4. Adequate Staffing Equals Quality Care

A recent report by Senate's Special Committee on Aging indicated that quality care for a single nursing home resident requires more than three hours each day of nursing and nursing aide time. However, statistical analysis of latest federal database on nursing home deficiencies indicates no relationship between quality of care and staffing levels. This finding is consistent with a number of university studies.

What should you look for, then, in nursing home staffing levels?

There is a level below which nursing homes are so understaffed that quality care can not be provided. I'd suggest that you not consider any home providing a level less than two hours per day per resident. For levels greater than this, I'd focus not on number of hours available for care but on motivation of staff available to provide care. Those who are motivated to care for elderly will do so. Those who are motivated only by a paycheck will probably provide shoddy care regardless of their numbers.

5. A Well-Known Chain Will Provide Best Care

This is another myth that can lead to tragedy. Sometimes, well-known companies do provide top-quality care. In other instances, however, a quick review of newspapers and magazines will show you other companies with long records of legal troubles stemming from accusations of neglect and abuse. One such company has been sued simultaneously by several states' attorneys general.

How will you know? The company is not likely to tell you, so you won't know unless you take time to look into company's historical performance.

There you have it -- 5 myths exploded!

What does work? There is no substitute for your own personal investigation. With a little research, with personal visits to nursing homes before you sign anything, you can avoid many of difficulties that have come to those who relied on such myths.

4) Use behavior modification techniques Behavior modification has gotten a bad rap of late, probably due to many ways in which its principles have been misused. However, used properly, behavior modification techniques can remove unpleasant behaviors and return sanity to your family. If you don't know basics of behavior modification, here is a site that can bring you up to speed quickly: http://chiron.valdosta.edu/whuitt/col/behsys/behmod.html A few tips to help you begin Before you begin, you must clearly define what outcome you want to achieve. For example, you find that you are spending an increasing amount of time waiting for your elder to get ready for an outing. If you want your elder to be on time, make that specified outcome. Identify your elder's positive reinforcers. Clearly they do not respond to your annoyance (or are you even allowing your irritation to show?), but they do enjoy outings. Tie outcome to reinforcer in a clear statement, for example, "If you are ready at 10:15, we will go shopping." Shape behavior you want. If your elder is habitually 30 minutes late, it is unlikely that they will suddenly be on time. So, decide in advance to shape their behavior. For example, you may choose to wait 20 minutes. If they are not ready, leave without them. Once that behavior has been established, wait only 10 minutes, then only five. By using this tactic, you will arrive at outcome you desire with a minimum of pain. Punishment. Punishers can work - if they are severe and immediate. However, they increase likelihood that you'll get results you didn't anticipate or want! Locking someone in a room or closet is punishment. Don't go there! Extinction. Use extinction techniques rather than punishers to get rid of unwanted behaviors. Extinction is simple. Offer no reaction to bad behavior. Don't talk about it. Don't react to it. Leave room, leave house if you must. But remove opportunity for reinforcement of such behaviors. Be aware that it will take time for extinction techniques to carry out your goal. Also realize that frequency of undesirable behavior may actually increase while extinction is occurring. Be patient and resolved. You'll get there if you don't weaken. 5) Identify your own contribution to difficult parents and difficult families

Perhaps most difficult (and perhaps most useful) technique is to identify your own contribution to problem, and stop it! ·Are you taking course of least resistance and putting up with undesirable behavior because it's too difficult to change it. ·Do you avoid conflict at all costs? ·Could you be afraid to give up your position as "favorite" or "good?" ·Do you feel emotionally superior when you deny your own needs to attend to those of others? Any of these may lead to more difficulties in future, so give them up. Decide what you can do within reason, and do that. If you need help, ask for it. You can deal with problems of difficult parents and difficult families if you are willing.