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Preventing Neglect and Abuse in Nursing Homes by Irene Repczuk-D’Alessio It is the right and responsibility of family members or designated representatives to be involved in the care of loved ones in a nursing home. Family members can play an important role in protecting the rights of their elders by monitoring the care that is be ing provided and by advocating for quality care. Most frail elderly do not have the capacity, strength, or will to voice complaints on their own behalf. They need strong advocates who are willing and able to insure that their needs are being properly met. Discovering that your loved one is suffering or hurt can arouse many emotions: anger, frustration, and helplessness. You may feel helpless because you cannot protect your loved one and frustrated that noth ing will be done. You may be angry enough to lose your temper. These emotions are normal, but they do not resolve the problem. The most important thing to recognize is that you need to intervene before your loved one’s condition deteriorates. It is imperative to insure that adequate medi cal care is provided. Remember that families are enti tled to have access to their relatives' charts and medical records and have a right to question any aspect of medical treatment. Advocating for good care in the nursing home requires a willingness to confront appro priate staff with your concerns. It often requires persis tence and tenacity to follow through on successful resolutions to the problem. What follows is a number of practical advocacy suggestions for nursing home residents and their families. • The first step is to voice concerns. Report them to designated staff members as soon as they occur, or soon afterwards, so that they can be dealt with imme diately. Talk with staff directly involved with the prob lem. For example, the nurse for a care problem, the director of the dietary department for a food-related concern, the social worker for discharge issues, and so on. It is important to be respectful and non- confrontational. Remaining calm keeps the issue the focal point of the discussion; anger turns the discus sion in an emotional direction that can be counterpro ductive. When addressing concerns, strive to be persis tent and confident. Don’t feel that you are unreason able to expect good care; it is the resident’s right and it is your right to expect it. • Document date, time, names of those involved, and the specifics of the problem. Keep a record in a small notebook. Also document any discussions about the problem. Who was spoken with? About what? What agreement was reached? What solutions were discussed? What has or has not been complied with? • If talking with staff directly involved does not solve the problem, bring your concerns to those who supervise the staff. This may be the charge nurse or director of nursing. Providing specific, details of the problem (and any previous attempts to resolve the problem) will help the supervisor to provide a success ful resolution. Make suggestions that will be helpful to staff. Your input is valuable. • Follow the facility’s formal grievance process, which is required by state regulations. Follow up with the administrator to insure that your complaints have been addressed. • Join the facility’s resident council to share your concerns and to obtain the support of other family members. • If you are unsuccessful in resolving your com plaints within the facility, contact the long-term care ombudsman. This is an advocate for nursing home residents who has the power, based on federal law, to intervene and investigate complaints on behalf of resi dents and their families. The facility must provide in formation on how to contact the ombudsman or call the State Office on Aging. • Reports of resident abuse should be reported im mediately to the state ombudsman and the local De partment of Health. Be mindful that some care problems may never be resolved. Neglect of residents may or not be inten tional. It may be the result of understaffmg or poorly trained staff. In an institutional setting, care routines are often established because it may be easier or more effi cient for them to do things in a certain way. These rou tines are not ironclad. They can and should be adjusted and altered if they create neglect or abuse situations. But remember that it is unlikely that adjustments or changes will happen if no one asks for changes. You can play an important role in this by educating staff about your loved one’s special needs. Often staff members wel come the input of a family member to help them to un derstand the individual needs required by the resident. Your interest in your loved one sends a clear message that someone is monitoring the care. Author's Note. The material in this article represents information gained through professional and personal experience. It is not intended to denigrate or condemn all nursing homes. Many nursing homes provide excellent care and are responsive to the needs of their residents as well as their families. “НАШЕ ЖИТТЯ”, ГРУДЕНЬ 2004 15
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