Blog
Seeing the ‘invisible patient’ in LTC
Here’s my latest article on McKnight’s Long-Term Care News:
Seeing the ‘invisible patient’ in LTC
Jane Gross’ recent post Seeing the ‘Invisible Patient’ in the “New Old Age” blog of the New York Times discusses how professionals often ignore the needs of caregivers of the elderly because they are focused on their identified patient. As the author states, “Not once in the years I cared for my mother did any of her physicians ask me how I was doing.”
While the article centers on the burdens of caregivers in the community, it got me thinking about whether we’re meeting the needs of families whose loved ones are in long-term care.
What are the burdens of family members in LTC?
Some families have been down a long road of illness with their loved one and are physically and emotionally depleted. Others have had the shock of a sudden shift in the condition of their relative and have been swiftly thrust into the world of LTC. Virtually all of the families are coming into a system that’s new for them and they could use our help in successfully navigating this change.
Benefits to the facility
Addressing the needs of family members can:
• Increase the likelihood of families making positive contributions to the lives of the residents, which is good for the residents and reduces the workload of the staff. If families are purchasing clothes, for example, that’s one less task for staff members.
• Improve satisfaction with our services and increase the chances that they’ll recommend our facility to others.
• Provide a benefit that appeals to the adult children decision-makers and makes our organization more competitive.
Below are some ways to creatively and inexpensively attend to the needs of families:
For the entire article, visit:
Seeing the ‘invisible patient’ in LTC
Secrets to Creating an Emotionally Healthy Environment for Residents: Webinar 12/10
Join Dr. El
Wednesday, December 10th
at 2pm Eastern Time (1pm Central Time)
for a
FREE Webinar on
Secrets to Creating an Emotionally Healthy Environment for Residents
sponsored by EmLogis
To register:
visit EmLogis Events
About the Webinar:
Is lack of attention to residents’ emotional health undermining your efforts to provide good medical care? Join psychologist Dr. Eleanor Feldman Barbera as she discusses how to create an emotionally healthy environment that enhances medical services and improves the experience of residents, families and staff.
What you will learn:
Symptoms of an emotionally unhealthy atmosphere
Elements that contribute to a healthy environment
Realistic, feasible steps toward creating an emotionally healing atmosphere
Who should attend this webinar:
Administrators and assistant administrators
DONs, ADONs, department heads, and nursing supervisors
Staff training coordinators
All direct care staff
Transitioning to Long-Term Care: What Your Loved One Wishes They Could Tell You
My second post at Care Conversations.org focuses on easing the transition to long-term care for families.
Transitioning to Long-Term Care: What Your Loved One Wishes They Could Tell You
As a psychologist, I’ve talked with hundreds of residents as they transition to living in a Skilled Nursing Care center. In the privacy of a psychotherapy session, new residents will frequently share with me things they haven’t mentioned to their families, often because they don’t quite know what to say or how to say it.
Their perspectives may surprise you:
- They’re worried about you. They’re concerned about how much time you’re spending at the facility. They worry you’re neglecting yourself and your life. They want you to take care of yourself because they love you and because they need you – so take their advice and do so!
- They know you’ve done your best. In most cases, new residents are aware they would have been admitted to a long-term care facility much sooner if it hadn’t been for you. While they may not be happy about the transition initially, they know that without you they would have been here long ago.
For the entire article, visit:
Transitioning to Long-Term Care: What Your Loved One Wishes They Could Tell You
5 Steps to Becoming a Part of the Nursing Home Team
I’m excited to let you know about my recent post for family members at Care Conversations.org. Readers who are long-term care staff members will find it a helpful resource to share with family members.
5 Steps to Becoming a Part of the Nursing Home Team
Moving to an assisted living or a skilled nursing facility can be challenging for both you and your loved one. To help make the transition less stressful, it’s often suggested that family members work with staff to ensure their loved one’s needs are being met. Here are some ways to become a valuable player on the nursing home team:
- Keep an open mind – It is normal to feel nervous about placing a loved one in a long-term care facility. But as our loved ones grow older and begin experiencing more and more health issues, their needs are often best met by skilled nursing facilities. Entering a facility with an expectation of good care puts you in a teamwork frame of mind.
