Family Councils Improve Quality of Care

California seems to be on the forefront of legislation aimed at improving the lives of nursing home residents. The legislature recently approved AB 1457, which provides transparency in the shell game of nursing home ownership and operation. 

California also has legislation in place which improves on the idea of Resident Councils by creating Family Councils. Resident Councils can have any number of residents as members, and are usually facilitated by the facility. The downside of a Resident Council is that there is no check on the accountability of the system. A problem may get reported to a Resident Council but not acted on. A Family Council allows two extra prongs of accountability. First, the Family Council involves not just residents, but family members external to the nursing home. These family members can push back without worry of the inherent power dynamic that is involved in an elder care relationship. Second, the concerns of the Family Council must be addressed by law. According to Walton Barber, the law in California provides improved protections not available in other states:

California law allows the creation of "family councils" by relative of a nursing home resident to help influence the quality of care given to a resident. Not merely gripe sessions, these councils can facilitate communications between families and residents with the nursing home staff and caregivers, and also offer peer support for friends and relatives of the resident, and help prevent substandard care.

A nursing home may not prohibit the formation of a family council, and must allow the council to meet on the grounds of the facility at least once a month. In addition the home must designate a staff member who is responsible for assisting the council, and to respond to all written requests made by the council.

Maybe its time to look at these types of protections in Washington. Below is a short video on Family Councils.

"The Unspeakable" - A heart wrenching story of elder neglect.

Juicy Nurse is a blog devoted to giving nurses an outlet for their stories, whether they be sad, happy, or just plain hilarious. Unfortunately, the following story is all too common:

Several months ago I stayed at work until almost midnight "cleaning up" a man that came from a nursing home and may, very well, die of nursing home neglect. This man was unable to communicate much at all because he had suffered a devastating stroke in the past leaving him unable to care for himself. As if this was not sad enough, he presented to me with the UNSPEAKABLE!

This man had a rash that covered his entire back, buttocks, groin and legs. This "rash" turned out to be burns from urine and feces that burned his skin only because he sat in it for several hours without being changed. He had ulcers, open and infected, on his ears caused from the oxygen tubing that stayed in the same position for so long that it actually wore through his skin and caused ulcers that became infected. His scrotum was the size of a volleyball and his penis was swollen and oozing. The Foley catheter that he had in his penis had remained there so long without being changed that bacteria had actually eaten a path in between his penis, scrotum and bladder. He had a tube for feeding (G-Tube) that was ulcerated and oozing with a dressing on it that had not been changed in weeks. He could barely breathe when he got to me. We did everything we could to support his oxygen level, just to find that he had a piece of pita bread lodged in the back of his throat......about the size of a hockey puck! When we were able to finally pull it out the smell was so foul that I actually began to dry heave in a nearby trash can. This smell was only a bit comparable to the smell that you can only imagine was coming out of his penis.

I was SO disgusted when this man fell on my list of things to do for the day. Clearly not because I was upset to care for him but only because it broke my heart EVERY TIME I walked into the room. He did nothing but stare at me. He locked his eyes with mine in a way that assured me that he could understand everything that I was telling him.

I immediately called social services, his family, and the department for children and family services. I cleaned this man from head to toe, with the assistance of many others. I stayed with him until midnight, not because I was busy, or overworked or covering for another nurse, but because what happened to him took away all of his pride and dignity. This man deserved a voice.....an advocate.

We took pictures and filled out paperwork and cried with family and talked about it in the break room and lost a little sleep here and there.........but ultimately, what happened to him was UNSPEAKABLE! Abuse at its finest, most disgusting and most difficult to prosecute!

This case is so sad and will NEVER leave my mind. I don't know what ended up happening to this man. I assume that infection probably took over his body and that he has probably passed on, but I don't know for sure. This is the case of many patients that we see and treat in the hospital. They impact our lives and we never forget them. We impact their lives, i assume, and then we only hope that things get better for them.

I thought of this man 2 weeks later when I admitted a mentally challenge female from a nursing home with severe bruising to both of her inner thighs, her chest and her upper arms. I did for her as I did for him, as I will do for the next one.

When will the unspeakable stop? How do those of us that deal with it all of time, move on?

All we can do is give these people a voice.

It is refreshing to me that people can come from such varied backgrounds and all have the same passion for these problems of neglect and abuse. The nurses, the investigators, and even the attorneys all see the same things and want the same changes to occur. We all want to fix the underlying problems in the system that will allow our most vulnerable to suffer. We will change things. We will give them a voice.

Continue Reading...