A recent study of more than 2.1 million point-of-care pain assessments conducted on 89,230 nursing home residents over five years using PainChek, an AI-powered pain assessment tool, found a strong connection between pain and behaviors often associated with dementia.

The study also found that caregiver burden increased significantly as pain levels rose. Residents with severe pain had caregiver burden scores nearly seven times higher than those with little or no pain. This finding is particularly important for an industry already challenged by workforce shortages, burnout, absenteeism, workers' compensation claims, and staff retention issues.

With a shifted focus, facilities have begun to navigate the new normalcy of the Healthcare Staffing industry—a focus filled with a heightened sense of responsibility for priorities such as financial sustainability and clinician quality amidst an unbalanced, ever-evolving market.

The COVID-19 pandemic fundamentally altered relationships and once-reliable life, work, school and home routines. More than ever, Americans have turned to virtual mental health programs during this time.

Before the pandemic, nearly one in five U.S. adults (47 million) reported having any mental illness. One in 10 adults reported symptoms of anxiety and/or depressive disorder. However, by July 2020, several months into the pandemic lockdown, a Kaiser Family Foundation Health Tracking Poll found that 41% of U.S. adults had reported symptoms.

With mental health care already being critical, the COVID-19 pandemic saw a surge in demand for services and pushed the need for optimal care, including effective digital solutions and virtual options for mental health care delivery into sharp focus.

ACHCA highlights member, Sherri Gunasekera, LNHA, MHA, MSN, RN-BC, LNC, and her medication aide training workshops with facility RNs and AITs. Sherri teaches the only Medication Aide program in Southwest Ohio. Her training workshops instruct registered nurses and administrators-in-training on how to start their own Medication Aide programs in their facility.

By definition, “comfort is a state of ease and satisfaction, of bodily freedom from pain and anxiety.” According to recent research, “The absence of physical pain is not always sufficient to provide comfort. The aged may have their biologic needs satisfied but still be emotionally distressed.”

Nurses understand the significance of the word “comfort” which describes the goals and outcomes that aid in determining the nursing measures needed to administer care. However, the meaning remains vague and essentially abstract to the person who is the recipient of that nursing intervention. The researcher, Hamilton, studied the meaning and attributes of comfort from the point of view of the chronically ill elderly who is hospitalized in a geriatric setting. Hamilton’s definition of comfort is “multidimensional, and means many things to different people.” The researcher, McCaffery’s definition of pain is “whatever the person experiencing pain says it is.”

The researcher Goldstein, coined the term “catastrophic reaction” to describe the overreaction to minor stresses which occur in patients with advanced dementia. It is precipitated by fatigue, overstimulation, an inability to meet expectations, and persistent misinterpretations. According to Goldstein, “When the environment is misperceived and one feels threatened, the following signs are noted:

According to the researcher Mace, “Intervention becomes necessary to avert or minimize these reactions.” Any sudden deterioration in cognitive function with worsened behavior should be considered as a warning that the patient may be physically ill and will act out.

According to a report in 2016 by the National Academies of Science, Engineering, and Medicine (NASEM), at least 17.7 million individuals in the United States are family caregivers of someone aged 65 and older who has a significant impairment.

The importance of being a home health care provider has risen in the past years – so much that in the next ten years, 1.1 million people will be working on it. Although it is assumed that only people in bed are cared for, homecare providers provide services to so many patients.

Accidents happen all the time, but in-home accidents are one of the major causes of death for seniors. While a slip and fall accident can happen anywhere around the house, the bathroom is by far the most dangerous room for them. Considering slippery floors, showers that don’t have slip-resistant tiles, and don’t have a grab bar installed.

With Call a Doctor Plus’ exclusive programs for ACHCA administrators, you’ll create higher value for your employees by offering 24/7 access to virtual healthcare services, when and where your team needs them.

Better care for staff translates to better care for patients, and with Call a Doctor Plus’ offerings, administrators now have the key to stabilizing their workforce. With this new partnership, Call a Doctor Plus is offering two programs that ACHCA members can offer to their employees at a discounted rate:

Skilled nursing facilities (SNF) began operating under the Patient-Driven Payment Model (PDPM) on October 1, 2019. Many current SNF employees have only been exposed to the Resource Utilization Group (RUG) model that was retired on September 30, 2019. The RUG model included therapy groups that ultimately trumped almost anything clinical being treated in the SNF. This may have resulted in minimum data set (MDS) assessments under the RUG model that didn’t include all diagnosis, condition, and treatment information simply because it didn’t affect reimbursement.

The MDS assessment was originally created to assist SNFs with developing a comprehensive care plan for residents admitted to a SNF. In the 1990s, the MDS also became a payment tool under the RUG payment model. Consistent focus under the RUG model was on accuracy of therapy days and minutes captured on each MDS assessment. The number of days and minutes of physical and occupational therapy and speech-language pathology services was ultimately the deciding factor regarding RUG group and daily payment amount.

