Karen McPhail, RN, MSN
Nursing Home Care Challenges
One of my clients shared with me a recent New York Times Article, "Its Almost Like A Ghost Town, Most Nursing Homes Overstated Staffing for Years". This article sadly does not provide any information that I am surprised about as a care manager. I work very hard to help my clients to live fully and avoid needing nursing home skilled care. I refer primarily to assisted living when possible and more recently I also like the options in many of the smaller personal care homes.
The patterns seen in nursing homes however seem to be spreading to general assisted living. I am seeing less staff on weekends and more med techs being used in many facilities. RN's are only seen now in nursing director roles in many facilities. This concerns me as the care for seniors especially in assisted living memory care is complex. Behavior management and medication adjustment needs careful clinical judgement and oversight. I do not feel that a med tech is trained in all the areas to be able to identify the trends and patterns for the resident post administration. Those managing care daily need to be able to work closely with the geriatric psych team to provide insightful information and feedback. It is not just about passing pills, it is about providing wholistic, individualized care and forming a successful treatment plan, as this is what leads to good outcomes and proper management of those with cognitive impairments. I feel that this is why we are seeing more individuals with behavioral aspects emerging that facilities say they cannot manage or can only manage with medications. Some facilities do not have primary individuals on staff with the tools to notice the subtle behavioral trends, assess, intervene, and manage the cognitive challenges properly. Non medication related interventions are the only consistently known treatment options for those with dementia. No one medication regime is proven clinically to be successful for all with dementia- each person needs a different and individualized plan and approach to medication management when required.
So before you decide on a facility for a loved one contact a care manager for current facility information; you will thank yourself later!
Do not lose hope based on the above as there are terrific facilities out there who are providing exceptional care and creating moments of joy for their clients and family members! However, before moving forward, ensure that you understand what you are paying for and the care that is being provided. Be knowledgeable consumer!
See the New York Times Article below:
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