I forgot what I was doing,
Retraced my steps,
On my way back, have no
idea what’s going on
and now I have to pee.
— Author Unknown
I believe it was Bette Davis (April 5, 1908-Oct. 6, 1989), a two-time Academy Award-winning American actress of film, television and theater, who said, “Old age ain’t no place for sissies.” And after one full year of asking for my “senior discount” at the movies, I’m beginning to see why.
It’s a particularly unpleasant aspect of aging. The older you get, the more prone you are to falls resulting in fractured bones, Alzheimer’s disease and dementia, multiple sclerosis, Parkinson’s Disease, heart disease, strokes, obesity and other chronic or terminal medical conditions.
In fact, Americans over the age of 65 have a 40 percent chance of entering a nursing home (source: The Wall Street Journal). A 2014 study from the Center for Retirement Research at Boston College broke it down a little further: 44 percent of men and 58 percent of women will specifically need nursing home care at or after age 65.
Why more women than men? Of course one reason is that women outlive men. But I believe the real reason (not backed up by any scientific study) is because if the man gets sick, the woman cares for the man at home. However, if it’s the woman who gets sick, the man throws his hands into the air and says, “I can’t do it,” and off she goes to the nursing home.
Now, the good news is that Congress passed a law known as the Nursing Home Reform Act in 1987 to make sure that nursing homes “must provide services and activities to attain or maintain the highest practicable physical, mental and psychosocial well being of each resident in accordance with a written plan of care.”
Unfortunately, the bad news is that nursing homes tend to violate the federal law and harm residents every day as a matter of standard procedure. This happens in both “good” and “bad” nursing homes. That’s why, in order to protect your loved one who is in a nursing home from abuse and neglect, you need to know the law and your legal rights.
For example, a nursing home must prepare a full-written assessment of a resident’s condition within 14 days after admission, and thereafter at least once every 12 months and after a significant change in the resident’s condition. More limited assessments must be done at least once every three months.
Also, a care plan can be reviewed and revised at any time as necessary. The care plan is prepared by a team that includes the resident’s doctor, a registered nurse, a nurse aide who works with the resident and other appropriate nursing home staff members.
Mos t importantly, the team should include the resident, the resident’s legal representative and/ or a member of the resident’s family.
What Might a Care Plan Include? Following are some examples:
- Assistance with daily activities such as dressing, eating and using the toilet
- Assistance with brushing teeth or cleaning dentures
- A favorite game or song or dietary restrictions and preferences
- Need to be repositioned frequently in order to avoid skin breakdowns
- Exercises or interest in visiting a nearby park
- Preferred schedule for waking up and going to bed
- Preparations for moving out of the nursing home
Some nursing homes treat care plans as a meaningless formality, resulting in care plans that are heavily repetitive from one resident to another. Such drowsy care planning can harm residents. To be meaningful, a care plan truly should address individual residents’ needs and preferences.
To ensure a good care plan, the resident and family member should attend all care plan meetings. If the nursing home fails to give notice of the meetings, the resident or family member should ask when the meetings are being held, and request to be included. Take care planning seriously. An individualized care plan can be invaluable in improving a resident’s life.
To promote the resident’s choice, the resident or resident’s representative should not hesitate in making requests. The nursing home receives thousands of dollars for the care of each resident. And money aside, there are legal and moral reasons for treating each and every resident as an individual human being.
Judd Matsunaga is the founding attorney of Elder Law Services of California, a law firm that specializes in Medi-Cal Planning, Estate Planning and Probate. He can be contacted at (310) 348-2995 or firstname.lastname@example.org. The opinions expressed in this article are the author’s own and do not necessarily reflect the view of the Pacific Citizen or JACL. The information presented does not constitute legal or tax advice and should not be treated as such.