What Are the Rules?! 

Dear Reader, Most of us really want to do the right thing, but sometimes we don't know what's expected of us. Just recently I had my second knee replaced. The orthopedic clinic does a wonderful job of telling you all about it. On top of that, knowing how human nature tends to be forgetful, they mail you literature telling you about the procedure, explaining your role in the recovery process, and what you might expect in the short and long term. This takes care of your hospital stay very well. After the hospital, if you're not yet ready to go home and you don't have relatives or someone to help 24 hours a day, you might need to go to a nursing home for a while. Here you receive the necessary physical therapy and assistance. However, in my case, they didn't lay out the rules very concisely. It wasn't obvious to me that I wasn't supposed to get out of bed on my own to go to the bathroom. Being independent, I just assumed I should try to do it myself! Also, they didn't want me to leave as soon as I did. I really had to assert myself to leave when I thought I was ready. In time, and with more people asking questions, nursing homes will better at explaining things up front. Experience is a good teacher. In the meantime, look for a place where the staff is caring, patient and encouraging. Mostly, I believe nursing homes want to get you back to being what you were, and they take as much pride in your achievements as you do. Grandma A personal Note From Carla MacGregor: Once again, grandma has us thinking about ways to improve things. Often, in the hubbub of nursing home placements (usually unexpected), we forget to ask the questions to make day to day living more productive and less overwhelming. After all the regulatory forms are signed and the resident is comfortable, ask to meet with the social worker or director of nursing. Hold this meeting in the presence of the resident, as appropriate. Take this opportunity to ask questions, like in the following paragraphs. We encourage you to write to us with your own suggestions, as well. Early to Bed and Early to Rise: Are there specific times when the resident needs to go to bed and get up in the morning? If the resident is used to a completely different schedule, are there ways to make compromises? How do they handle roomates who have different schedules and nursing needs? You Are What You Eat: One of the biggest complaints at the nursing home is about food preparation and dining atmosphere. Nursing homes have to adhere to strict dietary and food preparation regulations. If, however, a resident is not eating well because he or she doesn't like the food, the matter needs to be addressed immediately. Are substitutions offered to residents? Are family members allowed to bring in food for the resident? Can the family take the resident out to dinner? If someone is able to eat without assistance and has no difficulty swallowing and is disturbed by eating with other residents who need more help, can the resident have their meal in their own room? Who's the Boss?: It's important for families and residents to understand the chain of command in the nursing home. Find out who to go to with complaints about specific aspects of care? How accessible will these people be? Determine who will begin the process of talking to a resident about going home or back into the community. Ask what you can do if there's a disagreement over the level of supervision or care needed by a resident. I Can Do it Myself: While nursing homes are a place for many people to regain strength so that they can return to the community, the ebb and flow of the facility often runs counter to one's attempt to be independent. Nursing aides, in an attempt to be efficient, will often perform even the simplest tasks for residents all in the name of saving time. Unfortunately, this has unintended consequences -- it fosters dependence instead of independence. Resident's should try to do as much for themselves as possible. Ask if residents can bath, dress, and get around without constant interference from the staff. If a resident seems to be growing more dependent upon assistance, talk with the nurses and ask if an occupational therapist could evaluate.