I spend a lot of time talking with families regarding the selection of an initial nursing home for a family member or perhaps transferring the person from one nursing home to another. Soon into our discussion, I see mild mannered people become downright angry when discussing the problems they encounter when selecting a facility.
Most of the time, the selection of a skilled nursing facility is done during a stressful period such as the onset of a sudden illness or when change in medical condition necessitates such a move. Frustration levels seem to get compounded when families visit facilities only to have all the facilities they visit appear universally average.
Sure there are things to look for when selecting a nursing home: location, amenities and the facilities themselves; but families need to focus on one factor in particular when choosing a nursing home staffing — staffing should remain the primary focus throughout the selection process. Without a properly trained and devoted team, the other aspects of nursing homes are insignificant.
I was again reminded of the importance of staffing— and how important it is for families to acknowledge its significance in a recent New York Times article appearing in the New Old Age blog. The article entitled One Way To Judge a Nursing Home written by Dale Russakoff has some really excellent points regarding the importance of a steady and enduring staff. However, all points aside, I think perhaps the most insightful part of the article relates to Russakoff’s suggestion for families to speak to the nurses aides during the initial nursing home selection process.
Though hardly a radical concept, speaking to the people who are on the front lines of providing patient care — really is a great idea. Asking CNA’s about their position, how long they’ve worked at the facility and their job satisfaction is really a brilliant way of gaining valuable insight on the facility in an accurate way.
As Russakoff points out, facilities where staff aren’t happy tend to have high staff turnover rates. High turnover rates of staff is continually related to higher rates in the development of bed sores (decubitus ulcers, pressure ulcers, pressure sores), use of catheters, increased use of feeding tubes and other troublesome medical problems.
Even if you only spend a handful of minutes speaking to the CNA’s, I firmly believe Russakoff is on target. Credentialing and tenuring aside, are the people pleasant? Do they smile? Do they seem satisfied with their job?
Unfortunately, when staff are unhappy they tend to seek work at other facilities or leave the field all together. Next time you go to a nursing home, listen to all the scripted information the marketing director, but take the next step and meander to the nursing desk to talk with the people who will be really caring for your loved one.
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