This is the thirty-seventh in a series of articles intended to demystify retirement living options.
Many people are involved in caring for your friend or relative in a nursing or skilled nursing facility (long-term care facility): doctors, nurses, aides, dieticians, activities staff, social workers, possibly physical and occupational therapists, perhaps companions who don’t perform medical services, and so forth.
How can you get attention to questions, concerns, or suggestions you have when a topic may involve several different departments?
If you have a topic that you want to discuss promptly, ask to speak to the person in charge of your loved one’s care right away. Otherwise, take advantage of quarterly care planning conferences. The federal government requires that these take place for all residents in long-term care facilities that are Medicare or Medicaid certified. As the name implies, they are scheduled every three months.
Tell the person in charge of your loved one’s care – and the unit’s secretary/clerk/administrative assistant – that you want to participate in these conferences. They should then give you a couple weeks’ notice of the date and time each quarter. If you cannot attend in person, ask that arrangements be made so that you can participate by calling in.
They will try to accommodate you by changing the schedule if you ask them to and if they can. Because they are legally required to conduct the conferences at specific intervals, they can’t delay the conference for three weeks because you are traveling.
They may not be able to change the day of the week, either, since they have to gather many people together who are already planning on participating in care planning conferences on the same day and time each week, such as Wednesday mornings from 9:00 a.m. to noon. However, they may be able to make other changes, such as moving the conference up a week, or changing the time slot from 9:00 a.m. to 11:00 a..m.
Keep track of topics you would like to cover, and a week ahead of time, send the person in charge of your friend/relative’s care an email explaining any issues you want to discuss in the conference. It helps to be specific. For example, rather than writing, “How is she doing? Does she like the food?” you might say, “My mother’s clothes seem loose on her. What is her weight now compared to three months ago? Are any dietary changes needed to help her maintain her weight?”
If you don’t give the staff advance warning of the topics you want to discuss, often you will be told, “We’ll check on that and get back to you.” This answer is less useful for two reasons. First, based on my personal experience, such follow-ups can easily slip through the cracks. Second, you miss the chance to have several different departments participate with you in a discussion about how to address any issues.
If you think that the discussion you want to have will take a little while, ask that the meeting be scheduled for, say, 30 minutes instead of the 15 minutes that they may routinely plan.
Typically, the staff will address any specifics you have raised, and each staff member will report on your friend/relative from their perspective. For example, the person in charge of activities might say, “She really loves going on our bus every Sunday to local parks to see what’s blooming, and she loves any music programs we offer. We’ve started a little photography group; we lend the residents digital cameras to use, and she took some really great pictures of the stream and the irises in the park last week.”
The nutritionist might say, “We’ve started giving her a Magic Cup (nutritionally fortified ice cream) at dinner every night because she’s only eating about half her meal but she’ll always eat the ice cream. Her BMI (body mass index) is in the low-normal range, so we don’t want her to lose any more weight. We’ll start adding Med Pass (a nutrition shake) at lunch if she is still losing weight in a month.”
Still, it’s important to read your loved one’s chart to identify any gaps or discrepancies that might not surface in care planning conferences.