Would you put your family member in a LTC facility?

[Cattitude]

What I'm learning about LTC facilities scare me. I know there must be some good ones out there somewhere????

But really, between staffing issues, cheap owners who shortchange on supplies, MD's who don't want to be bothered.

Is there anyone here who would put there family member in a nursing home? I think of the day when my mother will need care. She is ambulatory now but in the next several years may not be.

I have other options but what about people who don't?

Would you do it? I think I would be very nervous to do so. I know there are wonderful nurses and CNA's in LTC. But not enough to do the job safely. What's the solution?

[chevyv, BSN, RN]

We all joke to my mother that she best behave or we'll find her one of those bad nursing homes. Honestly, we are joking with her. I would not want to put my mother into a nh, but one can never say never unless you have very deep pockets.

My grandmother had alzheimers and my grandfather had to put her into a nh where she would be safe. She would sundown and leave the house to wander. Sometimes she would sneak out at 3am. She would become violent if redirected. She would tell people that my gradfather was kidnapping her! It was time to weigh what could happen against putting her into a nh. When my grandfather put her in, he visited her just about every day. Everyone knew him so she was cared for well by the staff. I think that's a huge part of it, if you have to put a loved one into a nh, try to get family to see them everyday. This way, you become a member of a bigger family.

I've told my kids for years to put me in a nh when I can't take care of myself. I also told them to go on with their lives and don't be coming to see me if I won't know who they are! That may change as middle age turns to older adult.

[rngolfer53]

I worked as a CNA for 2 years in a very posh rich nursing facility top of the line. It still scared me the care given by some of the CNA's, we had a few good ones but mostly bad. I would NEVER ever ever put my parents in any home, no way. I would hire people to care for the 24/7 in their home or mine before i would send them to a place like that. At least then if they were with me i could supervise things and make sure they got what they needed. Also it seemed to easy for even the nice families to forget about their parents in there. Id want my parents close to ones that loved them. Just my two cents

If a NH is just a way to warehouse Granny until she dies, then chances are she will not get the best care. While it would be wonderful to think that all residents get the same care, even in good facilities, let's be real. Staff will do more when they know family will be involved regularly........the squeaking wheel does indeed attract more grease.

I go into a lot of NHs as a hospice on-call nurse. One thing I've noticed: some doctors will not be associated with lousy, neglectful homes, and others could care less about what conditions the patients endure.

If I were forced to put myself into a NH, and I'll literally walk into the mountains and die first, I would find those doctors in my community, then I would also visit any NH, unannounced, at 0200. See how many of the staff are asleep, watching TV, texting, etc. Look over charts and see how often prn meds are given. Too often or too seldom can be a warning sign of inattention by the staff.

Of course, if the smell of urine hits you as you turn into the parking lot :angryfirerun away like brave, brave, brave Sir Robin. :chuckle

[CoffeeRTC, BSN, RN]

i know that this is an old thread, but it has some thoughtful responses on it.

i'm in the position now of "having to do something about" my parents from a distance of 1000 miles, and it's an uncomfortable position. already i can feel the "judgement" from my peers because i am indeed preparing to put my parents in some sort of assisted living or long term care facility -- i just don't know what my options are at this point. and hard as i try not to feel guilty for a choice that has been foisted upon me by my parents, some of the responses on this thread are indeed rather judgemental.

my mother has alzheimer's and cannot be left alone. she isn't safe around a stove, might get lost in the local grocery store and panics when my father isn't visible. my father has made the decision to care for her at home. that's been working ok for them for the past four years or so; but mom is getting worse and dad's physical health is deteriorating. furthermore, he's getting tired of looking after mom. he won't consider any options other than taking care of mom at home, but lately he's been forgetting doctor's appointments, neglecting to pay the bills, refilling prescriptions then losing the pills or neglecting to refill them at all and just not taking his pills or giving mom hers and this past week he hasn't been cooking. i called on christmas to wish them merry christmas, and dad hasn't cooked anything for three days (and meals on wheels won't come for two more). dad isn't hungry, but mother is. she's physically capable of putting a meal together but can't remember how and dad says (as he's ensconced in his comfortable recliner in the living room) that he doesn't feel well enough to sit in the kitchen and coach her as she prepares a can of soup for herself. mom says she'll figure something out, but she can't keep track of anything for more than a moment or two. it's breaking my heart, and i'm angry with my father.

