ADVOCATE:

Nursing homes know that the only thing that can hurt them is bad publicity;
this why they want the finger-pointing to stop. Bad publicity has cost some
nursing homes up to 65 percent of their census. It works. Every family of every
nursing home resident should escalate efforts to get the promised and paid-for
care. These efforts should include calls to police and the press when neglect
and abuse occur.

Long-term care consumers should not believe the expensive brochures, ads and
promises the nursing homes make. Nursing homes are institutions with clout and
virtually no accountability. Believing this, families who have no other choice
but to place a loved one in a nursing home should take special precautions:

* Inform the nursing home that you will be visiting your loved one at any
time of the night or day. Then do it. Go in at midnight, quietly, for a quick
check. Stop by at 5:30 a.m. before leaving for work.

* Question and photograph all skin tears, cuts and bruises and note changes
in behavior.

* Inform the nursing home, in writing, that there will be an autopsy at the
time of the resident's death.

* If needs continue unmet, install a legally allowed overt surveillance
camera system and challenge the facility if it tries to stop you.

Taking these precautions may cause the facility to attempt to involuntarily
transfer the resident on some pretext to get rid of you. Never, ever, accept an
attempt at an involuntary transfer without an appeal. You have a good chance of
winning on appeal, and it will cost the nursing home plenty of money, which
should teach them not to do it unless there is very good reason.

Involuntary transfers are the loaded guns at the temples of families who
dare to care. Fear of involuntary transfer keeps families silent and allows
deplorable conditions to continue. Federal law places the burden of proof for
the need to involuntarily transfer exclusively on the facility.

The nursing home is only a stroke away for any of us. The extensive and
courageous coverage of this issue by the Post -Dispatch should empower all
families to set aside their fears and dare to care.

A FORUM FOR OTHER VOICES, IDEAS AND OPINIONS\

Violette King is executive director of Nursing Home Monitors, Godfrey,
Ill.