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Choosing The Right Nursing Home

Nurse helping an older woman

An illness, a disability, or old age can make it impossible for a loved one to take care of themselves. As a son or daughter, it may be your responsibility to find a nursing home to care for your mother or father, but do you know what to look for to make the right choice? 

Just as you would if you were purchasing a new home or leasing a new car, you need to do your research and ask the important questions before making a decision on a nursing home. An attorney can also provide support when it comes to choosing the right nursing home.

Our Baltimore Nursing Home Attorneys Are Here to Protect Your Loved Ones

A lawyer from our firm can help you understand what to look for when choosing a nursing home for your loved one. The following are some critical factors to consider:

1. Is the Facility Clean, Maintained, and Temperature-Adjusted?

A nursing home should provide a comfortable living situation for all residents. As you go on your search, look for clutter-free hallways, well-lit rooms, clean bathrooms, comfortable beds and furniture, working electronics, and modern technology. If the nursing home looks outdated and dirty, that’s not the place you want your loved one to live.

2. Will Your Loved One Have Freedom?

Look for a home that allows residents to roam freely (without jeopardizing safety) and has programs designed to reduce isolation. Without independence, a resident may fall into depression and/or loneliness.

3. Will Your Loved One Get Enough to Eat?

In older age, people may experience a significant loss in appetite, so they may easily go hungry or become malnourished. Your nursing home of choice should have a plan in place to combat any issues of anorexia or constipation.

4. Are Residents Protected From Theft?

Poor mental functioning can make it difficult for a resident to keep track of all their belongings. Ask the nursing home staff how resident possessions are protected. Aside from lockable cabinets, a facility should have a list that tracks every resident’s belongings.

5. Will Your Loved One Be Able to Keep Their Doctor?

Most nursing homes have assigned physicians, which means a resident may have to leave the doctor they’ve been seeing for years and feel most comfortable with. Ask the facility how often the physicians see residents and what the healthcare plans look like.

6. Who’s Responsible for Paying the Nursing Home Bills?

While a nursing home bill can be split among several people, there’s always the risk that expenses may be accidentally sent out to other relatives, forcing them to pay. Read up on the state laws regarding billing and check out the fine print before signing a contract.

7. Are There Smoke Detectors, Sprinklers, and Emergency Exits? Do They Work?

Federal law requires nursing homes to have all of the above in working condition. As you tour the facility, the emergency exits, smoke detectors, and sprinklers should be common enough that you easily spot them. Ask an employee how often smoke detectors are tested; the answer should be at least once a month.

8. Is There a Security System?

If there isn’t a security system in place, that should make the decision easy for you. Security systems not only keep intruders from breaking in, but they also keep residents with dementia from wandering outside and possibly getting hurt. A security system should include cameras, alarms, and people standing watch 24 hours a day.

9. Are Residents Clean and Well-Groomed?

Poor hygiene is just one sign of neglect. Many nursing home residents need daily assistance with bathing, grooming, and getting dressed. 

If bed sheets aren’t changed, residents can get bedsores. Aside from the health factors, being well-groomed and appropriately dressed is a matter of dignity for every resident.

10. Are Staff Members Clean?

Many nursing home employees are cited for “hand hygiene” deficiencies. When choosing a nursing home, look for one that is adequately staffed; usually, understaffed facilities have the most issues with hand washing.

11. Is There Neglect or Abuse Occurring in the Home?

Staff members may initially be polite, respectful, and warm, but you should look at how residents react when interacting with them. Do the residents seem comfortable, or do they withdraw? If you notice a resident exhibiting fear or apprehension around certain caregivers, it may be a sign of nursing home abuse.

12. What Is the Staff-to-Resident Ratio?

Under federal and state law, a nursing home must have enough staff members to meet the needs of its residents. For example, in Maryland, nursing homes must have a registered nurse (RN) on duty during the day, seven days a week, and a licensed nurse on duty 24 hours a day. Unfortunately, there are no minimum staffing levels for nurse’s aides, who provide most of the day-to-day care.

13. Are the Nursing Assistants Adequately Trained?

Due to understaffing, sometimes nursing homes hire untrained workers to become nursing assistants. Do your research and look at how many assistants have a degree as a certified nursing assistant (CNA).

