaged, or do they seem to be unhappy and lonely?

· Is there a separate dining area? Does the food appear nutritious and healthy?

· Does the facility have an open and liberal visitation policy?

Perhaps most importantly, has anything you've seen raised a "red flag?"

5. Keep your eyes open

Once you have done your due diligence, found a suitable facility and moved your loved one in, your work isn't done. You need to remain vigilant. The sad truth is that anyone in a nursing home, assisted living facility, senior community or other residential care facility could potentially become a victim. By knowing the potential signs of abuse or neglect, you might be able to nip mistreatment in the bud, ensuring the safety of those you love and other residents as well.

Have you noticed any bruises on your loved one's body while visiting him or her in the facility? Can those bruises be explained to your satisfaction? If not, are there any other indications that a staff member is either being physically abusive, or that there is inadequate supervision of the residents. Does your loved one seem afraid of or hesitant to interact with particular staff members? Has your loved one suddenly lost weight? Have his or her grooming habits changed (i.e., a person who has always been fastidious about cleanliness now appears disheveled or has a strong body odor)? Yes, these symptoms could be related to a decline in health or difficulty settling in to a new environment, but they could also be potential indicators of abuse or neglect.

Should you notice these or other changes to your loved one's health, personal appearance, demeanor or general condition, ask questions of the staff and of facility administrators. Remember: serious maltreatment could be fatal to someone in a nursing home or care facility, especially when complicated by serious preexisting health concerns. If your questions aren't adequately answered by staff or management, contact the Missouri Department of Health and Senior Services, and strongly consider seeking the advice of an experienced nursing home abuse and neglect attorney.