Thursday, July 17, 2014

Visiting, Volunteering Advocates for Nursing Home, Long-Term Care Residents

Some loved ones and volunteers think that visiting nursing home residents is a purely social call. They want to remind residents that they are still loved and decrease their loneliness. They want to check on how loved ones are doing in very general ways so they can report back to relatives, church members, colleagues, coordinators, and others about a simple level of patient progress to soften their worries. What they often don’t do, in addition to socializing, is see themselves as healthcare advocates who should be seriously evaluating the quality of residents’ lives in terms of appearance, conversation, environment, interactions with others, and unmet needs. What’s really important is that visitors and volunteers have a clear understanding of their roles as active patient advocates.
People will have personal approaches as to how they can most effectively serve as patient advocates with visits more than social. I write about my true observations of visits by a caregiver named Lonnetta in my book. She always impressed me with the seriousness of how she viewed her role as visitor and caregiver whenever she dropped by to see her sister. While I would not recommend Lonnetta’s approach for everyone, it worked for her. She was laser-focused on the fact that, above all, she was there as an advocate for improving the quality of life of Sister, her loved one.

(Excerpt from Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes)

“Lonnetta’s eyes surveyed Sister’s condition. Was her hair combed? Were her clothes and linen clean? Did she appear overly medicated, hungry, depressed? Did she have any mysterious bruises? Lonnetta was evaluating Sister’s care at the nursing home. Sister’s mind was fading with dementia. It was hard for her to explain what went on when Lonnetta wasn't there. But, if Lonnetta wasn’t satisfied with her sister’s care, she made her voice heard until the problem was corrected. She wasn’t the kind of woman people wanted to agitate, particularly if she had already tried to work with them in a calm manner. With a black-belt tongue that could give air a whipping and make dinner trays tremble, Lonnetta didn’t care what people thought when she finally caused a scene. All she cared about was Sister.

Employees at the nursing home knew that Lonnetta did an evaluation during her visits, which were scheduled at different times. That way, they never could be sure about the time she would arrive. Conscious efforts were made by employees to be in compliance, even though they didn’t always succeed. Lonnetta checked Sister’s personal belongings located in her closet. Several caregivers had complained about patients’ clothes being missing and a few gifts that had disappeared for unexplained reasons. One of my patient’s portable oxygen tanks that had been provided by hospice turned up missing. I checked everywhere, but no one knew what happened to it. Another patient had an overcoat missing. He couldn’t take a car trip with his family until he could borrow someone else’s coat. Lonnetta took Sister's clothes home and washed them, so she could keep track of them better.

Lonnetta was diligent about taking care of her sister.  Her method wasn’t perfect, but it was better than no method at all. For the most part, it seemed to work, but there were still times when she had to raise the roof with a complaint about Sister’s care. Sister was one of the lucky residents who had a persistent advocate with a personal interest in her welfare and the quality of life to which she was entitled.”

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.


  1. AnonymousJuly 17, 2014

    God knew exactly what He was doing when Sister and Lonnetta became members of the same family. Sister was given an incredible gift and Lonnetta too was blessed in her own very special way .

    My concern is for those seniors and some who are not so senior, that are currently living in in long term care facilities, especially those who do not have family members of the financial resources for a paid Lonnetta of their very own.

    The number of people in these circumstances are on the rise, as we are well aware. and will only continue to grow exponentially as the decade whirl by at lightening speed. What is going to happen to all of these individuals? Who is going to attend to their needs? Who is going to be their watchdog? We're a society that kowtows to youth and of course, money. That is a given. We can be absolutely certain of that fact. Are the old, sick, comprised and poor going to be left to just decay? Jettisoned into space? I fear for all those that do not have a personal Lonnetta complete with her black belted tongue.

  2. "Are the old, sick, comprised and poor going to be left to just decay?" I am much more optimistic about the future of the older adult population. Over 70 million baby boomers are quickly filling the ranks of older adults, the largest population in the near future. They will have the vote and will certainly be improving the status of their own population. Many baby boomers now who are taking care of elderly loved ones are seeing and experiencing many of the negatives you mention and are highly motivated to make changes. In fact, improvements are already taking place, but, in this early stage, there is still a lot more to be done, especially in the area of policy changes. In the meantime, we can all continue to be patient advocates in whatever ways we can.

  3. AnonymousJuly 19, 2014

    My wife has completed a three country study of nurse aides in long term care. She found that in all three countries in for profit nursing homes, the staffs run short handed on help and short on supplies. This is driven by owners greed, pure and simple. The nurse aides are NOT to blame, management and ownership are, even when nurse aides are paid a middle class living wage and are more educated, as in Canada, they still are forced to run short handed. This translates into bad care for residents because the staff has no time to establish relationships with them.

    1. AnonymousJuly 22, 2014

      I agree with this and have witnessed it for many years.

  4. I have spoken to nurse assistants in two states. Many said they were overworked and under appreciated. There was often a staff shortage, but they were still expected to complete more work in the same amount of time. The morale was not good. I also felt more ongoing staff inservices were needed due to staff turnover.