Aug. 30, 2004

AMARILLO – In August, news sources across the country included reports on:

- An 87-year-old woman, wheelchair-bound and living in a nursing home in Pittsburgh, who was assaulted by a handyman;

- A 50-year-old nursing home resident in Lexington, Ky., who was arrested after stabbing a police officer responding to a call from the employees;

- An 87-year-old woman in Temple who died after being left in a nursing home van for several hours during the summer heat;

- Two residents of an assisted living facility in Alexandria, Va., who had to call 911 for help at 2:55 a.m.. When emergency workers arrived, they discovered all three on-duty employees of the facility were asleep.

What is going on? Are extended care facilities falling apart? Are any of them safe places for older adults who can no longer live alone? Most of these kinds of facilities are safe, said Andrew B. Crocker, Texas Cooperative Extension gerontology and health specialist in Amarillo. Don't let the occasional news story affect such an important family decision, he said.

And make sure it is a family decision, he said.

"One thing that is most important is to involve the older loved one in the decision as much as possible. Families (who have faced this decision in the past) will tell you if you've had this discussion with the loved one, that is a big comfort.

"It needs to be a conversation that involves everyone as much as possible," he said. "Everyone needs to agree."

But once everyone has agreed on the need for some kind of assisted living for a loved one and before choosing that facility, "do your homework," he advised.

One place to start is with the Texas Department of Human Services. The agency's Web site is http://www.dhs.state.tx.us/ . One link is to Nursing Home Consumer Information. Crocker recommends clicking on that link and from there, clicking on the link to Find a Long-Term Care Facility or Home Health Agency, and then clicking on the link to Quality Reporting System. The direct Web address is http://facilityquality.dhs.state.tx.us/ltcqrs_public/nq1/jsp2/qrsHome1en.j sp?MODE=P&LANGCD=en

This site, which is also available in Spanish, provides a wealth of information, including the numbers of beds in each facility, the facility's rating, and the number and type of violations, if any.

"Before you go look at the place, do your homework," Cocker said. "Once you get there, remember the cosmetic is important too. Make sure the facility is nice." Are the grounds and facility clean and well-kept? Does the air inside the building smell odd?

Once the family selects a care facility for their older loved one and the move is made, relatives need to be aware that vigilance doesn't stop there, Crocker said.

"Make random visits," he said. "Go by at different times. Go by at least once during meal time. See how residents are fed. Are the meals appetizing?

Visit at odd hours and after shift changes, which are usually 7 a.m.-3 p.m., 3 p.m.-11 p.m. and 11 p.m.-7 a.m., Crocker suggested.

Know who the employees are and what their qualifications are, he said.

"Most facilities have a registered nurse as director of nursing. Medication aides have to be certified, and most of the assistants should be certified nurse's aides."

Keep the lines of communication open, Crocker said. "If the loved one is not mentally impaired, he or she can tell you if something is wrong. Encourage the loved one to tell you when there is a problem, then you go to the facility and take it up with the person in charge."

Another help to Texans is the ombudsman program of the Texas Department on Aging. On the Web, information on this program can be found at http://www.tdoa.state.tx.us/Ombudsman/NHLTCovervw.htm .

These volunteer ombudsmen "can receive training to go and spot-inspect a nursing home and be advocates for older adults," Crocker said. "They do a fantastic job. A lot (of these volunteers) start out because they had loved ones in nursing homes and wanted to insure others' loved ones are taken care of."

More information on care for older adults can be found at the Web site of the Department of Family and Protective Services, formerly called the Texas Department of Family and Protective Services, Crocker said. Go to http://www.tdprs.state.tx.us/Interest/Elderly.asp for a Web site on Protecting the Unprotected.

Deciding on a care facility for a relative isn't an easy thing to do, Crocker said, but if families research their options, check out several facilities before making the decision, are aware of their loved one's quality of life, and are happy with their choice, they've done the best they can.

For more information on this and other issues affecting older adults, visit Extension's Family and Consumer Sciences Web site at http://fcs.tamu.edu/ and click on the link to Family Life.