I am honored to be a featured expert and pleased at how well my organization and profession is represented. There is not an online version of the article yet, so I encourage you to head to the newsstand!
One Hundred by Matt Maupin, HFA
Life’s challenging at only thirty-three
But if I ever live to be one hundred
I hope my friends will still remember me.
How’d you ever get to be one hundred?
I sometimes ask our friends with us today
“We never drank or smoked,” they say so proudly
“And ne’er to God did we forget to pray.”
Did you ever think you’d really be one hundred
And are you glad you’ve made it all this way?
“My wife’s one hundred too,” said one good man,
“My love for her grows stronger every day.”
Things get clearer once you turn one hundred
The wisdom starts to overtake your head
The things you know, the things you’ve done
The love that you have spread!
I still don’t know the feeling of one hundred
It’s something only those who’ve been there know
But if I ever live to see one hundred
I’ll cherish every day until I go.
Tube-feeder? Is that what you become right before you're consider a bottom-feeder?
We're a month away from National Nursing Home Week, and I thought we had all taken a step forward as an industry. I don't even think about calling someone a "Medicaid resident" or "a fractured hip" any more than you would call your neighbor's child with a developmental disability, "retarded."
I am frequently reminded, however, that not everyone we work with understands the importance of language in long term care.
So please, if you are reading this, take a moment to think about the language you use to describe our residents and their needs. Feeders, screamers, assists-of-two, memory-care residents, hip-fractures, hospice residents, and level two's all should have went away with OBRA '87. We don't toilet people anymore than we sink them or exhaust fan them. You walk your dog, but you don't walk a resident. We assist people with their needs; people are Medicaid recipients and in some cases require that level II paperwork is completed before they move into our neighborhood. This isn't a marketing gimmick - it's basic respect for your fellow human beings.
You wouldn't call your own grandma a feeder, would you?
1. "Please explain what is meant by persistent non-compliance."
2. "What are the staff expected to do when a resident has a care plan for a seat belt, the seat belt is not used, and the staff are called away?"
I'm afraid I've answered their questions with even more obscure answers than the original POC...
What I wasn't expecting was this wonderful video montage of the centenarian interviews. I'm so glad that more people are taking the time to utilize technology and document resident stories.
That's Eva Teeters, one of my great neighborhood coordinators, in the picture on the left.
Of course, my organization's newest local ad ran during the same Sunday morning commercial break. No Flo, but at least we have the sharpest local ads around, and we use actual residents.
A lot of healthcare professionals struggle with this, particularly in and around the nurses stations and other naturally congregate areas. So while its easy to ask staff to pull their business conversations behind closed doors and to "keep all patient information confidential," it's a good rule of thumb to more specifically designate phone areas as safe communication spots. By telling staff to keep all patient or business sensitive conversation within arm's reach of a phone, it's an easy way for them to hold themselves accountable to bringing conversations back to that safety zone. By building this expectation into the culture, everyone understands to also avoid those areas when a conversation is happening, as it is likely sensitive information being shared.
Nurses stations and other public work spaces in health care come in a lot of forms nowadays, but most if not all have at least one phone stationed at their core. Teach your staff to gravitate towards offices or other phone/communication stations to avoid resident disruption and protect health information.
"LOVED the Scrabble playing with the 108 year old. My grandma used to be a nationally ranked player and she still plays every day. I played her at the beach this summer and was sadly crushed. She brutalized and embarrassed me, laughing all the way to victory. Then told me she would play whenever I wanted. SIGH."
- Finalizing the renovation plans for a shower room
- Meeting with activities about organizing and increasing outings
- Setting up the logistics for delivery of goods for our soon-to-open skilled nursing campus
- Reviewing process for tracking lost referrals
- Maintenance rounds
First of all, here's what you can expect in terms of trip logistics:
-It takes two days to fully tour the DS headquarters and product lines;
-Direct Supply is the Google of the LTC industry; they have a fun work environment, awesome benefits, and an inspirational story;
-Take two items: comfortable shoes and a camera; you will walk several miles and want to remember a number of specific products you demo; you will see ten buildings and hundreds of innovative FFE offerings;
-DS paid our hotel, food and beverage; they were very hospitable;
-DS asks you to pay your own travel expenses.
