Top five resident complaints about nursing homes (and what to do about them)

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Editor’s note: The following article originally appeared in separate chunks on Dr. Barbera’s blog, www.mybetternursinghome.blogspot.com.

#1: No one coming when the call bell is pressed

I’ve worked on units where the moment the call bell goes off, the charge nurse immediately and calmly asks an aide to check on the room. The bell goes off, someone arrives. Simple customer service. This leads to a unit full of residents who feel confident their needs will be addressed in a timely fashion, and they are therefore far less anxious. Staff training is a good way to change the nursing home culture on this issue, but each worker can take it upon themselves to make it their own personal policy even if the nursing home as a whole isn’t making it a priority.

#2: The food

Where is the Emeril of nursing home food? It’s time to kick things up a notch. There’s a huge opportunity for improvement in the quality, number of choices, and presentation of food in nursing homes, and to positively affect resident satisfaction with meals.

A good start is to increase the food rotation schedule to at least a four-week rotation. Residents also appreciate having their hot food hot and their cold food cold. Restaurant-style service, where residents are offered options while sitting at their tables, is as popular as the flowers decorating said tables.

I’ve heard of facilities stimulating appetites by filling the dining rooms with the aroma of fresh-baked bread. What other meal-enhancing ideas are out there?

#3: The patient lift

The patient lift is a machine used to transfer a resident from their bed to their wheelchair and back. No resident I’ve met likes using one, and I suspect the reason is the combination of loss of control; the frightening feeling of being suspended, helpless, in midair; and a lack of training that makes the procedure more alarming and uncomfortable than it needs to be.

When I was in grad school, all psychologists-in-training were required to undergo psychotherapy. Similarly, aides could gain perspective from a ride in the lift as part of their orientation or ongoing training. (I’d like to do this and blog about it, so if there’s a home in the New York Metro area willing to let me, please contact me.)

A professional approach by staff members with a focus on increasing confidence in the transfer procedure can reassure anxious residents. Techniques that reduce anxiety include:

· letting residents know what’s about to occur at each step of the process;

· engaging in a dialogue with residents so they know the focus is on them; and

· listening to feedback about how they’re feeling (frightened, uncomfortable, etc.) and responding to their concerns

What techniques do you use to make this procedure more pleasant?

#4: Nighttime disturbances

The main culprits:

· TVs blaring into the wee hours

· agitated neighbors

· loud conversations between workers

Steps toward improved sleep hygiene:

· Implement a TV curfew and require night owl viewers to use headsets past the curfew.

· Encourage nightshift staff to report resident sleeplessness so sleep/wake cycle disturbances can be reversed and medications adjusted if necessary.

· As part of in-service training, address ways in which nightshift staff can communicate with each other to avoid disturbing sleeping residents.

Good sleep hygiene on an individual basis can reduce irritability, improve memory, and promote healing. Good sleep hygiene on a unit-wide basis is good customer service that can benefit the physical and mental health of residents and reduce conflict between residents (it’s hard to be friendly toward someone who’s kept you up all night). #5: There’s no one here for me to talk to

Untrue! But we need to prove it to residents by helping them connect with their peers.

The false impression that they’re alone in the nursing home is based on several factors:

· New residents carry the prejudices of most people outside the nursing home, believing everyone inside is confused or too ill to carry on a conversation.

· The tendency of people to believe they’re unique, when in fact there are many uniquely interesting people in nursing homes. (I know they’re there—I’ve spoken to them.)

· Nursing home “old-timers” who are more alert tend to leave their units to attend activities. When newbies arrive, they try sitting in the hall or in the day room and, finding the more confused residents, come to the conclusion that everyone is confused. Then they retreat to their rooms.

· Because most residents are visibly physically disabled, people often incorrectly assume they’re cognitively disabled as well.

Techniques for staff members to connect residents include:

· introducing new residents to others with similar interests;

· encouraging them to attend activities before they settle into spending their days alone in their rooms;

· recognizing strengths and sharing them with others in the community. (For example, a new resident agreed to be interviewed for a feature story in a nursing home newsletter.); and

· helping residents establish a welcome committee.

Dr. Barbera is an author and a licensed psychologist consulting in long-term care facilities in the New York City area. She frequently lectures on subjects related to psychology, aging, and nursing homes. Dr. Barbera is available for private consulting with organizations, institutions, and individuals around eldercare issues.


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