A local Denver area nursing home was recently cited for a number of issues including staffing and regulatory issues, allegations of sexual assault and wrongful death. Records at the nursing home revealed high staff turnover and low quality ratings. A recent expose of a large assisted living community indicated similar concerns of the community keeping residents long after care levels exceeded what could realistically be provided by assisted living staff resulting in unnecessary resident deaths. In my profession as an advocate for my clients, I have issued complaints to the Department of Health for investigation of sub-standard care on behalf of clients for whom I am responsible.
Is care disappearing from professional caregving? Are communities rushing to fill beds served by staff who see caregiving as a job rather than a vocation? Is this an industry wide trend or an isolated issue related to financial solvency and lack of management belief in the provision of ethical and dignified care? I believe it’s a little of both. For nursing homes primarily reliant on Medicare reimbursement for short term therapy the story is often different from nursing homes reliant on long term care services reimbursed by Medicaid.
Most nursing homes have a mix of both populations. Many are struggling financially to balance staffing costs versus insurance reimbursements and other costs. Supervisory staff is stretched. Budgets for training caregiving staff, who by the way make all the difference relative to quality measures of care, are practically non-existent. It’s no wonder the quality of care is diminishing across the country while the number of individuals needing care is increasing at an alarming rate.
What will it take to reverse this trend? A good executive director in any community, just as a skilled president of a corporation, makes all the difference in setting the tone, character and values of an organization. A couple of poorly managed nursing homes or assisted living communities have the ability to damage the reputation of the entire group. A single employee with a poor attitude can drag down a company department or division.
Employees who view positions of care at nursing homes and assisted living communities as jobs rather than a privilege or a vocation chip at the very fiber of a committed organization. The unemployment rate remains high. Care communities need caregivers with a passion for caring. Turnover remains high resulting in poor quality ratings.
It seems common sense that care communities might realize that staff training has the potential to improve quality of care. Yet it’s not just the hard skills of bathing, dressing and toileting but the soft skills that make a difference. A “good morning” to acknowledge residents living in the community. Not rushing past a resident in the hallway asking for help, but taking a moment to respond and to find someone who might help, makes a difference. It’s easy for professional caregivers to becom immune to the smells, sights and sounds in a community when everyone is asking for assistance now.
When so much work has to be accomplished in a single day by so many, it is difficult to invest time in training. Community populations are becoming more complex in care needs; dementia, mental health disorders, conditions that require more time and attention. Admittedly all the complexities are no reason not to provide needed care. Caring begins one person at a time. A sense of caring can be contagious. Humor and laughter are important when stress levels are high.
A good leader, a good president, a good executive director and committed and consistent support staff make all the difference. One solution to the vanishing act of caregiving is management willing to invest time and training in the front line employees who provide care and give their heart and soul to residents day in and day out. If training cannot occur from within then organizations must seek outside experts to train.
I have worked with many amazing caregivers and some caregivers who should seek another profession. Caring isn’t something that one learns. Caring is an internal quality posessed by individuals who are truly angels on earth with a love for caring for a population in need of physical and emotional support. I am in awe and honor professional caregivers who bring joy to our older adults day in and day out. Because ofmy workin the aging and healthcare industry over the past 15 years, I know how hard the work can be sometimes with ittle acknowledgement or thanks.
Those of us who love working as professional caregivers have a duty to support the industry and to advocate for recognition of caregiving as an important profession and a role in life that benefits from ongoing training and support. The aging, sick and disabled needing care are relying on professional caregivers to be present, ready and available when the time comes that care is needed.
Through my organization, The Care Navigator, I support the local community through memberships in various organizations and I chair theCommunity Healthcare Ethics Committeeoffering education and support to professional caregivers inthe community. Together we can stop caregiving from becoming a vanishing act.