Several of the key goals of assisted living facilities (ALFs) are to promote aging in place and to maximize function and quality of life for residents. To assure the timely identification of acute clinical problems and to optimally manage physical and behavioral problems, nursing care in assisted living facilities and nursing oversight is critical.
While every state has different nursing staff regulations, every state requires “sufficient staffing” to meet resident’s “scheduled and unscheduled” needs on a 24-hour basis. On-site licensed nursing may be present 24/7, or it may be periodic or on-call basis.
However, according to the 2007 “Scope and Standards of Assisted Living Nursing Practice for Registered Nurses,” figures show that residents of assisted living facilities with a full-time RN are not as likely to transfer to a nursing home as those from ALFs with less RN staffing.
Why is Registered Nursing Oversight Critical?
The responsibilities of registered nursing staff that provide nursing care in assisted living facilities are many and varied. They often include admission assessment and periodic review, evaluation of residents who show significant physical, mental or behavioral changes, review medication regiment, supervise staff and provide education to residents and staff.
To Budgie Amparo, Senior Vice President – Quality and Risk Management for Emeritus Senior Living, now a part of Brookdale, the most important part of an RN’s role in an assisted living facility is to observe changes in condition and articulate that information. Nurses are present at all Emeritus assisted living facilities; Amparo explains, but they are not health care providers (physicians), nor are they allowed to serve as clinicians and make health care decisions.
“The value of a trained and skilled nurse is to observe changes and communicate this information to the doctor or family so it can considered for further evaluation,” says Ampara, an RN with a master’s degree in nursing. “In other words, the main job of assisted living facility nursing staff is to assist.”
How Nurses Make a Difference
One of the most common scenarios with nursing care in assisted living facilities, explains Amparo, evolves like this. Mom is usually alert, but all of a sudden gets really confused. A trained clinician should be able to pick up on this sort of unusual behavior or symptoms in a timely manner and request immediate physician involvement. The problem could be as simple as a urinary tract infection.
As a result of astute nursing observation, the assisted living facility resident is back to normal in a few days. “If it hadn’t been picked up, the infection could have exacerbated or if medications were inappropriately prescribed, a wrong move could cause lots of problems for a fragile senior,” says Amparo.
Nurses Provide Education and Quality of Life Assistance
On-site nursing care at assisted living facilities is a significant part of the health and wellness equation for residents. To maximize quality of life in consideration of preexisting, medical complications, it is important for a licensed nurse to properly manage residents’ care.
“Nurses help educate residents about what they can expect to experience with a disease or condition, so when things go awry the resident can report strange symptoms,” says Amparo. “Nurses also help residents take responsibility, for example, by helping them learn how to enhance their mobility and strength to avoid falls.”
Utilizing registered nurses, along with a cadre of other professional and licensed care staff, is key to Emeritus’ mission as well as that of many other assisted living facilities as they strive to help residents enjoy a life of dignity and independence. “Families really appreciate that we assist, educate and respect our residents,” says Amparo. “Families, staff and residents are in a collaboration to help them live longer and enjoy a high quality of life.”
Wellness and Health Care Questions
Here are some questions you should ask when you are looking for independent or assisted living:
- Is there a nurse? Responsibilities and hours?
- Regularly scheduled visits by a nurse or other health care provider?
- Is there a care plan? Who oversees this plan?
- What if residents or families do not agree with the plan? What if a resident is confused?
- What health services are available in the facility: Physical therapy? Podiatrist?
- Who gives medications? How is the medication system managed?
Written by senior care writer Leslee Jaquette.