You'd be surprised what you learn when you just listen. I had the opportunity to speak to a young lady yesterday who is a State Tested Nurse Assistant (STNA) in another county close to ours.

She was telling me about the dementia unit she works in and said she has never had any training whatsoever on how to really interact with the patients. She said she does her best, but always feels she could do more if she and her coworker had some specialized dementia training.

She, like many others who work there, is scheduled and assigned on an as-needed basis. In other words, if assistance is needed in one part of the facility, then she works there. If, on another day, help is needed in another section, then she is assigned there.

Basically, her assignment depends on whether another employee calls off, or if the facility is understaffed for whatever reason.

She then told me of a patient at her facility who is forgetting how to walk. She said she asked management if they could get the patient a wheel chair to use, or even a walker.

The powers that be told her that they were unable to do that. I suppose it has to do with doctor's orders or some other lame excuse.

This is an accident waiting to happen. It is only a matter of time before this patient gets up out of bed, takes two steps and hits the floor.

It is not a question of if this will happen, but when. All thanks to some rule they have at this facility. To me, this is beyond absurd.

I told her, if I were in her position, I would speak to the patient’s family members and tell them they need to insist that their loved one uses a walker or wheel chair, or has assistance any time she is out of bed.

This is a perfect example of professional caregivers and facilities not having proper training. They are basically saying that they are unable to do anything until this patient falls. She, of course, is elderly and a fall could mean a broken hip, which in many elderly patients is a death sentence.

Nursing facilities have to do what is proper for their patients. Knowing that this woman has begun to forget how to walk and not doing anything to prevent her from falling is negligent on their part.

I have said many times that if you do place your loved one, your caregiving role does not stop. You are still the number one person who has to look out for them.

This story tells it all. There should never be anyone working on an Alzheimer's or dementia unit without some training as to how to deal with these patients. Never.

Back in the day, I was an investigator for the State of Ohio for these kinds of residences. It was my job to go into these facilities and see that things were being done properly. For example, I ensured that all ongoing education was being completed, training was being done and all employee records corresponded with their training.

I had four counties here in Ohio that I was responsible for. Countless times I would show up unannounced and find violations. One time, the training was so lax, and there was no paper evidence that any of it had been completed. I had no option but to recommend that the license of this facility be suspended.

No one wins in this situation, but you have to have a system where these facilities and their employees are being held accountable.

This one instance in which action was taken, the facility had no continuing education in the basic things like CPR, transferring a patient from a bed to a chair, operation of a hoyer lift, etc.

I have long been a proponent of having the right people in the right places when it comes to care facilities. I think every employee has to have training on dementia patients. Ideally, they should also know who their patient was before this disease came into their life.

An untrained STNA who has no clue about choking hazards or peripheral vision issues could easily frighten a patient just by trying to feed them.

Like I said, you learn a lot by just listening. She asked for my input. You know me, I gave it.

I told her I would like to come to this facility and talk to the staff or have a question and answer session. This would not be to put down what they are or are not doing, but would be a great place to start for some constructive criticism.

Remember, once you do place a loved one, your responsibilities do not stop there. You are still a caregiver for them, speaking out for them when things are not right, and making sure they are getting the care they need and deserve.