After reading these, I really don’t want to document anything, but documentation is a part of taking care of others. It reminds you of things you might not remember when it’s important to remember.
It feels like a simple case of a desire to enjoy things of the past, like wood working or fishing or knitting is now replaced by cards, or bingo, and that with people who may not be able to have a good conversation! Suddenly, because it is a place that requires certain protocols in which to receive certain reimbursements, one’s whole life becomes a fishbowl with no privacy whatsoever. What I see as a normal reaction to sudden life in a structured environment, simply because a person needs help, and the facility can’t replace all parts of a person’s life, the assessments ask young people to respond as to the person’s ability to adapt to a totally unfamiliar life.
Nursing could document a desire to pursue one’s own activities as much as possible. That might mean reading, and playing puzzles, and maybe for my generation, socializing online. It also might mean the person is simply bored. Nursing could say that the resident doesn’t enjoy community activities. Does that mean a therapy assessment is triggered because one prefers to be alone and spend time with family and friends instead of playing bingo? Who wants to have a monthly birthday party with twenty other people, of whom maybe one person is familiar?
What if he or she is busy with something, and well, it’s time for lunch. Get ready and go to the dining room to wait with fifty other people for trays to come up from the basement. The tray could be delivered to the room, but when? The aides are busy with the people in the dining room. Someone might be physically challenged. For my elder, that meant constant arranging of materials so that she could reach them. As she got older and frail, she had a hard time doing even that.
No wonder Dr. Thomas wants to take a bulldozer to traditional facilities.
Karen,
Interesting thoughts to ponder. But how do we now take what we know about our elders, facilities, care giving, and regulations to create a home that all can live in and with? What about payment for services, i.e. reimbursements? Kristi
Interesting thoughts to ponder. But how do we now take what we know about our elders, facilities, care giving, and regulations to create a home that all can live in and with? What about payment for services, i.e. reimbursements? Kristi
Kristi,
That “How” is why I’m taking these classes! My current pursuit is a Green House style home (with suites as opposed to rooms) combined with a co-housing community (and their community house). Between the people, the tools and good planning, solutions can be found, I’m sure. A few people will recognize the necessity of not depending on society for everything. I still have some puzzles to work out.
Having professional help in the community without losing their value as community members was one, realizing I could not keep a community small (30 households or less) and still support a fully staffed (or even a fully occupied) Green House. (That answer probably is subsidizing participation in the (intentional) community by a forgivable loan on six to eight professional homes – I particularly like the idea for nurse’s aides, since they are often just starting out and could use the leg up). Professionals are people, too, and they also need care and sharing. When our government decided that public servants should be paid instead of supported, and they should pay taxes to pay their own income, something went wrong.
Allowing a company to run the facility portion was a possibility, but one would need a way to build several communities (which would each support one Green House even if not all the residents were “theirs.”) The loss of social contact that residents feel, even with a Green House, would be greatly reduced if they had the activity of their designated community house right next door, and they could see the activities going on. Staff would not be limited to the structured activities or finding some way to otherwise occupy a resident.
Such a community would likely be saving a lot of money for society since many of societal ills are a direct result of people not receiving proper attention. Many illnesses also manifest themselves as a result of helplessness, boredom or loneliness. The Green House projects are a great start, but even they are a work in progress.
I’ve considered the possibility that, between medical science and technology, the need for life care will become very short and skilled care facilities will become more like hospice homes. If so, do I need to just wait it out? No.
My main conundrum is that I do not want to build (or end up with) what has already been done. I am sure there are private homes and groups managing such things somewhere, but they are awfully quiet! Karen
I'll keep you posted with further discussions as I find them worthy of this blog. Life is interesting, and about to get more so. As I continue in my sixth quarter in classes, with two more to complete the requirements for an Nursing Home Administrator designation, I am still maintaining a 4.0 average. Considering some of the highly technical material, that is a real feather in my cap!
