Living in a small assisted living residence, my mother was quite close with the aides that came by to help her. They knew when she liked to go to bed and often stopped by just to say hello, or offer her some juice. And she knew them and would ask about their children, and so on.
However, when she broke her hip and transferred to a skilled nursing center for rehab, she rarely knew who would be there, who would wheel her to therapy, or if anyone would even show up to do that. Not only did it give her a feeling of isolation, it undermined our family’s confidence in the facility.
A recent blog by Paula Span in The New York Times, December 13 edition, discussed the importance of consistency in scheduling aides specific resident assignments. Not only does this give the aide a better handle on a resident’s habits, preferences, and daily schedules, it also gives the resident a feeling of security and familiarity, which encourages CNAs and residents to really get to know each other, translating into better quality of life. Even more importantly, aides can also be helpful in recognizing changes in a resident that can signal a medical crisis. Aides also feel their jobs are more meaningful when they can provide consistent one-on-one care.
The Commonwealth Fund’s ongoing national campaign to improve nursing home quality, Advancing Excellence in America’s Nursing Homes (also known as the Nursing Homes Quality Campaign), is a coalition of 28 organizations. Rose Marie Fagan, cofounder of the Pioneer Network, comments that a lot of people think consistency is a good idea. But as she states in the NYTimes blog, “[P]eople are very quick to say they can’t do it.”
The “household” or “neighborhood” design that has been instituted over the past few years has done a lot to provide consistency of care, staffing, and service. Long-Term Living’s annual DESIGN issue spotlights many outstanding neighborhood projects.
Close, personal, one-on-one care is what families want, residents need, and staff prefer. If you currently employ consistent staffing assignments, please let us know how they’re working out for you.