|
- Professional
Caregivers
- Special Services
- Family Involvement: A Key to Success
Nursing homes, or nursing facilities, represent the fundamental link
in the continuum of long-term care. Their job is to provide 24-hour
nursing care to those who are chronically ill or injured, have
health care needs as well as personal needs and are unable to
function independently. But, a nursing home is about more than
medical care. It’s a place where patients can go on with their lives
– and even engage in many activities they may have never taken part
in before – while under the secure and capable watch of a team of
trained caregivers.
In addition to the higher level of care and services they provide,
nursing homes are separated from other types of long-term care
providers by an extremely high level of oversight by both state and
federal governments. Specific federal regulations apply to all
nursing homes that participate in the Medicare and/or Medicaid
programs. These regulations include everything from patient rights
to fire safety to patient care provisions for quality of life and
quality of care. All but a half dozen or so of Tennessee’s nursing
homes participate in Medicare or Medicaid and are subject to federal
regulations.
All nursing homes in the state are subject to state licensing
standards. Tennessee law has given authority to the Board for
Licensing Health Care Facilities (BLHCF) to determine the
requirements of licensure and to suspend or revoke the licenses of
nursing homes or apply other sanctions to ensure compliance.
The state also requires nursing home administrators to be licensed
by the Board of Examiners for Nursing Home Administrators (BENHA).
Other health care professionals required to be provided or employed
by Tennessee nursing homes include physicians, nurses and therapists
who are licensed by their respective professional boards.
Compliance with all state and federal regulations is ensured through
annual inspections, known in the long-term care industry as
“surveys.” These are performed on an unannounced basis by the staff
of the Health Care Facilities division of the state Department of
Health. Surprise inspections typically involve a team of three to
five inspectors who spend several days in the facility. Tennessee’s
survey system is designed to make sure that long-term care
facilities meet professional quality standards and that care is
provided in a clean, safe and properly-managed environment.
back
to top
Professional
Caregivers
For every patient, nursing homes have a single mission: to enhance
the abilities rather than the disabilities of that individual while
providing comprehensive care that upholds his quality of life. To
accomplish this, each staff member, from the maintenance supervisor
to the bookkeeper, must work as a team to see that high standards
are met.
Here
are some descriptions of the trained and experienced professionals
you’ll find at every nursing home:
Administrator
– Administrators must meet state qualifications and pass an exam. To
remain licensed, they must earn 18 hours of approved continuing
education credit each year. Administrators are responsible for
facility operations as well as compliance with regulations.
Medical
Director – Medical
directors can work full time or as consultants. They work in
cooperation with each patient’s individual physician to oversee
implementation of a care plan.
Licensed
Practical Nurses (LPN)
and Registered Nurses (RN)
– State and federal regulations help determine the number of
registered nurses (RN), licensed practical nurses (LPN) and CNAs on
staff at a nursing home at any given time. The nursing staff is
supervised by an RN who serves as director of nursing (DON).
Long-term care nurses are tested and licensed just as nurses working
in hospitals and physicians’ offices are.
Certified
Nursing Assistants (CNA) –
CNAs have the most interactions with patients. One way to understand
the role of CNAs is by referring to activities of daily living (ADL),
such as bathing, dressing, toileting, eating and transferring (from
a wheelchair, bed or chair). The average Tennessee nursing home
patient needs assistance with at least four of the five ADLs.
Dietary
Supervisor – A dietary
supervisor manages the daily operations of the food services
department, in conjunction with a registered dietitian who either is
on staff or serves as a regular consultant. Therapeutic diets
ordered by physicians must be followed, but dietary staffs try to
incorporate patients’ individual tastes as much as possible in
planning menus.
Activity
Coordinators – Activity coordinators provide non-medical
care that is essential to patients’ overall well-being and
satisfaction. Activity plans are developed to include meaningful
activities that reflect patients' interests and lifestyle.
Social
Service Worker – A social service worker’s role is to
serve as a counselor to patients and families, easing their
adjustment to nursing home life. Social service workers are
essential to the admissions process when emotional, social and
financial difficulties sometimes arise. By keeping abreast of
community resources, social service workers assist patients and
families in identifying and obtaining services available to them.
Environmental
Service Workers – Environmental
service workers maintain a clean, safe environment for patient care
while making sure proper improvements are made to the facility.
back
to top
Special
Services
The staff of professional caregivers described previously provides
care that is available at every Tennessee nursing facility. In
addition, the typical facility has a number of other professionals
who provide patient services including:
 |
Dental
– both
regular and emergency dental care |
|
|
Eye
care – arrangement for
optometrist or ophthalmologist |
|
|
Laboratory
– to
provide analysis of tests ordered by physicians |
|
|
Mental
health – to address
mental and emotional needs of nursing facility patients
(Nursing homes are not staffed or intended to treat serious
mental illness.) |
|
|
Occupational
therapy – restorative
retraining of the use of the extremities through repetition of
the mechanics of such daily activities as bathing, eating,
dressing and grooming |
|
|
Physical
therapy – rehabilitation
of patients with disabilities or injuries using massage,
exercise, heat, water, etc. |
|
|
Podiatry
– treatment
of foot disorders by a podiatrist |
|
|
Speech
therapy – treatment of
communication and swallowing disorders |
|
|
Radiology
– X-rays
and their analysis |
|
|
Respiratory
therapy – treatment of
breathing difficulties and disorders |
back
to top
Family Involvement: A
Key to Success
Every
nursing home strives to provide patients with a home-like
environment while keeping them safe and promoting their well-being.
Activities are offered to foster a home-like atmosphere, and staff
and patients often become quite close.
But
anyone who has ever moved away from home – out of state, or even out
of town – knows how it feels to be surrounded by the unfamiliar.
It’s unsettling. Add to that the stress of declining independence or
the stress of having a chronic illness or permanent disability, and
the feelings go from a bit unsettling to frightening.
Families play a key role in helping their loved ones adjust to life
in a nursing home. One way to make the experience more positive and
comfortable is, of course, to visit regularly and spend quality time
together. Try to incorporate things your loved one enjoyed doing
prior to moving into a nursing home. For example, if he enjoyed
reading, start a book together that can be read aloud one chapter at
a time. If he loved perusing the newspaper every day, make sure his
subscription is continued.
Most of
all, enjoy the time spent with your loved one. And remember, if you
have to miss a visit, a meaningful phone call or letter will be well
received, too.
Besides
maintaining regularly-scheduled visits and attending special events,
another common avenue for involvement is the family council. Getting
to know the facility’s caregivers can make the nursing home
experience more pleasant for both families and patients. Council
meetings provide a wonderful opportunity for families to speak with
facility administrators and staff, as well as get to know other
families. Family councils can address concerns, suggest improvements
and help plan activities.
back
to top
|
