Thursday, November 4, 2010
Barrington Court review
My husband has been a Barrington Court for almost 10 months and it has certainly been a rollercoaster ride in a non-amusement park. People's problems with Alzheimer's and other types of dementia are pretty severe here and so the staff is highly stressed.
The caregiver/resident ratio is problematic, in the early mornings especially when all the residents have to me gotten up, dressed and fed. Then in the middle of the day and in the early evening, there is very little to do, other than housekeeping, and more housekeeping is certainly warranted. Almost all of the caregivers and med-techs are kind to the residents and do a very difficult job well---some are a little lax. The primary problems are; lack of a real management team, providing good direction; lack of a good set of systems of medication management; and a true understanding of the varieties of needs of all of the individuals with this dreadful disease by the corporation along with a willingness of the corporation, Emeritus, to accommodate those varying needs. There is a lot of turnover in management, much less so among caregivers. We are about to get another new nurse. I wish her well. She is only the second one during my husband's stay, but there are long stretches where there is no nurse at all, nor any administrator only people who come in sporadically from other branches for a day or two a week. It is truly bad!
Falls are common, as people cannot be watched at all times, so there is always a choice of being highly medicated and therefore non-mobile or mobile, with an overall better quality of life, but at a greater fall risk. Being on blood thinners complicates the falls, for many. The corporation does not allow half side-rails on the beds, a choice more suitably made by medical personnel.
Trips to the emergency rooms as a result of falls are particularly awful for these people, as they don't understand what is going on.
The physical layout of the building is generally good, there is a lot of light, but it is 'cleanliness challenged' due to an almost 100% of incontinence among the residents. I certainly am hesitant to sit on any of the upholstered furniture. Also the chair arms, seats or floor are often spotted or sticky with food residue. The dining chairs are very heavy and unwieldy; some sort of wheels would help both residents and caregivers. Of course then the residents might be more likely to get up and wander away during a meal, a common occurrence, or possibly fall. There must be a good chair somewhere for these people. I suspect the laundry facilities are not up to the greater needs of this population and there is a need for more consistent use of bibs and napkins, and more of them. Plate rims might be helpful for people who are still able to feed themselves to some degree, and casseroles with small bits of food already in bite sized pieces. Spaghetti noodles are waaaay too challenging, tortellini and macaroni noodles are a better choice. Full stalks of asparagus are difficult; as is anything that needs to be cut into smaller bits by the resident, most of them are not up to it. Bread and rolls should be served with the soup and not the meal, as they are often way too dry, having no spread to moisten them.
Only a small fraction of the resident population is able to participate in 'activities' such as crafts, most are severely impaired, but music is always a good choice; most people listen and enjoy. Human interaction is the best for all, but it is very hard to carry on a conversation with a person who is unable to interact, except through eye contact and touch.
Care there is also quite expensive as are all Alzheimer's care choices --- Unbelievably expensive, 1 1/2 times our yearly income. Luckily we have some long-term care insurance; otherwise we would both likely be dead from the stress of dealing with this awful, awful disease.
But starting today there is a new administrator---next week---the new nurse---maybe it will improve---who knows. read more
