Category: Customer service
Posted by Dr. El - July 25, 2010 - Communication, Customer service, Resident care
Complaint #1: No One Coming When the Call Bell is Pressed
I’ve worked on units where the moment the call bell goes off, the charge nurse immediately and calmly asks an aide to check on the room. The bell goes off, someone arrives. Simple customer service. This leads to a unit full of residents who feel confident their needs will be addressed in a timely fashion, and are therefore far less anxious. Staff training is a good way to change the nursing home culture on this issue, but each worker can take it upon themselves to make it their own personal policy even if the nursing home as a whole isn’t making it a priority.
[First post in a biweekly series]
Posted by Dr. El - July 7, 2010 - Customer service, Resident care, Tips for gifts, visits
The phone rang mid-session with Velma. Knowing the frail 87-year old was fiercely independent, I refrained from handing her the telephone, and watched as she slowly wheeled herself toward her side table.
Ring…
She was halfway there.
Ring…
She reached out with an unsteady arm. The phone wobbled in her grasp as she held it up to her ear.
“Hello?” She was silent for a moment, then scowled and slammed the phone onto the receiver.
“Who was that?” I asked, surprised by her sudden anger.
“I don’t know! It’s some machine! They keep bothering me. Want me to buy car insurance or some such nonsense. I haven’t owned a car in years!”
“You’re getting phone solicitations. That used to happen to me until I registered my phone with the National Do Not Call Registry. If you give me your phone number, I can sign you up too.”
“But I don’t know my phone number. I think I wrote it down somewhere.” She looked toward the stack of papers piled on her tray table.
“That’s okay,” I reassured her. “I’ll get it.” I called my mobile from her landline, capturing her number in my display, then dialed the toll-free registration number. One minute later, the process was complete. “There! We’re done. It’ll take about four weeks, but those calls will stop.”
Velma looked at me like I’d just worked a miracle.
“Really, it was nothing,” I told her, but one less annoyance for Velma meant a great deal.
National Do Not Call Registry: 1-888-382-1222
Posted by Dr. El - June 15, 2010 - Customer service, Engaging with families, Transitions in care
Many residents have shared with me the experience of leaving their homes suddenly because of a medical emergency, only to find themselves unable to return. Now living in the nursing home, it’s difficult for them to wrap up their affairs in their former home, causing depression, anxiety, and a loss of control. In this post, guest blogger Katie Hustead of Paper Moon Moves describes how Senior Move Managers can assist residents and their families with the move to a nursing home. — Dr. El
Katie Hustead, on right
Downsizing and transitioning into a nursing home
By: Katie Hustead
Owner and Senior Move Manager, Paper Moon Moves
Their stories are unique but share a common thread:
- A woman in her eighties finds she suddenly can no longer live independently after she falls and breaks a bone; she can’t manage with an aide in her walk-up apartment.
- An elderly gentleman has been in rehab for a few weeks, planning to return home to his house in the suburbs. But his doctors advise him to enter a nursing home instead, and he agrees this is the best decision. He hasn’t even begun to think about how to pack up all his belongings.
- A woman in her early nineties comes down with pneumonia and is hospitalized. Her doctor will not release her unless she moves somewhere where she will have care around the clock, and there are no relatives to supervise home care.
Each one has thought about moving – perhaps for years – but has put it off until now. “Now” has come and they realize that the vast majority of their belongings won’t fit in their new home. They can’t imagine how to start the process of figuring out what to move and what to do with all the things that won’t come with them.
Because these stories are being played out more and more often, an industry has evolved to provide the solution. Members of the National Association of Senior Move Managers – a countrywide organization with more than 500 members – fill in when there are no adult children or friends available to help with the stressful process of disbanding a home and moving a senior.
Most senior move managers start with a floor plan of the new residence or room. They work with the senior to decide which of their things can fit comfortably and they help decide what to do with the remaining possessions – selling, donating, recycling or shipping to the senior’s family and friends.
When a senior can’t be physically present to coordinate their own move, a senior move manager can find creative ways of helping them maintain control over the process. In some cases a senior will entrust the senior move manager to work in their home without them. In other situations, a senior will prefer to have a neighbor or relative supervise the senior move manager. All senior move managers are insured and bonded.
In either scenario, the senior move manager involves the senior as much as possible – keeping them updated on progress and helping them make decisions. For most of us, the best part of a job is making the seniors’ new home as comfortable and warm as the home they left. It can be as simple as hanging a favorite family photo or painting on the wall across from the seniors’ new bed so it is the first thing they see in the morning. And the reason we all love what we do is that when we walk out the door, the senior is comfortable and relaxed, surrounded by his or her favorite things.
Paper Moon Moves, a member of the National Association of Senior Move Managers, is a senior move management company serving seniors in the New York City area. To find a senior move manager in your location, go to www.nasmm.org.
Posted by Dr. El - June 1, 2010 - Anecdotes, Customer service, Role of psychologists
When I arrived at Mr. Johnson’s room, he was sitting in the doorway in his wheelchair, frowning at the passersby. He was immaculately dressed, as usual, in a button-down shirt and shorts on this hot summer day, looking much younger than his 90 years.
