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The Honolulu Advertiser

Posted on: Thursday, March 13, 2003

Here's our wish list to improve care homes

As the Hawai'i Legislature crafts a bill to better protect the residents of adult residential care homes, it's important to differentiate between annual re-licensing inspections and spot checks.

We understand that licensing inspections take several hours and that operators need fair warning so they can pull the necessary records, among other tasks.

It is reasonable, then, to schedule such inspections. Not only do the care home operators need time to prepare, they should have advance warning so both staff and patients will be on hand.

Spot inspections, however, should be a surprise — and that means wholly unannounced — so that staff can't sweep any dirt under the carpet, so to speak. Inspectors absolutely must get an accurate real-time picture of the health and safety of the residents.

A House bill is striving to reach a compromise on this issue by proposing that care-home operators be notified of the tentative dates of annual inspections, but also subject them to at least one surprise spot check a year.

Those unannounced spot checks should not be cursory. In fact, we recommend that a registered nurse familiar with geriatric medicine accompany an inspector and check for bed sores and other ailments. We can't stress enough how these festering ulcers can be fatal if not spotted early enough.

As for state volunteer programs, we're glad that trained volunteers have the authority to go into care homes to visit with residents and look out for irregularities.

But there aren't enough volunteers. Anyone interested in volunteering should call the state Executive Office on Aging at 586-0100.

Lastly, state elder care ombudsmen have heard numerous complaints from people who say they have to make appointments to visit relatives in care homes. If that's the case, it's most unfortunate.

Like hospitals, care homes should post regular visiting hours. If relatives are forced to make an appointment, they're bound to become suspicious about the condition of their loved one.

Rather than foster such suspicion, it's best to allow visits at reasonable times. It's good for the residents. It's good for the relatives.

And if it's inconvenient for care home operators, perhaps they should consider a different line of work.