Realities of the Nursing Home Staffing Shortage

By: Jennifer Beach, LSW, MA, C-SWCM

Mr. Smith is 88 and lives in a long-term care setting also known as a nursing home. At 8 a.m., a breakfast tray was delivered to his room and left on his bedside table. Normally, he would be taken to the dining room for meals but due to several residents on his wing testing positive for COVID-19, all residents must now eat their meals in their rooms until the isolation period has ended.

Mr. Smith needed to use the bathroom before he even considered eating. He pressed his call button for assistance. Several minutes later, an aide came in to turn off the call light and let him know she would be back in a few minutes, as she was helping another resident. Unfortanlty, after 45 minutes, Mr. Smith’s wait resulted in his incontinence.

At 9 a.m., when the kitchen aide came to pick up his breakfast tray which was never uncovered or touched, the aide asked Mr. Smith why he didn’t eat breakfast. Tired, weak and uncomfortable, he stated he need to get to the bathroom. At 9: 20 a.m., he was finally taken to the bathroom and cleaned up.

Most nursing homes in the U.S. are facing staffing shortages. A survey released in June of 2022 by the American Health Care Association found that 98% of nursing home operators are having trouble hiring, 59% said they are losing money, and 73% said staffing issues could force them to close. The impact the staffing shortages are enormous, resulting in poor care, poor quality of life, increased infections, falls, ER visits and progression of chronic illnesses.  

There are many contributing factors, including:

  • COVID-19
  • Low wages
  • Challenging work 
  • Burnout & exhaustion of overworked staff 
  • Turnover of owners & management resulting in inconsistent policies, standards and practices
  • Lack of oversight, consistency, follow-through
  • The use of temp agencies  
  • Older nursing home care models 

The staffing shortages have affected not only long-term care (nursing homes) but all the other senior care communities and services, including assisted living, memory care, non-medical in-home care (care givers & care companions) and even hospice and palliative care. 

Some larger potential reform options include strengthening the regulatory process, improving information systems for quality monitoring, strengthening the caregiving workforce with training, education, increased wages, and opportunities for growth, providing consumers with more information, making consumer advocacy stronger, changing Medicare and Medicaid reimbursement. 

The question is what we can do for our loved ones receiving services, or in need of services:

  • Get involved.  Ask to meet the administrator, medical director, management, nurses. Ask them who to contact with their concerns. 
  • Be willing to develop relationships with the facility. Be prepared at every chance to introduce yourself, re-educate all new staff about your loved one’s preferences, personality and needs.
  • Take an interest in the staff and show them gratitude
  • Talk to a variety of staff regularly to get their input

Communication with the facilities is vital now, more than ever, for families. Never assume things are being done; always verify. In senior care services, there continues to be significant staffing challenges and the consistency of care has changed. Families can no longer assume that facilities are aware of your loved ones’ needs or concerns, and are responding and providing decent care and services.

If possible, families members should be visible, or consider bringing in support to ensure someone is asking questions, advocating concerns to the appropriate people and observing the entire care community. The individual and family are a vital part of the care team now, more than ever. 

Here is a short list of resources to go to for guidance and assistance:

Original Article: https://www.northeastohioboomer.com/blogs/realities-of-the-nursing-home-staffing-shortage/