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Posts published in “Research”

Choosing a Nursing Home – Things to be taken care of

Choosing a nursing home is an incredibly important matter, and you should know that there are several things that you should take into consideration when you are trying to decide on one. For instance, you should know that most nursing homes have eligibility standards and if you don’t meet these standards then you or your loved one will not be accepted.

The following are some items to consider before settling on a nursing home for long term care:

  • Comparing

You should always do a comparison when you are trying to decide between the nursing homes located in your area. You should take some of the best and then compare the pros and cons between the companies that you choose so that you can find the best one. Price, comfort and accessibility should be the main aspects that you should compare when looking into a long-term care facility.

  • Consider Your Personal Needs

It is important that you need to take your own personal situation into consideration so that you can find a nursing home that fits all of your wants and needs. One feature that you will want to consider is the social environment of the nursing home. For example, you will need to consider if the nursing home is close enough to your family members that they will be able to visit often, whether or not religious services are available, if there is an outdoor area for you and the other residents to enjoy, and what types of activities are available for you to participate in. If the patient is unable to consider these things, it is your responsibility to decide for them.

  • General Levels of Service

Knowing how the service works at a particular nursing home will make choosing one far less difficult. For instance, you should go in and talk to the staff members at a facility that you are contemplating. Ask questions about the facilities and try to gauge their responses in order to decide how they will interact with the patients at the facility. Ask to tour the nursing home; this will give you a chance to see how the staff treats the residents. If possible, speak with the patients or their family members to see how they feel about the care that they receive at the facility.

You will also want to check out the activity programs, because you certainly do not want to choose a place where you or your loved one will end up being bored because there is nothing to do. In this regards, you will want to check and see if there is a schedule of daily events posted, as well as whether or not the activities listed cover a range of different interests.

Additionally, do not forget to check out the dining area and menu, so that you see if the mealtime atmosphere is to your liking, whether the residents there are happy with the quality of the food, if the food appears appetizing or not, if residents are allowed to get substitute meals when they do not like the menu, and whether visitors are allowed to join residents for meals.

Choosing a nursing home is an extremely difficult decision. Many people finish out their days while being cared for in these facilities. This is why it is very important to choose a residence that is of the highest quality and affordability.

The Ethical Side of Nursing Research

Although nursing research and nursing practice influence each other and co-exist, they are not the same entity. The difference between the two areas was outlined in 1979 by the National Commission for the Protection of human Subjects of Biomedical and Behavioral Research or the Belmont Commission. The commission mentioned that the design of nursing practice is geared towards the improvement of a person’s well-being with the application of several interventions. Nursing practice will offer diagnosis, preventive treatment or therapy to patients. Moreover, the Belmont Commission stated that research, in contrast to practice, is geared towards testing a hypothesis, drawing conclusions, and generally contributing to the acquisition of knowledge. Research activities are continuous. They involve Continuous Quality Improvement and clinical trials at random.

The most important provision in nursing research refers to the ethical principles governing human subjects. The three ethical principles are: autonomy, beneficence, and justice. To explain further, autonomy refers to self-determination and informed consent. Before research can be conducted on an individual, he must be informed and must be given the right to choose whether or not he will participate or withdraw from a research study. Autonomy recognizes the basic principle of respect for a human being. Would-be participants of a research study must be told of the risks involved. Autonomy is usually reduced in instances where the participant is a child or is unconscious. In which case, the participants are given the right to safeguards. Next of kin, a health care surrogate, or a guardian could act as safeguard for the participant. Beneficence is the principle that guides health care assistants and providers.

The principle has its foundation on health care moral advocacy. Beneficence provides maximum benefits and protection from harm. In order to follow this principle before a research, there is a thorough and fair analysis of known risks and benefits of the research. If consent is given, there should also be monitoring of a person’s response during the course of the study. The last principle is the principle of justice. It mandates that every participant should not have been coerced to join a research study. Also, it provides that the subjects of the research exclude those persons who are with severe mental or physical illness. Persons who are economically and educationally at a disadvantage are also covered in this principle. All subjects must be selected that only from the group listed above. They must come from a broad population, of various societies, gender, socioeconomic status, age, and ethnicity.

Now, if a nurse or any health care giver has an ethical conflict with a certain research, he has no moral obligation to see through the procedures of the experiment. The nurse in question must bring his concerns to the others’ attention, specifically to those persons involved in assisting the patient and reviewing the suitability of the research. There may be a personal consequence of reporting, but failure to communicate perceived ethical injustice violates the ethical principles of the nurse and the profession. The last one is so much more difficult to ignore than the first.