Lately he’d been frustrated that his memory was interfering with his ability to get things done. Last week I’d tacked onto his bulletin board a calendar we’d created to outline the days and times of his favorite activities.
“How are you?” I asked, settling into the chair across from him.
“Not good.” He shook his head. “My daughter Letty is in the hospital and I can’t reach her. She just had surgery and I’m worried about her.” He spoke in slow, measured words, so that sessions with him, while always fruitful, took on his Caribbean pace.
I could tell his anxiety was high, and not good for any of his medical conditions. “Can we call her?”
“I lost my cell phone. And I dropped the answering machine with her message giving me the phone number and all my messages disappeared.” He sounded close to tears.
“Is there someone else we could call who might have her number at the hospital? Or does she have a cell phone? Let me see your phone book.”
He dug around in the bag on the back of his wheelchair, pulled out a book, and slowly started flipping through the pages. I held out my hand. “May I?” He handed it to me and I saw it was filled with neatly written phone numbers in no particular order.
“Look for her brother, Clifford Johnson. He might know how to reach her.”
I found and dialed the number, and handed him the phone. A brief, pleasant conversation ensued with his daughter-in-law, who then put his son on the phone. After a few minutes Mr. Johnson handed me the phone. “I’m out here in Oregon,” Clifford Johnson told me, “and our sister Annette might have her number, but she’s visiting her daughter in Florida. I’ll give you that number. I appreciate what you’re doing for my father.”
A few minutes later I had Annette on the phone. Mr. Johnson gestured for me to talk to her.
“I don’t have Letty’s number, but I can give you her boyfriend’s cell phone number. They’re in Chicago.” she said. I handed the phone to Mr. Johnson for another brief chat.
Letty’s boyfriend picked up immediately and I explained that her father was worried and wanted to get in touch with her. “Boy, is she going to be glad to hear from him! If there’s anything else I can help you with, please let me know.”
“If we reach Letty,” I told Mr. Johnson, “I’m going to give you the phone and then go.” I dialed the number and a tired voice picked up the line. “Letty?” “Yes?” “I’ve got your father here. He wants to talk to you.” “Oh, good!” Her voice energized immediately. I handed the phone to her dad, touched him good-bye on his shoulder, and left the room.
I was sitting at the nursing station writing up my notes when Mr. Johnson stopped by and fixed me with a long look. “God bless you. I will never forget your kindness.” I almost began to cry at the sincerity in his voice. “I feel so much better now. It’s like a weight has been lifted.” He settled in across from the nursing station. Every so often I’d glance over to find him watching me and smiling.
Posted by Dr. El - May 24, 2010 - Business Strategies, Communication, Customer service, Engaging with families, Technology
For families with hectic schedules, trying to attend Care Plan Meetings, which occur during daytime work hours, can be a major challenge. Of course they don’t want to miss the opportunity to meet with the whole treatment team to provide and gather information, and to advocate for their loved one. On the other hand, taking time from work and other obligations may prevent even the most dedicated family member from being able to show up for this very important meeting. Using the free Skype or another video call option would allow family members to be present from almost anywhere — even halfway across the world.
For nursing homes, offering families the option to Skype into Care Plan Meetings shows their understanding of the challenges faced by family members and their dedication to customer service. It highlights their commitment to providing the best possible care for the residents, which includes facilitating the ability of families to be part of the treatment team. And did I mention it’s free?
Posted by Dr. El - May 10, 2010 - Business Strategies, Communication, Customer service, Engaging with families, Technology
My hip 80-something mother-in-law uses
Skype’s free video calls to view the family as she talks with them over the computer. I’d like to see video calls in nursing homes, either via a video phone or over the Internet in the resident computer room (what, your facility doesn’t have a computer room yet?).
- Families could literally see how their loved ones are doing, relieving anxiety and contributing valuable information to the treatment team. (Who knows better than her family that Mother isn’t quite right today?)
- It would allow long-distance family members to participate more actively in the lives of their loved ones.
- A laptop could be put on a movable cart in a wifi hotspot nursing home to bring to the rooms of residents who are unable to get to the computer room, reducing isolation.
- It’s a great marketing tool for families and residents alike.
Posted by Dr. El - April 5, 2010 - Customer service, Tips for gifts, visits, Volunteering
Most of the excellent nursing home volunteers I’ve encountered over the years have been involved with the recreation department, hosting or bringing residents to activities. Here are some other positions of great value to the residents, some of which I’ve witnessed and others I’d like to see. Please add your additions to the Comments section.
Nursing home residents really need someone to:
- Mend torn items and replace missing buttons
- Take them outside for some fresh air and sunshine
- Run errands (or maintain the Independence Cart)
- Organize their belongings and make their rooms homey (it’s hard to reach stuff from a wheelchair)
- Replace broken watch bands. worn-out watch batteries, and missing eyeglass screws
- Cut and style their hair (many residents have no funds to pay for the fee-based hairdresser)
- Facilitate visits between friends on different floors (when mobility is an issue, they might as well be in different countries)
- Help them write letters to friends and family
- Provide computer education and support (hopefully, all nursing homes will soon have computers for the residents)
Posted by Dr. El - February 16, 2010 - Business Strategies, Customer service, Resident care
My civic-minded in-laws created a dining companion program at their Continuing Care Retirement Community. Couples invite singles who sign up for the program to share a meal with them, fostering a flow between community members and helping to bridge the divide that often develops between the two groups once a spouse is lost.
