Monday, 24 July 2017

Never Overlook Hygiene in a Care Facility

Never Overlook Hygiene in a Care Facility
Soumya Nair

The phrase “respect your elders” is ingrained in most minds. This phrase, however, has been lost its sheen over the years and a recent visit to ‘Aseervatham’ endorses it. ‘Aseervatham’ claims to be a care home for elders and it was sort of a first time experience for me of what all things can go wrong in a care home.  You cannot compare it with a pigsty as pigsty gets cleaned everyday.  It was a shock to me that children have no qualms in admitting their parents to such care homes overlooking the unhygienic conditions. The inmates, who need help to do even the most mundane of daily tasks, are often disregarded and left in unsanitary conditions for long periods of time. Who bothers? Remember, cleanliness is an attitude.

Life threatening conditions can develop when care homes do not keep up with their sanitation needs. When germs and bacteria spread, vulnerable elders can be affected in a negative way. This is especially important because these infirm elders are most likely to have medical conditions that, along with poor hygiene, can wreck havoc on their health.

It is of utmost importance that care facilities maintain  high standards of cleanliness and personal hygiene for all their residents. Poor hygiene in a care facility can often be a cause of serious health complications for the patients living there. This can be especially dangerous for patients suffering with debilitating diseases such as cancer – where even something as simple as a cold can lead to massive medical complications. Moreover, the bacteria and germs all over the place can also affect the senior citizens under care, compromising their immunity, which will exasperate their medical complication. The increasing age of elder patients further inhibits their body’s ability to counter such diseases.

Most infections prevalent among care home residents are attributed to poor hygienic conditions. Moreover, nurses and other staff members neglect providing optimal care such as changing bandages, diapers, etc. on time, which is something that can also lead to medical emergencies. Lack of hygiene and sanitation can cause them to suffer preventable diseases that could be avoided by the nursing home that practices proper hygiene. In many cases, the reason why a nursing home might not be putting the appropriate attention to hygiene is because of a lack of staff or resources to keep up with this important daily task.

The care home’s staff often fails to recognize the importance of hygiene given their lack of training and basic awareness. Many times, due to understaffing, employees may come under excess workload and may simply forget to carry out their necessary duties to ensure they provide professional care when it comes giving patients a bath, serving them food, etc. For example, not washing hands can lead to numerous problems such as infection and other types of problems that sensitive patient will not be able to bear. Training is therefore a big must when it comes to successfully running a nursing home.

Not only can care facilities disregard the patients’ needs for cleanliness and basic personal hygiene, but the care facility itself may also be lacking cleanliness. The physical environment is also an area of concern for care homes where proper hygiene is important. It is possible that toilets, showers, bathtubs, bathroom floors, and rooms are not properly sanitized. This can lead to the propagation of germs which could ultimately cause disease and infections.

The kitchen area, where food is prepared and served to care home residents, is also a place where it is vital to have the utmost cleanliness possible. The kitchen staff needs to be properly dressed for the job and take all the necessary measures to handle food hygienically. Also, the dining area needs to be sanitized, including the tables, chairs, buffet tables, floors, and every other area that is touched or handled by the residents.

Most aged care facilities have insufficient number of caring staff thereby compromising the caring standards. Lack of basic maintenance and janitors could be the cause of poor cleanliness in caring facilities. Healthy patient-nurse ratio must be maintained otherwise, the caring staff feels exhausted and they overlook hygiene. When there are many urgent situations going on at once, a nurse might forget to wash her hands between treating different patients. This is how germs can easily spread throughout the facility, affecting everybody living there.

Management has the responsibility to train staff to take proper hygiene measures to ensure the health of the residents. Care homes with the right amount of trained staff are less likely to have issues with poor hygiene. Cleanliness is of vital importance in this type of facility and cannot be overlooked. Relatives who wish to admit their parents should be observant and seek hygiene protocols of the facility and can also personally inspect the facility. In many western countries, care facilities can be liable for improper care of their patients due to lack of hygiene, which is not the case with our country.

