Archive for September, 2009

Now this is real different! A nursing home that offers 24 hour meal service. Culture change at it’s best.

Highlight:

The staff says 24-hour dining and all the changes it produced have had a huge impact on quality of life for every elder. They now may choose exactly what and when they want to eat. They can sleep in if they wish and are able to maintain the same daily routine as they had at home. Physical health has improved. The number of elders eating a puréed diet was reduced from 30 people to seven because of the selection of food available and because there is time for one-on-one interaction while dining. Pressure ulcers have also decreased due to increased food intake and ability to choose the food they like. Residents are gaining weight, pain and behavioral issues are improving, and elder satisfaction with the entire home has improved. “Our care plan meetings and elder council meetings no longer revolve around food issues,” Godfrey says. “In fact, at our annual state survey in May, there were no elder complaints about food.” The surveyors who stayed for lunch even complimented the food!

There has been such a demand for meals that sales to staff and family have gone from $2,000 per month to $6,400 per month. There has been such a demand for families to eat with their elder, Rolling Fields has hired a hostess to seat and take reservations. Some family members were even coming without their elder to eat. “This was happening so often we had to put up some parameters to limit family members to only eating when accompanied by their elder,” Moody says.

I wonder what will eventually happen to this program, if this insightful administrator ever resigns from this facility, er, home?

The New York Times posted an article about the benefits of moving nursing home residents back into their homes, and how this truly benefits them…and how it’s a real threat to the industry.

“It was like being in jail,” Mr. Brown said on a recent afternoon. “In the nursing home you’ve got to do what they say when they say it, go to bed when they tell you, eat what they want you to eat. The food was terrible.”

But recently state workers helped Mr. Brown find a two-bedroom apartment in public housing here, which he shares with his daughter. “It just makes me more relaxed, more confident in myself,” he said, speaking with some difficulty, but with a broad smile. “More confident in the future.”

A growing number of states are reaching out to people like Mr. Brown, who have been in nursing homes for more than six months, aiming to disprove the notion that once people have settled into a nursing home, they will be there forever. Since 2007, Medicaid has teamed up with 29 states to finance such programs, enabling the low-income elderly and people with disabilities to receive many services in their own homes.

The nursing home industry is fighting these ideas, in order to keep their doors open. By empowering residents to go back into their communities these states are finding out that people come first and it’s not nearly as expensive as some like us to think.

“Medicaid has had an institutional bias in favor of nursing homes,” even for people who do not need them, said Gene Coffey, a staff lawyer at the nonprofit National Senior Citizens Law Center. “Federal law requires states to provide nursing home services. They don’t have to provide home or community-based services.”

I think this bias lives on due to the herd belief: It’s cheaper, easier and more managable to keep lots of people together in one building (institution). They use safety as an excuse, often…but does that really justify taking away a person’s independence? I don’t think so- not for those who can think for themselves and who can get by with a little help.

Sorry for the summer long hiatus here! We’ve been quite busy with moving, attending summer camps with kids and other activities. We’re back now.

Provider Magazine has an article about the traits of successful CNA’s.

Traits of A Successful CNA (PDF file)

The five most important foundational skills that a successful nursing assistant needs are:
Reading for information
Locating and using information
Observation skills
Applied mathematics
Writing

I agree. We do have a problem here, though. A lot of CNA’s cannot read and comprehend English very well, therefore they cannot report (verbally and in writing) the things they observe. I think more education is needed in order to carry out observations- I see problems every day with this. Math is a no brainer, but it goes with the language problem.

The characteristics of successful CNA’s:

cooperation, goodwill, optimism, order, savvy, and determination/striving

Good start. We have some articles that go into detail on these issues:

Observation Skills for CNA’s

Legal Issues for CNA’s

Professional Boundaries

Being Professional

CNA’s & Respect

Why Being Negative Can Really Hurt You

7 Habits of Highly Effective CNA’s

7 Habits of Highly INeffective CNA’s

This sounds promising.

State of the art technology is changing the way nursing homes operate.

Inside one Louisiana Alzheimer’s facility, each room is equipped with a fall prevention system.

“We have a ‘smart’ system, which is a computer system that will learn, actually learn patient movement and activity,” said Neal Rider, Guardian House CEO.

Each resident has an individual profile that determines their risk for potential falls. If they are categorized as a “fall risk,” the computer and motion sensor devices will monitor their every move in bed and alert the staff if anything is abnormal.

“The unauthorized bed exit is coming in and you can see an individual getting out of the bed. It identifies where the person is in the building and where other individuals and staff members are located throughout the building,” said Rider.

Does anyone have experience with these types of systems?