Mary K. Fleck

In the legal profession, we often hear concerns over care in nursing homes. Nursing homes do wonderful things for our loved ones. Nursing homes offer the expertise and care needed when the time comes that seniors cannot live independently. But our elderly family members are at their most vulnerable when they are in nursing homes and they need protection.

There are seven things which we can do to make sure that our loved ones are safe when they become residents in nursing homes.

1. Keep contact information current. Make sure the facility has home, work and cell phone numbers.

2. Visit often. Family members who visit often can be the resident's eyes and ears. Vary your visit time to include evenings (6 p.m. to 8 p.m.) and weekends before and/or after meals. This will provide a good picture of resident care during periods when the facility is staffed at its highest and lowest.

3. Have a durable power of attorney and living will. A durable power of attorney puts a responsible family member in charge in the event the resident is incapable of making decisions. A living will directs how the resident should be cared for in the event of a terminal condition. Be sure that the nursing home and the resident's primary care physician have a copy.

4. Know the signs of abuse or neglect. Signs of physical abuse include bruises, black eyes, cuts, burns, sudden changes in behavior. Signs of neglect include bed sores, falls, messy or inappropriate clothing, poor personal hygiene, malnutrition and dehydration. If the resident is withdrawn, agitated, upset or engaged in rocking, sucking or biting, he or she may be experiencing emotional abuse. In addition look for bruising on the trunk area in places not normally vulnerable to bumps such as breast and inner thigh area.

5. Ask about the facility. Check the website operated by the Washington State Department of Social and Health Services, http://www1.dshs.wa.gov. The website contains links to the federal government and helpful information about all nursing homes in Washington State and any DSHS deficiencies.

6. Communicate. As people become old and infirm, they are often unable to communicate well or to advocate for themselves. Family members must step in and communicate. The first step is to know the names of the care providers and second, to develop a good relationship with them. Talk regularly with all the care providers, nursing home staff, social workers, administration and nutritionists. Ask to attend care conferences or team meetings to be involved. If you are unable to attend the care conference, request that a copy of the care plan be sent to you for review with a follow-up phone call for any questions or concerns you and/or the facility may have.

7. If you have concerns or complaints, talk candidly to nursing home administrators. If you have serious concerns about the resident's care, contact DSHS's Long-Term Care Ombudsman: 1-800-562-6028. If you suspect a vulnerable adult is being abused, contact Adult Protective Services toll-free at 1-866-ENDHARM.

Mary K. Fleck is a partner with the law firm of Rogers & Fleck, PLLC. She resides in West Seattle and is experienced in representing families of persons injured in nursing homes.