Well this is encouraging. On Friday the Centers for Medicare and Medicaid Services - the federal agency that sets quality standards for nursing homes – issued new guidelines for nursing home surveyors that emphasize the importance of “resident quality of life” and “homelike environments.” CMS says the goal is to get nursing homes to focus on resident-centered care. It’s about time, don’t you think? And just what have they been focusing on prior to this decision? Profit margins?

Last fall my father had to spend several weeks in the nursing home that is part of his Florida continuing care retirement community. He had fallen in his apartment, received treatment at a local hospital and then was discharged to the nursing home for rehabilitation and physical therapy. To be blunt, initially it was a terrible experience. When we arrived at the nursing home, they assigned my father to a room and then left us to fend for ourselves for what felt like an eternity. How wonderful it would have been to have someone – a nurse, an administrator, anyone -  take a few minutes to welcome him, explain his daily schedule, meal options, etc. Yes, I understand that he was just one of many patients they had to deal with. But a little warmth and time spent in his admission would have gone so far in starting things off on the right track. Instead I left the nursing home that afternoon with a knot in my stomach, with no confidence in the care he would receive. It certainly did not feel like a “homelike environment.”

One of the other points in Friday’s CMS report is that nursing homes should start to pay “close attention to resident’s preference for his or her own daily schedule.” I know this will be a difficult task, but how wonderful it will be for the residents in nursing homes that can fulfill this suggestion. My father prefers to eat his dinner later in the evening, 6:30 at the earliest. While he was in the nursing home, he had to eat at 5pm. That may seem like a minor issue, but to anyone who has dealt with a family member in this situation, you know that it has a big impact on their attitude and sense of dignity. One of the things that upset my father the most while he was in the nursing home was that he was dependent on the nurses and CNAs just to use the bathroom. He would have to ring the call bell and then wait, and wait, and wait, for someone to come into his room to help him up to the bathroom. As you can imagine, at 84-years-old, this was often an urgent issue for him.  But most of the nursing staff seemed to exhibit total disregard for this.

I believe that part of the problem initially was that my father was placed on a floor where most of the other residents were much more incapacitated that he was. So I think the staff was a bit slack – it is tempting to not be “resident-centered” if the resident doesn’t know the difference, and can’t even articulate any frustration. He was also placed in a corner room at the end of the hall, a bit of the “out of site, out of mind” phenomena. After my sister and I raised a fuss, he was transferred to a different floor and that’s when things turned around. He was surrounded  by more active residents, and more engaged staff members. I recall the dining supervisor found out that he had been asking for honey to go with his hot tea (which was usually served lukewarm, by the way). Just when he had given up on ever getting honey, she arrived with several small packets  delivered personally to his room. A small gesture that made a big impression.

I’m sure there are nursing homes in Florida and the rest of the country that already focus on “resident-centered care” and “homelike environments.” But there are far too many that don’t. This won’t happen overnight. But I have hope that these new survey guidelines will at least get these important issues on the table and create greater accountability for nursing homes. If you’d like to learn more about the CMS guidelines, visit http://www.cms.hhs.gov/transmittals/downloads/R48SOMA.pdf

For a searchable database of nursing home in Florida, visit Florida Senior Living Advisor.

This just makes me sick to my stomach. Yesterday police in Punta Gorda, in southwest Florida, arrested an employee of the Punta Gorda Elderly Care Center on charges of abuse and battery on a 76-year-old resident. Police say 58-year-old Letitia Calderwood was employed as a Certified Nursing  Assistant at the facility. According to police, an employee of the center reported Calderwood had requested the assistance of her and an additional employee in helping the resident who had fallen in a bathroom. Calderwood and the two other facility employees had difficulty helping the resident to her feet and reports say Calderwood subsequently kicked in her lower back while using a profanity. Once the resident was helped to her feet, Calderwood reportedly struck her in the face with an open hand.

Detectives say Calderwood admitted to kicking and striking the resident as originally reported. She reportedly stated that her actions were done out of frustration although she knew the patient was disabled and had limited ability to stand on her own. Calderwood was arrested and transported to the Charlotte County Jail.

Thank goodness the other employees of this facility immediately stepped forward to report this alleged abuse. If you are concerned that someone you know is being abused or neglected in a Florida senior living facility, you can report it to the Florida Department of Children and Families. On their website – http://www.dcf.state.fl.us/abuse/ – you will find detailed information about the Florida Abuse Program, and how to submit a claim via phone, fax or online.