Should I be calling the nursing home every day to check up on my dad's status?

Karsten, I can fully understand your worry about Dad. But it is time to cut the engine to the helicopter.

When I first placed my own Dad into senior living I also was worried. Then I realized if anything was out of the ordinary or if Dad fell, that the facility would call me. Dad was in good hands and Dad liked where he was living :)

I think this is always a judgment call, varying depending on your father's strengths and weaknesses, as well as your availability to visit in person.

I try to visit more during the first days to make it known that I'm involved. Questions are raised when I'm there when nurses, aides or doctors are available, but I also call from home to get answers.

Generally the staff are more responsive, and in more detail than at hospitals, where I think there's an assumption that most families can be comfortable with generalized responses rather than specific answers to specific questions.

I.e., I want to know if the CHF or pneumonia or whatever is responding to antibiotics. In rehab, I want to know if therapy is strengthening or if the status quo prevails.

I don't want just a "he's doing better" response. This is partly why I spent time years ago learning the medical terms so I can approach staff on more of a detailed level.

At the current rehab facility, the therapy department head came out to speak with me when he saw me walking down the hallway. That's service! And it displays a higher level of care than I've seen at the last facility (which I would never use again).

What are your specific concerns? Are they something to the effect of whether he was agitated overnight, whether a new med was working, or are they general ones as to whether he's basically okay?

You can always ask if one of the staff will call you back, at HER convenience.

I won't deny that sometimes I feel as though I'm bothering the staff, so I always ask if they have time to respond to a few questions. Sometimes I've left lists of questions, asking that they respond when it's convenient for them.

And take the time to get to know them; bring donuts or bagels or something by which they'll remember you and like you. And thank them prolifically.

You chose the facility to provide care; you do have a right to ensure that that care meets standards.



ETA: I've just read FF's good advice. This illustrates an important issue - comfortability and confidence in the staff. As you get to know the staff, you may find that it's not necessary to check up so often. On the other hand, as I've found, sometimes it's necessary to really be diligent if the staff isn't.

thanks all. I guess there are two issues here. I suppose I do have the right to call the staff and inquire. On the other hand, for my own (selfish) benefit, I need to trust the home is taking care of him and if something is wrong they will call. When we visit (and we have visited daily so far for the most part) I can then catch up on issues. I am just new to this.

Karsten, I think most of us are in situations where we experience new issues as we make this challenging journey. So I compliment you on your diligence in caring for your father and ensuring he's getting the care you want.

Assuming that you feel more comfortable as time goes along, you might want to think about gradually decreasing your visits, or showing up randomly.

Adding to my previous post, there were times in various facilities (as well as in hospitals) that I felt I should have been notified about a negative change but wasn't. In that case I usually try for a short meeting with a nurse, or DON, explain my concerns and ask how we can communicate better in the future....i.e., what could I have done, taking the responsibility on myself rather than blame someone else (even if they should have been blamed!).\

An opposite situation occurred recently. A life threatening event occurred, test was ordered, internist (probably a hospitalist) called me and asked me to rescind the DNR order b/c of the dire situation. Given his explanation (malignant mass on the larynx), I did. Following up, I spoke with the doctor who ordered the test, and learned that the initial diagnosis was wrong.

Karsten, I found it useful to make contact with the NH social worker and ask the best way to contact mom's unit to find out how she was doing or to address issues that mom brought up.

I was of the best time to call, and to ask for my mother's nurse, and asking for a call back, rather than to speak to them then and there, unless it's an emergency.

Visiting in person is of course the best and doesn't have to be long. And yes, cookies and chocolate, always!