(Soumya Nair is from Bangalore, India and is a practicing Social Gerontologist at advantAGE seniors.  She is the co-founder of this 17 year old company. She has been a social gerontologist since 2002, which was her inspiration for writing this well researched article. She loved being with her elderly patients, and she wrote this article highlighting the importance of hygiene in care facilities as she noticed the appalling conditions in few existing care homes. She insists that the ‘consumer’ of long-term care definitely deserves more personal hygiene and a clean environment.  Soumya hopes country’s long-term care needs overhauling changes so that elders would receive the best treatment that is necessary and so much deserved to elders.)

Friday, 21 July 2017

                                                                                     Soumya Nair

MOVING an elderly parent from home into a residential facility can be one of the most difficult things a family goes through. We can share our advice for taking the pain out of the process. Deciding to make the move to a care home can be a difficult decision and families usually play a vital role in helping their elderly relative pick the right one. The move from one’s own home into a care home can be upsetting, even traumatic, for both the elderly relative and their family. Relatives can feel guilty about assigning the day-to-day care of their loved one into the hands of others, and anxious about the level of care and support they will be receiving. Though it is painful, our options are limited as the parent may need more professional care or you simply cannot extend care for various reasons.

Here's our list of the 10 most important things to consider to make the transition as easy as possible.

Choosing a home in a hurry is never a good idea but often there can be pressure to find somewhere quickly, especially if a hospital is keen to discharge a patient. So last minute scurrying should be avoided. Because you know that after discharge or the health condition warrants a care home and he/she cannot be taken back to home.

As mentioned in my earlier article, introducing the care facilities, there are four basic types of care possible and facilities and services differ, again the  prices will vary for each. If there is a strong possibility that your loved one may need greater levels of care in the future, it can be wise to choose a home where this extended care is possible, rather than having to move.

A discussion with the parent is necessary to convince them about the need for a more professional care or the need to get admitted in a care facility. Most elders fear depending on someone and they dread loosing their comforts. That’s why we say a little bit forceful convincing is norm, saying we have few options left. If your parent is not well enough for this conversation, or is unable to communicate, discuss it with all your close relatives who know your parent well. Find out what the most important things to them are about the care home and what they would like the staff to know about them to help them care for them in the best way.

Think about the distances you, other family members and friends may need to travel and how easy it is to get there, including for those who don’t have their own transport. But this is again secondary because you are not going to be a regular visitor.  More than that, let’s know what kind of access do you need?
Many homes are in adapted buildings and even if they say they can offer a ground floor room, there can be steps into the lounge or dining room. Again it all depends on the availability.


Some homes are very large and this can have its advantages, such as better entertainment facilities, including having a minibus and obviously, a wider social circle. If your parent is quiet and shy, however, they may be better off in a much smaller home. It all depends on the personality of the person and again the Bathroom arrangements can be very personal, especially access to one’s own toilet. Do they want access to a garden? Do they have specific dietary requirements? Many older people are inseparable from their cats and dogs and want to take them with them. If not, they want the presence of Dogs (therapy dogs). Knowing the preferences is important beforehand. Ask your loved one what's important to them.

Importantly, if your loved one will be a “self funder”, how much can they afford? Costs are escalating and eldercare is no more cheap. Prepare to shell out more for a decent stay and again cost vary depending upon what type of care you need. Fees will vary considerably between homes, and this can mean that families may want (or feel they need) to top up the fees from their own resources to secure the quality of care and environment desired. After determining what benefits and entitlements are available, the rest of the fees will need to come out of investments, savings or against the future sale of a home.

Crisis is an event that is perceived as overwhelming and is something not ‘normal occurance’. A situation becomes a crisis when the client believes that they have exhausted their resources and coping abilities. What is perceived as a crisis by one person, may not be perceived as a crisis by someone else. It  can be a fall, infection, high temp, unconsciosness, occurance of a bed sore etc,. Some other social and financial aspects also can be turned into a crisis. It is important to know the protocols followed by the care facility to manage the crisis situations. You must evalaute the prepardness of the facility to seize the situation under control.

