Thoughts On Nursing Home Care From A Nursing Home Psychologist

I’ve been getting some great feedback from blog readers regarding our series of interviews regarding the state of nursing homes– positive and negative.  I’ve made efforts to get responses from people with a variety of backgrounds to get a more balanced perspective.  If you or a colleague are interested in participating in this series or in upcoming matters, feel free to shoot me an email.  Thanks.

Nursing Home PsychologistWho are you and what type of work do you do?

Eleanor Feldman Barbera, PhD, nursing home psychologist and founder of My Better Nursing Home, a website focused on bringing psychological insights to nursing home life.

What are some positive trends (if any) in the nursing home industry?

Nursing homes are more aware now of the need for person-centered care. As a psychologist talking with residents, staff, and families, it’s clear to me this is a good idea not just for the residents, but for all involved.

Nursing homes have been slow adaptors of technology, but the increased use of technology will improve the efficiency and experience of workers, and the satisfaction of residents and family.

What are some negative trends (if any) in the nursing home industry?

Financial fears, and a lack of creativity and cooperation in overcoming financial hurdles. I believe each nursing home is a community with the potential to thrive, and, by utilizing the skills and ideas of all its members, we can overcome many financial challenges. For instance, imagine a financially struggling nursing home that had a bake sale, craft sale, and other events to raise money for a computer for the residents, with the nursing home providing the IT support, and community volunteers teaching the residents how to use the computer. This would foster ownership and community within the nursing home, empower and create a sense of hope for those involved, and increase the visibility of the individual nursing home within the larger community.

What correlation do you see with respect to the national trends in the nursing
home industry and the impact on patient care?

There are many people engaged in innovative and exciting programming in the nursing home industry, but more of this needs to occur in average facilities that haven’t necessarily committed themselves to Culture Change, for example. Like an adolescent with a punitive parent, many nursing homes are afraid to make changes because they don’t want to “get into trouble” with surveyors. The more regulators lead, support, and encourage changes, the more likely we’ll be to implement the kind of programming that will make a difference in the lives of the residents.

How would you compare the nursing homes of today vs. those of 20 years ago?

Today nursing homes are much more fast-paced, with an increased number of short-term rehabilitation beds, and residents who are more ill than those of the past. This presents challenges in meeting resident needs. At the same time, there are many positive changes in the nursing home environment, particularly the person-centered care movement. We still have a long way to go to make nursing homes somewhere I’d want to live by the time it’s my turn, but it’s an exciting period to be involved with long-term care because there is so much potential for positive change.

What suggestions do you have for families when it comes to selecting a facility for their loved ones?

I’d look for a facility that:

  • Doesn’t have glaring deficiencies listed on the medicare.gov site; they should be well-rated
  • Is conveniently located for maximum visitation by family
  • Good at whatever illness I have (ie; if I’m prone to pressure ulcers, I’d want a place that was good at preventing/healing them; if I had MS, I’d want other people there with MS (or Alzheimer’s, or another illness)
  • For me, I’d want computer access, and pleasant and easily accessible outdoor space.
  • Consider individual preferences.
  • Offered food that’s halfway decent, with numerous options if I don’t like the main meal, and at least a four week rotation on the food schedule
  • Provided interesting recreational activities

Three words to describe nursing homes:

Community, Home, Opportunity

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