More importantly, we learned about so many products. I've purchased a lot of beds, mattresses, lifts, carts, etc. in my lifetime but never really understood the differences between various products lines and models. I'm part of an independent not-for-profit, so I don't have corporate staff advising me on the latest technology and offerings. One example:
We still use the 1.5" blue mats next to resident beds to reduce injury from out-of-bed falls. Turns out those are practically obsolete. Now they offer 1/4" versions that are more effective, don't have to be moved during day, and look like floor rugs. I honestly had no idea. I've already order some replacements. Sales pitch + education is okay if it benefits your residents.
Here are some of the items we had the chance to test and learn about:
-Clinical monitoring equipment
-Lift equipment and assistive devices
-Floor care equipment
-Housekeeping equipment and carts for all areas
-Kitchen equipment from hoods to teaspoons
-Furniture, including living rooms, dining, and resident rooms
Direct Supply also offers several services, notably TELS. You will learn that their TELS product is a web-based maintenance tracking, life safety code scheduling, and inventory management system. TELS is designed to be the centerpiece of your facilities maintenance program, serving as both a maintenance request system as well as scheduling, tracking and documenting your annual regulatory requirements. Here are the facts:
-$97 per month, per facility for unlimited users
-Designed for all facility staff to use as maintenance request system 12-month scheduling system for LSC, PM
-Requires some Direct Supply input of information
-Has iPhone capability for easy entering and receiving of new maintenance requests (great feature)
Many large for-profit organizations use TELS and when considered as a monthly cost $97 seems reasonable. When comparing to a one-time software purchase, however, the fee may be excessive for your organization. The biggest drawback is the built in dependency for DS to scan and upload your key documents and scheduled annual tasks. We plan to trial the system for a few months and will ask our Director of Facilities to determine if this system is worth the input time and associated maintenance costs.
Overall our trip to Direct Supply was well worth the expense and time. You've seen the catalog, but it's only a small portion of what Direct Supply really offers. DS is an employer of choice in Milwaukee, an expert in long term care, and an advocate for quality and process improvement. I highly recommend you make this trip if it is offered to you and your organization. Even if you are not a direct purchaser, chances are your maintenance, environmental, and nursing departments are buying products from DS. I suggest you educate yourself on the latest products to better serve your residents and employees.
Submitted by Matthew G. Maupin, HFA
I have no idea where to start!
If you have any policies, guidelines, stories about bringing your dog into a facility on a routine basis, would you please contact me at email@example.com? I want to make sure I do it right. Thanks!
~Antoine de Saint-Exupéry, Wartime Writings 1939-1944, translated from French by Norah Purcell
“The models are an excellent guide to leaders at the operational level for both employee recruitment and identification of continuing education needs,” said Matthew Maupin, administrator of Lutheran Life Villages in Fort Wayne, Ind., and a blogger on the long-term care industry. “Often as leaders we focus solely on technical competencies without consideration of broader foundational principles, leading to increased training costs and ultimately employee turnover. The models support professional development programs geared towards customer service, communication and utilization of technological efficiencies, which is precisely what the long-term care workforce needs for the upcoming influx of Baby Boomers requiring care.”
See the rest of the article here.
Then why do we make it so difficult to volunteer? I had to laugh last night watching this sketch last night on Jimmy Kimmel Live. It sums up my thoughts on how we drown every good intention in regulation and risk management initiatives. Yes, I acknowledge the operational needs, but Kimmel really hit the nail on the head in a very funny way.