- Recognize the expertise of LTC workers – Nobody knows Mom, Dad or Aunt Sue like you do, but chances are that you haven’t handled a situation quite like this before. By contrast, those who work with elders have observed hundreds of similar situations and bring a vast amount of knowledge and experience to the care of your loved one. It’s good to have them with you on this journey.
- Appreciate your essential role on the team —
For the entire article, visit:
5 Steps to Becoming a Part of the Nursing Home Team
10 reasons I’m thankful to work in LTC
Here’s my latest article on McKnight’s Long-Term Care News:
10 reasons I’m thankful to work in LTC
Every year as Thanksgiving approaches, I take a special moment for gratitude and to reflect on the many blessings of my life. I owe a lot of them to working in long-term care, and my LTC career is a blessing in itself.
1. I get the chance to learn from experience — other people’s experience. Talking to elders gives me insight about what leads to happiness and what doesn’t. I’d like to think this has spared me a few mistakes along the road.
2. LTC has improved my perspective. On days when I feel the weight of too many tasks to accomplish, I remember how lucky I am to be physically capable of taking care of my responsibilities. This allows me to focus on constructing a life I’ll be able to look back on with satisfaction when I’m 85 years old.
3. I’m told regularly how much I’m appreciated. Residents express their gratitude for my assistance in various ways. It could be a beaming smile at my approach, finding out from a family member that I’m talked about all the time, or a warm comment like, “I don’t know what I’d do without you.” It’s a good reason to get to work every day.
4. Little things make people so happy. Cleaning off a pair of smudged eyeglasses or changing a clock battery can turn me into a hero. It’s really easy and feels really good.
For the entire article, visit:
10 reasons I’m thankful to work in LTC
Planning for the holidays
With the start of the holiday season, it’s time for this perennial post from Dr. El at mybetternursinghome.com:
‘Twas the Week Before Christmas…
And 83-year old Albertha assured me her family was planning to take her home for the holidays.
“Have you talked to them about it? Have they called the social worker to arrange a pass, and meds, and transportation?”
“No,” she replied, “but they’re coming to get me.”
‘Twas the week after Christmas, and Albertha was glum.
“They didn’t show up. I waited all day, but they didn’t come.”
Albertha spent Christmas day watching other people go out on pass and return, and seeing families arriving with food and gifts and smiles.
Now my patients and I start discussing the holidays a few weeks in advance, addressing wishes and practicalities, phoning families if needed, and getting the social worker involved. We set up a hierarchy of plans.
Plan A: Go home for the day.
Plan B: Go out to a wheelchair accessible restaurant with family.
Plan C: Have visitors come with food and go around the corner for coffee, if possible, just to get out.
Plan D: Stay in with visitors and food.
Plan E: Talk to family members on the telephone, discussing plans for a future visit, while sitting in a room festooned with cards and holiday decorations. Attend the nursing home holiday party.
Plan F: Have a small holiday gathering in the room with nursing home friends after the facility party.
Since then, my people know what to expect from the holidays, even if the expectation is that their family might not arrive as hoped.
Three tips from Dr. El for the holidays (click here or view below): http://youtu.be/8HTjVoKQmKo
Working on how to communicate in facilities (McKnight’s LTC News)
Here’s my latest article on McKnight’s Long-Term Care News:
Working on how to communicate in facilities
Poor communication and coordination between staff members contribute to medication errors and adverse events. These problems are more likely to occur during a transition of care from one setting to another.
AMDA, The Society for Post-Acute and Long-Term Care Medicine, working with the National Transitions of Care Coalition (NTOCC), recently released its free Transitions in Care in the Long-Term Care Continuum guideline. The goal of the document is to identify areas where problems in transitions occur and to offer methods to avoid these common errors.
Reading through the guideline got me thinking about the in-house communication glitches I’ve noticed in my role as a psychologist. While we clearly need to address communication and coordination between settings, we also can look within our own facilities to see if there are areas where communication could be improved.
Below are examples of problems I’ve observed in some high-quality facilities. (Imagine how much better the care would be if these problems were addressed!) While I mentioned my concerns to the relevant staff members, interdepartmental communication issues can sometimes fall into that gray area between job descriptions and don’t always receive the attention they deserve.
• Each floor of one facility had a notebook where staff members could leave messages for the social worker. Except that the social workers never looked at those notebooks. New staff members would leave notes in there until they learned it was pointless. But nobody took the notebooks away.
