Wednesday, September 7, 2011

Long Term Care: THEN AND NOW

Ever said, “Just give me back the good old days”? Let’s take a look at what was good about those old days.

The year is 1990. The “new” OBRA regulations had just gone into effect. Our world of long term care was reeling and we were very busy trying to get our hands around what were the items the surveyors would be asking. Sure, we had regulations, but we were pretty comfortable with them and had learned how to work with surveyors successfully.

We were giving good care with the knowledge we had at that time. Most of the elderly folks presented with physical limitations. Those limitations were in ambulation, transferring and eating and we knew how to help them.

Many nursing homes were small and family owned where everyone knew the residents and their families from their community. Often the owner and the staff were personal friends with the folks from the community. The care was truly focused on the person.

Times have changed...or have they?

Contact us today to receive a complimentary copy of Long Term Care practices still used today! Clearing out my VHS tapes and would like to see them used if you still have a VHS player!

REGULATIONS: The laws governing nursing homes haven’t changed since 1990. We have learned how to meet those requirements. We have learned how to support our practice with evidence-based information. I often hear caregivers agree that the regulations speak to the kind of care they want for themselves when and if they become “residents”.

KNOWLEDGE: Sure there are new techniques and new approaches that we have learned. But we now have computers where we can find information with the click of a key. We have education available from a much wider variety of sources to keep us “up to date”.

STAFF: As I travel the country I continue to find the vast majority of staff members do care deeply for those entrusted to their care. Yes, the facilities are now owned by big companies, but the staff are still from the community they serve; they still know the folks as the people from their community.

RESIDENTS: Sure, the physical acuity of our residents has increased drastically. The number of residents with cognitive loss has compounded the challenges we are now asked to meet. But they are still folks from our community. They still are seeking to be known as individuals.

WHAT HASN’T CHANGED? We are still people caring for people. The residents are still looking for someone to know them and provide care that meets their needs.

The “good” we talk about from the “old days” is the same now as it was back then. I believe if we focus on our service to the people we will find the exact things that were important “back then” are still the things that make the difference.

In the final analysis it’s not about focusing on meeting regulations but on meeting the needs of people. That focus worked back in 1990 and it works today.

Clearing out my stock of VHS tapes - so contact us today to receive a complimentary copy of Long Term Care practices still in use today.

Wednesday, April 6, 2011


The time to "know it all" before you consider readmitting a resident to the hospital is here.

I want to share with you a wonderful tool that will empower your nursing staff to effectively communicate with the physician regarding the resident's condition prior to the consideration of readmission.

A review of the new publication from AMDA entitled KNOW IT ALL BEFORE YOU CALL reveals a step by step approach to gathering the vital information the physician needs to determine their course of action. It provides an easy to follow list of data that needs to be provided during the nurse-physician collaboration.

If I ran the world (always keep hoping!) I would highly recommend a copy of this dynamic tool be available on every nursing station. As a fellow nurse, I appreciate the need to share appropriate, to the point resident information with the physician. It can reduce "call backs", frustration and most importantly decreases the time needed to explain the resident's medical status.

Simply click on the tile of this blog to be connected to the AMDA products page for this publication.

Knowledge is power and sharing it is rewarding to nurses, physicians and the resident.

Get your copy now!

Tuesday, March 22, 2011


I am very concerned about the increase in the use of personal and bed alarms in long term care facilities. In my opinion, we have exchanged physical restraints for psychological restraints in the form of devices that emit an annoying noise when the resident moves.

We say they are valuable to "alert" us. That seems to fall in the category of staff convenience at best as the alarm serves as a means of notification of an incident rather than prevention of an incident.

What about the effect of the alarm on the resident? If it works at all to stop an action it does so by psychological intimidation. An archaic approach at best. Actually an approach that is not sanctioned even when working with possible criminals. Since we never use alarms on alert oriented residents, the problem is simply compounded by the resident's dementia.

So the bottom line is we take a person who already is having problems understanding their environment and make them buzz when they move.

Recently there was an interesting article discussing ALARM FATIGUE for hospital staff members. Take a moment to review the video and the article and then please consider the rampant use of these devices in the care of the elderly.

Simply click on the title of this blog to read the Boston Globe article on ALARM FATIGUE IN HOSPITALS.