May we be worthy of the trust that our patients and residents, our administrators, our staff, and our community place in us. May we seek Your wisdom and guidance. Bless each employee; multiply time and energy.
May each and every person here experience Your strength and joy as they complete another day in this journey.
I was leaving work and a group of residents, as always, was sitting on the porch enjoying the sun and a nice breeze. One gentleman, sitting away from everyone else, looked especially relaxed - eyes closed, smile on his face, reclined in his chair. I know he's in renal failure and has chosen to spend his time on Earth peacefully rather than going through extensive treatments.
"Enjoying the sun?" I asked as I approached him.
"I sure am," he said without opening his eyes. "The days are numbered though."
"Oh, Mr. Baldwin, I'm sorry to hear that. You're not feeling well, huh?"
We've had a few of these deep conversations and I know that he's been to the hospital recently. He reads the obits pretty religiously and is some ways I'm sure he is counting his own days. I wasn't surprised at all to hear him comment on his own mortality.
"No, I meant the weather," he replied.
Dear Mr. Maupin,
Thank you for your letter and for sharing your thoughts with the Governor. He appreciates the time you took to share your views on this subject.
House Bill 1065, various provisions concerning firearms, passed the Indiana General Assembly and was signed by Governor Daniels. This bill will go into effect on July 1, 2010.
Governor Daniels statement regarding HEA 1065:
"Considering the clear language of the Second Amendment of the U.S. Constitution, and the even stronger language of Article 1 Section Thirty-Two of the Indiana Constitution, protecting these rights as provided in HEA 1065 is appropriate. I also am compelled to give great weight to the overwhelming consensus of both Houses of the General Assembly as they passed this bipartisan statute. The law does contain ambiguities that the General Assembly may wish to refine at some future date, to avoid unnecessary litigation, but the understandable concerns raised against the bill do not suffice to justify a trespass on a fundamental right so expressly protected by our founding documents."
The 2010 Bill Watch on the governor's website has been established. We will continue to update the website as bills are received and/or action is taken by the governor. You may view this webpage at http://www.in.gov/gov/billwatch.htm.
Please be assured that Governor Daniels monitors all legislation very closely as it proceeds through the legislative process and thoroughly reviews all bills that are brought to him for approval or veto.
Thank you for your citizenship.
Sebilius should be aware how strongly providers feel about her statement. The fault of the system is that it forces all provides into a single pre-determined quintile, arbitrarily moving individual facility scores around during the year as other providers complete survey cycles. Rather than measuring quality improvement, it is strictly comparative, and certainly not on a real-time basis. Additionally, many facilities and organizations usie their survey as a true quality improvement process tool, and make significant improvements 3-6 months after a health survey. The system forces a single score on providers for up to 17 months at a time, quality measures component aside.
The Secretary seems to agree with providers that an improved system would include all three componets, namely better measurement and explanation of quality measures. "If everyone ends up being excellent or everyone ends up being failing, so be it,” continues Sebilius. We couldn't agree more. While CMS is unlikely to open up to most provider recommendations, we can continue hope and lobby for reform in this area. Until then, just know that a facility in another state could bump you from a three-star community to a two-star community with one good survey.
I can't find any proof of its existence or declaration in 2010.
So from me to you, in the most unofficial of terms, Happy Nursing Home Administrator Week!
Don't tell your staff.
Community Historic Trivia Contest with Silverchair online in-service
Group photograph of everyone on campus by Professional
Family photography giveaways through Professional – Have your family photo taken in the same style as the Annual Report photos (plus we could use some of the shots for advertising), we could easily do 5-10 of these packages
Banner with every employee’s name on it in front lobby
Letter of recognition to editorial of local paper, mayor’s office, state representatives, etc.
More general “Thank You for what you do” banner to employees outside on main Blvd.
Addition and dedication of new employee wellness equipment, ie. New treadmills, bikes, etc.
