Dr. El’s Theory of Angry Activities

“Scream as loud as you can,” I encouraged my companions before we plunged down the waterslide in our rubber raft at the water park on Independence Day. “There aren’t enough opportunities for yelling in everyday life. Let’s make the most of it while it’s socially acceptable.” The shouts of our foursome pierced the air as … Read more

Dr. El’s ‘Quality of Life’ star ratings are the way to go

The Nursing Home Compare star rating system assesses quality of care based on health inspections, staffing and quality of resident care measures. It examines important factors such as emergency preparedness, resident/staff ratios, re-hospitalization rates, falls and antipsychotic use. After writing about turnover in my last column, I wondered what might happen if high marks were … Read more

Relationships key to long-term care success

Long-term care success is about steady, reliable relationships. That’s my takeaway after attending two recent conferences that echo my experiences in the field. The first event delivered the results thus far of an ongoing program that won a coveted grant from the Center for Medicare & Medicaid Services’ Center for Innovation. The OPTIMISTIC project is … Read more

On power, teamwork and communication

Having enough of it at work, I tend to avoid drama in my entertainment choices unless it involves aliens or post-apocalyptic nonsense. My family and I are currently enjoying the creative spectacle of Project Runway “Teams” version from a few seasons ago. In it, the judges of the clothing design competition repeatedly make the point … Read more

Self-disclosure: What your staff needs to know about revealing personal information to residents

As “Eileen” suggested in the comments section of a recent “Dr. El” blog, disclosing personal information can be a good way to establish a more intimate connection with residents. While self-disclosure can create warmer relationships, there also can be unintended and unwanted consequences to revealing such details. In contrast to psychologists who study interpersonal interactions … Read more

Taking teamwork to a deeper level

When we think of teamwork in long-term care, we envision a group of dedicated specialists working together to provide the best care for our residents. They read notes from other disciplines, bounce ideas off colleagues at the nursing station and convene care plan meetings. In reality, teamwork in long-term care is much more complex. Teamwork … Read more

Enhancing organizational communication improves outcomes, reduces adverse incidents

McKnight’s Long-Term Care News frequently notes stories about rogue employees engaging in illegal and disturbing behavior and then trying to cover it up after the fact. There are regular reports about intra-organizational systems that fail, leading to wrongful death lawsuits and other problems, such as this one about a resident who died from scabies. Occasionally … Read more

A gift from LTC families

A study of interactions between families and healthcare providers published in the BMJ this month sparked my interest. It showed that improving communication between the two groups reduced harmful medical errors by 39%. As if that vast reduction in medical errors weren’t enough, it was caused by harnessing the input of team members who don’t cost facilities … Read more

The keys to reducing turnover in long-term care

“They keep giving me these new aides and they don’t know what they’re doing,” a disgruntled resident commented during a psychotherapy session. “You’re not the first person to tell me that,” I replied, looking for a way to acknowledge her experience without criticizing either the facility or the new aides. “You have the honor of … Read more