Elder Care...continued

This is kind of a comment to an answer…

First there was an article like comment, on Huckleberry On Line,
Then there was a comment to that, which was answered in Nuts and Nonsense
At http://jeaniespokane.blogspot.com/2008/12/elder-care-edler-abuse.html.

I was an aide for over 17 years. I would love to tell you that every aide is a
great aide and goes beyond the call of duty for each of their residents.
in health care centers, (that is what they call nursing homes). But that would
be a lie. It is true of 20 per cent of the aides. Another 40 per cent will be at least
most of that. The other 40 per cent are there for the money, or they can’t get another job
anywhere else.

All health care centers are suppose to screen their employees. But some are so desperate for help that they will let that person work, while they get the screening done. (a week usually) and then fire them if there are questions. Some of them are not so fussy. Depending what the results are of the screening. This went into effect about 10 years ago.

While health care centers are on the low pay scale, it has gotten a little better in the past 5 years. I had worked for 17 years and was paid $3.60 an hour in the beginning. I was paid $11.05 when I left in 2003. Experience and good reference usually will get you a fair wage. Not great, but fair.

The life of the aide is a hard one. The ratio is 20 to 2 in the elder care unit, smaller if it is a specialty unit, like brain trauma unit, which usually has a 10 to 2 ratio. Those in the elder care unit with the 20 to 2 is counting if both aides show up. The facility tries to get a replacement and that happens 90% of the time. The other 10 is one aide doing all the work, the other aide from another floor will help with the lifting. 98% of the time the nurse will NOT help.

Depending on the shift, of how much time the aide has extra for the resident. (they are not called patient in a health care center, they live there so they are residents). The Day shift has no time for extra chitchat. They talk quickly as they do the care. The first 2 hours is a mad rush. Dressing, doing teeth and hair, the aide has the average time of 5 to 7 minutes to get each person dressed. Many of these centers have the noc shift aide help by getting up 3 to 6 residents. Meaning that there are many who are getting up and dressed at 5am. Not choice, it is an institution, and that is their policy. They will tell you, that the resident has rights, and choices, which they do. But sleeping in to 8 or later is not one of them. All residents are to up by 7am. When you have 20 to get up, you have to start early. Some one has to be first. And if the resident has the unfortunate pick of being dressed by the noc shift, then you are up before 6am, when they leave.

While family get upset with their family member being in urine (or any other disarray) when they arrived, they have to understand, it is in a rotation of every 2 hours. And it takes that much time from the time they leave your love one to coming back to them again. And 60% of the aides do not like their residents in urine either. And they are on the run to keep them from it. If you see an aide who is just standing around, they are doing their work. And you should expect them to be helping your love one.

Evening shift, is slightly more relaxed. They get up the ones who laid down for a nap, who are half dressed or more. There are activities, so they use that time to help in different areas. The rush for them is after dinner. Getting everyone ready for bed. And doing baths if the facilities don’t have a bath team. Which is separate from the regular aides.

Noc shift (10 to 6) is the most relaxed shift. They are busy, but not the mad rush of the other two shifts. They make rounds every 2 hours, toileting, clean up those who can’t, and also answering call bells from those who are mentally alert. Between 3 and 4 a.m. is the quietest time of the shift. Which the aide does their book work usually at that time. At 5 am is when thing get busy, as some residents wake up, and depending on how many people the shift is to get up for the day shift, will make a difference of how fast it becomes.

While your family member might be the picture of the sweet old lady or gentleman, not all residents are. So the aides are beaten, bit, spit at, pushed, scratched and punched at least once a day and depending on how many Alzheimer residents they have.

An aide has to fulfill 24 hours (at usually 2 a month) of in-services. Which is a class of information that is given by employer. They are paid for this, but it is done in their off time. There are yearly CPR classes, fire fighting classes, and how to deal with different types of residents.

5 years is the average work span for an aide. Some don’t make it that long. Rarely does one last more than 10 years, and very rarely do they do over 20. Burnout is a major factor. The aide not only deals with residents, some combative, but some nurses with a bad attitude, and a facility that is there for the money, even the no profit ones can be very money minded. Putting a lot of pressure on the aides.

What is the answer to this… of course like anything else more money. The Medicare and Medicaid pay only for so many hours per resident. 90% or more are Medicare or Medicaid residents. If in fact they had the aides they have now and also had a floating aide per 2 floors, it would help a great deal. If the place has a bath team besides the aides on the floor it helps. And even workers. Lot of aides work on their days off, because someone called in, and there wasn’t anyone else to get to come in. One year I worked 52 hours of overtime, in a 2 week span. Many times I worked 16 to 30 hours of overtime. And one time I worked 24 hours thru. When the flu hits the building it takes it total on everyone.
So like I said in the beginning, I would love to tell you, that your love one is getting top-notch care. But I will tell you that 80% of the aides are trying their best to