Understaffing leads to conflict and depression among family members
NY Times has a blog called The New Old Age. Recently, they had an entry by Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions” regarding nursing homes. The entry begins with a story about Sharon Kenney’s mother, Eunice. Eunice was waiting, and waiting, for an aide to answer her call bell and help her to the bathroom. Her daughter stayed on the phone with her for 45 increasingly desperate minutes. Finally Ms. Kenney hung up, called the desk nurse and asked that someone be sent to assist her mother. The ensuing conversation, as she recalls it:
Nurse: “We’re really busy and we have a lot of residents here. You’ll have to wait your turn.”
Ms. Kenney (after long pause): “That’s not the answer I was expecting. The answer I was expecting was, ‘I’m so sorry, we’ll send someone right down there.’”
Nurse: “I only have one person on that wing. She needs to wait.”
Ms. Kenney: “Maybe you could go down and help her. Do I have to drive over there and help her myself?”
Ms. Kenney takes meticulous notes of the neglect. Her motto for dealing with the staff: “Be as polite as possible. But relentless.”
Virtually all nursing homes are chronically short-staffed, with too few aides and nurses scurrying to help too many residents, who are more impaired and suffer higher rates of dementia than their peers a couple of decades ago.
The article goes on to discuss Cynthia Dyer-Bennet. She grew frustrated when the aides caring for her mother in a dementia facility outside San Francisco seemed to routinely neglect brushing her teeth. “I could tell because her toothbrush was always bone-dry,” Ms. Dyer-Bennet said. The staff denied any problem. “They’d say, ‘We did brush her teeth.’ I’d say, ‘No, look, here’s her toothbrush — it’s dry at 9:30 in the morning.’ They’d lie to me.” She understood that with three aides caring for 27 residents, the staff was doing its best. She knew, firsthand, that with an Alzheimer’s patient, brushing teeth can take 20 minutes. But she persisted, citing what she saw as broken promises about diet and activities, as well as oral hygiene. “It reached the point where the caregivers didn’t want to see me because I was waving a toothbrush, and the administrators didn’t want to see me because they didn’t want to hear complaints,” Ms. Dyer-Bennet said. She eventually moved her mother elsewhere.
Family members who perceive conflict with staff have significantly higher levels of depression, according to a 2007 study conducted in 20 upstate New York nursing homes. And interviews with nearly 700 nursing home nurses and nursing assistants revealed that conflict with family members increases staff burnout and lowers job satisfaction, which contributes to the sky-high staff turnover rates that already plague many nursing homes.