I visit Mom daily from 10-2. If she’s been having an issue I always stop at the nurses station first on the way through to see what’s up. If things have been going well I just smile and wave on the way to her room. If for some reason I can’t go during an "issue" period I do call to check in. An aide, LPN or unit secretary is always happy to update me. But if she’s not having any issues, I don’t call. You will soon figure out if you can trust their judgement on issues....at first I obsessed and felt I needed to be in the loop on almost everything, but after I realized they were dealing with issues exactly the way I would have, I calmed down. Once you get a certain level of trust (or not) you will know how closely you need to be involved on a daily basis.
They all know me, and it’s helped a lot to be able to chat a little with the staff. I bring in a couple dozen donuts occasionally and if they’ve had to spend a lot of extra time with her like when she was quarantined, I bring Edible Arrangements chocolate strawberries etc. And I help them out with her as much as I can. You’ll see quickly how overworked and under appreciated the CNAs are.

Despite having empathy for your concerns, I believe you are burdening the staff with such calls. If there is something wrong with dad they will let you know.

My comment is blunt, I know. (Having spent 10 years as a twice-daily visitor to my massively handicapped wife and having hired ladies be with her at the supper hour every day, my experience is that the staff have more than enough to do with duties at hand than to be expected to handle such calls from the loved ones of residents.)

You may want to consider expressing your concerns to the NH social worker.

Grace + Peace,
Bob

If your loved one is that cognitively impaired where they cannot have a conversation on the phone, they certainly are not able to appreciate your calls. It seems like you are calling for your own emotional needs, and that the needs of your family member. As others have said, if something dire occurs, they will certainly call you.

I could be wrong - but I say, call if that is what you need to do.

Maybe you're calling at shift change and that could explain why you don't get the responses you are hoping for. Ask if there is a better time to call. But for what a NH costs, check up daily if you need to. Eventually you will relax and not feel the need so much.

To me, your calls indicate that you care and sadly, so many place their LO's and then forget them. I think that would be a lot worse than calling daily.

And please, don't think you're overusing this site (or any other) as this is what AgingCare.com is here for.

It could be all about timing. When you call and expect someone to talk with you on your schedule, that can be a problem because they need to be doing something else (delivering care, taking care of paperwork, staff meeting), particularly if you are calling fairly early in the morning when there's a shift change, breakfast, dressing, bathing, bedding changes, etc going on. Consider discussing the schedule during one of your visits with the nurses/CNAs and asking for them to give you a quick call during a time frame that works for them as you get accustomed to your dad being in someone else's care.

No, do not call every day. They have a job to do. Let them do it.

When my Dad was in a dementia psych-unit to get his meds adjusted- I called every day to check in on him. I also checked in very regularly at the Memory care facility where both of them resided ( I was out of state). My folks are both gone now, and I still have a relationship with their previous caregivers and the management at their Memory Care. I believe that my folks got better care due to my involvement.

No. You want to perform check calls twice weekly and let your heart and mind lead you to visit as often as you can. The staff will not view you as an enemy and will welcome your calls as a loving concerned son or daughter

TO also be blunt, I agree with Old Bob, you are overburdening the already overworked staff by calling every day. every phone call that nurse answers is taking time away from the residents who need her care. IF every resident's family called every day she could not do her primary job which is caring for your loved one. They are required to call you if there is a problem.

When my Father was very ill, I employed the assistance of an Ombudsman to help me find a good, compassionate nursing facility. Ombudsmen are volunteers who compassionately give their time and inspect nursing homes and report the findings and advise people like yourself. You should really look them up in your area.

The one who came to my aid took me on a tour of a few nursing homes and he told me that in many instances, these elderly patients under nursing home care, are twice as likely to be abused if they have few visitors. I think that mere phone calls would fall short under that advisory.
Some relative really should go to see how their "loved?" ones are doing "in person" on a very regular, "surprise visit" basis, (they should not know when you are coming) as the quality of available "paid" (operative word) care these days is not too encouraging. The quality of employees in any field is abysmal, in my opinion. So, what do YOU think your answer should be.

