There used to be a question that was asked to all nursing students when I was studying to be a RN...
Who is the most important person in the hospital?
Although there was a range of answers from a few of my colleagues, most students answered that the obvious, most correct response was:
This principle applies to Long-Term care homes. There is no management team, union, owner, MOHLTC (Ministry of Health and Long-Term care) Inspector, etc. that holds greater importance than the Residents.
The Residents should be the center of the universe in LTC (long-term care) and all other services and staff should evolve around them. Our fundamental purpose in this care environment is to provide exactly that…care.
When touring LTC homes I am very sensitive to the physical, emotional, and spiritual well being of the occupants. Although this sounds like a tall order, let’s break it down into smaller, more identifiable observations.
- Are the Residents dressed appropriately for the season? Is there attention provided to modesty, so undergarments and sensitive areas are covered?
Kudos to them, their actions showed support and respect. The morale of the story is, if you see something out of the ordinary ask the tour guide about it.
However, clean, modestly appropriate clothing should be a given, so the residents are comfortable, and warm.
- Individuals in wheelchairs should have their feet supported on footrests, not dangling. The chairs are a form of comfort and support, and should be clean and appear in good repair. There are specific rules about the use of seatbelts in homes. The staff when asked, should be able to explain these rules clearly, and with confidence. Ask the question….
- Has there been attention to body odour, cleanliness, and skin care? Is there evidence of breakfast on someone’s face after lunch?
- Is someone calling out to use the bathroom, and are they heeded?
- Are clothes clean and are laundry tags with identifiers discreetly hidden? I do not want someone reading a name tag that has been carelessly steamed to the top of socks! How demoralizing!
- Are call bells answered with expediency, or are they ringing for several minutes?
- Do staff interact with the residents or each other, when addressing needs or just chatting? (Watch for more information in my next blog)
- Is there evidence of activities, or are residents grouped around televisions, and nursing stations?
- Are the residents relaxed, smiling, joking with staff and visitors, or is there a dead silence except for a call for assistance?
- Is there laughter?
- Do people have the choice to rise late, and have a mid morning muffin or light breakfast? ASK
- Is everyone readied for bed right after the supper meal? (Not on my watch!) ASK
- Did you observe a resident being scolded for ANY REASON?…NOT Appropriate. (Report this to a manager. Abuse appears in many forms.) Example: I told you I would be back later.... Imagine how small and vulnerable that resident feels? Is this the accepted culture of the workplace?
- Is there the sense of compassion, empathy, and kindness, when staff interact with the Residents?
- Is there a place where spiritual needs can be met, such as a chapel, designated area etc.?
- Is there a palliative care team that helps individuals who are experiencing a decline in health? ASK
- Does anyone address religious affiliations and requests, on admission and thereafter? ASK
- Is there the opportunity to attend in-house multi denominational, or non-denominational services?
These are but a few thoughts about observing Resident care when touring homes. For more information, review my free mobile app checklists, or check out the manuals (that have built in resource guides).
In the meantime, on your next tour of a LTC home, ask the staff…
Who is the most important person in the building?
Their answer will speak volumes.