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Karsten Asked March 2018

Should I be calling the nursing home every day to check up on my dad's status?

I have probably overused this very helpful site a lot lately. So sorry for that. But my Alzheimer's dad was put in nursing home a few days ago (looking to maybe move him to memory care) but I have called every morning to find out how he did overnight, etc. I think the nurses have sounded a bit annoyed by this. Maybe it is not customary to do this. Perhaps they assume that they will call you if something is wrong. And I guess for my own benefit, the reason we pay to have him there is so people take care of him and I don't have to be worrying all the time. I cannot call my dad as he is not cognitive enough to answer phone and talk. What do people usually do on this? Perhaps I am being overly hovering.

freqflyer Mar 2018
Karsten, I can fully understand your worry about Dad. But it is time to cut the engine to the helicopter.

When I first placed my own Dad into senior living I also was worried. Then I realized if anything was out of the ordinary or if Dad fell, that the facility would call me. Dad was in good hands and Dad liked where he was living :)

GardenArtist Mar 2018
I think this is always a judgment call, varying depending on your father's strengths and weaknesses, as well as your availability to visit in person.

I try to visit more during the first days to make it known that I'm involved. Questions are raised when I'm there when nurses, aides or doctors are available, but I also call from home to get answers.

Generally the staff are more responsive, and in more detail than at hospitals, where I think there's an assumption that most families can be comfortable with generalized responses rather than specific answers to specific questions.

I.e., I want to know if the CHF or pneumonia or whatever is responding to antibiotics. In rehab, I want to know if therapy is strengthening or if the status quo prevails.

I don't want just a "he's doing better" response. This is partly why I spent time years ago learning the medical terms so I can approach staff on more of a detailed level.

At the current rehab facility, the therapy department head came out to speak with me when he saw me walking down the hallway. That's service! And it displays a higher level of care than I've seen at the last facility (which I would never use again).

What are your specific concerns? Are they something to the effect of whether he was agitated overnight, whether a new med was working, or are they general ones as to whether he's basically okay?

You can always ask if one of the staff will call you back, at HER convenience.

I won't deny that sometimes I feel as though I'm bothering the staff, so I always ask if they have time to respond to a few questions. Sometimes I've left lists of questions, asking that they respond when it's convenient for them.

And take the time to get to know them; bring donuts or bagels or something by which they'll remember you and like you. And thank them prolifically.

You chose the facility to provide care; you do have a right to ensure that that care meets standards.



ETA: I've just read FF's good advice. This illustrates an important issue - comfortability and confidence in the staff. As you get to know the staff, you may find that it's not necessary to check up so often. On the other hand, as I've found, sometimes it's necessary to really be diligent if the staff isn't.

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rocketjcat Mar 2018
I visit Mom daily from 10-2. If she’s been having an issue I always stop at the nurses station first on the way through to see what’s up. If things have been going well I just smile and wave on the way to her room. If for some reason I can’t go during an "issue" period I do call to check in. An aide, LPN or unit secretary is always happy to update me. But if she’s not having any issues, I don’t call. You will soon figure out if you can trust their judgement on issues....at first I obsessed and felt I needed to be in the loop on almost everything, but after I realized they were dealing with issues exactly the way I would have, I calmed down. Once you get a certain level of trust (or not) you will know how closely you need to be involved on a daily basis.
They all know me, and it’s helped a lot to be able to chat a little with the staff. I bring in a couple dozen donuts occasionally and if they’ve had to spend a lot of extra time with her like when she was quarantined, I bring Edible Arrangements chocolate strawberries etc. And I help them out with her as much as I can. You’ll see quickly how overworked and under appreciated the CNAs are.

OldBob1936 Mar 2018
Despite having empathy for your concerns, I believe you are burdening the staff with such calls. If there is something wrong with dad they will let you know.

My comment is blunt, I know. (Having spent 10 years as a twice-daily visitor to my massively handicapped wife and having hired ladies be with her at the supper hour every day, my experience is that the staff have more than enough to do with duties at hand than to be expected to handle such calls from the loved ones of residents.)

