I am interested in the process for assisting residents in your facility when they deteriorate and require additional care. I am dealing with this with a family member and in the process of trying to get my grandmother proper care I am stepping on toes. It is an exasperating process.
The issue I am facing is trying to figure out who and how one determines and then communicates to all CNA's that someone needs additional help. Until very recently my grandmother did most of her care independently. I'm not even sure what has caused the deterioration as no one has spoken to us about her condition...in fact I was concerned they didn't notice. When I raised the issue with them initially they assured me they could offer her more help but that didn't happen. There are two CNA's on her section and they are very busy at bedtime which is when she needs the most help. There is also different CNA's working throughout the week so it isn't just a matter of needing one or two people to be on board. Management at this particular LTC is useless. The nurses and CNA's are almost all really nice, helpful, kind people who certainly seem fond of my grandmother but still haven't stepped in to fill this new need. One of them told me that they pretty much need permission from management to make her care part of their daily routine as until now she is 'designated' as independent care and so there is no time allotted to her. They also don't really realize how much difficulty she is having as when an aide/nurse comes in my grandmother becomes very stoic and insists she is fine/doesn't need help. Then when they leave she tells me she doesn't want them to know she can't walk/toilet herself anymore. She wants to be independent (but physically can't do the tasks now) and has the mindset that she is an inconvenience/burden.
I have been providing most of her care since she went downhill however I have to go back to work and I really the whole reason she is in LTC is to get help - but we can't seem to access that. I have a meeting next week with the DON to try and get somewhere and I gave a list of tasks she needs help with to the staff but the once night I didn't go in she didn't receive any help at all. It is so strange I really thought the staff there would step in and help her when she needed it and it is pretty upsetting to not see that happen. I'm not sure who though is dropping the ball. Do they need permission from the DON/manager? Is it the RN / LPN who assigns the CNA's their responsibilities for the shift? How is it communicated to casual/agency/part-time/floats that she now needs help? Is there a checklist typically or something they work from?
Any ideas based on your facility policies on how to get her on the 'list' to get assistance on a regular basis would be appreciated.
Sadly, call-offs and short staffing is a fact of life in ltc. Until healthcare corporate decides to pay the price, things will continue the way they are.
What do irresponsible workers have to do with corporate "paying the price"?
SuesquatchRN, BSN, RN
10,263 Posts
What do irresponsible workers have to do with corporate "paying the price"?