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The staff in the nursing home my mom is in seem tired all the time,they rarely smile and I always seem preoccupied with paper work like they are trying to avoid me asking a question. They rarely introduce themselves to me.

Example of concern: They start rolling the patients into the dining hall around 4:45 for dinner. The patients end up sitting at the tables waiting for about 45 minutes until their food is brought to them. God forbid they need help opening something if they don't have a visitor they are on their own.

Is this common in most nursing homes?

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I'm sorry it's because they are, my mom died April 5th 2015 and before she passed she had been in 3 homes, I kept moving her thinking I would find a better one. I would go in her room and push her call button just to see how long it took anyone to come or even check to see if she had fell or anything and it mostly took 45 minutes to a hour for anyone to show up. I know people who work at NH say it's a hard job, they don't make enough money, they are short of staff etc... then QUIT !!! I finally quit my job and the last 5 years of her life she was at home with me where she got the care she needed, yes it was hard on me and I didnt make enough money I didn't get paid at all and I didnt have a husband to help out, it was just me and her, and she was bed ridden so I had a lot on me but I did it and do not regret it at all. Nursing homes are awful, I think they hire the staff from the streets, or they couldn't pass nursing school. Sometimes I would go in my moms room and she would be laying in a dirty diaper for god knows how long. Nursing Homes make enough money from the poor people in there to hire more staff, and I found out after I brought mom home that they were charging Medicaid for services they were not doing. PLEASE try anything else before you put the mother who took care of you in a home where she doesn't know anyone and my moms clothes would get missing and I was told they would give them to others in the home who didn't have anything to wear, that would upset my mother so much. I could go on and on abut how bad Nursing Homes are but I'm really missing my mom right now.....I wish she was here with me
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The reality is, most nursing homes are operating understaffed. I agree, a Care Plan meeting would be the best way to address your concerns, along with Resident and Family Council meetings. If the home doesn't have these council meetings, speak with the Administrator and the Director of Social Work. If you still are not satisfied reach out to the Ombudsman and voice your concerns. If there are activities going on that you feel are putting residents at risk, call the Department of Health and complain, they will have to investigate.

I worked for over 15 years in nursing homes, and while some are truly dreadful, there are some very good places. Look around for another home and tour.
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I am setting here with tears in my eyes at the abundant understanding of a CNA's job !!!! It is so awesome to see how many truly understand the demands and lack of time and lack of help... I only worked in a NH for a few months... I do private care now, and it is demanding also... the families can become emotional vampires, micromanaging me into a coma....... and do I always have a smile on my face.... when I turn my back I don't....but to my clients face I do.... I am in constant pain, constant fatigue, and low pay..... why do I do this.... shared with someone today, that after almost 23 years, I'm not sure anymore.....it IS a hard job. so thank you ALL so much for understanding and helping me to know that families do care...... from my heart, hugs to all of you....
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Thank you all for the input. Several of the suggestions you gave I had already undertaken because I do understand it can be a demanding job. I acknowledge and thank the staff for there help, I give gifts and I help with my mom when I am in the facilty. I guess the major problem isunderstaffing as a result to run a profitable business. As in so many businesses these days they are profit driven.
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I worked as a CNA while going to college and it was the hardest job I've ever had!
So many patients with so many needs. It was incredible. Always low staffed and the physical and mental stress was exhausting. After I became an RN I temporarily worked at a NH. The physical work wasn't quite as hard but it was replaced by other work that was equally exhausting. Sherridene pretty well sums it up.
Obviously there are good and bad care facilities and good and bad caregivers. You can't lump everyone in the same pile. Obviously we need to do good research on a facility before we place our loved one. And, we need to stay positively involved in monitoring their care. Nursing can be a pretty thankless job, whether you are a CNA or a Nurse. Whether you are working in a long term care facility or a hospital ER. As a family member don't forget to thank the staff for good care. Bring in those donuts or cookies once in awhile to show your appreciation. And, don't forget the night shift they are usually the lowest staffed and some of the hardest working. Yes, it's our job to care for your loved one. But it takes family positively involved as well as the staff to do a great job for your loved one.
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I had someone suggest to me to slip the aide (find one who cares) a ten dollar bill every once in a while. "That's how you get good care in a nursing home," she said.
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Not all nursing homes are the same. Unfortunately a large percentage are very understaffed. I only worked at one for 3 months before I quit. Imagine trying to pass medications, answering call bells, being hit, spit on, verbally assaulted, not being able to use the bathroom when your bladder is about to burst. Throw in a ringing telephone at the nurses station and patients family's demanding immediate answers to some minor problem that if they would just give me a minute to finish a task I would gladly answer. I consider myself a very compassionate person and love being a nurse but quickly realized that I was not able to handle the emotional stress that it takes to work at a NH.
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We just had to put my father-in-law in a nursing home six days ago. He's in a locked memory care unit. He has dementia and several major health issues. We could not have him at home any longer due to his angry outbursts. What I've seen in the past six days has given me a brand new appreciation for the workers in nursing homes, especially CNAs. They are awesome! They have to take elderly people to the bathroom-think about that. Is that something anybody loves doing? They have to clean them up after they use the toilet-they wipe their faces, hands and clean up many different messes. It's a job I know I would never want. Every two weeks I plan on making or taking in treats as a thank you. It costs very little to be kind, smile and say thank you. I can't imagine how exhausted these CNAs are! With the low wages, I know several of them work other jobs or go to school. I am so grateful for the job they do.
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Anita, thanks for a well reasoned, pragmatic and insightful explanation of nursing home staffing issues.
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I want to preface my remarks by noting that I am a consultant to non-profits regarding organizational development and fundraising (for 15+ years), and had a few non-profit NH clients in New England - one for over 7 years. As part of my services, I wrote a number of grant proposals to cover both capital and staffing needs. To do so I needed to learn alot about long term care issues in the USA and how they are handled. That knowledge has been invaluable as we've cared for my MIL w/dementia and frail health in our home for the past 10 months. Here are some of the things I learned in my work:

1.) These days most frontline nursing home staff are CNAs (certified nursing assistants). This is a low-level job that requires training of not more than 3 months, including some field work, followed by a certification test. Nevertheless, ongoing training is essential for CNA staff (and others) to be able to provide quality care. But whether or not V\NHs provide this is up to them.

2) CNA positions are very frequently filled by former welfare recipients and immigrant women. CNA jobs are VERY hard both physically and mentally. There are HIGH levels of injury to the women who fill these positions, due to lifting, lack of assistive lifting equipment, AND inappropriately low staffing levels. Many CNAs leave their jobs after a few years - there is extremely high turnover in this industry. In addition, pay is generally quite low, although higher pay is available for those who work 3rd shift and/or weekends. At the same time, MANY NHs keep their CNA staff on a part-time basis so that they don't have to pay health insurance for them. (Yes, the people caring for your elder loved one likely have no health coverage of their own! Or have a very low-rate plan.)

3.) Despite continuing advocacy by national and state-based Nursing Associations, neither hospitals not NHs have any mandated nurse-to-patient staffing levels. Any such staffing levels might only be achieved via unionization at this time, OR by the NH's own desire and ability ($$$) to increase or maintain a certain quality of care (QOC). See here for just one article on this issue: http://www.aacn.org/wd/practice/content/nurse-staffing-ratio.pcms?menu=practice

4.) Since for-profit/private NHs are - in my experience- largely focused on profit and are ineligible for 99% of private and gov't grants, I would only seek a non-profit NH for my loved one. EVEN then - such NHs MUST maintain a healthy mix of private pay, rehab, medicare and medicaid patients to maintain their bottom line and stay out of the red. Medicaid has historically FAILED to pay the total costs of NH care - the balance must be made up by private pay, grants, cut-backs, or such schemes as keeping many staff part-time to avoid the costs of employee benefits required by full-time staff.

5.) NHs are a ghetto for women: 90% of the residents are women, and usually 90% of the staff are too - esp. those who are lower paid. Long term, end of life care is very much a women's issue - and I'm sure that is why it has not yet been addressed.....I first heard of the nursing-to-patient ratio staffing problem during Bush W's presidency - and he refused to address it at that time. As has Obama. And likewise any Congress.

6.) As the advocacy and movement has increased to raise the minimum wage, it will be interesting to see what results for NHs and their QOC. In New England, NH CNAs can start at $9-$10/hour. Neither NHs nor any other healthcare facility will be able to compete for employees with fast-food chains and others unless they raise their pay rates. However, these rates are determined by what their States will pay for a daily Medicaid patient/long-term care resident. In short, look for a period of intensive chaos, as states try to find the $$$ (from the taxpayers!) to enable NHs to stay open and provide a REASONABLE - not even high quality, but just "safe" - level of care!!!!