Special limited edition Community branded pen – one time run only of 500 for both employees at both campuses
Employee Wellness walk to raise money for Employee Assistance fund
Arrange for 2nd shift nursing staff to work over so that we can throw a 3rd shift party at 10:30 p.m.
Recognize National Nurses Day by purchasing a print media ad
Letter to families of employees thanking them for their support of Community
Make a video of employees saying positive things about other employees and show at Town Hall Meeting
Daily Employee Spotlight Profiles on Facebook every day during National Nursing Home Week
Employee dog show with residents as judges
Themed dress days that will have more than 50% appeal – breast cancer (pink) day, Alzheimer’s (Purple) Awareness day, etc.
I work with a great Director who sometimes laments that she misses the days when she was able to work more directly with the residents. You've heard your managers voice similar concerns, reflecting on their former roles in direct care positions and supervisory roles. As a department leader or Administrator in a CCRC setting though, these daily opportunities are rarely included in your job description. You must seek them out; they probably won't just come to you. Even as a leader, as a manager, as a Director, you must connect with the residents you serve. Especially as a leader.
So I grab these flowers from the reception desk as I scoot in this morning. Sure, they probably already called down to the nurses station when the flowers arrived, and someone on the other end said they'd be down when they had a moment. I may even pass them on the way down. But c'mon, this is no chore! I'm heading that way anyways, so I'll just take those flowers, Nancy!
It's a ten-minute walk across campus as I snake through the buildings, and though I sometimes exaggerate, I'm sure no less than 15 people made some comment about these flowers. What a hit! This will definitely be a feel-good moment for Ms. R. As I finally reach her room, I hear one last person down the hall saying, "Awwwww, for me?" I knock and thrust the roses in front of the awed resident for her inspection.
For the next 15 minutes, this lovely resident tells me all about her family as I help her unpack the carefully cellophaned arrangement. I make sure to ask her permission each time I pull anything away, and I am careful not to look at the contents of the card. I don't throw anything away without her permission either, and I make sure that the flowers are left in a place that is a) sturdy, b) where she can see them, and c) in a place where other people can see them and ask her about them.
So what, you ask? Well, I find that I often miss these opportunities with both my own Grandmother and other people's Grandmothers, and now I'm reminded of the little things in life. So, if you have a Grandma, send her flowers for Valentine's Day - it really DOES make her feel good. And if you're an employee, grab the flowers when you walk past them at the reception desk.
It's your perfect opportunity to connect.
"It is with great sadness that we say goodbye to our dad - Captain Phil Harris. Dad has always been a fighter and continued to be until the end. For us and the crew, he was someone who never backed down. We will remember and celebrate that strength. Thanks to everyone for their thoughts and prayers.
- Jake and Josh Harris
Rest in peace, Captain.
From start to finish, you and your team will spend 2.5 months from day one of a survey to the completion of an average re-visit. Once the survey cycle is closed, find ways to continue quality assurance monitoring of survey deficiencies per your plan of correction. Remember, though, your core group has spent a lot of extra time auditing records, checking ted hose, reconciling labs, in-servicing staff, conducting return demonstrations, etc. Don't fall back from approaches that are exhibting value, but re-tool other parts that aren't working. Don't be afraid to amend your plan of correction if it becomes irrelevant.
Finally, go back through your notes from the surveyors. Those "FYI's" they give you aren't just small talk. Expect close scutiny of those very topics during your next survey. Re-organize all of the copies that you collected during the survey, type up the most relevant of your own notes, and put a cover sheet on top with the dates of the survey and any other significant information. Leave something that's easy to comprehend for the next person in your seat.
I encourage you to start planning now. These events sneak up on you, and before you know it, you are throwing something together - and your staff don't feel appreciated, like they should. Watch for more posts here regarding ideas for celebrating the week with staff, families, and residents.
Wondering how the swing-bed unit in your local hospital works? How about the vendors you work with? It's all included, and so easy to reference. I recommend saving the table of contents PDF and your organization's applicable guidelines to your desktop for quick reference.
