What is the best way to bring concerns to nursing home staff about their treatment of my dad who has dementia?

1 answer | Last updated: Sep 20, 2016
A fellow caregiver asked...

When my dad was first admitted into a nursing home for Dimentia-Alzheimer's Type, I experienced a huge learning curve in mastering nursing home etiquette. In the two nursing homes my father has been in there have been very different methods for and responses to requests for changes, inquiries, or updates to treatment. I have avoided going the route of the Ombusman when things got difficult as I did not want to be considered advisarial. It seems that becomes the blanket judgment anyway though if I question decisions or treatment of my father's care. I want to be respectful of the ginormous job they do and still be my dad's advocate. Any suggestions?

Expert Answers

Brenda Avadian, brings knowledge, hope, and joy to family caregivers for loved ones with Alzheimer's and dementia. She cared for her father with Alzheimer's and helps families one-on-one and in groups. She is the author of eight books, including the pioneering memoir "Where's my shoes?" My Father's Walk through Alzheimer's and the Finding the JOY in Alzheimer's series. She presents vivid, compelling, and funny keynotes to both professional and family caregiving audiences.

There three critical steps to dealing with issues with nursing home care for a loved one with dementia or Alzheimer's.

The first is communication.

In trying to find a mutually agreeable outcome, clearly (and gently) express your perceptions.

Then ask questions. For example, if the staff is doing something you don't like or don't understand, gently ask why or how the actions fit within their procedures.

Try to sincerely arrive at an understanding; especially, since you see differences in the other nursing homes your father has lived in.

Sometimes it's a misunderstanding or a state mandate (requirement).

In either case, arrive at an agreement of how to proceed; whether this entails a change in staff actions or an acceptance on your part that this is the way things are done.

Second, follow-up.

Observe then follow-up.

Usually, the hands-on caregivers (CNAs) are willing to work with you if they perceive you to be a concerned and involved family member. If management gets defensive, try to hold your own emotions in check (this is very hard when it's your father), and gently share what you observe and ask how they advise proceeding. After all, they are the experts you're paying to care for your father.

Keep observing and following up. Follow-up is the key to being successful and where many fall short in their attempts to constructively work with nursing home staff.

Third is patience.

Remain committed. After all, if the care is acceptable, you don't want to increase the stress in your life much less your father's by moving from one nursing home to another. Eventually, you will prevail.

You are to be commended to try to find a way to work around the issues without taking steps to be adversarial. Sadly, your efforts will be compared (perhaps unfairly; perhaps too hastily) to others' who lose patience and take a less constructive approach.

My best wishes to you and please update us on how these steps work for you.