Grandma in a Skilled Nursing Facility (SNF)

[abbaking]

Hello everybody. I am just having a blue moment. My mother called me today and informed me that our elderly grandmother has been admitted to a skilled nursing facility (SNF). Although I realize that her personal health is most important here aswell as her social needs, I am upset at the prospect of her in a SNF. My mother reassured me that the SNF is high-end and up scale (for $6,000 a month it better be!) and that proper nursing supervision is implemented 24/7. Still, for a 95 year old lady (fully A&Ox3 in good neurological health, by the way) it seems that it is one of those "FINAL" events before God calls her home.

I have never worked in a SNF so I have limited knowledge about the nursing care provided at most SNF's. Is there primary nursing or team nursing pattern? Are CNA's the primary care-givers or the LPN/RN?

Thanks for listening to my worries.

[BradleyRN]

Howdy,

Typically, the LPN gives the meds on the floor. An

RN

oversees the entire building, and the CNA is the primary caregiver. Here are a few tips:

1. Bring clothes that are very elastic and stretchy such as sweatpants and sweatshirts. The turnover is LTC is very high and so many times there will be new CNA's working there. If the clothes are too tight, they may have to wrestle to get them on. The easier the clothes are to put on, the better, both for your grandmother and a CNA with very little experience at dressing another human being.

2. Make random visits. People like to come at the same time so their loved ones can establish a pattern. However, if the staff knows when you are coming, they will always be prepared at that time. Random visits assures that the staff will provide excellent care at all times.

3. Perform your own skin assessments. LTC facilities like all other areas of nursing are short staffed. Things can slip through the cracks. By checking the heels, elbows, buttocks and sacrum for reddened areas, skin breakdown can be 100% preventable.

4. Finally, during visits make sure your grandmother's water pitcher is iced and full. Elderly people have a diminished thirst reflex, so be sure to offer fluids many times during visits. Adequate fluids prevent dehydration and skin breakdown, the two most common diagnoses seen in LTC.

Good Luck!

[Xbox Live Addict]

Hello everybody. I am just having a blue moment. My mother called me today and informed me that our elderly grandmother has been admitted to a skilled nursing facility (SNF). Although I realize that her personal health is most important here aswell as her social needs, I am upset at the prospect of her in a SNF. My mother reassured me that the SNF is high-end and up scale (for $6,000 a month it better be!) and that proper nursing supervision is implemented 24/7. Still, for a 95 year old lady (fully A&Ox3 in good neurological health, by the way) it seems that it is one of those "FINAL" events before God calls her home.

I have never worked in a SNF so I have limited knowledge about the nursing care provided at most SNF's. Is there primary nursing or team nursing pattern? Are CNA's the primary care-givers or the LPN/RN?

Thanks for listening to my worries.

SNF is supposed to be a higher level of care than LTC. As with all areas of nursing, scope of practice varies state to state. In my neck of the woods, LPNs act as charge nurses and must chart on each SNF resident once a shift (as opposed to charting by exception for LTC), CMAs dispense enteral medications, and CNAs provide ADL care. The RN is only required for 8 hours a day to comply with Medicare. It is usually paid for by Medicare for up to 100 days a year, requiring periodic certifications by the physician that the resident requires SNF-level care as opposed to standard LTC. Most SNFs I've worked in contract for PT, OT, and ST, in order to justify payment from Medicare. SNF is a transitional level of care - many residents are there because they are not ready to take care of themselves and need rehab, but are not ill enough for a hospital, while other residents are transitioned from SNF into standard LTC.

The tips the previous poster had will help, and I hope this is helpful too. This is SNF as I understand it, and it may be different in your grandmother's home state. Good luck, and best wishes.

[Jules A, MSN]

it seems that it is one of those "FINAL" events before God calls her home.

Yes, this is how life winds down sometimes but there many nice facilities and sadly sometimes there are no other options. My advice to you would be do some spot checks and also visit as often as possible, send her cards, trinkets, be super nice to the staff etc. because it has been my experience that the residents that are loved and cherished by their family get a bit more attention from the staff.