• There are communication books for the attending physicians at most nursing stations, but the doctors vary in their diligence about looking at the information. Sometimes I’d check the log to see the status of something I’d previously reported and see that nothing had been checked off in the book for a month or even several months. While very urgent information should be reported directly to the charge nurse, many staff members don’t have the training to know what’s urgent.
• Along those lines, I once mentioned to a charge nurse that I wrote a note in the communication book and she said, “Oh, Dr. Smith never looks in there. If you have something important to tell him, you let me know and I’ll write it on a sticky note and tell him when he comes in.” She pointed to the ledge of the desk filled with scrawled memos. Things I pondered: What if the sticky note loses its “stick,” falls to the floor, and is swept up by the porter? Who else is leaving notes in the logbook without realizing they’re never seen? What if the nurse is off from work on the day the physician comes in? The nurse retired shortly thereafter. I wonder what they’re doing now.
For the entire article, visit:
Working on how to communicate in facilities
Creating an Emotionally Healthy Workplace: Free Webinar 11/12
Join Dr. El
Wednesday, November 12th
at 2pm Eastern Time (1pm Central Time)
for a
FREE Webinar on
Creating an Emotionally Healthy Workplace
sponsored by EmLogis
To register:
visit EmLogis Events
Aunt Sylvia Stays Psychologically Healthy: Click here or view below: http://youtu.be/NlNZVnmNpfo
About the Webinar:
Is your work environment undermining the efforts of staff members to provide high quality services to the residents and families under their care?
Join psychologist Dr. Eleanor Feldman Barbera live on November 12th at 1pm central as she discusses the positive impact of addressing the emotional health of the workplace and offers immediately implementable tools and suggestions that will foster an emotionally healthy environment.
What you will learn:
- The practical (and financial) benefits of a psychologically healthy workplace
- The five different elements that contribute to a positive environment
- Realistic, feasible steps toward making your workplace emotionally healthy
Who should attend this webinar:
- Administrators and assistant administrators
- DONs, ADONs, department heads, nursing supervisors, and charge nurses
- Staff training coordinators
- Human resource department staff
The White House Conference on Aging: Why it should matter to you (McKnight’s LTC News)
Here’s my latest article on McKnight’s Long-Term Care News:
The White House Conference on Aging: Why it should matter to you
If you, like me, completely missed the 2005 White House Conference on Aging (or if you weren’t in the field at the time), you may be wondering what the WHCOA is, what it does, and how one can get involved. Below, I share the answers to my own questions under the theory that I can’t possibly be the only one who doesn’t know enough about the conference.
What it is
The White House Conference on Aging is a once-a-decade national conversation about the needs of our aging population. The goal, according to the WHCOA website, is “to identify and advance actions to improve the quality of life of older Americans.” The first WHCOA was held in 1961, with subsequent conferences in 1971, 1981, 1995, and 2005. As indicated on the conference’s website, the 2015 conference takes place during a year that marks the 50th anniversary of Medicare, Medicaid and the Older Americans Act, as well as the 80th anniversary of Social Security.
The 2015 WHCOA agenda
Next year’s conference will focus on four main areas:
• Retirement security
• Long-term services and supports that allow elders to remain in the community
• Healthy aging
• Preventing financial exploitation, abuse and neglect of elders (elder justice)
What it does
For a positive view of the conference, Anne Montgomery’s article for the National Academy of Social Insurance points out concrete actions taken as a result of previous conferences.
According to Montgomery, the 1961 conference led to the development of 50 State Units on Aging as part of the Older Americans Act; the 1971 WHCOA resulted in the creation of the Supplemental Social Insurance program and establishing the National Institute on Aging within the National Institutes of Health; the 1995 WHCOA lead to the National Family Caregiver Support Program; and the 2005 WHCOA “provided momentum for reauthorizing the Older Americans Act in 2006, which strengthened the role of Aging Disability Resource Centers.”
Delegates to past conferences commented on her article, stating that the WHCOAs have been crucial in identifying problems and their solutions.
No stranger to controversy
For the entire article, visit:
The White House Conference on Aging: Why it should matter to you
Inspiring street musician (video)
The beautiful music in this video reminds me that each resident holds secret treasures if we take the time to stop to listen.
Listen to the video below or at this link: http://youtu.be/s3PGNnG1OGw
