By Peter G. Tamburro, Boomerang staff writer
Jane's sister Cathy recently had knee replacement surgery. Although Cathy is a fairly young woman, part of her rehabilitation plan included spending a week in a nursing home. When Cathy's first choice nursing home did not have an open bed, she accepted the first other nursing home the hospital staff offered. When she got there, she found a lovely, modern facility with friendly people, and settled in for her brief, and hopefully uneventful stay.
When she visited her sister, Jane noticed that Cathy never got to choose what or when she ate; the kitchen would just deliver the daily menu at pre-scheduled times. She also noticed that staff never asked Cathy if or when she wanted to take a shower. Cathy also never knew when someone was coming to take her to her physical rehabilitation appointments. Jane told her sister that this didn't seem right, but Cathy didn't want to complain or be a problem, and was willing to accept the care the staff was willing to give for the short time that she was going to be there. Jane reminded Cathy that she was the customer, paying for a service. "Would you accept less than excellent quality from a resort hotel or a new car?" She asked. "Why should a nursing home stay, long or short, be any different?"
Ohio is raising the bar for long-term care by encouraging all providers to embrace person-centered care. We believe that everyone deserves to feel at home, even if they must live somewhere other than their own house or apartment to get the care they need. In the past, a nurse at a nursing home may have told loved ones, "Your mom is adapting well to life here." But, shouldn't we prefer her to say, "We are adjusting well to your mother"?
Person-centered care is all about choice, and choice starts with you and your loved one understanding what you value.
Involvement in planning and directing your own care - A person-centered facility will include the resident in developing her personal care plan. Long-term care residents should be allowed to review their plan with staff and discuss changes at least quarterly. The better that staff knows the person for whom they are caring, the better they can meet her needs. This includes asking about her life story, family members and friends, ambitions, faith, hobbies, what makes her angry, sad or happy and overall, what makes a good day for her.
Choice of when to go to bed and when to wake up - Sleep patterns set the stage for energy, appetite and physical wellness. You know that when you get up and go to bed on someone else's schedule, you're never really at your best. Yet, staff and operational routines have historically dictated when nursing home residents go to bed and get up. Truly person-centered nursing homes foster individual sleeping and waking patterns guided by the routines of residents, not the operation of the home.
Dining and meal options - As with sleeping, eating on someone else's schedule can be very disruptive. And, since dining is also a social event, choice in dining also means choice in how you socialize, with whom and when. Person-centered facilities give residents choices in when, where and what they eat, and many offer alternative dining options, such as family-style, buffet, restaurant-style, open dining and 24-hour service.
Choice in bathing - For most of our adult lives, bathing has been about choice. We choose how often we bathe and at what time of day. We choose bath or shower. Person-centered facilities respect those choices and offer a bathing experience that is comfortable and able to accommodate the needs and preferences of the resident.
Other person-centered values include the availability of private rooms and bathrooms, the ability to personalize one's room and the consistent assignment of staff.
Armed with information about person-centered care, Jane and Cathy spoke with the administrators of the facility. The management assured them that the care Cathy had received so far was not up to their standards. For the rest of her stay, Cathy was consulted about her wishes and the facility staff worked to ensure she received excellent care.
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