Entering nursing home is a tough decision

By MISTY MAYARD

Monday, April 2, 2007 6:00 PM EDT

EDITOR’S NOTE: At the turn of the 20th century, Americans could expect to live to the ripe old age of 47. Today, according to the Centers for Disease Control National Center for Health Statistics, the average American can expect to live 77.9 years.

As the percentage of the population which reaches "old age" continues to increase, we are faced with how to best prepare for it. Over the next few days in a series of stories we will examine the process of aging in our area and the unique problems it presents, not only for those who are aging but also for those who are charged with the care of those who cannot care for themselves in their golden years.

Three years ago Bob Biddle made the decision to place his parents in the Maysville Nursing & Rehabilitation Facility.

Biddle’s father was developing dementia, and his mother was unable to care for herself any longer, Biddle said.

While his father died last August, Biddle’s mother, May Biddle, remains a resident at the facility.

The decision to place a family member in a nursing home can be difficult for many, but Biddle said it was the best option to guarantee the care needed for his parents was provided, and their quality of life did not suffer.

"The nursing home has been wonderful," Biddle said of the Maysville facility. "I can leave there and know she’s under good care."

At 98 years old, May Biddle has more of a social life now than she ever did at her home, Biddle said.

"My mother goes to bingo … and church," he said. She exercises, and has a number of friends in the facility. Bob Biddle said she also receives more visitors than she ever did at her home.

"It’s been good for her," he said.

Biddle himself visits his mother every day.

"I’m an only child, so I watch her pretty closely," he said.

In addition to the social aspects, Biddle said his mother receives the assistance she needs to complete various daily activities, as well as the nursing care she requires. The staff is pleasant and professional, and Biddle said the remodeling of the facility recently made it even better.

"She’s very satisfied," Biddle said. And so is he, with the convenient location, right in Maysville, and the quality of care.

While Biddle’s decision to place his mother in a nursing home was not hard to make, others find the decision to place loved ones in a long-term care facility difficult.

"There is a lot of self-inflicted guilt," said Belinda Fay, director of nursing at the Maysville facility. "It does become a very heavy decision for these folks."

While many would prefer to keep loved ones at home, there may come a time when the level of care required goes beyond what the family member can provide. In Biddle’s case, as an only child, it would have been difficult to care for an elderly mother and father, especially when his father was developing dementia.

The initial decision may be difficult, but many times the families and the residents of nursing homes find once they each adjust to the new situation, it is much better than previous circumstances.

"A lot of the elderly are very isolated at home," said George Balz, administrator of Ohio Valley Manor Nursing & Rehabilitation Center, adding their move to a nursing home can actually result in an improvement in their quality of life.

Balz said many times the resources needed to care for an aging or infirm family member may not be available in the home. If the family member requires 24-hour supervision and that cannot be provided because of work responsibilities or for other reasons, or the medical condition is too complex, the nursing home may provide the necessary environment.

"It’s a judgment that the family has to make," he said.

Nursing homes in the area provide a number of services to the elderly or infirm. In addition to medical care there are also various therapeutic services, from physical and occupational therapy to speech therapy. While many people associate nursing homes with long-term care, Ohio Valley Manor, Maysville Nursing & Rehabilitation Facility and Pioneer Trace Nursing Home in Flemingsburg all offer short-term care for those who need the different kinds of therapy.

Those who may need to become short-term residents of the nursing home are those who get joint replacements, experience strokes, have motor vehicle accidents, or suffer from other temporarily debilitating conditions.

In most nursing homes, the staff to patient ratio is minimal. Each facility staffs according to the acuity of the patient. At Pioneer Trace, according to Cyle Hazelrigg, social services director, the ratio is typically about eight patients to every staff member. The facility is a 93-bed facility, though currently there are only about 72 patients.

At Ohio Valley Manor, which has 150 residents, the ratio is different for each shift, but ranges between five patients to every nursing staff member during the day to about seven patients per nursing staff member at night.

At the Maysville facility, the staff to patient ratio is about five or six to one. The facility has 135 beds, though currently it has 120 patients.

Nursing home facilities are evaluated annually, and whatever deficiencies are noted must be corrected within 60 days of the evaluation.

The Medicare Web site lists the evaluation results of facilities which are approved for Medicare and Medicaid. In the 2006 evaluations, both Ohio Valley Manor and Maysville Nursing & Rehabilitation had five deficiencies in various areas. Pioneer Trace Nursing Home had 17 listed deficiencies. The Web site not only provides the types of deficiencies noted, but rates the deficiencies according to level of harm and the number of residents affected from few to some to many.

Ohio Valley Manor’s deficiencies ranged from failure to give residents proper treatment to prevent new bed sores or heal existing sores to making sure staff members wash their hands when needed.

Among Pioneer Trace’s deficiencies were failure to provide care in a way that keeps or builds each resident’s dignity and self respect to keeping adequate and comfortable lighting in all areas.

Maysville Nursing & Rehabilitation’s deficiencies include failure to give or get dental care for each resident and failure to quickly give a resident’s personal money to the heads of his or her estate after the resident’s death.

Balz said a nursing home cannot keep its license unless deficiencies are corrected.

According to the Medicare Web site, all deficiencies in each of the three facilities mentioned were corrected within 60 days, as required.

The Web site also gives percentages comparing each facility with the average in Kentucky and in the nation for various quality measures. For example, Ohio Valley Manor gave 93 percent of long-term residents the influenza vaccination during flu season, compared to the average of 91 percent in Kentucky, and 87 percent in the nation.

Before deciding whether a nursing home is the right option for a family, the Medicare Web site provides a handy resource for families. And staff at every nursing home suggest researching options and visiting the facility before making the decision.

"I counsel people through (the transition)," said Hazelrigg. "But it’s not my place to talk them into it. They have to decide what’s best for their family member."

Contact Misty Maynard at 606-564-9091, ext. 274.

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