If I could create a perfect nursing home, it would be like:
-NO CNAs with attitudes. You can not have a nasty attitude and work in Geriatrics. It takes a lot of patience and compassion to work with the elderly and if you have a nasty attitude, how will that work?
-CNA/Resident ratio will be 5:1. I think it's unfair to give CNAs 10+ residents. Many of them are stressed out because of all the work. I would want them to spend time with the resident. Have them play games with them. I would want them to create a bond with the resident.
-Nurse/Resident ratio will be 10:1. The workload for the nurses is ridiculous. I'm not a nurse, I work with the administration side of things, but I can clearly see that the nurses have a lot to do. Like the CNAs, I want the nurses to build a relationship with the resident. How can you create a relationship with a resident if you're busy talking to pharmacy, passing out meds, charting, paperwork for administration and serving the residents for whatever need?
-I would pay CNAs $15 minimum. I think some of them would care more about their jobs if they made a little bit more.
-NO CELL PHONES ALLOWED. They must be locked up somewhere. It annoys me when I see a nurse on a cell phone.
-An equal amount of male and female nurses. Too many female nurses creates too much drama.
-No residents in the hallway!! That irriates me!!!!!!! That is a pet-peeve of mine. I do not like to see residents sitting in the hallway like they're useless. All residents must be placed in an activity room or sitting in their room watching TV. If a resident is in the hallway longer than 5 minutes, then the CNA will be written up.
-There would be a gated park outside of the building for the residents to sit around and get fresh air. GIVE THEM FRESH AIR!! Sometimes I want to shout this out loud when the nurses are wondering why a resident wants to escape. Give them a change of scenery!!
So there you have it, my perfect nursing homes. :)
One of my biggest priorities would be to require that the central soiled linen and trash collection areas would be taken to an outside receptical q4h during each shift. The CNA's. nurses, wound care etc would simply walk into rooms with a bag and bag things up after any procedures and walk out with it to dump in receptical. This throwing nasty stinking soiled Depends in the residents trash can in their rooms left for 8 hrs or more is just rotten. Get it out of the building and reduce the urine/feces smell that builds up especially with all those stifling hot rooms and no fresh air coming in. This would be a marked improvement for the residents, family members, employees and anyone wishing to do a walk through to not be assaulted with "that nursing home smell."
I have thought of this many, many times. I think more CNAs are a must, and they have to be well paid. I want the staff, everyone from the nurses to the cooks, to housekeeping, to be proud that they work there.
Many places say they are resident focused, but I would truly try to be. I would like pets and live plants. Trips to favorite, local spots for those that can. More activies. Nice wheel chairs and geri-chairs. I know much of this sounds like "looks", but staffing would be so important to me. I don't want anyone to be rushed with the residents and I would want staff that really enjoyed working with the elderly.
Sounds like some of us need to start our own nursing homes! Great ideas. I have just resigned from a nursing home where I have worked for the past 10 yrs, most recently as the DON. We have had pets that whole time, big dog, lap dog, cat, birds, rabbit, hampster, etc. My employees were allowed to bring their kids to work if they behaved. The kids thought the nursing home was a great place to go to play. Some of my residents loved sitting in the hallway, however. Seemed to be their form of entertainment. I begged corporate to make a way for residents to go outside and be safe, even the most confused. They said it was too expensive. Maybe someday they'll be in a nursing home and remember that they said that. I have to have fresh air. And I hate all those medications. If there were more activities that the residents really enjoyed, they wouldn't need so many meds. As for staffing...I agree, lower ratios would be great. But my state pays so little for care that it is hard to afford. Corporate has decided to make the home less homey and more institutional. I quit because of that decision.
Everything everyone has said so far! I especially agree with flexible mealtimes (and meals...buffet-style, maybe, with several main options), flexible wake-up and bedtimes, and the Eden philosophy. Not just a couple of fake plants here and there, I want this place to be ALIVE! Edible/safe plants all over the place, and animals.
To stay away from allergies I'd have a couple of ultra-friendly resident bichon shih tzus (hypoallergenic, they have hair instead of fur and are awesome awesome dogs!) that would like to visit with people. Really nicely done up fish tanks. Arrange for lots of visitor volunteers so people get one-on-one time. Depression analysis and psych's coming in regularly to talk to the residents. Gorgeous outdoor gardens that have lots of trails to wander on. Huge windows for lots of sunlight. Single rooms.
Lots and lots of outings! People can tell you whether or not they feel like going and there could be picnics, restaurant trips, tours of the city, scenic drives, maybe trips to the mall or something...just something to get them out. Regular walks around the neighborhood for those who care to go. Travel50, I love your idea of bringing kids to work! That's really brilliant. Once I've been working at this place a bit longer (I'm fairly new) I hope I can bring this thread in to work and show them some of our suggestions! Or maybe I'll steal a suggestion sheet from work and pretend I'm a resident's daughter full of good ideas >
To the OP that stated no residents out in the hallway: There are several residents on my hall that likes to sit in the hall an watch the staff work. They enjoy this and so does the staff. We joke around and visit with these residents all the time. Most of the time these resident choose to sit out in the hall rather than an activity. Also, there are many times that my dementia residents have to come out in the hallway and sit by my cart or at the nurse's station for their safety. They will stand unassisted and they will fall if they are in their room. There just is not enough staff to allow for 1:1 most of the time and these residents will not remember to ask for help, so we do what we need to do for their safety.
