I am frequently asked how to find a good nursing nursing home. My answer is . . . LOOK FOR BEDSORES.
The fact is that choosing a nursing home is difficult. For most people, it may even be the most difficult and stressful decision in their lives because it is not your life that your decisions are ultimately affecting. I recognize that this last statement isn't exactly true. For many working adults, a nursing home is the last best option available when a parent isn't safe at home by themselves while you must work.
However, for the most part, this is not a decision about the family, it is a decision about the person that needs around the clock care. Let me also qualify my answer by saying that bedsores should never be the only factor that you consider, but I consider it an opening and absolute requirement. In other words, start by choosing a nursing home that is above average in prevention of bedsores.
Once you have met that wicket, then consider everything else. My reasoning is very simple. Bedsores or pressure ulcers happen very quickly. They are preventable and generally occur when a patient is allowed to remain in one place for extended periods of time causing sustained pressure.
The key to the prevention of bedsores is regular relief of pressure. This is typically prevented by moving a patient regularly. So, if a nursing home is good at preventing bedsores, this means that they are also good at providing regular one-on-one care to monitor the skin, have a system in place to do so every shift, and, when necessary, actually provide personalized care. Furthermore, it is my experience that the only way that this can occur systematically is by developing, implementing, and enforcing strict behaviors among nursing home staff. It is a sign of high standards and good management.
On the other hand, when a person is in a wheelchair and sits in it all day without adding cushions, or is in a bed and lies on their back for long periods of time, or has incomplete or non-existent skin inspections, then bedsores are more likely. These are signs of poor management, uncaring staff, and a lack of concern for patients.
New York recognized this problem some time ago by instituting a “ War on the Sore.” One facility in New York, St. Barnabas, was able to decrease pressure sores by 56% through monitoring and care. Dr. Mary Jane Koren, Vice President of a health care quality think tank has stated that “ It's hard to pin all of your assessment of quality on a single indicator, but [pressure sores] are a good indicator if you had to pick one.” Of course, New York's fine of $2000.00 is not a deterrent for bad management. “Our goal isn't to be punitive or to collect fines, but to make sure that the quality of care is being met,” said Jeffrey Hammond, a spokesman for the New York State Department of Health.
I would submit to you that the best deterrent to bed sores is first to choose a nursing home wisely and, should a bed sore occur, call an attorney. There is no better deterrent for a nursing home that the possibility of a lawsuit. At Rumph Childers we are dedicated to contributing to the prevention nursing home abuse by holding nursing homes accountable. We help make it impossible to make a profit by neglecting nursing home patients — one case at a time.
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