Dear Mary,
I really don’t know what to do. Almost every time I go into the senior’s home where my Dad lives he is alone either in his room or stuck in front of some TV. It seems like he is just left alone and nobody is taking care of him. What can I do to make sure he has better care?
Angi
Hi Angi:
When a loved one moves to a senior’s home (whether it is a private or public building) one of the most important things that both you and the facility need to understand and manage is “setting expectations”. This requires learning and communication from both parties. If you are frustrated with his care, try these ideas:
1. Write down your expectations for his care. Be as specific as possible.
2. Write down what your expectations for his care would be if he were living with you. What would be different and what would be the same between your two lists?
3. Write down your observations of his care. Be as specific as possible.
4. Write down your perceptions of his care in the facility. Take note of both the good and bad elements of his care.
5. Does it seem that he is being less cared for than others in his area? Do they all seem to get the same levels of attention from the staff?
Once you have documented your expectations and your observations, begin to have regular meetings with the managing director for his area to better understand what they do, when they do it and how they currently take care of your Dad. Ask them about the # of people in his area and the ratio to staff. Ask how often they check on him and is it documented. Most likely the staff will tell you that they check on him frequently but that they are often busy with others on the floor. Please know that many times the staff is overwhelmed themselves with the amount of work to be done and extra staff is not in the budget. Most likely they may never meet your expectations and demands, but here is what you can do.
1. Think of them more as your partner to help care for your Dad. Yelling and demanding things of them will back-fire. You will be known as a problem family member and no staff member will go out of their way to do extras for you or your Dad.
2. Make your visits at different times of the day. Do not always arrive at the same time. This way the staff will not know your routine and may make a greater effort to check in on your Dad more frequently.
3. Be part of his care team. I always say, “It takes a village”. Know that you can and should be part of the solution and not expect the staff to do everything. Don’t think that because money is being spent for his care, that you should not have to pitch in. This again is all about setting expectations – expect to pitch in.
4. Thank the staff for taking care of your Dad. The care he receives may not be perfect, but I bet if he were living with you, it would not be perfect either. You should be very thankful that you have the facility staff who can share in his care – it is a team effort and you are part of the team!
I know many families who have come to the conclusion that the facility staff cannot do all of the care of their loved ones, exactly as the family wants and expects. Their expectations have come in line with the reality of what the care facility does (or does not do). Some families learn (usually the hard way) that extra hands are required. Some families rotate shifts to help with the care, while others hire third party care agencies to do private (extra) care inside these facilities. For those who do not live close to the care facility, hiring an agency is often the only solution for better care and peace of mind.
Understanding expectations is the key to making this work. The staff may be able to better meet your expectations if there is honest, good, on-going communication between both of you. However, you should also assume that the facility will never have enough staff to meet all families’ expectations, requests and demands. There may be gabs to what you expect and what they can deliver. These care facilities have a business to run and budgets to work within. Your demands will not change their business model. Some families will not have the extra family members or money to hire agencies. Some families will say “we are paying all this money and look how Dad is treated”. Well, Dad is part of their system now – and advocating for his care and being part of his care team are major roles that you will have to play. It is the squeaky wheel concept.
How many times do you go into a senior’s care home and wonder if any of these seniors actually have visitors on frequent bases? I bet many do, but many families just dump off their seniors, expecting the care facility to do all the work. This is so wrong to expect and so unfair to the care recipient. The care facility cannot do it all and you need to be part of the solution not just part of the complaining committee. Figure out how to work with the staff, try to get what you want and then you will know that your Dad is actually receiving the best care possible. This will be an on-going changing challenge that you need to make your responsibility.
Mary