Additionally, the Health Herald is currently featuring it's Top 50 Hospice Care Blogs. Between the two lists, we have a pretty nice compendium of currrent "resources."
Healthcare facilities are rightfully expected to protect you from infection but that's just not always the case. Sometimes people are picking up infections, from pneumonia to antibiotic-resistant staph (MRSA), while under treatment for other health problems, or even while just in the hospital having a baby. That's a situation that could, and should, be completely avoidable.
Kimberly-Clark Health Care is on the forefront of protecting patients from Healthcare-Associated Infections (HAI) and has put together a site dedicated to that prevention called HAI Watch: Not on My Watch. The site has information for both healthcare professionals and healthcare consumers.
Click on the link above to access their resource.
For the afternoon session I attended (85-A) "Effective Event Reporting in a Risky Environment." This session highlighted the cost benefits of successful risk management in the long term care environment. Speakers made interesting points on unavoidable statements (compare your unavoidable statement verbiage to CMS interpretive guideline language) and the legal benefits of the family notification process. They really did stress the importance of family notification at the time of an incident and talked about methods for educating families on both community policies and the aging process in general. Education in risk management techniques is encouraged now at all levels of the organization, in many different forms. By educating staff on risk management policies, caregivers should not feel as threatened by a facility's investigation procedures and their own involvement.
I hate to mention the shuttles, but coming and going may be a bit difficult this week! The city traffic and unbalanced ebb and flow of conference traffic extended some shuttle waits to 45+ minutes tonight. Fighting a disappointed Bears crowd, thousands of sunny-day bikers and runners, and a reported crowd of 9,000+ (unverified), the buses just had some difficulty pushing all of these type A personalities from McCormick to the hotels and back.
This hotel charges $14.95 a day for internet. Shameful. Good night.
I had the pleasure of spending the day with Captain Phil Harris from Discovery Channel's "Deadliest Catch." Phil graciously visited with Lutheran Life Villages residents and was the V.I.P. at our first annual Foundation Crabfest.
As a hobby I carve portraits into pumpkins. Stupid human tricks. I carved Captain Phil into a pumpkin the night before and gave it to him. He and his agent were so pumped about it! It was on display for the Crabfest and Phil made it the screen saver on his phone.
Thanks to Captain Phil, his agent Russ, and the whole Lutheran Life Villages crew that made it possible.
I'm a real sucker for creating a new form. For all of you form-makers out there, this is usually a bad habit and a poor use of your time. While I haven't found any great resources for long term care forms, the fact is, most of the tools you make have already been created a thousand times over - good, bad, and ugly.
You know who you are.
So last month when Apple came out with the iPhone's newest operating software, I was excited to find a new feature: Voice Memos.
Now when making rounds, there is no audit form needed. No pen, no clipboard. No sitting your materials down to intervene and then forgetting where they are. It's as easy as 1-2-3.
1. As you round, use the Voice Memos application to make notations to yourself, such as, "Peerage Room 363 needs the closet door fixed."
2. Don't push STOP, push PAUSE in between notations. By pausing, you can keep the rounds to just one file. Otherwise, you may end up with 50 separate audio files at the end of the rounds.
3. When rounds are completed, go back to your computer and transcribe your Voice Memos. Because you created a single file using pause, it is easy to stop the recording in between notations or rewind if you missed something.
The Voice Memos application works well enough that it allows the Administrator to be discreet - you can talk softly into the mic and still easily capture your thoughts. And the transcription process is where the majority of time is saved. Even if you are accustomed to just making lists during rounds, you know that communicating your observations afterward can take a lot of time. Voice Memos eliminates this.
I know that the concept of snippet voice recording is far from new. The iPhone, though, has made making rounds much easier than it was in the past. I appreciate your feedback or tips on using this and other applications to improve your efficiency.
