Admission into a long-term care facility is a difficult decision for many individuals and their families. The move to long-term care is often thought of as a permanent move; however this is not the case for many residents!
Often times, residents are admitted following a significant illness that left them requiring increased care. With time, these residents recover to a point where they no longer need the level of care provided in our nursing homes. Helping residents accept this is no simple task – it takes a very dedicated staff that is committed to resident-centred care.
Resident-centred care is more than caring for the resident’s physical needs; it involves advocating, empowering and respecting the resident’s right to be involved in decision making about their care and lives.
As a resident care manager at Eastern Health’s Agnes Pratt Nursing Home, I am proud to share that our staff do more than talk about resident-centred care, they deliver! Lucy’s (a name chosen to respect the privacy of the resident) story is proof!
58 year-old Lucy had a massive brain injury that left her with several severe cognitive deficits. An interdisciplinary assessment in hospital determined that she was not capable of making safe and appropriate decisions related to her own health, finances and shelter. As such, she was admitted as a resident of the Agnes Pratt Nursing Home.
As health care professionals, we recognized that cognitive impairments caused by trauma can sometimes improve over time. However, given the length of time Lucy was in hospital and although we hoped, many of us wondered if she would improve to the point that she would be able to live independently again.
Lucy was able to complete her own activities of daily living such as showering, dressing, toileting, eating, etc. She had no major problems getting around and was quick on her feet. Soon after her admission, she was helping staff and residents on her unit. She helped set the tables; assisted some residents with their meals; and often got drinks or other items for others. She was quite happy to help out whichever way she could.
Over time, nursing staff began to notice that Lucy was becoming bored, which was impacting her mood. It became evident that she needed to participate in more meaningful activities on a daily basis. She had worked hard all her life, raised several children and liked being busy. Using an inter-disciplinary approach, our staff worked with Lucy and her family to develop a care plan that would challenge her and help reach her full potential.
Gradually, we saw that Lucy’s cognitive abilities were showing signs of improvement. She remembered employees’ and residents’ names and was functioning very well at the home. She was able to recall memories from her long- and short-term past accurately and verbalize that she felt improvement in her thinking.
Lucy and her family were confident that she had come a long way, but the question remained, had she come far enough?
To help Lucy realize her goal of returning to the community, Social Worker Cathy Connors coordinated development of a plan to reassess her ability to make her own decisions. An assessment by Kelly Fry, the occupational therapist, revealed that Lucy had improved in many areas of cognition. On the day Lucy was assessed by the psychiatrist, our staff anxiously awaited the results.
When the results came in, Lucy was deemed as having the capacity to make her own decisions, which meant she could leave long-term care and return home!
With that, we worked with Lucy to develop a discharge plan that would help her safely return to independent living.
On her last day at the Agnes Pratt Nursing Home, the nursing and recreation staff arranged a farewell party that was attended by several employees on their day off!
Lucy comes to visit from time to time and says that she is very happy to be home again!
Lucy’s story demonstrates the positive outcomes of resident-centred care when delivered by all team members. I am proud of our staff at Agnes Pratt Nursing Home and pleased to be part of a caring and devoted team. ■
This story was written by Shawna Delaney-Martin, resident care manager, Agnes Pratt Nursing Home in St. John’s, NL.