Newly formed "Family Counsel" at Assisted Living Facility

[Snawdad]

A concerned family member recently initiated a "Family Counsel" meeting open for all family members at this Oregon Assisted Living Facility. Our first meeings was very well attended. It was the stated intent of the newly formed "Counsel" to share knowledge, concerns, and hopefully bring about improvements that could effect our aging parent or parents that reside there. This first meeting seemed to empower us as family members by making staff and administration more aware of our expectations of quality care. Special care was taken to avoid making the outcome of this group a punitive experience for the facility or a "gripe" session for the counsel by emphasizing what the facility was doing right as well and recognizing the talented care givers.

Everyone seemed to have a suggestion to improve conditions but the main areas of concern seemed to center around quality of food and medical supervision. Almost immediate improvements were noticed in the food service. The remaining concerns are perhaps more of an obstacle.

1. How often should the only RN make rounds to include minimal care residents? Not just resident problems as they come up. (She is the only licensed person in the 80 bed Assisted Living Facility.)

2. Medication Aids are not required to be certified. They pass oral medication as well as inject insulin. (licensed CMA's cannot do this)

Should we now push for both CNA and CMA certification?

With the hight turn over and apparent low availability of staff, I don't see how they can comply with this. I realize I can be seen as a "trouble maker" but am planning on especially presenting these two issues before the next counsel meeting. Comments are welcome. Any other "Family Counsel" meetings out here? Thanks. DJS Oregon RN

[pagandeva2000, LPN]

A concerned family member recently initiated a "Family Counsel" meeting open for all family members at this Oregon Assisted Living Facility. Our first meeings was very well attended. It was the stated intent of the newly formed "Counsel" to share knowledge, concerns, and hopefully bring about improvements that could effect our aging parent or parents that reside there. This first meeting seemed to empower us as family members by making staff and administration more aware of our expectations of quality care. Special care was taken to avoid making the outcome of this group a punitive experience for the facility or a "gripe" session for the counsel by emphasizing what the facility was doing right as well and recognizing the talented care givers.

Everyone seemed to have a suggestion to improve conditions but the main areas of concern seemed to center around quality of food and medical supervision. Almost immediate improvements were noticed in the food service. The remaining concerns are perhaps more of an obstacle.

1. How often should the only RN make rounds to include minimal care residents? Not just resident problems as they come up. (She is the only licensed person in the 80 bed Assisted Living Facility.)

2. Medication Aids are not required to be certified. They pass oral medication as well as inject insulin. (licensed CMA's cannot do this)

Should we now push for both CNA and CMA certification?

With the hight turn over and apparent low availability of staff, I don't see how they can comply with this. I realize I can be seen as a "trouble maker" but am planning on especially presenting these two issues before the next counsel meeting. Comments are welcome. Any other "Family Counsel" meetings out here? Thanks. DJS Oregon RN

The issue I have (and I know you are not in the position to do anything about it) is that there should be a licensed person administering those medications besides a medication aide. If I were a family member, this alone would make me very uncomfortable. And, I also would not be comfortable with one licensed person being available for 80 people. I know that these clients should be stable with predictable outcomes for the most part, but, there should at least be two, especially if an emergency arises.

I guess that if they are not going to hire anymore nurses, it would be worth their time to at least certify the medication aides. Also, it is wise to have CNAs because their certification numbers can be researched by the BON to check their backgrounds. But, certifying medication aides, in my humble opinion do not replace nurses. It is usually a few weeks or hours with almost no rationale of why, and that nurse is responsible for all that they do, or don't do.

[Snawdad]

Thanks so much for your reply. I value it. :) Snawdad

[prowlingMA]

First let me say I have worked at three such facilities in the state of Oregon. My first thaught is that this is a wonderful program you have started. We often wished for families to be more involved in the patients care.

However, to pay for "certified" care givers, your monthly rent would probably double. These non-certified caregivers that work in ALFs earn a lot less than CNA's. If your loved one is needing " medical " care they should consider a LTCF. Caregivers are hired to do basic cares, serve meals, and " keep house", not to do "medical" procedures of care.

The Med aids, which I have also worked as, work under the RN's license. They are given basic medication training and injection training. It is a good idea to be proactive if your family member in insuline dependant and have them chart their CBG and insuline doses for their own records. ALF are often unregulated as to continuity of care, so do your homework before entering into care. Check with state licensing comittees and safety regulators in your state.

Just my 2 cents from the " other side" of the issue

[Snawdad]

Great food for thought. Thx. so much. Snawdad