Thanks for being a caregiver. You are essential to those you care for. Their strength often comes through you, whether through physical help or emotional response. You do something that most people could not do. You have training, experience, patience, and grace. You are there for us 24 hours a day, 365 days a year.
Thanks for all you do.
That's what we need in this economy. It's not cheap, it's smart.
What similar ideas have your employees brought forward in the past quarter?
Today we opened a new 15-room Memory Care neighborhood for residents with early-stage Alzheimer’s disease. Nestled within another portion of our skilled rooms, the new Memory Care is designed to test new household concepts of care delivery. Our staff is excited to make it home for our residents (it is), and I can’t give enough thanks to all of the people that helped make it possible.
Which is what makes the next part of this story disappointing.
Last week we left the doors open for on-lookers as we moved furniture, installed fixtures, and inventoried equipment. It was late afternoon and our Director of Maintenance and I were wrapping up for the day. A family member from another area of the nursing home wandered in to look around. She had actually followed me in.
“Can I ask you something?” she said.
“Of course.” I was acquainted with this particular family member.
“You’re going to cover up the windows or these doors so we don’t have to look at these people, aren’t you?”
“I’ve worked with these people, and we shouldn’t have to look at them. I don’t want to see these people, I know what they do.”
I know, there are a lot of things I could have said next. Reading what I wrote, it’s was more offensive than the way it reads. Anyways, I was speechless. And just to go on the record, her sentiment is exactly the opposite of how I feel, about not just long term care, but how I try to treat every person on God’s earth. Even animals and bugs, now that I think about it. Everything has a purpose, and the right to serve that purpose with dignity.
Our residents with Alzheimer’s disease have the disadvantage of memory loss. Difficulty remembering their former purpose often leads to frustration and confusion. Rather than attempt to alter this reality, we now understand that is better to direct residents down the most comfortable path than to redirect or reality-orient. We will encourage our residents to assist us with the “activities of household living ™” that will help to give them a purpose, even if it is different than the one they remembered in an earlier stage of their life.
We will not let any resident live a life without purpose. I hope that is the mission of many organizations such as ours. I believe that we do the right thing by co-habitating these residents so they may receive focused programming and well-intentioned care and attention. Looking down upon this group or any group of residents, though, is wrong, and I believe that as a resident advocate, a long term care professional, and a good Christian, that I was right in saying... Well, it doesn’t matter. I said the right thing. I received a snide remark in return, but that’s okay – we do it for the residents.
AHCA is proud to announce this year's National Nursing Home Week® (NNHW) theme: "Nurturing a Love that Lasts". NNHW will be held May 10-16, 2009, beginning on Mother's Day. "Nurturing a Love that Lasts" will encourage all to think of generations of parents and grandparents nurturing future generations to carry on life and family traditions. A supportive and caring environment, such as a nursing home, nurtures and enables residents and families to continue growing, learning and teaching through various ways. Nursing home staff, residents and volunteers nurture a caring environment that values communication, relationships and partnership. Be a part of this celebration in May 2009!
Get started now and you can still be "ahead of the curve":
AHCA Planning Guide
Promos on Time: "National Nursing Home Week
This is just start. Plan now so that you can also consider communications to families, recognition of nurses (National Nurses Week), and of all staff. Some communities prefer to focus on aging, wellness, or community instead of "nursing home" in order to avoid unnecessary stereotyping or generalization of residents.
The complete article is fascinating, including hard data and charts. Be sure to check it out.
Now consider the traffic cop that notes some drivers exceeding the speed limit by 8-12 miles per hour, but doesn't issue tickets. Most of these drivers slow down when they see the officer as their adrenaline increases and they realize the potential harm and consequence in speeding.
Sometimes you have to be a traffic cop, and every officer has to pull over the most obvious offenders, but you have a choice.
What kind of traffic cop are you?
Click here for more information from AAHSA.
Indiana is currently considering implementation of the Silver Alert system. Click here to read more about Silver Alert systems across the country.
