The pandemic has caused many of us to reflect on our lives, work and priorities. It’s also led to catastrophic losses and to greater public awareness of problems in our field. In the mental health world, we encourage people to try to learn and grow from tragedy. I hope we in the long-term care world can do the same.
My hope for our evolution is grounded in my belief that most people working in this field have a genuine desire to assist elders. In my opinion, the first step in revamping long-term care is to limit the industry to those companies with this primary goal. With mission-driven organizations remaining, we can provide services with the greatest benefit to seniors and their families.
Based on thousands of conversations with residents over the years, I suggest we put more emphasis on the following:
- End-of-life discussions: The pandemic has heightened the public’s awareness of mortality. Long-term care facilities can build on this enhanced recognition by addressing end-of-life concerns earlier in the care process so that palliative and hospice services are accepted sooner, when they can be of most benefit to the families and residents.
- Family healing: Restrictions on family visitors during the pandemic have crystalized the importance of family involvement in the care of residents. As I pointed out in this piece, we don’t admit residents, we admit families. Establishing resources such as support groups for relatives as they cope with the illness of loved ones pays off in improved care quality, increased resident and family satisfaction, great likelihood of good facility reviews and referrals and other positive consequences.
- Toileting: Lack of timely assistance with toileting is residents’ most common frustration and it can result in anger, depression, falls, urinary tract infections, skin breakdown and a host of additional problems. The unorthodox idea of revising the fee structure to reimburse for toileting would allow for more aides paid at a better rate, address resident priorities and prevent costly ailments, as I discuss here. The proposition is at least worth an outcomes study.