The nurses may be a little annoyed, they're busy and might think "how much has happened since yesterday?". BUT you have every right to call every morning. Residents with family members who are around tend to get better care (I know, not always the case). I am a nurse and feel it's my responsibility to take the 3 or 4 mins it takes to give a family member reassurance and an update. On the other side my mother and son we're both in a nursing home for 3 yrs (at different times). I was a very involved family member. I visited my son 5 times a week and my mother twice a week. They both got excellent care. My opinion- keep calling for your peace of mind until you feel comfortable not calling.

Karsten, call me an old cynic if you like but as I see it the problem is not so much wasting the staff's time (though ringing phones are inherently irritating, that's why they sound testy) as that...

You: Hi, just checking in on Mr Bloggs, how is he this morning?

Nurse: Oh yes he's doing great/he's fine/he's just finishing his breakfast/he had a good night/we're keeping an eye on him... [select at random]

... you are wasting *your* time.

The nurse, that is, will not have a clue which patient you are talking about. And unless it becomes necessary to continuing the conversation, trust me, she is not going to bother figuring it out, either - she will just use whatever neutral to positive formula gets rid of you quickest.

If there is anything important to report, they will call you. Call them only if there is something they need to know, or something specific you need to ask.

I would actually pop in unexpectedly if you are able. Keep them on their toes and let them know you are involved and will be checking up - Annoyed? Well, they work for you- Follow your gut instinct.

We are learning to let go of our loved ones, it is so hard! It reminds of my kids first day at school. I cried after they got on the bus worried about them all day this soon ended. I actually liked "my time" We can visit our parents whenever we want, we can build a relationship with the staff, you can let go a bit. I think it's God's way of helping us through the seperation we will have one day permanently. I have learned to back off when keeping in touch with my parents care in the NH. It is hard there are issues but in the long term there is no way I could take over the level of care I was doing nor do I want to. I love them so much but I need my life back! Thank God for caregivers. If you stay pro active spend time help out when you can be kind to staff you will soon relax and not feel so guilty or worried. There WILL be times you need to speak up for some reason but having that conversation is usually enough to get back on track. I am a newbee to my parents being in full time NH care. we are all learning this together, this site is so helpful. I was their fulltime caregiver for over 8 years I am feeling the burden lift my husband and I are actually planning datenights and a vacation once everything is finalized with their care, medicaid is no fun to deal with but I am thankful. God Bless all on here, prayers work wonders! Go to the Lord before you call too much :)

Karsten, Since you are visiting daily, unless your dad is in some kind of emergent crisis, you probably should skip the daily calls. During your visit, you will see how he is doing and you can ask questions that are applicable to his condition.
The responses on here that say you can call as much as you want are not wrong, but Old Bob and rocketjcat have given the best advice.
Consider that if the person you are calling has only 25 minutes a day to devote to each patient, do you want to take up some of your dad's personal attention time to reassure you that all is OK?
Because you are there, you will soon know if the care he is receiving is good; and, if it's not, your calling every day is probably not going to make it improve.

I think you should call if you feel the need, especially if you are not able to go visit. If you are visiting daily and talking to staff while there then you really don’t need to call unless there is a problem.
When they facility knows you are there all the time and are calling they are going to watch out for your loved one more. My Dad has been in a Memory Care Facility for over 3 years and I have noticed the residents whose family is there really get taken care of not to say if you Rent there they don’t but I see what’s going on for example. Doors get left open and things are removed by other residents. My Dad’s door remains shut because they know I am there all the time. I see things that others don’t because they are not there and when I a, there I do speak to the nurses, his caregivers and the director and i find out things I would not have.
Good luck and keep on top of it and don’t let anyone intimidate you into not calling or visiting.
Sue G

Having worked all three shifts in an Intensive Care Unit as an RN, the very best time to call is 0300, and ask to speak to your loved one's nurse. If the nurse is too busy to talk, hang up.

