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Long-Term Care Homes: Shining a light over the landscape of care. Seven ideas to build caregiving capacity and improve quality

Posted Aug 8th, 2015 in News, Long-Term Care, Safety, Tips

Long-Term Care Homes: Shining a light over the landscape of care. Seven ideas to build caregiving capacity and improve quality

Being a health care professional, advocate, and consumer, integration into the system provides you with complex views from varying angles, depending on the hat you are wearing. 

I guess it would be easier to sit on the sidelines and watch the ensuing game pass from the bleachers, but I’ve never considered myself to be the benchwarmer type.

That being said, here’s how I picture initiating preparedness to reach the Long-Term Care improvement goal line…

1.     Lose Stereotypes:  Stop referring to seniors in negative undertones.  Elders aren’t hapless victims of aging, rather simply, individuals who are growing old.  I haven’t heard the words that elders are “bed blockers” in hospitals for a while.  Thank goodness.  Blaming an age demographic, for the failures of the system is ridiculous. Last time I checked, seniors were still paying taxes.

2.     Foster Champions: Increase scholarship opportunities for Individuals wishing to pursue Gerontology as a career.  Research into diseases of the aged is wonderful, but let’s not forget the frontline staff: Doctors and nurses who want to focus their care on seniors. 

 Several Corporations are sustaining huge financial gains relating to services and supplies for elder care.  Let’s encourage them to donate some scholarship monies, directed to individuals who have geriatric care as a career goal.  I have no problem with scholarships bearing the name of those industries, that are willing to step up and step in, to reduce education costs and student debt...no strings attached.

3.     Rethink Resource Allocation:  Utilize more nurse practitioners (NPs) in LTC to help address health issues, and potentially avoid emergency room visits.   NPs provide excellence in care re assessment, intervention, and treatment recommendations within their scope of practice.  I am certain that elders would prefer an IV for hydration and medication, in the comfort of their own room, versus waiting on a cold, hard stretcher for hours in the Emergency Room department.  Let's look at a higher utilization of these care professionals.

4.     Quality at a Grass Roots Level:  Regulating all Health Care workers through mandatory registration and reporting, just makes sense.  This will cost money and require administration, however tracking the team members who spend the most unsupervised time with the most vulnerable members of society, seems too simplistic for argument.  For further thoughts regarding this: please see the related blog: http://www.elderpilot.com/site/blog/2015/07/27/the-ontario-psw-registry-weve-proven-the-numbers-are-countable-now-lets-make-the-numbers-accountable

5.     Integrate better equipment into Capital Expenses:  Start to improve equipment in LTC through gradual replacement with more electric beds, mechanical lifts and mobility aids. First of all, electric beds foster independence, by allowing the user to self adjust their position to a certain degree. These items also reduce employee repetitive strain issues.

Let's start making smart choices when purchasing equipment. Any government funding for items should allow LTC homes adequate time to research, and review possible alternatives.  Year end government surpluses should come with more flexible timelines for utilization of monies.

Bariatric equipment should be gradually assimilated into LTC capital expenditures, as the population trend has shown increasing body mass indexes.  In other words, standard equipment has weight restrictions, and we need to be able to meet future care needs safely, with the appropriate equipment.  (Population healthy lifestyle coaching is important as well, but it is inevitable that adaptable equipment will be needed.)

6.     Prevent/Reduce Workplace Injury:  Start implementing comprehensive employee health programs to reduce injuries and encourage wellness.  Any reports of repetitive strain should result in a workload analysis to be sure that we are providing the right equipment, to provide the right care.  An active Joint Health and Safety Committee comprised of Management and Worker reps would do well to investigate any workplace injuries thoroughly. 

With an aging population, we need to insure that care providers are not compounding health care costs through preventable personal injuries. 

Building and equipment inspections, as well as accident investigations reduce reoccurrence of similar events causing injuries.  Keeping caregivers healthy and safety wise, makes for a strong worker-management team that keeps our elders safe as well.

7.      What is the right level of care for the population we are serving?
As complex health issues arise in the elderly population, perhaps we need to start trouble shooting alternative care options, in locations equipped with more resources. 

For example: Individuals who may put others at risk because of responsive behaviours may require more intensive therapeutic interventions. How can we expect a typical LTC home staffing quotient to manage safely?  Realistically, we need to allocate space and resources, to provide more care, and reduce risk for other Residents.

If we are hoping to implement other treatments such as dialysis in LTC settings, there needs to be staff allocation, with the expertise to provide care.

With younger individuals entering LTC how can we best meet the social and physical needs of this growing demographic? Integration into an elder population may create other issues.

Long-Term care has become the 'go to' place for care and services for elders, and all individuals who need 24 hour nursing care. 

Perhaps the system is breaking at the seams, because the diversity and acuity of the Client’s needs have not been assimilated into the funding structure.  Increasing the acuity of admissions, without adjusting funding, providing educational supports, and enhancing resources, is a recipe for disaster.

If we truly want to fix the system let’s start making adjustments now, integrating changes, and building capacity to provide better care, today and tomorrow.

Photo credits by nhuisman.  I couldn't have captured my thoughts more clearly than through this picture; thank you

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