What to Look for when Researching a Nursing Home

One of the hardest things for a family to do is to have to resort to placing their elderly loved one in some sort of Nursing Home facility. There’s no easy way to get through it but this article will guide you through the process.
We are human. We age and grow old. We break down and repair ourselves. But much like an old car, eventually our parts just wear out. Bones get brittle, skin gets loose, our posture gets bad, and walking can become difficult or cease all together. Then there is our mind. Confusion or dementia can set in. We can forget things that we’ve known how to do for most of our lives. We can be a danger to the well being and safety of others and ourselves without even realizing it. And when we get to that point, it may be necessary for us to have constant supervision and 24 hour assistance as needed. These days, when most couples both have a job, having someone there to take care of our loved may not be possible. Nor does everyone in the household have the proper training and skills to properly and safely assist our loved one.

It’s times like this when you may have to start looking into alternate care for our loved one. This may mean removing our loved one from the house that they may have spent most of their lives in. It’s not an easy thing to do at all. There is a lot of red tape not to mention the emotional tool it takes on the family.

First you need to have a talk with your loved one’s doctor and find out just what her or his needs are and the level of care that is needed. They may only need an assisted living apartment in a residential community. Your doctor can also give you information or contact information on who to talk with to find out how to pay for this care as it can be VERY expensive. But fear not, the state and Social Security Administration have a hand in the funding as well.

Second, you have to sit down and discuss this with your loved one. They may be upset and angry. This is normal. Calmly explain to them just why this is needed and work on getting through to them that they NEED this care as the quality of life they deserve is not being provided in their present home setting and that it’s for their own safety. If your loved one is confused and such, they may not protest at all but if they’re not, getting them to accept it all may be somewhat of a process. Be patient and try to be considerate of their feelings. If they are active in their church or even somewhat active, ask the church’s Priest or Pasteur for assistance. They have dealt with this before and can be a tremendous help.

Based on the doctor’s recommendation, visit the area’s facilities. Find out what area of the facility your loved on will be in. In many nursing homes, certain level care patients may be kept in different areas. Ask the admissions advocate to take you for a tour of that specific area. Take a look around. How clean is the area? Observe the staff. Look at their faces. Do they seem stressed out like they have 100 things to do in 5 minutes?

Ask to speak to the charge nurse of the area your loved one will be in. They are the ones who are on the ward from day to day and can answer your questions far better than the person in the admissions office. Ask the charge nurse if it would be possible for you to speak with one of the C.N.A (Certified Nursing Assistant) staff. The C.N.A staff will be providing about 85% of the care to your loved one.

Here are some questions to ask:

What time is breakfast, lunch and dinner each day?

This may not seem very important but it will help you to know their daily schedule. And take note of the breakfast time.

What kind of activities does the facility do with the residents?

Many facilities do bingo, square dancing, movie nights, and arts and crafts.

Do they offer physical therapy or occupational therapy?

These things can help your loved one keep their joints in proper working order.

Do they get bathed daily?

Good hygiene is essential to your loved one’s health and comfort.

What is the C.N.A to patient ratio on the unit your loved one will be in?

A C.N.A has a very physical, and emotionally demanding job and they don’t get paid NEARLY what they are worth. In fact, many of them are very underpaid. If when observing the unit staff during your tour, they seem stressed out, the unit is likely understaffed. A single C.N.A may have to take care of 18 patients during their shift and perhaps 12 of them are total care patients who aren’t capable of doing anything for themselves. They are a LOT of work.

What time does the staff get them up in the morning?

This is kind of a sneaky question and it has to do with the meal times. If Breakfast is at 8am and the staff starts their morning care at 5am that’s 3 hours before breakfast that they’re getting up. (Morning care includes bathing, brushing their teeth, shaving, etc.) If that’s the case, the facility is likely understaffed. An experienced C.N.A should be able to have your loved one ready for breakfast in about 30 minutes. Now they have more than one patient to take care of so 2 hours should be sufficient if they are properly staffed.

How much money do you make here?

Ask the C.N.A that question. If it’s under $8 per hour they are very underpaid and staffing is likely a problem there because the second the C.N.A finds something for $9 or $10 per hour, they quit. (And who can blame them?)

You may very well have to go to a FEW facilities before you find a decent one.

And when the time comes and your loved one is settled, make it a point to visit them at least once weekly and bring the grandchildren.

Nursing homes aren’t really a pleasant environment to visit. There are some very ill people there. But they provide a service that our community greatly needs and one day, you may need one as well. Good luck.