Clicking on banner ads enables JWR to constantly improve
Jewish World Review Dec. 21, 2004 /9 Teves, 5765

Jan L. Warner & Jan Collins

JWR's Pundits
World Editorial
Cartoon Showcase

Mallard Fillmore

Michael Barone
Mona Charen
Linda Chavez
Ann Coulter
Greg Crosby
Larry Elder
Don Feder
Suzanne Fields
James Glassman
Paul Greenberg
Bob Greene
Betsy Hart
Nat Hentoff
David Horowitz
Marianne Jennings
Michael Kelly
Mort Kondracke
Ch. Krauthammer
Lawrence Kudlow
Dr. Laura
John Leo
Michelle Malkin
Jackie Mason
Chris Matthews
Michael Medved
Kathleen Parker
Wes Pruden
Sam Schulman
Amity Shlaes
Roger Simon
Tony Snow
Thomas Sowell
Cal Thomas
Jonathan S. Tobin
Ben Wattenberg
George Will
Bruce Williams
Walter Williams
Mort Zuckerman

Consumer Reports

Our fight to improve Mom's care | Q: When our mother was no longer able to care for herself at home due to a stroke and (what her doctor calls) dementia — even with caregivers around the clock — my brother and I spent a good three months interviewing and visiting various facilities to find the right one.

We made surprise visits to each facility on our list, got the 50-cent tours, checked out references and even looked up each facility on various Internet comparison sites. We looked into their licensing status for violations at the state level and personally met the administrator of each facility. We even enlisted the assistance of a licensed geriatric care manager to help us.

After Mom was admitted to one we approve of, we sighed with relief, but little did we know that finding a facility was not the hardest job. The hardest job has been making sure our mother receives appropriate care. We have had a series of disagreements with the administration about what we consider to be substandard care, less-than-adequate levels of help for Mother, her difficult (for lack of a better word) roommate who keeps her awake all night, a lack of privacy, and what we consider to be disrespect for our mother as a person. The facility refuses to move Mother or to medicate her disruptive neighbor.

We have talked until we're blue in the face. We have written letters and notes. For the more than $5,500 per month my brother and I are paying, it would seem we could buy our mother some type of respect and peace, but it does not. Short of moving her, something we do not want to do because our "inspections" would start all over again and she would be disrupted, do you have any suggestions?

Donate to JWR

A: As facilities of last resort for folks who don't want to live there, and families that don't want to place their loved ones there, nursing facilities have the daunting task of caring for the sick and chronically ill, while, at the same time, convincing family members that their relatives are receiving the best money can buy.

In truth, however, family members may tend to be overly concerned (not that that's entirely a bad thing) that the facility is not providing ideal care for a loved one. The question becomes when does the care become so substandard and deficient that legal or other types of intercessions are mandated.

Making that distinction is often difficult for a family member basing his or her opinion on subjective factors. So it's best to retain that geriatric care manager (like the one you consulted) to make independent and objective assessments of the facility and the plan of care.

Your mother has both federal and state rights within the institutional setting that protect her from loss of dignity and guarantee her appropriate care. In fact, the federal Nursing Home Reform Law of 1987 mandates that each nursing home resident be provided with services that allow him or her to function at the highest levels possible.

For example, unless authorized in writing by a physician (and, even then, for limited periods of time), the facility can't medicate your mother — or her unruly neighbor, for that matter.

And if your mother's health deteriorates or her care plan is expected to change, the facility must notify your mother, her physician and you as her interested family member before a change is made. Then there are her rights to privacy, to assemble with other residents, and to meet with agency personnel and investigators, all without fear of interference and reprisal for exercising her rights.

Based on our experience, being forceful in pointing out problem areas is generally destined to bring good results. But if talking fails and the problems worsen, consider contacting your state long-term care ombudsperson, who has the right and responsibility to get involved and try to secure an appropriate result.

As an advocate for nursing home residents, the ombudsman is trained to head off and resolve problems. Since every state must have an Ombudsman Program, you can go to to find the ombudsman nearest you. Please remember that, if all else fails, you may need to hire an attorney to help resolve the issue.

Find this column helpful? Why not sign-up for the daily JWR update. It's free. Just click here.

JAN L. WARNER received his A.B. and J.D. degrees from the University of South Carolina and earned a Master of Legal Letters (L.L.M.) in Taxation from the Emory University School of Law in Atlanta, Georgia. He is a frequent lecturer at legal education and public information programs throughout the United States. His articles have been published in national and state legal publications. Jan Collins began co-authoring Flying SoloŽ in 1989. She has more than 27 years of experience as a journalist, writer, and editor. To comment or ask a question, please click here.


The long path to deducting at-home care
Getting respite for adult caregivers
Do we tell the kids they're not in our plan?
HIPAA hurts careless life planners
Son's sins infect Mom's care
The sudden pitfalls of an immediate annuity
Furious at home's poor care of Mom
How the government bilks seniors
Solid answers about osteoporosis
The taxing affair of gift giving
Searching for a facility that offers independence
Does anesthesia enfeeble the elderly?
Warning about 'Do Not Resuscitate' (DNR)
Why is Mom such a hoarder?; Medicaid law may leave child homeless
Brother's reaction to Mom's death angers siblings
Unwisely reducing drug dosages
Why is my sick husband frantic at sundown?
Are Dad's living expenses tax-deductible?
Recovering confidence after a fall
How do I plan my estate?
My parents need a caring lawyer
Can banks reject powers of attorney?
Tech innovations help parents remain home
Looking back for a healthy future
Alzheimer's-stricken Mom is destroying marriage
A cautionary tale of quick-fix mortgages
Why can dad's new wife control his life?
Sister's early death sparks family estate war
Poor financial planning leaves Dad cash-strapped
How do I protect my parents from falling?

Bad 'Will' makes seniors prey
Bankrupt seniors now the debt generation
How can we help ease Dad's depression?
Compensating sister for Mom's care; purchasing life insurance policies from terminally ill individuals
My aunt profited from grandpa's weak will; foreclosing against senior is best
Pay employer taxes for caregivers?
Help Mom organize her finances
Where can seniors get the best health info?
How do we stop our mooching daughter?
Can you stop a double-dealing lawyer?; caregiver red flags
How the government bilks seniors
Dad's new wife took the inheritance
Parents' trustee choice a hidden blessing
Finding the money for home care
Elderly mom is sweet on a hunky aide
'Ziva' gets the scoop on nation's nursing homes
Care decisions for 'elder orphans'
Seeking help for dementia victims
Read admission-package 'agreements'; booting a patient once Medicaid kicks in
Can the kids block our cash flow?; childless couple agonizes over whether to use
powers of attorney or a living trust to manage our assets

Control your assets from the grave
Slacker son will blow his fortune; lawyer's role in "estate-planning"
Mom remarried and spent my inheritance; doesn't want daughter-in-law to receive anything from estate
Can we stop our brother from swindling us?
What Gifting Will Disqualify You From Medicaid
The 'magic' language for a power of attorney agreement
Is care insurance a healthy choice?
Is there protection against Medicaid costs?
Long-term care insurance comes up short
HIPAA -- too much privacy?; nursing home doc could care less
Private pay nursing home residents pay more
Separated families should use care managers
What Makes Up a Caregiving Team?
Who is the client, parents or children?:

© 2004, Jan Warner