As my in-laws know, meals are one of the most enjoyable aspects of life for many people, nursing home residents included, and it’s important not to neglect the social dimension even when the focus is on dietary needs.
Here are some things I’ve noticed make for a pleasant nursing home dining experience, plus others I hope to see:
- Hot food served hot, and cold food served cold
- At least a four-week food rotation, so each meal is repeated infrequently
- Separate dining areas (or seatings) for residents more able to dine independently
- Table service similar to a restaurant, with care taken in serving the food
- Flowers on the tables (plastic or silk works fine)
- Dining music
- Residents who speak only one language seated with residents who speak their language
- Residents on chopped or pureed diets seated with others on similar diets (reduces food envy)
- Seating flexibility so friends can join each other at will
- Dietary department-approved spices and condiments available to those who’d like them
- A place for people who are being tube-fed to hang out and socialize during mealtimes
- Is this one a total pipe-dream? A drizzle of contrasting color puree to enhance the appearance of pureed meals
Please add your suggestions in the Comments section below.
Posted by Dr. El - January 26, 2010 - Common Nursing Home Problems and How Psychologists Can Solve Them, Communication, Customer service, Depression/Mental illness/Substance Abuse, Resident care
An iatrogenic illness is one which results from health care treatment, and iatrogenic depression is typically a side effect of medication. I take a broader view of “treatment” and think of iatrogenic depression as a customer service failure. I see nursing home residents who have become depressed as a result of interactions with staff that left them feeling unimportant, and with nursing home systems that resulted in feelings of powerlessness. The good news is that this type of iatrogenic depression can be cured by training staff and adjusting systems to be accountable to the residents.
Resident/Staff Interactions
Without Accountability
Staff: “I’ll be right back.” (Never returns.)
Resident: feels neglected, invisible, possibly paranoid (why are they doing this to me?), angry, anger turns inward to depression
With Accountability
Staff: “I’ll be back in about ten minutes, after I finish up with someone down the hall.” Returns in about ten minutes.
Resident: knows how much of a wait to expect, which reduces anxiety; feels cared for and respected
Or, Staff: “I’m sorry about yesterday. I meant to come right back to you, but I had an emergency and didn’t remember until I was halfway home. Please accept my apology.”
Resident: will probably take some time to forgive and begin to trust again, but feels better having the situation acknowledged
Nursing Home System
Without Accountability
Resident Council Staff Representative/Leader: “Great suggestion. I’ll bring it up with the administration.” (The last the group hears about it.)
Residents: feel bringing up concerns is pointless, the resident council meaningless, and that their experiences aren’t valued
With Accountability
Resident Council Staff Representative/Leader: “The administration and I discussed the suggestion raised by the group at the last meeting, and we’re going to begin the project by taking this first small action.”
Residents: feel their recommendations and experiences are valued and that they’ll get their needs/wants met by a responsive organization; feel energized as a group
Or, Staff Rep: “The administration and I discussed last month’s suggestion, but there were some obstacles in the way. Let’s work as a group to think of ways in which we might overcome them and move forward with the project.”
Residents: feel respected and included in decision-making even though they might be disappointed their suggestion wasn’t immediately implemented.
Posted by Dr. El - January 19, 2010 - Anecdotes, Communication, Customer service, For Fun
Today’s story, courtesy of Sandra Cherry, LMT (Licensed Massage Therapist), is a humorous reminder to those of us in long term care to be mindful of jargon and the words we choose when speaking with those new to the nursing home.
Today I visited my dad at the nursing home and, as I prepared to leave, I came in contact with a fairly new resident who was somewhat agitated.
Me: Ms. Williams, why are you so upset?
Ms. W: I am so sick of these people in here. They want me to sit in this wheelchair and I keep telling them no. I don’t know how to work that chair and no one has even tried to help me with it. That old aide over there told me she wasn’t going to be helping me up and down that hallway anymore. Well, I’ll just sit here in this chair!
Me: Ms. Williams, they’re supposed to send someone to help you learn how to operate the chair. Are you sure no one has come to help you?
Ms. W: The only person that’s been coming is some boy saying he want to take me to occupational therapy. He comes every day. I look at the clock when he comes to my room. Every day he comes between 10 and 10:30 and every day I tell him no. I don’t know who he is, and why I got to go for some occupational therapy? I ain’t looking for no job. What, they expect me to be doing some work, and I’m here in a nursing home. They must think I’m crazy!
Me: (Trying to contain my laughter) Okay, I’ll ask them to stop sending the occupational therapist to you and send the wheelchair guy down instead.
I explained the confusion to the nurse, who immediately went to Ms. Williams and confirmed that the wheelchair guy would be there on Tuesday to help her with the chair. She appeared quite relieved.
