May is Elder Law month, and we have tried to take part in a few special events this month to promote public awareness of issues about which those who practice elder law are especially concerned. Last week, Keystone Elder Law’s Care Coordinator, Karen Kaslow RN, wrote a column in which she took a closer look at those issues. Ironically, after reading Karen’s column, I noticed that this week is also National Nurses Week.
Karen has written before about why, as a Registered Nurse, she is especially interested in Elder Law.Because theAmerican Nurses Association says this is a good week to pay tribute to nurses, and because Karen is too modest to do so herself, it might be a good time to share a couple examples of how an independent nurse can be an advocate in the development of a long-term care plan for an older person. Some nurses do this as independent Geriatric Care Managers (GCM), others work for hospice organizations, and our organization is fortunate and unique as a law firm to have a Karen as a Registered Nurse as a part of our team.
Most of us are familiar with the role of a nurse to provide hands-on care as an assistant for a physician when we visit the doctor’s office or need hospitalization. But nurses can do more than that. A Registered Nurse is a highly trained medical expert who understands technical terms related to a medical diagnosis, treatment options, and how to read a medical chart to monitor progress.
The ability of an RN to decipher the medical components of the health care system, and to have oversight and understanding of care options for long-term care can be very important for a family trying to advocate for an older person.In addition to hands-on caregiving, there are some things nurses can do better than lawyers. I can quickly think of an example from our officewithin the past week which I will share.
One of our client’s family members initially approached us to understand options for asset preservation in relation to their 90-year-old father’s treatment in a skilled nursing facility, to which he had needed to move due to his increasing frailty. His wife remained living somewhat independently with some assistance with her daily activities, although her care needs were also increasing. Their retirement community recommended that she also should move into nursing care. The family resisted because they preferred a higher level of independence offered outside the nursing facility, and sought options for treating their mother in a way that would maximize her independence safely.
Karen was able to use her nursing background to articulate why and how a care plan could be put together to treat the mother with supplemental support services in her present environment, while allowing the retirement community to feel safe about the care plan. The retirement community and family were able to feel like a win-win situation had been created. Even though it is ElderLlaw month, attorneys like myself lack the technical knowledge related to themedical aspects of the care plan to be an effective advocate.
According to the American Nurses Association (ANA),National Nurses Week begins each year on May 6th and ends on May 12th, which coincides with the May 12th birthday of Florence Nightingale, a nurse who became famous as “The Lady with the Lamp” while caring for wounded soldiers during the Crimean War.
In 1859 in her Notes on Nursing: What It Is, and What It Is Not, Nightingale wrote: “To be in charge is certainly not only to carry out the proper measures yourself but to see that everyone else does so too; to see that no one either willfully or ignorantly thwarts or prevents such measures. It is neither to do everything yourself nor to appoint a number of people to each duty, but to ensure that each does that duty to which he is appointed.” That is quite similar to what a care coordinating nurse does today within the long-term care system.
Occasionally, someone will ask me what makes one nursing home better than another. The Center for Medicare & Medicaid Services has a credible ratings system on their website. But my answer is that it’s all about the attitude and level of attentiveness of those providing the care. Most of the care provided on a hands-on basis within any long-term care environment is provided by certified nursing assistants (CNA). A typical training program for a CNA requires a high school diploma or GED equivalency and several weeks of focused study. According to the Bureau of Labor Statistics, an hourly wage for a CNA is between $12-$15 per hour. Anyone who has been to a personal care home or skilled nursing facility recently knows that a good CNA is a modern day Florence Nightingale.
Next week, May 11-17, is also National Nursing Home Week. A couple of local nursing homes shared their plans for the week with us. Shippensburg Health Care Center residents and staff will enjoy a picnic, various theme days (anyone interested in returning to the 1960’s?), and games. If you aren’t doing anything on Friday, May 16th, stop by from 1-3pm for their 1950’s CAR SHOW, which is open to the public. Claremont Nursing and Rehabilitation Center will kick off the week with a strawberry social for residents, families, and staff, followed by games and numerous musical events throughout the week including a bluegrass jam, Dennis Heckard as Elvis, the Eagle-View Choir and the South Middleton Jazz Club. They will wrap up on Friday with a picnic, rocker Tom Schultz, and the Mennonite Youth Choir. Forest Park Health Center has a Hawaiian theme planned, with several musicians, a smoothie bar and Rita’s Ice, a coconut dessert baking contest, games, crazy dress days, chair massages, and a picnic finale. All are ready to celebrate!
On behalf of those of us who serve in the elder care industry, or have family members who are living within it, let’s give a shout-out this week to all the staff who coordinate the care and provide comfort to our aging population!
By Dave Nesbit, Attorney