Excuse me for a moment while I step up on my soap box.
Let me start by stating a couple of facts:
1. The population of the United States is getting older, our largest generation of the last century (Baby Boomers) are now in their 60’s and 70’s and many are starting to need nursing care.
2. It is very expensive to stay in any type of nursing or assisted living facility. In the United States the average monthly cost for assisted living is $3,550. This price varies state to state from just under $1,000 to up to $10,000 – PER MONTH!
OK, so here comes the ranting madwoman on a soapbox. In the United States there is very little regulation regarding how many caregivers (nurses and CNA’s) are required per resident! Some states have no rules regarding caregiver to resident ratios and in states that do have regulations the ratios are unrealistic and woefully inadequate.
Residents in nursing homes and assisted living facilities cannot receive the basic care they need in a timely manner because the staff are overworked, understaffed and often have insufficient supplies.
Imagine your loved one is in a nursing home, due to age they are now incontinent, they are weak and unstable on their feet so cannot get up to do anything for themselves, basically they rely on someone else for even the most basic of care needs … this can describe the vast majority of people living in nursing and assisted living.
Now, imagine you are a caregiver, C.N.A. or nurse working in your loved one’s facility. You entered your profession because you care about people, want to help them and have a heart for the elderly. You want to not only be able to meet the physical needs of your charges but also help to enrich their lives. You recognize them as human beings who still mean something in the scheme of life. You love being able to look someone in the eye and be able to communicate to them that they matter to you. When you show up for work you are expected to provide care for as many people your employer can legally assign to you, and in many states that is unlimited. You aren’t in this for the money either as most caregivers are paid minimum wage or possibly a bit over but not much.
A large majority of seniors in nursing homes and assisted living facilities are incontinent and wear adult diapers. Many are obese should require two caregivers to be involved in any care to prevent the possibility of the senior taking a fall or injury of the caregiver. Most require assistance in dressing, eating, bathing, and many other activities of daily living that we perform for ourselves without much thought.
Sleeping a solid 8 hours during the night is also something that rarely happens with residents, many nap during the day and aren’t tired at night or just don’t sleep more than a couple of hours. Most get woken during the night on a regular basis by caregivers needing to do personal care such as changing adult diapers, showering, vital sign checks, and for giving medications.
Here is a scenario that is all too likely to be true and happening near you:
Mr. Smith’s family has placed him in a nursing home after he started having problems falling at home and being confused about his medications. His family looked at many places in their hometown so they could visit often and finally chose a facility that was fairly new, with beautiful, comfortable decor and wonderful programs and amenities. The rooms seem spacious, Mr. Smith will have his own room and will be able to have some of his own furniture and belongings there. While the price per month makes his family shudder, they have just sold Mr. Smith’s home and the profits should cover the cost for a few years.
So, Mr. Smith is now in his new “home” and must rely on the staff to assist him with all of his personal care and proper dosing of his medications. This is where the difficulty starts, depending on the number of residents, the level of care needed, state regulations and the time of day Mr. Smith may have to compete with anywhere from 10 to 20 to even 50 or more other residents to get the help he needs from the caregiver assigned to his room.
Mr. Smith needs to go to the bathroom, he dutifully presses the call button to summon his caregiver to assist him to the bathroom and he waits. Five minutes pass and he’s feeling very uncomfortable with his full bladder. Ten minutes pass and he’s contemplating trying to get to the bathroom by himself. Fifteen minutes pass and he’s now trying to stand up. Twenty minutes pass, he stood up briefly, fell on the floor when he lost his balance and to add insult to injury lost control of his bladder when he fell. He is now lying on the floor, potentially hurt and in a puddle of his own urine. Finally, twenty-five minutes after he pressed his call button, his caregiver enters his room.
His caregiver wasn’t slacking off, didn’t ignore the call light because they didn’t care, quite simply they were in the middle of assisting another resident and couldn’t get away. They also very likely had several other residents that had hit their call button prior to Mr. Smith. It is actually quite common for caregivers in a facility to forgo their breaks during a shift in order to care for their charges, they are that dedicated!
In the end what happens is residents don’t get the care they need in a timely fashion which can lead to falls, injuries, sores developing from sitting in their own waste, infections and premature deaths. They don’t receive the personal and social interaction to remain alert or feel like a human being and begin to fade away into themselves and/or become depressed.
Caregivers see this happening, they know what’s going on and that their level of care is substandard because of the incredible workload heaped upon them by their employers, they feel like they’ve failed, they’re tired, they’re injured, they’re depressed and they burn out. I can’t tell you the number of caregivers I’ve spoken to who are frustrated by the overwhelming number of residents they are required to care for and the limited time and resources available to provide adequate care. There are hundreds of forums out there for C.N.A’s with huge threads on frustrations over the under-staffing at their facility.
There needs to be a huge outcry from this country regarding resident to caregiver ratios in nursing and assisted living facilities! This is not just a situation where a worker is being pushed to produce more for an employer. This is Grandma, Grandpa, Mom, Dad, Aunt, Uncle being put in danger, so that some corporation can have higher profits. This is putting caregivers in danger so some CEO can claim a larger bonus. This is about human beings, residents and caregivers, being dehumanized into a number on a spreadsheet column.
I hope I’ve opened your eyes, I hope I can reach people and do my part to affect a change. Our loved ones deserve it!