I've been the nurse on these units for many years and I can tell you that every time one of us, be it a nurse, an aide, a social worker is called to the phone, it is also calling us away from our residents. We have no spare moments in these facilities, so it literally removes us from caring for people to be on the phone instead. Please be sure your calls are necessary, not for our convenience, but for your own loved one's sake. I always appreciate family members, believe me, there are plenty of people with no families or families that just don't stick around, but calling the unit is a poor use of resources and we must use our resources very wisely. What I would do if I were in your position is come in every day for the first few days, staying a little less time each visit, and getting to know the nurses, aides, social worker, and activities director. These are the folks your loved one will be closest to and they should be able to put your mind at ease. Hopefully, you can use your time there to ask any questions and avoid phone calls altogether. For an out of town family, I would suggest maybe a bi-weekly/monthly check in with the social worker and know they will call you if needed. The best times to call a unit like this in a non-urgent matter, in my opinion, is in the evening when the day has settled down and the call is less likely to interrupt something more important. Hope that helps.

I am a nurse and have worked in the facilities before and we have always called a family member if there was a change in the patient's health. Once a week, as a concerned child should be enough because I am sure the report you are getting daily from the staff is that he is fine. Nurses work very hard and they want to give the best care that they can for the patient and by interrupting them daily cuts down on the time that they have to do their work for them.

Your dad has only been in the facility for a few days, so of course you are concerned and attentive. Good for you! It sounds from other comments like you are in a position to visit your dad regularly. If that is the case, I don't see a need for the morning call - at least not daily, especially if you will be visiting that day. If not, I don't have a problem with calling but maybe would not do it first thing in the morning when staff are trying to get residents up, to breakfast, etc. How about around 11 or after lunch? Remember that you are your dad's advocate and paying the nursing home bills, one way or the other. You have every right to be involved to whatever extent you want. Do not ever apologize for caring. As far the advice to step back and let the nursing home do its job, that is fine if you're not particularly concerned about your loved one's care. Sorry, but the squeaky wheel does get the grease, and to believe otherwise is, IMHO, a very naive view of nursing home care. So yes, stay involved. Your dad is lucky to have you.

At present my hubby is in rehab at a very poor quality rehab. I try and go in every day and of course he is competent to use his phone
Any questions or requests I make are met with a brief "we"ll look into that or I"ll tell the girls to do that" Well guess what nothing happens.
In the process of getting him transferred to a proper rehab facility further away but they are dragging their feet. Dr only showed up yesterday and has to send recommendation but he only dictates his notes so wait for transcription. Send to new facility, they request approval from Ins co. The new facility was ready to take him five days ago!!!!!!!!!!
As far as calling every day unless your loved one is seriously ill I would not do it. All facilities are seriously understaffed these days and many are so dispirited they call in as often as possible, so every call takes away from patient care especially at week ends. Find out what time the shifts change and call a couple of hours after that if you need to.
When you visit make sure your loved one is being properly cared for and then find the RN and address any issues.
Try and deal with any issues you find yourself. For example I have clean my husband up a couple of times and when his water jug was empty went to get it refilled myself rather than wait the 1/2 hour it takes to get a bell answered. be as helpful as you can to the staff and they will be appreciative and more responsive. I don't suggest you have to change dirty diapers but as a retired RN it was no big deal for me and I had the satisfaction of knowing the job was properly done. As most of you know it is a minefield out there.
DD just called and she is lighting fires at both ends to try and hurry the move. She does not take no for an answer. She employs 40 people and if someone steps out of line they are out the door especially with patient care even if the the patients are all of the cuddly furry kind!

Karsten, first off don't ever apologize for using this forum or feel like you can overuse it, we all have more needs at certain times and helping others is so often a big part of helping ourselves so there will be times you are asking more than answering and others that you are answering more than asking, both are helpful to people other than you as well.

