Nursing homes are often the end game

I am confident most of you heard the news about the 14 seniors who died from overheating after Hurricane Irma in September. They were all in a licensed “nursing home” in Hollywood Hills. Nursing Home is a euphemism for a home for seniors who are at the poverty level and qualify for Medicaid.

Nursing homes are like every other industry; they have to make money to survive. In the case of nursing homes they are paid by the state Medicaid fund and it is per patient. This fund is made up of state and federal dollars. Obamacare expanded medicaid in the states that took the federal dollars but Florida is not one of them.

Bottom line: these are not the luxurious environments for either staff or residents. In my parents’ case, Mom had been in a lovely residential facility where she was one of three or four people. Her Long Term Care Insurance paid for it. She outlived her two-year policy and we had to place her in a nursing home. It was our only realistic option as Mom’s care in an Alzheimer’s facility would be close to $7,000 a month. Mom and Dad couldn’t afford it and neither could the children.

In pursuit of the best we could find, I went to several nursing homes and learned more than I needed to know. All these homes are very austere and it is a shock. Bare floors, usually formica, and waiting rooms with plastic chairs. Almost all the receptionists were behind a barrier — some better designed than others.

The patient population is made up of mostly Alzheimer’s and dementia sufferers. All the residents are in a wheel chair, a portable bed or never moved from their beds.

Another surprise, the aides often use pulleys attached to patients to change their clothes, move them to the shower or simply change their diapers. Depending on the home, these medical aides must change and clean about 19 patients each. Some work in tandem, others work solo; it all depends on the chore.

Further, most patients are only bathed twice a week, maximum three times a week. During one of these showers their hair is washed. Bottom line: it is not how we envision our last days, weeks, months or years of life.

On the good side, the “better nursing homes” have excellent care. They hire a team of geriatric doctors that include psychiatrists. These geriatric groups come to the nursing home through a PPO and the doctors physically visit once a month. There usually is a podiatrist group that also visits once a month (Medicare pays for podiatry services) and a dentist who comes once a quarter. The day-to-day care is with the registered nurses (RNs), Licensed professional nurses (LPNs), physical therapists and medical technicians. They also have a contracted Hospice service.

Here are some tips when you need to look for a nursing home:
What is the turnover rate of its employees? Needless to say, the less turnover the better the place. If the staff is not leaving then something is going well — usually their paid above average wages.

Is there a hair salon? If there is a hair salon, then there’s a market for it. This means the residents take pride in how they look. People who take pride in themselves care about their environment.

Is it clean? As we all know, cleanliness is godliness.

Is there a smell? Again, if it smells, that means it is really not clean no matter how good it looks.

Is there a smile on the faces of the staff? A smiling staff means a happy staff.

Again, hopefully it doesn’t come to this, but if it does, know how to choose the best one.

Frances Reaves, Esq., a graduate of the University of Miami Law School, spent 10 years as a litigator/lobbyist. Today, she Is an accomplished business woman who, when her parents could no longer take care of themselves, learned the ins and outs of senior care (or the lack thereof). She founded Parent Your Parents to assist seniors and their children through the myriad pitfalls and options of “senior care” in the 21st Century. If you have any questions or comments contact Frances at

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