The staff in the nursing home my mom is in seem tired all the time,they rarely smile and I always seem preoccupied with paper work like they are trying to avoid me asking a question. They rarely introduce themselves to me.
Example of concern: They start rolling the patients into the dining hall around 4:45 for dinner. The patients end up sitting at the tables waiting for about 45 minutes until their food is brought to them. God forbid they need help opening something if they don't have a visitor they are on their own.
Is this common in most nursing homes?
If you ask a lot of questions of random staff members maybe they ARE looking at papers in order to appear busy. You should probably try to direct your questions to the charge nurse or set up a care meeting if you need more detailed answers. And if try to greet those working around your mom by name and take compliment them on their work I'm sure they will be more apt to greet you with recognition and a smile.
I found the staff very helpful. But that may be the exception.
Just a suggestion. I brought good quality candy once a month for the nurse's station. If I was there at mealtime, I helped other residents by bringing their milk, salt, whatever. Also helped staff clear the tables. Everyone knew who I was. I think that got mom a little extra attention when I wasn't around.
BUT!! I always noticed staff helping.
You might also look into different nursing homes because some are definitely better than others. Now that you have experience, you'll know what to look for. I would take recommendations from friends, but also take them with a grain of salt because different people have different standards, and some people are just ignorant.
The attitudes you describe suggest a too low level of staffing and overburdened and overworked staff. What investigation did you do before bringing your mother there? What is the staff to patient ratio?
As to the dinnertime moves, volunteer to help them out, even if it's just getting bibs for the patients or helping distribute the dinners. That's what we did. Not only were we helping the staff but the patients saw volunteers pitching in and that was a positive interaction for them as sometimes we'd stop for a few words with the people with whom we had become acquainted.
And show your appreciation instead of criticism - cards of thanks, donuts, bagels, flowers, jugs of cider, fresh apples and fruit of the season that doesn't spoil quickly.
Find ways to brighten their days and help them with the hard work and challenges they face.
1.) These days most frontline nursing home staff are CNAs (certified nursing assistants). This is a low-level job that requires training of not more than 3 months, including some field work, followed by a certification test. Nevertheless, ongoing training is essential for CNA staff (and others) to be able to provide quality care. But whether or not V\NHs provide this is up to them.
2) CNA positions are very frequently filled by former welfare recipients and immigrant women. CNA jobs are VERY hard both physically and mentally. There are HIGH levels of injury to the women who fill these positions, due to lifting, lack of assistive lifting equipment, AND inappropriately low staffing levels. Many CNAs leave their jobs after a few years - there is extremely high turnover in this industry. In addition, pay is generally quite low, although higher pay is available for those who work 3rd shift and/or weekends. At the same time, MANY NHs keep their CNA staff on a part-time basis so that they don't have to pay health insurance for them. (Yes, the people caring for your elder loved one likely have no health coverage of their own! Or have a very low-rate plan.)
3.) Despite continuing advocacy by national and state-based Nursing Associations, neither hospitals not NHs have any mandated nurse-to-patient staffing levels. Any such staffing levels might only be achieved via unionization at this time, OR by the NH's own desire and ability ($$$) to increase or maintain a certain quality of care (QOC). See here for just one article on this issue: http://www.aacn.org/wd/practice/content/nurse-staffing-ratio.pcms?menu=practice
4.) Since for-profit/private NHs are - in my experience- largely focused on profit and are ineligible for 99% of private and gov't grants, I would only seek a non-profit NH for my loved one. EVEN then - such NHs MUST maintain a healthy mix of private pay, rehab, medicare and medicaid patients to maintain their bottom line and stay out of the red. Medicaid has historically FAILED to pay the total costs of NH care - the balance must be made up by private pay, grants, cut-backs, or such schemes as keeping many staff part-time to avoid the costs of employee benefits required by full-time staff.
5.) NHs are a ghetto for women: 90% of the residents are women, and usually 90% of the staff are too - esp. those who are lower paid. Long term, end of life care is very much a women's issue - and I'm sure that is why it has not yet been addressed.....I first heard of the nursing-to-patient ratio staffing problem during Bush W's presidency - and he refused to address it at that time. As has Obama. And likewise any Congress.
6.) As the advocacy and movement has increased to raise the minimum wage, it will be interesting to see what results for NHs and their QOC. In New England, NH CNAs can start at $9-$10/hour. Neither NHs nor any other healthcare facility will be able to compete for employees with fast-food chains and others unless they raise their pay rates. However, these rates are determined by what their States will pay for a daily Medicaid patient/long-term care resident. In short, look for a period of intensive chaos, as states try to find the $$$ (from the taxpayers!) to enable NHs to stay open and provide a REASONABLE - not even high quality, but just "safe" - level of care!!!!
So - hollerfatgirl - that's why NH staff seem so uncaring and emotionless - BURNOUT pure and simple.
What can we do? As one commenter here said - speak with the Charge Nurse and/or administrator at the NH where your parent lives. Use Google to check the pay rates and regulations regarding CNAs and nurses, as well as nurse-to-patient ratios in your state or region. CONTACT your state and federal representatives - preferably via email and/or snail mail letter, as well as by calls - and advocate for changes to MANDATE a safe nurse-to-patient ratio. Make sure to VOTE and it doesn't hurt to make a small donation to your reps either! This will not change until we insist that it does. Meanwhile, elders are suffering, as are the people who love them but cannot care for them 24/7, and have entrusted their care to "professionals".
Hope this helps!
So many patients with so many needs. It was incredible. Always low staffed and the physical and mental stress was exhausting. After I became an RN I temporarily worked at a NH. The physical work wasn't quite as hard but it was replaced by other work that was equally exhausting. Sherridene pretty well sums it up.
Obviously there are good and bad care facilities and good and bad caregivers. You can't lump everyone in the same pile. Obviously we need to do good research on a facility before we place our loved one. And, we need to stay positively involved in monitoring their care. Nursing can be a pretty thankless job, whether you are a CNA or a Nurse. Whether you are working in a long term care facility or a hospital ER. As a family member don't forget to thank the staff for good care. Bring in those donuts or cookies once in awhile to show your appreciation. And, don't forget the night shift they are usually the lowest staffed and some of the hardest working. Yes, it's our job to care for your loved one. But it takes family positively involved as well as the staff to do a great job for your loved one.
I worked for over 15 years in nursing homes, and while some are truly dreadful, there are some very good places. Look around for another home and tour.