You may want to consider expressing your concerns to the NH social worker.

Grace + Peace,
Bob

BarbBrooklyn Mar 2018
Karsten, I found it useful to make contact with the NH social worker and ask the best way to contact mom's unit to find out how she was doing or to address issues that mom brought up.

I was of the best time to call, and to ask for my mother's nurse, and asking for a call back, rather than to speak to them then and there, unless it's an emergency.

Visiting in person is of course the best and doesn't have to be long. And yes, cookies and chocolate, always!

Karsten Mar 2018
thanks all. I guess there are two issues here. I suppose I do have the right to call the staff and inquire. On the other hand, for my own (selfish) benefit, I need to trust the home is taking care of him and if something is wrong they will call. When we visit (and we have visited daily so far for the most part) I can then catch up on issues. I am just new to this.

RayLinStephens Mar 2018
I could be wrong - but I say, call if that is what you need to do.

Maybe you're calling at shift change and that could explain why you don't get the responses you are hoping for. Ask if there is a better time to call. But for what a NH costs, check up daily if you need to. Eventually you will relax and not feel the need so much.

To me, your calls indicate that you care and sadly, so many place their LO's and then forget them. I think that would be a lot worse than calling daily.

And please, don't think you're overusing this site (or any other) as this is what AgingCare.com is here for.

GardenArtist Mar 2018
Karsten, I think most of us are in situations where we experience new issues as we make this challenging journey. So I compliment you on your diligence in caring for your father and ensuring he's getting the care you want.

Assuming that you feel more comfortable as time goes along, you might want to think about gradually decreasing your visits, or showing up randomly.

Adding to my previous post, there were times in various facilities (as well as in hospitals) that I felt I should have been notified about a negative change but wasn't. In that case I usually try for a short meeting with a nurse, or DON, explain my concerns and ask how we can communicate better in the future....i.e., what could I have done, taking the responsibility on myself rather than blame someone else (even if they should have been blamed!).\

An opposite situation occurred recently. A life threatening event occurred, test was ordered, internist (probably a hospitalist) called me and asked me to rescind the DNR order b/c of the dire situation. Given his explanation (malignant mass on the larynx), I did. Following up, I spoke with the doctor who ordered the test, and learned that the initial diagnosis was wrong.

KellyOrtega Mar 2018
I've been the nurse on these units for many years and I can tell you that every time one of us, be it a nurse, an aide, a social worker is called to the phone, it is also calling us away from our residents. We have no spare moments in these facilities, so it literally removes us from caring for people to be on the phone instead. Please be sure your calls are necessary, not for our convenience, but for your own loved one's sake. I always appreciate family members, believe me, there are plenty of people with no families or families that just don't stick around, but calling the unit is a poor use of resources and we must use our resources very wisely. What I would do if I were in your position is come in every day for the first few days, staying a little less time each visit, and getting to know the nurses, aides, social worker, and activities director. These are the folks your loved one will be closest to and they should be able to put your mind at ease. Hopefully, you can use your time there to ask any questions and avoid phone calls altogether. For an out of town family, I would suggest maybe a bi-weekly/monthly check in with the social worker and know they will call you if needed. The best times to call a unit like this in a non-urgent matter, in my opinion, is in the evening when the day has settled down and the call is less likely to interrupt something more important. Hope that helps.

Karsten Mar 2018
Thank you very much for all the great answers - answers even of diverging opinions. Very helpful. I am beginning to taper my daily visits to every other day, and getting to know the staff there on visits to communicate my concerns. I may check in on an a no visit day on phone, but we will see. I agree it is both somewhat of a burden to me, and most of all a burden to the staff who have many patients (i.e. other peoples parents) to care about. (I am kind of amazed how during my visits, that I see very few visitors to the other patients, maybe they are long tie patients and their LOs know the drill). I also have established a pretty good email hotline with the Social Worker whos is not always the person directly in charge of my concerns, but she get pass them on to the right person ,and can read and act on the email at her convenience. Thanks again all.

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