The early days after admission to a skilled nursing facility are often critical to the newcomer. The anxiety surrounding the older person’s separation from his home, personal possessions and the dread of what may await him, may eventually intensify.

It is this time when a facility should be expressing their concern for this individual’s state of mind and how they plan to deal with it. Without a well thought out care plan there can be an unintentional disruption to the newcomer’s previous life that may leave him no opportunity of moving forward and settling into a new environment.

The role of the middle-aged offspring in caring for the elderly parent has been often described in social science research and popular magazines. Even as elders are being cared for, they are a source of support – emotionally, socially and financially – by providing living arrangements for the adult child who may be the caregiver.

The caregiver in an elderly couple is most frequently the wife, as women live longer than men and are usually younger than their spouses. If the woman is impaired, the husband will often become caregiver.

Virtually everyone remains capable of learning throughout their lives. There is no known age at which the elderly lose their ability to learn new things although due to illness and other medical issues, many can and do experience increased difficulties in learning.

It may appear as if the elderly have failed to grasp any new ideas. This is not because they have been unable to learn, but because they may choose not to risk making mistakes and looking foolish – a caution which the old share with younger people.

Facilities face supply chain disruptions and staffing shortages

Faced with a global pandemic now affecting everyday life across the country, the U.S. healthcare system is struggling to cope with potential staffing shortages and supply chain disruptions.

“Everybody is stressed,” said Bill McGinley, President and CEO of the American College of Healthcare Administrators, or ACHCA. “Most of the stress is coming from the conflicting information put out by the CDC, CMS and various state agencies. Often it is conflicting and changes from day to day. It is very hard to keep up.”

“Professional education is acquired through the learning experience offered with courses preparing the student for the role of leader and teacher, and that can be implemented at a level of competency.” Eleanor C. Lambertsen, RN, Ed.D

Nurses play a critical role in caring for the sick and frail older adult, and in promoting healthy aging. Yet not only is there a general shortage of nurses in the United States, there are even fewer nurses who have specialized in geriatric skills. Of the 2.5 million registered nurses in the U.S., less than 15,000 are certified in geriatrics. And of the 111,000 advanced practice nurses, only 3,500 are geriatric nurse practitioners and/or clinical specialists.

When a dying person senses that he is being abandoned and that others no longer feel he is worth their time and effort, he is likely to show very understandable mental and emotional reactions. He becomes demanding and agitated or more depressed. He thinks and talks in ways that may come across as peculiar to others.

For whenever patterns of communication deteriorate, it becomes increasingly difficult for an isolated person to speak logically. Unfortunately, reactions of this type often provoke responses that compound misery. Depressed because he feels abandoned, the terminally ill person may stop eating. Sensitive caregivers may recognize the psychosocial dynamics involved and increase their efforts to provide a sense of affection and security. Less sensitive people, however, may immediately resort to forced feeding through intravenous needles or gastrointestinal tubes. Or, they may decide the person is ready to die and let him go.

The following is a quote by the researcher, M. Schwab: “These early morning hours are terribly lonely…that’s when I have such a longing for someone who loves me to be there just to touch and hold me…and to talk to.”

Touch is the most important and neglected of our senses. An individual can survive without one or more of the other senses, but one cannot survive and live in any degree of comfort without the physical and emotional sense that touch is capable of offering.

Western clinicians are beginning to embrace Eastern healing modalities more than ever, especially in regard to patients with unrelieved pain. According to Maureen Foye, an RN, employed at the in-patient pain management program at Spaulding Rehabilitation Hospital in Boston, “Many people don’t understand the role that Eastern healing can play in the management of pain.” Foye began working with patients in severe pain after being exposed to the principles of therapeutic touch. She has now come full circle by instructing other practitioners in the value of these principles with plans to conduct further research into the clinical effectiveness of energy healing and therapeutic touch associated with the field of pain management.

Many patients with chronic pain tend to isolate themselves. A major focus of the program is to therefore, create community among her patients.

Ageism and Aging are stereotyping and discriminating against individuals or groups on the basis of their age. The term was coined in 1971 by Robert Butler to describe discrimination against seniors, and patterned on sexism and racism. Butler defined “ageism” as a combination of three connected elements. They are prejudicial attitudes toward older people, old age, and the aging process. There are also other discriminatory practices against older people, such as institutional practices and policies that perpetuate stereotypes about older people.

Contrary to common and more obvious forms of stereotyping such as racism and sexism, ageism is more resistant to change. For instance, if a child believes in an ageist idea against the elderly with few people correcting him, then as a result, he will continue to grow into an adult believing in ageist ideas. In other words, ageism can become a self-fulfilling prophecy.