My blogs have recently been concerning ways that a family can measure the quality of care and dignity that a resident recieves in a senior facility. As a family or friend, you are not at the faciity 24/7 and must rely on your assessment skills and observations when you visit. An excellent way to assess an organizaiton is to be observant of activity while you are visiting. This is a good estimate of what goes on when you are not there.
A memory care facility often has residents of all ages. Some of the residents are relatively young and others are elderly and frail. One of the resident's wives is often at the facility when I am visiting my patients. I often see her mascara smeared and a tissue in her hands while she is at the facility. The visit to see her 70 year old husband is filled with trauma and emotion and this is certainly understandable.
Staff walk by her and do not see the tears, fears and anixety in her face. At a recent visit, this wife was leaning against the hallway wall and crying. Not one staff member approached her. They walked by her like she did not exist. I approached her and asked if she was ok. She looked up and began to cry harder. I touched her shoulder and she grabbed me in a bear hug which I returned. We stepped aside into a private area and I listened to her story.
Why did no other staff member see this woman's pain and respond? Her pain was obvious not like the sllent pain that many caregivers experience. She was not demonstrating her pain in isolation. She was clearly in need of support and that need was not recognized as staff walked down the hall seemingly oblivious to her.
As a nurse and geriatric care manager, my first duty is advocacy. As a director of healthcare services, wellness or nursing, our nursing responsiblity is to offer advocacy and to train our staff to recognize and respond. Had this experience been the first, the crticism would be less warrranted, but this was an experience that had repeated at least twice each month on my visits to my patients at this facility.
When you see family needs that are overtly not being met, you can anticipte that resident needs are not being assessed or addressed either. What a terrbile experience for this woman. She is paying privately for a level of care that she and her husband are not receiving. As an exhausted caregiver, she does not have the energy to advocate and fight for herself and her husband.
Watch the relationships and interactions with staff, resident and families. They provide benchmarks for measurement of facility care.