i'll be flying back to the midwest to personally assess the situation and see what can be done, but i can't get there in time to feed my mother dinner. the nearest relatives just had a knee replacement and isn't mobile, and most of their friends and neighbors are already doing all they can. my folks have always said they aren't willing to leave the area they've lived in for nearly 80 years to move in with or closer to my sister (on the west coast) or me (on the other coast) and i have a family and responsibilities here as my sister has there. we cannot move back to care for my folks. my parents made some lifestyle choices in their youth that limit their financial resources now -- dad hasn't worked for anyone but himself since he was 30 and ran his business into the ground and retired by the time he was 50. even if i could afford to give them money or support them, we have my husband's daughter to support. it makes me angry to even contemplate delaying my retirement to bail my folks out financially when dad made the decision to stop working when he was younger than i am now. (and when i've been self-supporting since the day after i graduated from high school.)

yes, i'll put my family member in a ltc facility, and i'll do it just as soon as i can get them there. nor will i be a visible presence from 1000 miles away. i can call, and i'll visit as often as i can, but it won't be more than a few times a year. i'm angry about the whole situation and i'm feeling some guilt, too -- obviously. but sometimes there just aren't any other choices, and i'm grateful that there are ltc facilities that can look after my mother and ensure that she's clean, fed and has other elders to socialize with.

i think this would be the best thing for them. hopefully they will find a place that will meet both of their needs. we have a lot of residents with family out of state and really try hard to keep them up to date and informed of everything. you might be amazed at what the increased stimulation and exposure to others will do for them.

good luck!

[One Flew Over]

I work LTC per choice and honestly I go in to work happy and leave happy.

:yeahthat: :heartbeat

Besides. I know a lot of family members who come in for respite care and wind up letting their loved ones stay. They have all told me that physically taking care of their very sick family members 24/7 (on top of job etc) has worn them out to the point where they are missing and not enjoying what may be the last years they actually get to spend with their loved one. If you have someone taking care of them you can focus on actually spending time with them, taking them out for trips, talking with them, strengthening your bond and truly making them happy.

You just have to find a nice place. Despite common belief, they are out there. :heartbeat :)

[Melinurse]

Depends on the facility. Yeah, I'd put my family in LTC, but I would be visible and probably hire a private duty CNA to come in in the mornings. I did that for my grandmother. It was well worth picking up an extra shift or 2 here and there to pay for the CNA who was wonderful.

I work at 2 LTC facilities and the single biggest problem I see is poor staffing, especially with lots of call-ins from both CNAs and nursing staff. Then don't get me started on managment not stepping in to help. There are some really wonderful nurses and CNAs at the facilities but usually poor management, poor staffing, and cheap owners who care more about the budget than the patient unless there is a lawsuit going on. Sorry, I could go on and on with this rant.

Back to the topic at hand, yes I would place someone in LTC but only if I had the means to hire a private duty CNA or nurse to go in once in a while and if I were able to visit often.

I agree with first day of my life; there are some good ones out there.

[TheCommuter, BSN, RN]

I agree that a person might be out of luck if they're old and poor in America.

For example, I work at 2 different nursing homes. The upscale facility where I'm employed caters to the middle and upper classes, and I care for 12 to 18 residents during the night shift. Anyone who has worked LTC knows this is an excellent ratio.

The downscale facility where I'm employed houses the poor and working classes, and I'll usually care for 70+ patients during the night shift at this place.

It is true that more money will buy better LTC care, so I urge people to plan ahead. When it comes to getting admitted into a nursing home, never say never. My youngest resident was 29 years of age, so it could happen to the best of us.

[lamazeteacher]

"......would be very nervous to do so. I know there are wonderful nurses and CNA's in LTC. But not enough to do the job safely. What's the solution?" quote from OP, cattitude.

What a great subject!

When we were born or had our own babies, did anyone think the baby was so much work, we'd have to put them in a facility where they'd get care we couldn't give them?

Eldercare is similar to babycare, except that most elders are able to help themselves more, are heavier, can appreciate good/bad care, and don't cry as much (usually). They can be just as annoying.........not quite as cute, sometimes stink as much......but does that mean our culture should give them less consideration, pass them to others for housing, feeding, etc.?

We all know we'd never do that to our babies. Why do we do it to our parents? Most societies in other countries consider it the responsibility of family to care for elders.

Somehow in the USA where lack of health insurance is rampant, greedy (sound familiar?) corporate heads of nursing homes made inroads, playing into the somewhat selfish mentality of those in the prime of their lives, who want to palm off their family responsibilities. Although keeping family members of advanced age at home is much less expensive than housing them elsewhere, it appeals to many adult children. It's less disruptive for them.

