SEE – JUDGE – ACT at

Hillside Manor

Group 4Juilly Aranja

Susan ChyouNyla Malik

Sabrina SantanaTheology 3300

April 26th, 2005

What is a Nursing Home?

A nursing home is a facility that provides 24 hr a day 7 day a week personal care

to patients including rehabilitation services, nutritional monitoring,

activities, case management, laundry service and meals.

Who usually lives in a nursing home?

• The types of residents who usually live in a nursing home have certain types of skilled needs like Alzheimer's and cardiac management or they might just be having a short rehabilitative stay after a surgery or medical setback.

• Information source is onlythebestformyparents.com

See

See• Mission Statement• Hillside Nursing Home• Costs• Patients at the nursing home• Few staff members• Dining room not sufficient• Residents neglected• Survey• Interacting with the residents• Easter• March Birthday Party

Mission Statement

At Hillside Manor Skilled Nursing Facility you'll find around-the-clock caregiving tailored to your loved one's

individual needs and preferences, life enriching activities, delicious and nutritious meals all within a warm, comforting environment.

Volunteer Site: Hillside Manor182-15 Hillside Avenue

Jamaica Estates, NY 11432

Facility Facts:

• 400 bed nursing home.

• Medicare and Medicaid certified.

• Clinical Laboratory Services

• Diagnostic Radiology Services

• Baseline Services

What are Baseline Services?• Those services included in the daily rate. At the time of

admission, a written copy of the following basic services must be made available to all residents:

• the daily, weekly or monthly rate; • board, including therapeutic or modified diets, as prescribed by a

doctor; • lodging - a clean, healthful, sheltered environment, properly

outfitted; • dietary services; • 24-hour-per-day nursing care; • pharmacy services; • diagnostic services; • the use of all equipment, medical supplies and modalities used

in the care of nursing home residents, including but not limited to catheters, hypodermic syringes and needles, irrigation outfits, dressings and pads, etc.;

Baseline Services (continued)• fresh bed linen, as required, changed at least twice weekly,

including sufficient quantities of necessary bed linen or appropriate substitutes changed as often as required for incontinent residents;

• hospital gowns or pajamas as required by the clinical condition of the resident, unless the resident, family member or designated representative elects to furnish them, and laundry services for these and other launderable personal clothing items;

• general household medicine cabinet supplies, including but not limited nonprescription medications, materials for routine skin care, dental hygiene, care of hair, etc., except when specific items are medically indicated and prescribed for exceptional use for a specific resident;

• assistance and/or supervision, when required, with activities of daily living, including but not limited to toileting, bathing, feeding and assistance with getting from place to place;

• services, in the daily performance of their assigned duties, by members of the nursing home staff assigned to resident care;

Baseline Services (continued)• use of customarily stocked equipment, including but not limited to

crutches, walkers, wheelchairs or other supportive equipment, including training in their use when necessary, unless such items are prescribed by a doctor for regular and sole use by a specific resident;

• activities program, including but not limited to a planned schedule of recreational, motivational, social and other activities together with the necessary materials and supplies to make the resident’s life more meaningful;

• social services as needed; • physical therapy, occupational therapy, speech pathology

services, audiology services and dental services, on either a staff or fee-for-services basis, as prescribed by a doctor, administered by or under the direct supervision of a licensed and currently registered physical therapist, occupational therapist, speech pathologist, qualified audiologist or registered dentist.

How much does it cost to live at Hillside Manor?

• $270-$295 a day for only a room what about other expenses?

• Medicare pays 80% for the first 60 days• Long term Care Insurance

– Purchase at age 30 for a $300 a day maximum benefit for 3 years = $2203.50 annually life pay

– Same policy purchase at age 55 =$3576.38– To get long term care insurance must be in good

health

Patients at the nursing home

• Patients diagnosed with Alzheimer’s disease– Disease that affects the growth and development of

brain cells.

• Some patients are wheel chair dependent or had a difficult time moving about.

• Other patients required constant supervision or assistance.

• Many do not have family visiting them

Few staff members

• In dining hall, only one staff member– Member of the dietary staff

• Recreational director (Barbara) was only one at recreational center

• Hillside Manor has many volunteers because they cannot afford more staff members

Dining room not sufficient• Looked very uncomfortable, uninviting,

unwelcoming• Looked like elementary/junior high school

cafeteria• No windows• Big room with small tables• Tables had plastic on them with name

cards

Residents neglected• No one paying attention to residents• Coordinator explained there isn’t enough

financial funds to hire a full staff• In adjoining room, several staff members

gathered around a table– Reading magazine– Chatting– Members of recreation staff

• Supervisor saw volunteer hours were over– Insisted to leave and go home

Hillside Manor Survey Result

• Percent of Residents Who have pressure sores 14%-----County average14.22%

• Percent of Resident’s who lose control of bowels or bladder 78%----county average 45.80%

• Percent of Resident’s who spend most of their time in bed or in a chair 1%---county average 0.96%– Survey results from myziva.net

Pressure ulcers on hip

Photographs courtesy of Ila Swan

Pressure ulcers

Tailbone

Photographs courtesy of Ila Swan

Interacting with the residents• Elderly man

– looked very lost and worried– Been resident for a very long time– Lost the element of time

• Asked for time and day

• Elderly woman– Son coming on weekend to visit and have lunch with her– Had relatives that came to visit

• Residents were friendly most of the time• Needed someone to talk to or interact with

Interacting with the residents• Volunteer coordinator gave manicure sets and asked to

paint nails• Residents in silent daytime room

– Reading– Watching T.V.

