Linda Strasburg moved her mother from a nursing home Strasburg didn't like. She said they overmedicated her mom, lost her glasses, didn't clean her up or brush her teeth, her clothes were dirty and the hair on her chin was an inch long. She advises that the most important thing you can do for an old person you love is stand up for them.

Adds Helen Rollins, who is managing her mother's care from 2,000 miles away, "the polite word is advocate. The real word is 'warrior."'

The experts offer advice on picking a nursing home or assisted living center: Don't just walk around but hang around, says Paul Fairholm, immediate past president of the Utah Assisted Living Association. Visit at least a dozen. And don't wait until you're in crisis mode, which is the worst time to make a decision. See how the staff interacts, adds Marilyn Luptak, University of Utah College of Social Work. "Do they stop and talk to the residents?"

One expert suggests not using the nursing home physician, who may only see the patient irregularly and at odd hours like, say 5 a.m. But you have to ask about policy on using outside physicians; some nursing homes won't allow it.

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It's important to look at the inspection reports for nursing homes, kept in binders at the Utah Department of Health. But you should also remember that the "deficiencies" they track measure a few specific things and are not definitive on good versus bad. They're indicators. For instance, someone may hate breakfast and choose to sleep in, but it counts against a nursing home at inspection time if every resident didn't get breakfast. You have to pay attention to the details. "It's a snapshot in time, but a facility with three deficiencies may not be any worse than a facility with one," says Greg Bateman, long-term care survey manager for the Utah Department of Health.

Deb Burcombe, Utah HealthCare Association deputy director, says to be wary if administration blames problems on the residents. That's a very bad sign. And take the lobby with a grain of salt, she adds. A chandelier in the lobby looks nice, "but it's the philosophy and attitude of the caregivers that matter."

Adds one nursing assistant: "If you're a family member, please, please check up on them. Make sure their briefs are dry. Just pop in on them, and not every day at the same time."


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