One of the hardest decisions many of us will ever face is how to care for an aging or terminally ill family member.  It used to be traditional for several generations of families to live together, and for the children to take care of their aging and ailing parents at home.  However, over the past century, life expectancies have increased by more than 20 years, due to advances in medicine and healthcare.  In addition, economic conditions have changed as has the “nuclear family.”  A greater percentage of women are working outside the home, people are commuting further, and free time has become a luxury.

              Many families have no choice but to place their loved ones in nursing homes or assisted living facilities.  The facilities can be very expensive and, due to Medicare and Medicaid requirements, the resident is required to use their assets to pay for the facility before they are eligible for government assistance.  Given these conditions, family members expect a lot from the facilities, and rightly so.  Unfortunately, the facilities do not always meet expectations, especially for the amount they are charging for the resident. 

              You cannot expect the facilities stave off the aging process, nor will they heal a patient who has a grave illness or is terminal.  However, there are some basic needs that must be met by the facility including hygiene, medicating, feeding, hydrating, turning and changing a patient.  The patient should also be protected from falls or other “unexplained” injuries.  Meeting these basic needs will not guarantee that a patient’s health will not deteriorate, however, failure to insure that they are met can exacerbate the patient’s condition by breaking down the skin allowing pressure sores or ulcers, decreasing immunities, creating infections and not providing what the body needs to protect and heal itself.

              You should keep in mind that the physical deterioration of a loved one does not always mean that there is neglect or abuse.  However, if there are concern, you need to get actively involved.  Bring any issues you have to the care giver assigned to the family member.  If not addressed to your satisfaction in a timely manner, request a meeting with a supervisor.  If this does not address your concern, request to meet with the Manager or Director of the facility.  Do not take no for an answer.   You must be an advocate for your family member as no one else will.   You must be assertive because no facility is going to want to admit that they are providing substandard care, nor do they want to admit that they are understaffed or overworked.   You should request copies of all of your family member’s records, as they may become necessary at a later time.  In addition, you may want to take photographs of anything out of the ordinary.  If the facility as a whole is unresponsive to you, you can contact the licensing board, the board of health, medicaid/medicare or the patient’s health insurer or a local agency that deals with the elderly.  You can also find local resources on the internet such as Eldercare Locator, www.eldercare.gov/Eldercare.NET/Public/Index.aspx  (800-677-1116) or other similar sites. 

              If it becomes clear that your family member’s needs are not being met, or if it becomes clear that the care and treatment they are getting are causing adverse health affects, you should consult with an attorney to find out what can be done on their behalf.  You may need to have a Power of Attorney or be appointed as a guardian in order for an attorney to advocate on behalf of your family member.  You should also find out whether there is a Will and/or a Living Will as this may also affect some of the decisions that will have to be made on your family member’s behalf. 

              The ultimate goal is to provide the best quality of life possible at this very vulnerable time of their lives and to allow a death with dignity.  If you feel that this very basic human right is being ignored or disregarded by the facility for any reason, it is important to take matters into your own hands.  If  the above suggested measures do not get you the results you are looking for, call Kamensky Cohen & Reichelson.  Nursing home abuse is one of our areas of specialty.  In NJ call  (609) 394-8585.  In PA call  (215) 945-0185.