This is about person-centered care. To repeat: We cannot provide person-centered care without the personnel! CNAs, do the administrators of the LTC homes you work get this? Do they really comprehend what your work day is like? Do they appreciate how much time it takes for you just to assist with ADLs, when a person is showing symptoms of dementia? Do the state regulators? Or are they ‘cognitively impaired’ when it comes to understanding life on a memory care unit. As my uncle used to say when his dementia advanced: “Donna, I hear you but I don’t understand what you’re saying.” Administrators may see things, but do they really understand? A Resident Acuity Assessment tool might help them understand.
A Resident Acuity Assessment tool is a descriptive list of the symptoms of dementia. This list isn’t comprehensive; it can’t be. We’ve all heard this: “If you’ve seen one case of dementia, you’ve seen…one case of dementia.” Everyone is different; each care partner may observe a new symptom. This list isn’t meant to be discouraging for those who, thanks to the support they have, may not show severe symptoms. The better care a person has, the more a person diagnosed with dementia can retain functionality, with fewer and less severe behavioral symptoms. But insofar as residents of LTC homes do experience serious consequences of dementia, those who regulate care homes need to appreciate their needs and regulate accordingly with regard to staffing.
Here is what I think a Resident Acuity Assessment tool might look like.* If you are a CNA working in a memory-care community, or a home care aide, or someone caring for a family member at home, these symptoms of dementia are familiar to you. I’m not sure they’re as familiar as they need to be to those who set long-term care standards. If they were, we would have better staffing.
Part Three, the next chapter in my mission to lobby for better aide-to-resident staffing ratios, will mention other factors that need to be taken into account by administrators and regulators.
RESIDENT ACUITY ASSESSMENT
Key: N = Never = 0 S = Sometimes = 1 F = Frequently = 2 A = Always = 3
** under 60: low to moderate acuity; 61 to 100: moderate to high acuity; over 100: very high acuity.
RESIDENT _________________________ Date Assessed _______ by ________________
*There may already be such a tool, a better one, that I haven’t found. (The tests used to diagnose dementia serve a different purpose.)