What to look for and questions to ask as you resume visits in a long-term care facility.

The Covid-19 pandemic has significantly impacted residents of long-term care facilities and their families. In-person visitation restrictions imposed to reduce the spread of Covid-19 required residents and families to adapt quickly to other means of connection. As in-person visits resume, be sure to focus on your loved one and how happy you are to see each other. Take a moment to also look at your loved one and your surroundings. You’ll want to note any changes in your loved one’s appearance or demeanor to get a better sense of the impact on him or her. This resource provides suggestions of what to look for, questions to ask, and what you can do if you have concerns about their condition.

What to Look For

Observe your loved one’s appearance and demeanor.

Things to look for include:

• Weight loss or gain
• Their hair is washed, nails have been cut, and teeth have been brushed
• They have their dentures, hearing aids, and glasses
• Healthy skin with no pressure sores, bruises, or cuts
• A change in energy level or alertness. Do they appear confused? Are they talking slowly? Do they have repetitive, involuntary movements? Are they unable to sit or stand straight? These could be the result of medication changes and you should ask about them.
• A change in their ability to walk or get in and out of bed
• Evidence of pain or discomfort

Look at what is happening in the building.

Does the facility have:

• Clean rooms, bedding, bathrooms, and common areas
• Personal protective equipment (PPE) such as face masks being worn in the facility
• Easy access to hand sanitizer and soap for both residents and staff
• Residents and staff that appear to have possible symptoms of Covid-19 such as fever, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, etc.
• Sufficient number of staff in the building. Is information about the number of nurses and certified nursing assistants working on that shift posted as required?

What to Ask

Asking questions during your visit can give you a better understanding of your loved one’s experience during the emergency period.

Consider asking the following questions:

• How are you?
• What activities have you been doing? How have you been spending your days?
• Do you get the help you need from staff when you need it?
• How have you been sleeping?
• Do you have any pain or discomfort?
• What medications have you been taking? How do they make you feel?
• Do you have access to a mask or face covering? When/where do you wear it?
• Do staff always wear masks while in your room or providing your care?
• Do you know anyone that has been sick?
• Have you been tested for Covid-19?
• How do you like living here?
• Are you hungry or thirsty?
• Is there anything I can do to help?

What to Do

Help is available if you have concerns or issues with care.

• Talk to the nurse on duty about your concerns.
• Request a care planning meeting to discuss issues of concern and how they can be resolved.
• Talk to the director of nursing or administrator about your concerns and ask what they will do to address them.
• Contact the Long-Term Care Ombudsman program for assistance. The Ombudsman program advocates for residents and can help resolve concerns.
• Many facilities have family councils. Discuss the problems you are having and get a sense of whether other families have similar concerns. Sometimes it is easier to work together for change. If this facility doesn’t have a family council, ask the Ombudsman program for information on starting one.
• File a complaint with your state survey agency which assesses whether a facility meets standards of care.

For additional information, please visit the website for the Northern Virginia Long-Term Care Ombudsman Program

Source: The National Consumer Voice for Quality Long-Term Care