I certainly don't have any solutions, but in my experience so far, most LTC facilities are in desperate need of:
1. Better dementia training programs for staff, especially informing them that "reality orientation" is NOT the most effective way to deal with a dementia patient!
2. Much higher staff to resident ratios. It might be helpful if more facilities were divided into clear units...if you contained the independent or supervision only residents to one unit where much less staffing was needed, it would enable more staff to be on the units with the total cares and major fall risks. I know some places do this, but around here, they tend to have everyone mixed together.
3. Adequate equipment. If a facilty does not have enough hoyer lifts, etc. to go around, people end up being lifted by hand, which is dangerous for the resident AND staff.
4. Better pay for staff. It would lead to less turnover each year, and that money that they have to spend on training new staff every few weeks could go toward the higher pay and facility improvements.
5. Revamped resident care. A "resident based" approach needs to be made. In my experience at a memory care center, dementia and alzheimers patients show far fewer behaviors if they are allowed to WAKE NATURALLY. Dragging these people out of bed at 4 a.m. is just wrong, in my opinion, especially since some of them are up late most nights.
I'm sure I'll have more to say on all this later, but I keep losing my train of thought.