Preventing Falls Out of Bed: Safer Than Bed Rails

There is an increased risk of falling among the frail patient population of nursing homes. The risk even exists for patients while they are in bed and roll off onto the floor.

Bed rails are the first thing a lay family member may suggest; however, a leading cause of strangulation of patients in nursing homes is bed rails. It may be counterintuitive that a bed rail, customarily thought of as protecting patients from falling out of bed, can cause more harm than good.

Yet, it’s a fact that a poorly designed bed rail is a deadly instrument when a patient’s body is caught between the bed rail and the mattress. This configuration constricts the patient’s chest thereby causing death by strangulation.

There are safer and more efficient ways of minimizing the risk of a patient falling out of bed, such as lowering the mattress or placing the mattress on the floor.

Why Is Mom Losing Weight? The Impact of Medication on Nutrition

An important yet overlooked consideration in the care of the elderly is the impact of medication on nutrition.

It is not uncommon for nursing home residents to be taking 9 or more medications. It is also not uncommon for physicians and nurses caring for nursing home patients to fail to consider the impact that medications may have on their patient’s appetite and their ability to absorb nutrients.

The remedy is simple and simply overlooked.

There is a dietary guide (Drug-Nutrient Resource) available in nursing homes and used by dietitians to assist them in evaluating unplanned weight loss.

The guide outlines the nutritional side effects of medications including appetite changes, weight changes, edema, altered taste, thirst, dry mouth, the risk of dental problems, GI distress, nausea/vomiting, diarrhea, constipation, blood pressure changes, drowsiness/weakness, etc.

However, in nursing homes, where communication among disciplines is poor; physicians, nurses and dietitians don’t customarily discuss common interactions between medications and nutrition.

Informed advocates and families may be the only source of information pertaining to this risk.
 

Will Monetary Incentives Improve the Quality Care in Nursing Homes?

The Centers for Medicare and Medicaid Services (CMS) announced a pilot program for nursing homes based upon incentive payments according to a report by Todd Neal, a staff writer for MedPage Today.

Participation in the pilot program will be offered to nursing homes in four states (Arizona, Mississippi, New York and Washington).

Nursing homes that show the greatest improvement in the quality of their care will be awarded monetary payments.

Quality will be measured by improvement in staffing, avoidable hospitalizations, resident outcomes and survey deficiencies.

It is gratifying that quality of care is finding its way back into fashion now that we have a new administration in Washington.
 

When there is JOY in Nursing

Every time I interview a nurse in one of my nursing home neglect and abuse cases, I find myself sympathizing with the position in which they find themselves.

Nurses know that their facilities are short staffed and they also know that their patients are not receiving needed care. Many of them are ashamed at working in such an environment and have lost the spark that once made their work enjoyable.

The essence of caregiving has always been supportive and nurturing. Even though nursing is hard work, and many times thankless, nurses continue to provide care because of the heartfelt joy that caregiving provides them.

However, what takes the joy out of nursing home caregiving is the knowledge that the nursing staff is not receiving the support they need from management to properly care for their patients.

In many respects, nurses as well as patients are the victims of corporate indifference and greed.

When nursing home owners limit the number of nursing staff at their facilities, the remaining nurses must struggle, and many times fail, to provide adequate care.

When patients suffer so do their nurses.