Changes in nursing homes to benefit residents, families, staff
By Michelle Hall
While surveying older patients about breaking a hip, researchers in the British Medical Journal found 80 percent of respondents would rather be dead than in a nursing home.
But according to Gayle Doll, director of the gerontology program at Kansas State University and a researcher on long-term elder care, the culture of nursing homes in this country is beginning to change, thanks to a new focus on person-centered care. The hope is that the new culture will be welcoming to residents, their families and staff members.
Previously, nursing homes focused on the medical side of long-term care. Now the trend is to look at the person and their various needs, rather than just their medical needs.
The focus on person-centered care includes more consistent staffing, Doll said. In the past, workers would go anywhere in the care center they were needed, while trying to remember the needs of many patients. Now, the same staff works with the same group of residents.
"It's all about creating relationships," Doll said. In the future, she said there may even be universal staff members who will tend to all of a resident's needs, including housekeeping.
Choice is another focus. This includes choices on eating, what to eat and when; activities; bedtimes; and bathing.
Private rooms are becoming more common as well. Doll expects that in the next 15 years, all rooms will be private in nursing homes.
Doll said it's easy to tell if a nursing home is focusing on culture change -- visiting one at about 6 a.m. will show if all of the residents are being awakened or if they can choose to get up when they wish.
"You also can view the interaction between staff and residents," she said. "See if they talk over their heads or to the residents."
This culture change is partially due to the ever-expanding options for the aging, Doll said. Now, older adults can consider home health, which allows the person to stay in his or her own home. Another option is assisted living, which provides supervision but a lot of independence for residents who can take care of most of their own needs. It's like a "very small apartment but with help nearby," Doll said. Yet another of many options available today includes "green houses," which are like boarding houses with only eight to 10 residents.
"Everyone's trying to make it more homelike," Doll said.
The gerontology program at K-State focuses on long-term care issues. Doll and other K-Staters are studying how culture change is affecting residents. In addition, researchers have written about Kansas nursing homes that have won awards for being more person-centered rather than medically centered. K-State's gerontology Web site also provides ideas for nursing home activities, as well as educational modules on culture change and other topics. The site is at: http://www.k-state.edu/peak
More information about K-State's gerontology program is available at: http://www.k-state.edu/gerontology/
Photos: (Top) The front doors of the healthcare households at Meadowlark Hills Retirement Community, Manhattan, Kan. (Bottom) A healthcare household kitchen at Meadowlark. At Meadowlark, households function independently of the rest of the community, making all decisions within that house as a "family." Photos courtesy K-State Center on Aging.