Essentials for Long Term Care

by David Quigley, MSW, PHR, Board-certified Coach

Have you ever had a loved one in a nursing home?

My spouse and I have both worked in hospitals and healthcare for the past several decades and I have been keenly interested in what constitutes exceptional care for the patient and family. We are currently in a situation where our work experience and life experiences have overlapped: for the first time we have a family member who has become a nursing home resident. It has been an emotional roller coaster with lots of inspirational highs and some sad and bitter lows.

As I experience the day-to-day care my loved one (let’s call him “Sam”) receives from the family member’s perspective, I’ve come up with the following short list of basic essential elements of quality patient care. I would coach caregivers in any hospital, clinic, or nursing home to communicate with their patients in this way:

• Connect first, then provide care. Take the time to get to know the patient and let him get to know you. His mentation varies from day to day, so take that into consideration. For example, you might introduce yourself by saying, “Hi Sam. You may not remember me but I met you yesterday.” (In one comedic moment during our experience, after an unintroduced doctor got done with his spiel, Sam asked him, “Are you a doctor?” Pretty relevant question isn’t it?)
• Always, always explain what you intend to do on this visit and ask his permission. I have seen caregivers walk in and begin to draw blood or give medications without saying a word.
• After you assess the patient’s mentation at the current moment, speak slowly and don’t “stack” your questions. Let him answer one question at a time and give him one instruction at a time.  For example, “Sam, first we are going to stand you up and then move you over into the wheel chair, okay? Here we go, first let’s stand you up. Good job, now over into the wheel chair.”

We have witnessed firsthand the difference that compassion and competence make, for both the patient and the family members, and we are deeply grateful to the caregivers out there doing this important work. Thank you for your competence, compassion, and empathy.

Now I would like to hear from you: What would you add to the above short list?