Short Staffed

One of the Certified Nursing Assistants (CNA) at Mom’s Memory Care comes over, sits next to me, and starts talking.  “I want you to know that we are still short staffed.  This morning I had to give your mother a shower and she had a fit.  She wanted a bath, but I didn’t have time to do that for her and she was so mad.  She was very nasty to me, but I had no choice.”  I was horrified to hear this.  Mom had never willingly taken  a shower in her life.  She was raised on baths and as an adult took a nightly soak.  She must have been shaken badly by the shower.

“Please call me if you are ever overwhelmed and I will come and supervise her bath. I never want my mother to have a shower.”

“I am sorry.  I will call you.  But, you and the other families need to tell the administration that we need more staff to take proper care of your loved ones.  We tell them but they don’t listen to us.  Two of us can’t take good care of 22 old people with all sorts of needs- we are supposed to keep residents clean and dressed, dispense medications, and serve and clean up meals. We are so busy we can’t cater to individuals with risk of falling, wandering, feeding or urinary issues, etc.  The families need to get together like a PTA or something and talk to administration as a group.  You are paying so much money for such sparse care, and we are so overwhelmed.  And the people who are supposed to be organizing activities here are not doing anything.  They just sit in their offices, and the residents are so bored. Please don’t tell anyone I told you this, or I might lose my job.”

I could tell she was distressed and she offered good advice. I told her, “Thank you for telling me this.  We have noticed that you are short staffed. My sister has talked to the administrators many times.  They keep telling her they are working on it.  I will take your suggestion of contacting other families and see what we can do.”  

So, my sister, Allison, and I organized a zoom call with three other ladies who have parents in Memory Care.  It was a relief for all of us to share our mutual concerns about lack of care and activities, and to tell each other our stories about asking the director about more staff.  We brainstormed ways we could support the staff: we would offer to volunteer to help run activities, help implement name tags to encourage more communication, and speak up during family zoom meetings to encourage others to speak freely.  Then, Allison and I met with the director to state our concerns and offer to volunteer. She thanked us and said she would investigate.  Three months later we have seen no changes and when pressed, she tells us she is working on it. 

It’s frustrating for families paying extraordinary high fees of $8,000 a month and up, to see very few people on the floor working. There used to be two Certified Nursing Assistants for every shift, but now there only seems to be one.  One caregiver for 11-22 people with dementia and other disabilities leaves little time for one on one care or attention. But, this seems to be the norm now. When I visit my mom she never has her hearing aids on, and though we repeatedly ask them to give her tylenol in the capsule form we have provided, they continue to give her enormous generic pills that she can’t swallow. We find these large pills left in places all over her room.  Over the last few months I have noticed that the staff is dwindling even more. When I ask workers about the shortages, they usually look stricken, and make offhand remarks about others being around somewhere else. 

The facility director announced on our monthly family zoom call last month that she has been working in the kitchen because they have no chef. The director seemed overwhelmed, so I didn’t make any comments. Then the receptionist quit, so the activity directors have been taking shifts at the main desk, as well as leading activities. In some ways the residents have been enjoying this change because they are kept together more in the lobby so that the directors can handle both duties at the same time. It is interesting for the residents to see each other and be out of their rooms more, even though there isn’t much interaction.

Ultimately, this failure to fulfill expectations of care for our loved ones lies with the owners of these for-profit facilities. Apparently the director of the facility has little power, and ours has minimal experience at running a facility. The director of our facility is a Registered Nurse.

Most of the care for residents is done by the CNAs. The average Certified Nursing Assistant salary is around $16.00 per hour. Low pay tends to make workers feel less enthusiastic about their jobs, so it makes sense that if they feel overwhelmed with the workload and receive low pay, they will not want to stay long. It’s outrageous that corporations can charge such high fees to families, and then pay their essential workers so little.

Like Mom’s caregiver told me, it is up to the families to hold the administration accountable. If the director can’t meet expectations, we need to talk to corporate officials. And we must do this as a group to have any real power.  But, families are reluctant to rock the boat, and may be worried about moving their loved one to a new facility. So, it is not an easy fix.  But, we have to speak up when we witness mediocre care because our loved ones health and happiness are at stake. And they depend on us to look out for them.