I wasn't referring to the "fall risk" and "sociable" residents. There are residents we allow to sit near the nursing station because they like it. I'm not talking about the residents that "choose" to sit out in the hallway. I'm talking about the residents that are rolled out to the hallway because the CNA doesn't know what to do with them.
Specializes in Acute Spine, Neuro, Thoracic's, LTC.
OH YAY! What a fun post!!!
Ok so first of all I would definitely increase the staffing ratio by A LOT. Each CNA would have 5 residents and each nurse responsible for about 10. (Not 40). This solves A LOT right here.
The residents would have the option to have a bath whenever they want one. Not just once a week and then a sponge bath the rest of the time. Then a hair salon right on site where they can go get their hair done andn nails whenever they like.
Also at night time every Resident gets a back rub with lotion if they would like.
There would be a on staff physiotherapist that helps people remain mobile as long as possible and that also provided daily range of motion to the immobile residents.
The rooms would all be private, very spacious with an INCLUDED tv and sofa for everyone. Also every room would have a very large window so the Res can see outside.
Breakfast would be chose from a menu by the Resident at the beginning of the week, there would also be an option on the menu to choose the time they would like their breakfast. The time that they get up could be coordinated with that time. Then all lunches and dinners would be take from a Restaurant style dinner. There would be one that has a menu with different selection they can order from any time of day. There would be several hot meal options as well as a variety of cold items they can have any time they like. There would also be a pub style restaurant on site where Residents can go have a drink and a meal. Oh and warm milk and cookies nightly!
Also FAR more activities are needed!
Oh and defiantly a house cat and dog for each wing of the building.
AND FAR less focus on "being sick" , "oh are you feeling sick today" blah blah blah. Much more emphasis would be put on wellness.
And no pushing pills on Residents for absolutely everything.
I could go on and on here but this is a good start
There is an awesome book called "Life Worth Living". It is about the Eden Alternative, the people who launched it, and the success stories the program has had. It is a quick read...I don't think I put it down once (mind you I am NOT a reader). If you have time pick it up, it is well worth it
When I was a kid there was a NH in the country It was right down the road from us. The thing I loved the most about the place was they had a good sized garden and all summer I would see all these little old folks out there every day. They ate the food they grew. And they had a decent sized pond and it had a little dock with nice chairs on it. It also had a rail on it for safety. The front porch was huge and covered. In the country everybody waves to each other. In the morning and afternoon everyone on the school bus would wave and yell Hello! I would ride my horse up there about once a week and they would come out and talk A couple of them wanted me to take the saddle off so they could brush her out. And there were apples galore The horse loved going up there LOL.
Then it was sold and went downhill from there. No More garden,fishing or anything They said it was forced labor in the garden They tore down the dock on the pond, it was too dangerous.I couldn't come up there with the horse any more They said it was too dangerous for the residents. The could still sit on the porch but only a handful did. The new owners just killed the spirit of all those seniors. It made me sick I went off to college soon after that. Now when I go see my family no one is seen outside anymore.
I would want one like the OP described and with the stuff from the one down the road from my Dad.
Allergic wing with limited or no pets and the rest RESCUED pets, maybe older dogs and cats. I think the residents would really relate in our throw away society that has thrown so many of our elderly away. My mother used to say, "Nobody cares about old people", but she sure did. She would have wound up in a very bad place because she lived many years with severe dementia had not my brother been rich and able to afford spending over a million dollars on her nursing home care before she died. My heart is broken, and yet she had the best money could buy. How can anyone stand to see their parent in some of the absolute holes so many people wind up in?
Specializes in trauma, ortho, burns, plastic surgery.
OH MY GOD! This is a BIG dream of me... a perfect NURSING HOME!
A nursing home is A HOME! Start from here and you will see ALL that you need to have a perfect nursing home!
What do you have in a home? How people behave in your NORMAL home? Your mommy, daddy, sisters, brothers, aunts, grannies.... What do you do in your home? If your granny is at home what she do, how you act behave with her? What she doing usual? A perfect nursing home is a NATURAL NORMAL ENVIRONMENT not an artficial created one, a nursing home need to be A HOME first, second and Last, not a office, not a hospital, not a military base, not a school, not a day care, .... IS A HOME, where you give meds to granny because she is sick and she live at her home around with her loving ones and we love grannies FIRST, not granny saving account, lol, that is all...
In a IDEAL nursing home, are much more people doing and acting good one to each other than people who fulfill papers for each think that any other do, did, or will do.
newtress, LPN
431 Posts
One of my biggest priorities would be to require that the central soiled linen and trash collection areas would be taken to an outside receptical q4h during each shift. The CNA's. nurses, wound care etc would simply walk into rooms with a bag and bag things up after any procedures and walk out with it to dump in receptical. This throwing nasty stinking soiled Depends in the residents trash can in their rooms left for 8 hrs or more is just rotten. Get it out of the building and reduce the urine/feces smell that builds up especially with all those stifling hot rooms and no fresh air coming in. This would be a marked improvement for the residents, family members, employees and anyone wishing to do a walk through to not be assaulted with "that nursing home smell."