November 07, 2016
At a recent conference hosted by National Aging Services Risk Management (NASRM), one of my fellow presenters made the following statement during her presentation: “Comfortable people don’t fall.”
The speaker, Tena Alonzo, caused the audience to pause at this extremely simple yet compelling idea. We spend time and money on bed and chair alarms, chairs, perimeter mattresses, physical and occupational therapies, and a host of other interventions that often have minimal impact in reducing falls in a long-term care setting.
What if we, instead, designed our orientation programs so that each and every employee of the facility became responsible for the comfort of residents—would outcomes improve?
If the licensed nurse communicated with the CNAs about which residents were prescribed diuretics, would we be able to intercede before a resident attempts to transfer independently to a bathroom? If the CNAs actually had quality time with the licensed nurses in order to exchange information about who might be constipated, would we have less abdominal discomfort?
If more department heads came to the dining room during meals, would there be enough hands on deck to ensure that no one left the dining room hungry or thirsty? If we asked CNAs, residents, and family members about who would benefit from having a nap program in the afternoon, would residents eat better at dinner and perhaps fall less? If we paid as much attention to recreational therapy as we do to physical, occupational, and speech therapy, would residents be more engaged, less bored, have more meaning in their lives and fall less often?
Comfort comes in many forms. It crosses disciplines. It is the cumulative sum of a resident’s daily experiences and activities. Becoming and remaining attuned to a resident’s comfort requires care and thought. Often, there is no device that can be provided, only the efforts of a team that makes comfort a priority all day, every day.
Ilene Warner-Maron, PhD, RN-BC, CWCN, CALA, NHA, FCPP, has been practicing nursing for 33 years, specializing in the care of geriatric patients. She is an Assistant Professor at Philadelphia College of Osteopathic Medicine in the department of Interdisciplinary Health Services. Dr. Warner-Maron is the president of the Institute for Continuing Education and Research, providing educational programs for individuals seeking licensure in nursing home administration.