Better Care in Nursing Homes

One of the reasons I chose to live in a retirement community was because I checked out the nursing home on campus, just in case. You hear a lot about boredom and even overmedication. How do you safeguard from that?  E.E. of Reedley.

When nursing homes first came on line in the 1960’s it was all too common to find over-medicated residents. The funding was minimal and therefore staffing inadequate.

Often you would go into a nursing home and see the residents lined up in their wheel chairs, sleeping or just staring off into space.  They would not respond well to the activity program. They did not have a desire to participate in much of anything.

Better knowledge for treatment and care of our senior citizens and more government funding through Medicaid brought about changes in the nursing home care. Today, there is training so the staff, who take care of the nursing home residents, are competent and have all sorts of ideas on how to provide care both efficiently and allowing dignity. The classes provide the students with both hands on and classroom learning.  Emphasis is given to how to assess the resident and make them feel comfortable. Nursing assistants are required to take a state-directed class with 50 hours of class time and 100 hours of hands on. They are required to have 24 hours of in-service each year.

Nursing homes have come a long way in the last 15 years. More and more emphasis is being placed on creating as much of a home like environment as is possible. They are inviting and pleasant places to hang out, windows that look out over flower beds,  grass and trees, aromas coming from the activity room such as bread baking, and places to be outside to feel the breeze. There is a staff of activity people whose job is to find out what each person did for entertainment or enjoyment at home and try to help that person do some of those very things to keep the resident motivated and encouraged.

All staff is responsible for stimulating the mind of the residents, helping them achieve a sense of well-being. The staff gives a listening ear or a helping hand to allow the resident to feel heard and successful.  There is assistance by the staff so the resident can use the common areas. When you come into nursing care centers you will see more chairs and couches for residents to sit on. There are large screen TVs in common areas so residents can watch their favorite programs. These areas also allow for visiting, people watching, or meditating.

The job of the activity director has become an important part of the resident’s care. The director assesses the resident’s interests and then plans activities to meet those interests. There is group time, game time, activities that allow residents to work with their five senses; the activity staff visit residents one-on-one, take the time to go for walks indoors and outdoors with the resident, celebrate birthdays and holidays, and more.

The well-being and stimulation of each resident is the responsibility of more than just the activity staff. The licensed nurses are constantly assessing resident’s mood and behavior. They watch for changes in mood. This often can signal a health change. Residents and resident family members are encouraged to share what the resident has done in the past to give staff some clues as to what activities to try and encourage the resident to attend.  We all have times of anxiety and feeling agitated. It is the job of the nursing home staff to help the resident get through those feelings.

The residents have a couple of advocates these days who come from outside the facility staff. One is the Department of Health. The State Department of Health sends out trained staff to survey every nursing home in the state at least every 9-15 months. These individuals are trained to look for any one who is over medicated or placed in a situation that is not in their best interest.  The other advocate for the resident is the Ombudsman. These are volunteers who are trained to spot potential problems or abuse. The Ombudsman often comes to the nursing home just to walk through, talk to residents and ask questions of staff. They work with residents, resident’s families and staff to find a solution to any problem reported to them. Anyone can report concerns to the Ombudsman.

The residents that experience a feeling of being cared for have a sense of well-being which lessens the anxiety and anxiousness that can be part of a resident’s life.  The nursing home staff have classes every week centering on how to make the resident’s stay as positive as it can possibly be. The Certified Nursing Assistants give the resident the ability to look good and feel good by being clean and tidy. All staff members are encouraged to interact with the resident in a meaningful way, keeping the resident motivated and engaged, and still continue to monitor for changes in behavior to see if there is a health change. The extra edge, for nursing home residents living in a retirement community like Sierra View Homes, is the frequent visits from residents from the independent apartments. The goal is for the resident to have as pleasant a stay as possible, not be over medicated and to have the highest quality of life they can have.