Now my 2 cents on your question, I haven't read through all the responses here the way I usually do but it didn't take long to see some varied opinions. We are all at different stages and on different journeys with our LO's and even though many things look similar no 2 stories are identical and of course where we are in the journey, our relationship with our LO, our experiences and our lives, personality, who we are all shape our answers to these questions. With that said IMHO you should not feel badly calling to check on your dad and if the staff is making you feel uncomfortable about it there is a problem with the staff or the places policy and you should talk to someone in charge about it, the person who showed you around, sold the place to you. Yes your dad is the patient but a caring family is an extension of that patient and as important to his care and health as anything else. This is a brand new transition for everyone and my guess is you have been doing a lot or all of the care and worry for your dad, it's perfectly natural that you would want, need to check in daily maybe a couple times a day for a while as you both settle in and it could very well come in handy for the staff as they get to know him as well if they care about making him as comfortable and at home as they possibly can. Afterall you know far more about him and the things that do or don't work for him and knowing you are anxious to share and be involved (which they do based on your morning calls) clears the way for them to ask about little things whenever they want, not all patients have families that want to get questions about what makes dad happiest they are more interested in simply knowing his basic needs are met and safety is secured and as long as he isn't being abused don't really care how that's accomplished. That sounds more harsh than I mean it too, I learned years ago that families and the way they handle these medical and caring for parents things differ. My family bands together and rushes to the bedside to care for the sick or injured person, that's the way we were trained. My husbands family goes about their lives and one person keeps tabs on how the patient is doing and then passes it on to the rest. They visit when they can and the one person is in more direct contact but the patient is left alone with hospital staff, after all there are tons of people around, for the majority of the time/day, even in the ED in the case of my FIL! It was bizarre to me at first but I came to realize it's all about training, what we saw growing up when family members got sick, it's not that they care any more or less it's just what they know and therefore expect.

My guess is you will feel less need to call each morning as he settles in, as you both settle in but you should do that at your own pace. It will happen naturally as you feel secure and he feels more comfortable and it wont feel like you aren't ready or worse like you are abandoning him to some degree. Yes we all know you aren't abandoning him and everyone is absolutley right this move gives you more time for yourself and freedom, it takes the physical need for keeping in touch away but that doesn't mean your emotional need isn't still there and very real. Just because you don't have to doesn't mean you, don't need to and you should do whatever it is that you need to for yourself and for him. They (the facility) are well paid to take care of your father and by extension that means informing you as much as you need (within reason but you are a long way from exceeding that), the very fact that you are questioning if your a nusence says to me that you wont cross that line so let yourself off the hook and go with your gut.

We have a direct line of communication with the Director of nursing at my Mother in Laws nursing/assisted living home. She updates us once a week via an email and calls us immediately if anything out of the ordinary happens. My husband and I try to pop in once a week individually at different times during the day (unannounced) so that we also can get a true picture of what is happening. You will become more comfortable with time so don't beat yourself up for checking in daily right now. You are a great daughter for doing so.

Thank you very much for all the great answers - answers even of diverging opinions. Very helpful. I am beginning to taper my daily visits to every other day, and getting to know the staff there on visits to communicate my concerns. I may check in on an a no visit day on phone, but we will see. I agree it is both somewhat of a burden to me, and most of all a burden to the staff who have many patients (i.e. other peoples parents) to care about. (I am kind of amazed how during my visits, that I see very few visitors to the other patients, maybe they are long tie patients and their LOs know the drill). I also have established a pretty good email hotline with the Social Worker whos is not always the person directly in charge of my concerns, but she get pass them on to the right person ,and can read and act on the email at her convenience. Thanks again all.

Karsten, your last message shows a very obvious tone difference from first message. I felt a panic in first message. Now you are settling in. I remember that same panic. I go see my mom every day. I try to go at same time as routine seems to help her. Since you are going often, you will find that you develop a relationship with certain nurses more than others. That’s just human nature. I suggest you ask that “one” anything like: Am I calling too much? What’s the best time for you for me to call? Is there anything else I can be doing to make things better? The nurses should never make you feel like you are an annoyance. They should guide you on this new journey. You will become partners with them.