Make Your Nursing Home Visits Count

Besides the emotional support you'll give your dad by coming to see him, you can become his best advocate. How? By staying on top of his care. You don't need to be a doctor or nurse to pick up telltale signs that something's amiss. Following is my list of what should catch your attention every time you visit. Share this with other family members and if none of you lives near your dad's nursing home then find a local volunteer—either through a senior center, church, or synagogue who'll make frequent visits for you. Residents who are visited regularly by family and friends are at a definite advantage. Don't let your dad be on the losing side.

Making Your Nursing Home Visit Count: What to Look For

• Any redness or bruises on the skin especially near bony areas like the tailbone, heels, and elbows? You're checking for bed or pressure sores.
• Any weight loss, change in appetite, sores in the mouth, problems with dentures, chewing, or extremely thirsty? You're checking for malnutrition and dehydration.
• Any ingrown toenails, infections, bunions, uncut nails on the feet? You're checking for potential serious infections and problems in walking, especially if your parent is diabetic. These could also be signs of poor care.
• Poorly kept hair, beard, clothing not clean or pressed, body odor, wet adult briefs, unclean sheets? These are signs of poor care and can lead to pressure sores, infections, and depression.
• Takes too long for calls to be answered, aides frequently tell you, Sorry, we're short-staffed today, meal trays are served late, no fresh water in the room, aides assigned to more residents than they can reasonably handle? These are signs of poor care due to lack of staff.
• Clothes or belongings missing? Periodically check closets and drawers to make sure that your parent isn't missing any personal items.
• Seems like every time you turn around there's a new director of nursing or head nurse, or your dad rarely has the same nursing aide from one week to the next? Staff morale seems pretty low? It won't take long for high staff turnover rates to spill over into poor care.

What to Do on Your Visits

Besides staying on top of your parent's care, there are a number of things you can do to make your visit with your mom or dad a productive and pleasant one. Here are some suggestions:

• Listen to your parent's complaints. If they are frequent and consistent, check into it. If Dad complains about food, visit during meal times; if it's about his roommate, get to know the roommate and determine if things can be worked out or not; if the complaint is about a certain staff person, visit when that person is on shift. Assess these complaints and work with the nurse supervisor to correct the problem.
• Take your parent out for brief excursions, if possible. If Mom can leave her room, take her to a quiet visiting area; if the weather's nice, head for an outside garden area.
• If you bring the kids or a family pet, arrange an activity that your dad can do with the kids or Lassie. My son at the age of eight used to play checkers with a resident of a nursing home. Dr. Jenkins had forgotten much of the game and Matt knew little of it but they had a great time.
• Bring a small gift when you come so Dad can remember you came (candy is not a good idea), mark the calendar to show him you were there, hug him, hold hands, and when you enter the room, announce who you are, “Hi Dad, it's your daughter Linda.” (I always add, “You know, your favorite daughter,” just to rattle my sister.) You could also bring a Polaroid camera and take pictures of your visit to leave behind.
• Always end your visit by checking in with a staff member. Let him or her know you were there, that you appreciate his or her help; share some tidbit about Dad and ask the staff member for of any insights he or she has about your dad's health. Don't stick to one staff member: take turns with the administrator, head nurse, social worker, recreation director, physical therapist, and various nurse aides. You'll learn more about your dad, and more people will know how much you care.
• If you live out of town, visit through frequent phone calls. If you can live by a schedule, then make a certain day a visiting day by calling on a set day, like Sunday afternoons. Sending a video of family events or just for the fun of it, is also a good way to reinforce that your parent is still part of the family. You'll need to make sure that someone at the home, perhaps the activities director, will play the video for your parent. And of course, there's always the mail. Older people love to receive letters and postcards letting them know you're thinking of them. If your parent is hard of hearing, getting a letter in the mail may be easier for both of you than talking on the phone.

Excerpted from The Complete Idiot's Guide to Caring for Aging Parents © 2001 by Linda Colvin Rhodes, Ed.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

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