14. Will the Nursing Home Provide All the Care a Resident Needs?

A nursing home should provide complete resident care. If the facility tells a resident to seek outside assistance for an additional cost, this is negligence and should not be tolerated.

15. Is the Physical Therapy Unit Up to Par?

Ask if the physical therapists are on staff or just doing contractual work. A modern and adequately staffed physical therapy unit is more likely to give better service.

16. Are There Activities for Everyone?

Not everyone wants to play bingo. A good nursing home should offer a number of activities, such as gardening, art, and cooking classes.

17. Will Your Loved One Have Privacy?

A private room may be too expensive to afford, which is why a nursing home should offer shared rooms. Still, these rooms should have adequate partitions so residents can have some privacy.

18. Are the Nurses at the Home Full-Time Employees or Temporary Workers?

Many nursing homes are understaffed, so they tend to hire temporary “agency nurses” who rarely form lasting bonds with residents. Look for a home with a staff that has at least 80% permanent nurses.

19. Can You Sue the Nursing Home If Something Happens to Your Loved One?

A clause known as a “binding arbitration agreement” may stop you from suing a nursing home. You must read through all of the fine print in the paperwork before making a decision and signing on the dotted line.

How do You Identify Abuse in a Care Home?

You may be looking for a nursing home for the first time or wondering if you should move your loved one to a new facility. Either way, you should know how to identify abuse in a care home. 

You may notice signs of abuse of your loved one living in a care home or a resident in a new care home you visit. If so, you should contact the authorities and a lawyer from our firm.

Signs of Physical Abuse

The signs of physical abuse can include:

  • An unexplained sprain, dislocation, or fracture
  • A bruise or scar that may be unexplained
  • Any signs of restraint, such as restraint imprints on the wrists
  • Broken personal accessories, like eyeglasses
  • Any issues with dosing or giving medication
  • Changes in a resident’s behavior or personality
  • Tension between a resident and a caregiver
  • A caregiver refusing to leave a resident alone with their family

Signs of Emotional Abuse

These signs aren’t always so obvious. Examples include:

  • Unusual behavior from a resident, possibly resembling symptoms of dementia, such as mumbling, rocking back and forth, or thumb sucking
  • Changes in behavior or personality
  • Tension between a resident and their caregiver
  • A caregiver behaving in a controlling, threatening, or cruel way

Signs of Sexual Abuse

You may notice signs of sexual abuse of your loved one, such as:

  • Torn, stained, or bloodied underwear
  • Bleeding from the genitals or anus that’s not related to a health condition
  • Bruising around the genital area or breast area
  • A sexually-transmitted disease (STD) you can’t explain
  • Changes in behavior/personality
  • Resident-caregiver tension

Signs of Financial Abuse

You may notice signs of financial abuse in your loved one, like:

  • Unexpected changes in their finances, such as withdrawals you can’t explain
  • Missing cash from your loved one’s residence
  • Unusual product purchases or service subscriptions
  • Too much or too little medication (which could indicate fraud)
  • A change in your loved one’s power of attorney

Signs of General Neglect

You could also notice signs of caregiver neglect and negligence, such as:

  • Unsafe living conditions, such as fire hazards or slip and fall hazards
  • Dirty living conditions
  • A resident that seems dirty or unbathed
  • Soiled clothing or bed sheets
  • A resident seeming poorly dressed for the weather
  • A resident being left alone in a public place
  • Bedsores
  • Unexplainable weight loss

What Qualifies as Medical Malpractice?

In addition to basic care services, nursing home staff often provide medical services. Sometimes, the staff can be negligent, and as a result, residents can be hurt. When this happens, it could fall under medical malpractice.

Residents in a care home may be victims of medical malpractice if they have any of the physical, emotional, or sexual signs of abuse or any signs of neglect we mentioned above. If you notice any of these signs, contact the police and a nursing home abuse/medical malpractice lawyer from our law firm.

Contact Us at Brown & Barron

At Brown & Barron, we understand the many issues families face when placing a loved one in a long-term care facility. Our compassionate Baltimore nursing home abuse & neglect lawyers have helped many families deal with legal issues related to nursing home care. If you have any questions or if you’d like a free consultation with a member of our team, please don’t hesitate to call us today.