Annie Oster of Scituate has seen enough of nursing home treatment of her sister to know conditions need to improve, and unless they do, she and the rest of us run the risk of less than adequate care in our twilight years.
Oster’s unrehearsed plea for lawmakers to enact legislation and for regulators to take action came at the conclusion of testimony from certified nurse assistants, or CNAs, and other nursing home caregivers at a forum held by the Raise the Bar on Resident Care coalition at Sts. Rose and Clement Church Tuesday evening.
The coalition is made up of SEIU (Service Employees International Union) 1199 Rhode Island, Sista Fire, Fuerza Laboral, Interfaith Coalition to Reduce Poverty, the Women’s Fund of Rhode Island and the Rhode Island Organizing Project.
The coalition defines the issue as “the nursing home staffing crisis.” It notes that Rhode Island is the only New England state without a staffing standard in nursing homes. It sets forth three steps to solving the crisis: A minimum staffing standard of 4.1 hours of direct care per resident per day; a raise in wages for caregivers and to recruit more staff; and to provide training opportunities for caregivers to match the increased complexity of resident care.
Indeed, Raise the Bar had the ear of Warwick legislators. Warwick senators in attendance included Senate Majority Leader Michael McCaffrey, Erin Lynch Prata and Mark McKenney. Warwick Reps. Evan Shanley, David Bennett and Camille Vella-Wilkinson also squeezed into the basement church room, as did Ward 2 Councilman Jeremy Rix.
Adanjesus Marin, union organizer and Raise the Bar coordinator, said while the stories of conditions are important, action is needed – and without pressing for change, it won’t happen.
Citing the goals of the organization, Marin said, “None of this is going to happen because we heard these stories.” He urged people to spread the word of falls, lack of hygiene and insufficient staffing to family members and to contact legislators.
“We’ve got to make sure they don’t forget we need to make change,” he said.
Oster gave first-hand accounts of her visits to see her sister in a nursing home.
“The state of Rhode Island is failing miserably in caring for our elderly,” she said. She talked of the odor of the nursing home and how she confronted caregivers to do something about it, only to be told they were shorthanded and would get around to changing patients.
Oster didn’t stop there.
“You all have cameras,” she said. She said she told staff she would be posting photos to Facebook and in some cases doing live Facebook in an effort to affect change.
“It’s a crying shame we don’t care about our elderly anymore,” she said.
Stefania Silvestri of Warwick, a nurse, told of how she had found her aunt in tears due of the pain of being left on a toilet in a nursing home. She noted the home had two to three staff to serve 31 residents and questioned how personnel could be expected to perform a variety of tasks – from combing hair and assisting with brushing teeth to washing and dressing patients, no less feeding them. In addition, she said people are living longer and that advances in technology and treatment require new skills that caretakers need to learn, placing further demands on the system.
A report prepared by Raise the Bar and made available to those in attendance found that numerous studies conclude that nursing homes have serious quality of care deficiencies that can be traced to a decrease in staffing.
“Simply put, when caregivers have too many residents, the quality of resident care suffers and more residents die,” it reads.
It goes on to say, “Rhode Island’s lack of staffing standards force caregivers to rush through the very basics of care tasks like feeding, bathing and dressing residents. Nursing staff do not have adequate time for answering questions or providing the type of social interaction with residents that is essential for maintaining quality of life.”
The report finds caretakers are leaving because of short staffing and that nursing homes can’t recruit and retain caregivers because of low pay. The report puts median hourly CNA wages in the state at $14.42 as compared to $15.54 in Massachusetts and $16.18 in Connecticut. Also it projects that 23.1 percent of the state’s population will be 65 years old or older by 2030. Currently it is at 17.2 percent.
A CNA and mother of three, Ashley Leveilee told of the frustration of not having the time to interact with patients. She said on occasions where there are insufficient caregivers to fill the upcoming shift, she would be “locked in” to another shift. That would mean sacrificing time with her family and only furthering the feeling she was not relating with residents.
Following the forum, Leveilee said she took a pay cut to leave a nursing home and work for an assisted care facility where she has more time to interact with residents. Yet she says there are still staffing pressures.
Amanda Sawyer described “extremely stressful” conditions where she worked third shift and was in charge of 24 beds. She said the home management disconnected bed alarms that alert staff when a resident has left a bed that made for quieter conditions yet required her to be constantly on the lookout.
“A fall can end somebody’s life,” she said. Additionally, she said she was forced to choose what policy to break in order to have enough time to serve each of her patients. In place of showers, she said she only had the time to “focus on hands, faces and butts,” and when another caretaker is absent “it means someone is not walking to dinner.”
“I had to quit my job, I couldn’t take it anymore,” she said.