I've worked in home health, visiting patients in nursing homes to admit them to care and manage the cases. The revelations I've had

about those places has alarmed me. In the community where I live now, the fact has surfaced that 1:8-10 of the "residents" have been registered sex offenders, and do attack other residents sexually. Yet no information about their status as such is given prospective residents' families. It was bad enough to hear about wayward staff of such facilities! They are dangerous places for anyone not in charge of all their faculties.

It's true that some privately hired home healthcare workers have similar mental problems, and haven't been monitored in the home as they should. The same equipment one would use to observe nannies, is available for elder situations at home.

Costco had low cost systems available, but I haven't seen them there lately. It would not be allowed for the families' observation in a facility. Surveillance video equipment needs to be in use in elders' living quarters whenever a family member is not in the home, or if the door is closed to the elderly person's room while they receive care.

It just isn't possible for government monitoring agencies to provide sufficient (24/7) supervision for safety in facilities for the elderly and disabled. That is something they took on due to demand caused by outrageous indignities/injury suffered in those places where financial gain supercedes human rights.

What's the solution? Keep loved ones at home and be there for them, hiring caregivers who are trustworthy (do background checks of anyone working in homes with children and elderly or disabled persons). In these tough financial times, with foreclosures lurking at the door of many homes, if elderly family members have paid off their mortgages, that housing can be a Godsend for their families who assume responsibility for the care of their elderly family members.

Yes, it can also be trying, as earlier hurts may surface. This could be an opportunity to work through earlier childhood problems and manage care of those who cared for us.

[Melinurse]

I agree that a person might be out of luck if they're old and poor in America.

For example, I work at 2 different nursing homes. The upscale facility where I'm employed caters to the middle and upper classes, and I care for 12 to 18 residents during the night shift. Anyone who has worked LTC knows this is an excellent ratio.

It would be really wonderful if there were legislation requiring better nurse to resident ratios like you have at the nicer facility. Maybe even 18-20 would be good too. Could certainly provide much better care if that were the case. With as many lawsuits against nursing homes as there are it amazes me that the nurse to patient ratios either remain the same or get worse. The one I am at has 28 - 30 residents per nurse on days and pms and you can double that on nights.

[lamazeteacher]

It would be really wonderful if there were legislation requiring better nurse to resident ratios like you have at the nicer facility. Maybe even 18-20 would be good too. Could certainly provide much better care if that were the case. With as many lawsuits against nursing homes as there are it amazes me that the nurse to patient ratios either remain the same or get worse. The one I am at has 28 - 30 residents per nurse on days and pms and you can double that on nights.

You can do something about that in your state. Write your representative, senator, and governor telling them about staffing problems (not using names of patients/residents). Ask them to write a bill requiring better nursing coverage and video surveillance of public areas. Let them know that people who are registered sexual abusers can live at facilities without that information available to prospective new residents. What a fabulous gift that would be!:heartbeat

[Not_A_Hat_Person, RN]

I wouldn't judge anyone who puts a relative in long-term care. My late grandmother had Alzheimer's, and was in LTC for over 20 years. Granddad still loved her, and visited often, but he couldn't take care of her.

If my mother became unable to live on her own, I would put her in LTC. I would visit, and make sure she wasn't neglected, but she can't live with me, and I can't live with her. She's a hoarder, among other things, and I refuse to live in filth again.

Somehow in the USA where lack of health insurance is rampant, greedy (sound familiar?) corporate heads of nursing homes made inroads, playing into the somewhat selfish mentality of those in the prime of their lives, who want to palm off their family responsibilities. Although keeping family members of advanced age at home is much less expensive than housing them elsewhere, it appeals to many adult children. It's less disruptive for them.

I'm going to catch heat for this, but some of the "warehoused" elderly deserve it. I had a job with a lot of elderly clients. Some would tell-hair raising stories about abusing their kids, or telling them they weren't welcome if they "married that [insert ethnic slur]", didn't come back to church, or didn't cut their hair. In the next breath, they would lament that their kids never called or visited, and they never saw their grandkids. There's no excuse for elder abuse, but sometimes it's karma.

[herecomestrouble]

quote"When we were born or had our own babies, did anyone think the baby was so much work, we'd have to put them in a facility where they'd get care we couldn't give them?

Eldercare is similar to babycare, except that most elders are able to help themselves more, are heavier, can appreciate good/bad care, and don't cry as much (usually). They can be just as annoying.........not quite as cute, sometimes stink as much......but does that mean our culture should give them less consideration, pass them to others for housing, feeding, etc.?"unquote

the problem with that analogy is that with babies/children you are younger and have more energy and you know that in time the child will be able to do more for himself.With your parent you know that things will just keep going downhill until death.

[sbyramRN]

I am sorry...I just don't see the correlation between the elderly and babies. No comparison