So - hollerfatgirl - that's why NH staff seem so uncaring and emotionless - BURNOUT pure and simple.

What can we do? As one commenter here said - speak with the Charge Nurse and/or administrator at the NH where your parent lives. Use Google to check the pay rates and regulations regarding CNAs and nurses, as well as nurse-to-patient ratios in your state or region. CONTACT your state and federal representatives - preferably via email and/or snail mail letter, as well as by calls - and advocate for changes to MANDATE a safe nurse-to-patient ratio. Make sure to VOTE and it doesn't hurt to make a small donation to your reps either! This will not change until we insist that it does. Meanwhile, elders are suffering, as are the people who love them but cannot care for them 24/7, and have entrusted their care to "professionals".

Hope this helps!
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Put yourself in their situation and imagine how you would cope with the responsibilities and situations every day. I could never do that kind fo work; probably most of us couldn't.

The attitudes you describe suggest a too low level of staffing and overburdened and overworked staff. What investigation did you do before bringing your mother there? What is the staff to patient ratio?

As to the dinnertime moves, volunteer to help them out, even if it's just getting bibs for the patients or helping distribute the dinners. That's what we did. Not only were we helping the staff but the patients saw volunteers pitching in and that was a positive interaction for them as sometimes we'd stop for a few words with the people with whom we had become acquainted.

And show your appreciation instead of criticism - cards of thanks, donuts, bagels, flowers, jugs of cider, fresh apples and fruit of the season that doesn't spoil quickly.

Find ways to brighten their days and help them with the hard work and challenges they face.
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oops - I meant MAKE the first move. Give a smile or a compliment.
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Not all N.H.s are the same. Check around. But remember that these folks are usually overworked and underpaid and they are dealing with so many folks who are 'difficult' and many are unhappy and ALL are in need of assistance of one sort or another. It is not an easy job. They have hearts - but cannot wear them on their sleeves. May the first move. Give a warm smile or a sincere thank you. They probably rarely hear a sincere thank you. Just think of the messes they encounter every day. I know that it is likely that one day soon we will be regular visitors at a N.H. near us - I hope I can remember to be kind to the workers. They, in turn, just 'may' be kinder to our loved one. Just my two cents.
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I think they have become hardened. They have seen so much suffering, so many sick people come and go, that they don't car anymore. In other words, they're bad people who should go into another line of work! I can't imagine "pretending" to be busy so they don't have to answer your questions. I've got news for them; you're the customer and that's their d*mn job! I made clear when my mother entered the nh that I would "talk to any staff member about any concern at any time." They were trying to bully me unto being a good little family member and keeping my mouth shut. I will say that not all nursing home staff member have lost their humanity, but eventually they all get used to the lower standards and expect you to accept them too. Soooo sad.

You might also look into different nursing homes because some are definitely better than others. Now that you have experience, you'll know what to look for. I would take recommendations from friends, but also take them with a grain of salt because different people have different standards, and some people are just ignorant.
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My mother has been in a family owned/operated NH for 3 years. It's an older one floor building with 60 residents and the staff are wonderful ... some have been there 40 years. They're far and few but try to find a NH that is family owned, not owned by a corporation where $ is all that matters.
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It's certainly not common in the nursing home mom was in...at least the part about no one helping them. The 45 minutes seems reasonable, especially since it probably takes that amount of time to serve everyone.

I found the staff very helpful. But that may be the exception.

Just a suggestion. I brought good quality candy once a month for the nurse's station. If I was there at mealtime, I helped other residents by bringing their milk, salt, whatever. Also helped staff clear the tables. Everyone knew who I was. I think that got mom a little extra attention when I wasn't around.

BUT!! I always noticed staff helping.
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As for getting them to the dining room early, you need to realize that a finite number of aides have to round up all the residents, perhaps change or toilet a few, and bring them to the dining room so all of them are there by mealtime. In my experience even those who don't need assistance are anxious to be at their seats earlier than necessary, perhaps they are afraid to miss out!
If you ask a lot of questions of random staff members maybe they ARE looking at papers in order to appear busy. You should probably try to direct your questions to the charge nurse or set up a care meeting if you need more detailed answers. And if try to greet those working around your mom by name and take compliment them on their work I'm sure they will be more apt to greet you with recognition and a smile.
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