Here's the news coverage from MSNBC.
Click here to watch the You Tube video of her crowing.
"Residents at Lutheran Home and Concord Village, 6701 S. Anthony Blvd., are not getting all their snack options these days, said administrator Matthew Maupin. Gordon Food Service, which is their food vendor, informed them of the recall. Residents have many other snacks to choose from, Maupin said."
Which is not what I said.
Extendicare and Beverly Healthcare both gave me great training on media response. But they also both had teams. If I recall correctly, I may have had a colorful laminated card with 24-hour PR response - basically, keep your mouth shut. I see that Lutheran Hospital had a "spokesperson" in this article. That's pro.
In this case, I actually explained over the phone that sure, we had received some product related to the recall, but that we were fortunate to have our great national vendor alert us immediately and assist with product replacement.
Why did I say this, even? There was no need. I did not ask to be quoted directly, which would have been responsible, even if it didn't work. I could have offered a quick written response via email, which would have been nice documentation for both parties(what if I had been quoted waaaay out of context).
I just don't gain anything giving some one-liner about peanut butter to my adoring fan base in Fort Wayne. So anyways, just some quick advice: Don't respond off-the-cuff.
If you don't buy my advice, click here for someone else's tips (a nice Powerpoint presentation) for dealing with a media call.
You have employees who feel abused by family members and residents. And if you're a member of your community leadership team, many employees blame you for not intervening. There is not a healthcare professional reading this that cannot recall a customer sitting on the other side of their desk, or standing on the other side of the bed, or even in the hallway, vociferously expressing their anger over an actual or perceived breakdown in the delivery of care. I have been sworn at, had fingers pointed in my face, and threatened. I fully understand my responsibility as a community leader, though, and I've benefited from more customer service and crisis management training than most of our employees combined. I know that I have a responsibility to find solutions and prevention through root-cause analysis, and every concern is taken seriously.
When a direct-care employee such as a nurse or a C.N.A. is verbally reprimanded by a family member, it can be perceived as a personal attack on their intelligence, proficiency, or even race and socioeconomic status. The linked article above, from a great C.N.A. forum, describes the frustration felt by many nursing staff members first-hand. I admit experiencing the same feelings as an Administrator, and the helplessness that can accompany them. Patti's article along with the subsequent reader comments, calls for a policy shift in retirement communities that holds customers accountable for their own behvior.
The topic has forced me to examine my own views and approach to conflict resolution, and I agree that families do not have the right to verbally accost employees, regardless of the situation. While difficult to craft an umbrella policy that does not discriminate against residents or breach resident rights, I recommend reviewing your process for prioritizing family and resident concerns. This process must be transparent, accessible to families, and objective. I believe that most communities have some version of this in place, but I also know how uncomfortable the worst of these situations be.
What is alarming about the conversation is that some direct-care employees are searching for their own methods to deal with situations because they feel a lack of support from their Administration. Several commenters promote calling 911 when they have been verbally (even physically) attacked by a family member. Their presumption is that communities pander to families in order to maximize revenue:
"We must stand up for ourselves if the DON won’t. If we lose the job, so what. The job wasn’t worth US. Getting hurt at work isn’t worth it. The management CAN draw the line but usually won’t cause it’s all about money- the paying customer. Mind you, I question if the payment equals the worker comp bills.
When it is family who is abusing staff, that is different. They should be banned from the facility until they are made to take an anger management course. And then they must apologize to the staff. It’s one thing to yell and hoot and scream. It’s quite another to shake and rattle and otherwise manhandle the staff. Limits must be set. Just like with kids."
So how are you going to effectively convey the right message to both employees and customers? No Administrator or Director of Nursing enjoys asking a family member to examine their own actions, but allowing your customers to act out against employees certainly sets the tone for your community. Feelings of resentment will build and employee morale will suffer greatly if leadership fails to address each individual circumstance swiftly. While I still have some introspection to conduct on the topic, I offer three tips to begin your own journey:
1. Include "Addressing Angry Customers" as part of your Abuse Prevention and Reporting In-Service. The resentment created by an angry family member can turn into retaliation - against the resident.
