As the occupancy of residents in our facilities begins to rebound, labor challenges appear to be one of the biggest dilemmas nursing home operators are facing. With staffing shortages, it may be difficult to implement optimal programming; however, as healthcare professionals in skilled nursing we are governed by the overarching concepts of quality of life, quality of care, and patient-centered care that are present in the 2016 Medicare and Medicaid Program Reform of Requirements for Long Term Care Facilities (81 FR 68688). These requirements provide the minimum framework of effective care regardless of resource availability or staffing.
Facility staff members should feel empowered to live a culture that improves resident’s quality of life and promotes healthy aging. Providing extra “care on the move” throughout the day while performing usual daily tasks makes a tremendous difference and allows facilities to meet federal requirements. Providing “care on the move” allows facilities who are facing staffing challenges or inconsistent program execution to meet residents’ needs and potentially document their “moves” on the MDS.
A key element at the center of this quality-of-life promotion is emphasizing resident’s ability versus disability and capitalizing on what the resident can do over what they cannot. Some examples of “care on the move” that take advantage of improving or maintaining abilities include:
- Allow any resident who is able to ambulate short distances or propel themself in their wheelchair, to mobilize to and from daily weight checks.
- Use daily assist with dressing and grooming as a time to incorporate effective communication by allowing time for conversation and encouraging the resident to express wants/needs, and complete tasks as independently as possible.
- When a resident is toileting, provide encouraging verbal cues versus automatic physical assist, as much as safely possible, to allow for maximal independence.
- Utilize bed mobility and transfers with a resident as an opportunity to encourage the use of bed rails; and to provide training for rolling, supine to sit, and positioning themself in bed.
- Use the facility PA system to elicit facility-wide range of motion activities. For example, when music is played, all restorative trained staff take time to assist with range of motion goals or perform sit to stand activities with the residents.
The moments spent reinforcing residents’ abilities builds both resident and staff confidence and satisfaction, and ultimately improves quality of life. For those facilities that have restorative nursing programs in place, “care on the move” is an additional avenue to promote the health and wellness of residents. In the face of challenges, we must do our part to ensure that our residents’ care needs come first. Lead the way with your interprofessional team by providing your residents those extra moves that make a difference!