• Met woman who wanted her nails done– Told her life’s story– Working in Gimbels for several years

• Spoke with many other residents• Volunteer coordinator joined

– Painted nails• Staff members showed care and respect for the

residents• Residents looked as if they were enjoying the activity

Easter

• Hillside Manor had a big Easter party for all the residents

• Volunteers helped with decorations– Helped prepare the Easter goodies and

other little things.

• The residents looked so happy at the party, the food and all the goodies they enjoyed.

• Many of the residents at this point came out of their shell and began to actually open up and have fun. We spoke and interacted with many of the residents.

March Birthday Party

• Last visit at Hillside Manor• Party for all residents that had a birthday in the month

of March• As a present, each resident received an individual

picture of themselves framed in a beautiful frame• A huge cake was lit and everyone sang “Happy

Birthday.” The residents looked so proud and special. • We felt proud of ourselves for bringing just a little bit

of joy in to their lives.

Judge

Negative Judgments

• Neglect in attending to residents

• Residents seemed lonely– Lack of activity

• Residents confined in Nursing Home

• Not enough funding

Neglect in attending to residents

• Residents were left at table waiting for food while recreation staff sat and chat (s)

• Insisted that Sabrina went home (s)• Staff preoccupied with themselves• Inattentive• Saw their job only as a job• Staff ignored responsibility and sensitivity

Residents seemed lonely (lack of activity)

• Residents sitting in rooms watching tv (s)

• Not many recreational activity provided for residents– Not due to lack of funds because piano

lessons were given once by a worker– May be lonely at certain times

Residents confined in Nursing Home

• Huge building with parking lot in back (s)

• No direct access to outdoor leisure

• Residents do not go out much during the summer– Confined to building even when there is nice

weather

Not enough funding

• Told there were many volunteers due to lack of funding (s)

• Residents have less recreational activities

• Staff has less to work with

Positive Judgments

• Residents are having a good time

• Person to person needs are attended to

• Residents are provided with Services

Residents are having a good time

• Residents get recreational activities (s)

• Residents get visits from volunteers (s)

• Parties are thrown for birthdays (s)

• Residents enjoy time spent in recreation

• Residents were happy from volunteers

Person to person needs are attended to

• Residents can go to the dayroom (s)• Volunteers visit (s)• Wednesdays and Fridays Bingo is played in

the recreation center (s)• Residents interact with each other• Volunteers speak and entertain with residents• Recreational games are played to get

residents involved

Residents are provided with services

• Weekly Church services (s)

• Medical attention is given (s)

• Volunteers can help with certain other activities

Christian Tradition• “In examining the human person we are taught to see

a person as an agent/subject. A moral agent with a certain degree of autonomy and self-determination empowered to act according to their own conscience with freedom and knowledge.”

• A resident in a nursing home loses this basic right. They are defined by their illness because their health is a factor in why they are at a nursing home. Any day to day activity as simple as eating is defined by their health or lack their of and the person truly loses their freedom in choosing what they might really like do to their incapability to eat solid food or incapability to break down gluten etc.

The Resident’s: A means to an end• Although we all need to work to make a living when we

work in a position in helping people it should not only be seen as a job but as a service. We are in the service of helping others feel both happy and well.

• When the staff members were sitting in a group together enjoying one another’s company and reading magazines; meanwhile the resident’s are alone in the dining room with only a volunteer and dietary member this job how are you being good to your neighbor. The staff is satisfying only their own needs of conversation at the time and ignoring the needs of the people they are supposed to be there for.

• If you can ignore people when you are in a job to help people then is it just a job to you.

ACT

Suggested Improvements

• More programs

• Motivate staff members

• Make residents join in activities

• Improve current facilities

• Fundraising

More programs should be implemented

• Residents do not have programs and activities to keep themselves occupied

• Add more programs to get residents to become more active and lively

• Different programs may be added– Special events– More activities

Motivate staff members

• Staff members are not motivated to work• Sitting in lounge while residents were all

alone unattended to• Need to encourage staff members to do

their job and motivate them to interact with residents– Perhaps establish weekly meetings to

discuss problems and/or progress

Make residents join in activities

• Need to get residents to be more active

• Residents are sitting in their rooms in front of the television or sleeping all day– Hesitant to get involved

• Persuade residents to join in current activities or new ones– Perhaps rewards or prizes

Improve current facilities

• Current facilities are rather plain and uninviting

• Furniture is not all that it should be

• Dining room needs to be reconstructed– Add windows– Bigger tables– More settings

Fundraising

• Local church events– Catholic school carnivals

• Dinner dances for staff and resident family members– Raffles

• Competitions– Bake offs/Cook offs– Bake sales etc.