2. Take ownership of the concern process. I receive all written concerns in order to ensure timely, objective follow-up, and review all concerns from the previous 7 days with our Concerns Committee. The Director of Nursing and I take time each week to sit down and call several families that have expressed concern or frustration.
3. Educate employees on involuntary discharge. The average employee believes that a nursing home resident can be "kicked out" at the whim of management. Involuntary relocation is an extremely cumbersome process, and rarely executed. Why? Because forced discharges are almost never to the benefit of the resident.
OH, the resident! We almost forgot about the resident. And that is what concerns me the most about this conversation. When employees become embroiled in family onflict, the resident almost always loses. By dealing quickly and honestly with family outbursts, leadership can minimize resident stress and undue harm. Focus difficult family conversations on how actions are impacting the resident's best interests, rather than scolding or threatening discharge. A successful Administrator or Director of Nursing can advocate for both residents and employees simultaneously - and should do so every time.
I look forward to hearing from you on this topic.
Lutheran Home is the largest not-for-profit retirement community in Fort Wayne, Indiana. Also the headquarters for Lutheran Homes, Inc., our well-established community takes a different approach to delivery of care, focusing heavily on holistic wellness programming and empowerment of all community residents. Considered home to more than 350 Fort Wayne residents, Lutheran Home offers many levels of care and endless learning opportunities for students.
Interested, qualified students should forward their resumes, in Word or PDF format, to firstname.lastname@example.org by March 31, 2009.
Bottom Line: Consumers demand and deserve your respect, rightfully so, regarding the prevention of this infectious disease. Here are several tools for you to use when communicating to employees, residents, and families:
Mayo Clinic Guidelines on Hand Washing
Center for Disease Control (CDC) Facts on Seasonal Flu
Dana Carvey was sub-par, an equal but disappointing replacement for the absent Aretha Franklin. Anybody that respects music would have preferred Aretha, but overall the crowd seemed to enjoy the impressions that were either Carvey circa 1994 (Swartzenager, Bush Senior, Church lady, Ross Perot) or Carvey circa 2008, which is an "impression" of every current political newsmaker, half of which require a serious stretch of the imagination.
The attendance is estimated at over 6,000, though I don't see quite that many people - as a first timer I'm still very impressed. The current presidential race and economic crisis are an intrinsic theme of the whole show, whether presented by a comedian or a nun. The audience here is the type that was abuzz today over the 900+ day the Dow had - you could feel the value of everyone's accounts rise as Monday passed. I wasn't the only one staring at my Blackberryhalf the day.
Great sessions, at least for me at this point. The speakers are experienced presenters, which is one key difference from smaller conventions. It's one thing to be a success or an expert - it's another thing to be able to tell your story really well. The educational sessions that I have attended all included multiple, related speakers. Fortunately, I chose presentations that will really help me pull some projects together, with best practice ideas presented that neither my team nor I had thought of. I am not 100% sure that all presentation materials are accessible online, but you can tell that AAHSA is at least on the way to being a green organization. You should've heard the audience clap at the opening address when it was announced that this was the last year they would be distributing tote bags.
I chose to sleep in for the John Glenn talk, but I can say that Whoopi Goldberg was decent. Her message was a bit of a stretch, and she was one up'd by Larry Minnix, AAHSA President. Minnex's discussion on the impending leadership void and the state of our government and economy was right on point and was also in line with the convention theme of "One Voice." The nun stole the show from both when she confessed to being a sinner by embracing Goldberg during the end of the opening session.
Overall, I'm excited to discover such a large, high quality convention dedicated to our profession. The polish that this convention has trulyturns the cost of sending your leadership into an investment in your organization's success.