Questions You Might Not Think to Ask...

My mom has been in nursing home care for a little over a year, and we are doing well.  The adjustment period was rocky, though, for Mom as she coped with confusion and anger, for the nursing home staff as they learned to know Mom and her unique set of needs, and for me as I attempted to release old responsibilities and accept new ones.

I admit I had thought that once Mom was released into the care of others, that, other than visiting her as often as I could manage, my responsibilities toward her would be over.

Was I ever wrong!

I feel I must call a warning to families preparing to place a loved one in nursing home care: your responsibilities toward your loved one will, for a season of time after placement, remain somewhat demanding.  If you missed it, please read this post: What I Didn't Know.  (Don't worry, I didn't include EVERYTHING I didn't know--it isn't an encyclopedic post...).

Today I've compiled a list of questions I ought to have asked before we chose my mom's nursing home and in the early months of care:

1. We would like to share a meal with our loved one occasionally.  What is the protocol for that?

Me, looking clueless. 

 We are so blessed at my mom's small nursing home--any time we show up around meal time, they are glad to accommodate us.  They pretty much treat us as though we were very special customers at a restaurant!  This is probably rare--some homes might need you to call ahead or even set a date a few days in advance.  Sharing an occasional meal together can be a wonderful way to help your loved one feel at home in a new setting.

2.  If we need a box of Kleenex, a hand towel, or other supplies during a visit to our loved one, do you want us to help ourselves from the supply closet or shall we ask an attendant to get what we need? I unwittingly offended the charge nurse when I opened the supply closet door to get a hand towel for my mother's bathroom.

3.  Clarify the kinds of caregiving checks you will perform for your loved one when you are onsite. Just be very matter of fact as in, "I will continue to check my mother periodically for pressure sores and to be sure she is changed and clean--may I have your assurance that no one will attempt to prevent me from doing this?"  If this causes defensiveness I would call this a red flag; find another facility.  When I encountered defensiveness or irritation, I was polite. I told them that as my mother's patient advocate that I not only had the right to check her for cleanliness and freedom from rashes, but that it was my responsibility to do so.  And so it was.  While they were learning my mother's needs she suffered redness and inflammation, overflowing adult diapers, and a suspected urinary tract infection.  It took a few months to remedy these caregiving challenges.  I wasn't critical, but when I found a problem as I often did during the early months of time, I drew it to their attention.  This provided accountability for them and was a safety net for my mother.  You mustn't back down too easily when your loved one's welfare is at stake.

4.  What is the procedure to report a caregiving problem...how can we communicate efficiently when a change needs to happen?  I should've asked this question even before Mom was placed, but did not. About four months into her care I learned there was an official needs form that could be filled out and handed to the head of nursing.  I've used the form just once, but it was an effective method to communicate a problem quickly to all staff.  I wish I'd known about this sooner.

I don't know that a period of "overwhelm" can be avoided when a loved one is placed into nursing home care, but asking the right questions can help to prevent that clueless sensation I endured!