Asking questions, touring facilities key in finding a good nursing home

    Editor's note: This story originally ran in June.
   
    Two strokes in two weeks robbed Carol Kelly of her ability to walk or talk. Doctors said she would never recover, but she could get stronger if she got the right help.
    She needed a nursing home -- fast -- and it was her daughter Carolyn Dickson's job to pick the right one.
    "You don't have time to do a lot of research at that point," said Dickson of Cottonwood Heights. Restrained by her insurance, Dickson took her ailing mom to one home, but she wasn't impressed.
    "It was not the place I wanted my mother to pass away," Dickson said.
    She transferred Kelly to Christus St. Joseph Villa, the state's largest nursing home, where she lived out her last eight months in a much more caring environment. Kelly died May 28 at the age of 81 from her health complications.
    Everyone from the federal government to nursing home owners, state inspectors to disability advocates have some tips for those who suddenly find themselves scrambling to find the right nursing home for a loved one. And once in a home, they have some advice for family members who visit.
    These experts suggest picking a nursing home close to where you live, so you can easily visit. They believe touring the facility is a must and you should watch out for homes with bad smells and staff who seem to ignore the residents.
    Some tips are more nuanced.
    The Disability Law Center, a non-profit group that monitors Utah's nursing homes, suggests approaching the nursing station. Some homes uses these desks as "barricades" between the staff and residents, when they are supposed to be places to get help.
    A national advocacy group said look for residents strapped into wheelchairs. If there are lots of people restrained, it might be a sign of inadequate staffing.
    The head of Utah's nursing home association said quality care is in the details.
    "Has the ladies' hair been done? Are their fingernails trimmed properly?" said Dirk Anjewierden IV, executive director of the Utah Health Care Association. "If they are doing the little things, they are probably doing the big things too."
    Such vigilant observations shouldn't end after families pick a nursing home, said Rebecca Burrage, a volunteer with the Salt Lake County Ombudsman's Office. Family participation can lead to improved medical care. Her job is to help those who don't have anyone else.
    "A lot of people who don't have family need someone to be an advocate for them," she explains.
    Once a week, Burrage walks the halls of a nursing home observing the staff and talking to the residents. She said the most important thing she can do is lean in close and ask the people living there "How are you?"
    That's critical, according to Eileen Maloney, an advocate with the Disability Law Center.
    "Most of the complaints that I hear from residents deal with the fact that they don't feel they are being heard," she said.
    For more suggestions on what to look for visit www.medicare.gov/nursing/checklist.pdf.
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    mcanham@sltrib.com
   
   
   Tips
    Things to think about when picking a nursing home:
   
    Location -- People are more likely to visit a relative if the nursing home is close by.
   
    First impressions -- Make sure the home is clean, free from unpleasant odors and has good lighting.
   
    Staff -- Watch how the staff interacts with residents. Are they warm and respectful? Do they knock when they enter rooms?
   
    Longevity -- The best performing nursing homes usually have stable leadership that have been on the job for at least two years. How long has the administrator and director of nursing worked at the home?
   
    The Room -- Make sure your loved one will be in a comfortable space. Will he or she have a window? Access to a telephone? Their choice of roommates? Are the rooms clean? Do they have windows?
   
    Food -- Have a meal at the home to check on the quality of the food and make sure the staff takes care of those who need help eating. Does the home offer alternative meals daily?
   
    Customer Satisfaction -- Just about every nursing home does an annual survey. Ask to see the results. Be wary of homes that won't turn them over.
   
    Things to think about when visiting a relative:
    Weight and Nutrition -- Keep track of your relative's weight to make sure it is not dropping rapidly. Ask the staff if your loved one is eating properly.
   
    Bruises and Bedsores -- Look for any unusual bruising or bedsores. Make sure they are recorded and treated properly.
   
    Medications -- A review of inspection reports shows that homes sometimes have problems monitoring insulin and Coumadin. Talk to the staff to make sure your loved one is getting the right medications at the right time.
   
    Living Space -- Check the bedroom. Is it clean and tidy? Are the sheets dirty? Make sure the call light button and fresh water are within reach.
   
    Staff -- Resolve any complaints quickly and don't make enemies with the people taking care of your relative. But also don't accept bad care either.