It is of utmost importance that care facilities maintain a high standard of cleanliness and personal hygiene for all their residents. The problem of poor nursing home hygiene is a serious one and a matter of real concern. The elders usually suffer from an array of conditions related to their advanced age and if they are allowed to live under conditions of poor hygiene, they are more likely to catch germs that can cause diseases that are then spread to other nursing home residents. In a nursing facility setting, the residents’ immune systems are usually more compromised than young people and they are more likely to become sick from having poor hygiene. Their immune systems are not properly equipped to handle an onslaught of germs that can arise out of having poor hygiene. Watch over these highly important factors which can compromise the health of your loved one.

An ageing population requires nurses to be fully equipped to care for their specialist needs. Health professionals’ values, beliefs and attitudes towards older people affect how they view and approach those in their care, which affect the quality of care that older people experience. Older people have special needs and dealing with an elderly person is no easy deal. Lot of attributes needed for a nurse or a para-medical to extend care to seniors. One should always be in a positive fame of mind while dealing with elders. Knowledge about the diseases, syndromes and its management should be there. Ideally the elderly should be nursed by staff trained in geriatric care who would understand the aging process and how it affects health, disease and rehabilitation. Finding out about the training and skill level of a potential caregiver is important.

References of people who utilized the services earlier are a good way of knowing the competency of the establishment. Try getting some testimonies from the people who can guide you to take a final call.

Wednesday, 19 July 2017

Senior Living Facilities for Your Parents. 
                                                                                           Soumya Nair

The dramatic growth and development of the senior housing business and the recent trend of few corporates flurried into this sector without much homework made me think of introducing the senior living options.

Elders need love, care and attention just as a child requires. But, due to the modern day living conditions, it becomes difficult for the family members to make adjustments amongst themselves. Also, caring for the elderly is a bit grueling and tricky. Depending upon their physical status, most infirm elders need professional help or nursing care round the clock. Fortunately, there are elder care homes that provide care and protection to senior citizens who are vulnerable and need help. Some of the important senior care services are:

Care at home:
Not all elders are interested in moving out of their houses in old age. They prefer to stay in the familiar environment of home and love staying among the memories they built there over the years. Also, moving to new unfamiliar setting is something they dread, due to poor health or financial restrictions. For such people care at home is the best and we call it ‘as ageing in place’. Lot of home care agencies operate in almost all cities and have programs to provide health care assistance to those elderly people who need assistance at home. But the crux of the matter is how qualified and experienced are these caregivers. You need to evaluate the competency and practices of these agencies before you hire someone.

Senior citizen homes:
Old age homes bring an aversion to many people because in earlier days, it is synonym of destitute home. Over the past couple of years, this misconception changed after the existence of well-run senior citizen homes. Today many people opt on their own volition to spend their twilight years in a senior citizens home.  With the growing age, people are not able to do all of their daily chores, especially those related to outdoors, on their own. They need help in buying groceries or for carrying out the banking procedures. Public dealings of various kinds require agility of mind which fades away with age. Thus, residences with assisted living facility help elder citizen live on their own and also provide assistance wherever required.

Retirement living:
There comes a stage in life when the people feel like giving complete time to themselves and to leave the hustle and bustle of city life. They do not feel like staying bonded or burdened with family responsibilities. The period of life after work is the time when they can pursue what they actually loved but could not do so due to family obligations. So, for such group of people, there is an option of independent living too. Separate apartments, fully furnished in all possible ways, with home assistants are designed to suit the lifestyle of elderly people and on a meager rent, senior citizens can choose to stay there for as much time as desired. So many such facilities are available in all our cities. Here the promoters are not providing any care.

Care Home:
Care homes provide with intensive nursing care to patients who need care and maintenance.  This is an ideal option for highly dependent patients. Few of the patients warrant more professional care and a team work which cannot be provided in other settings. For example, People suffering from acute dementia, Alzheimer's disease or critical ailments like cancer and stroke require 24 by 7 support. Thus, these care homes are good option for keeping highly dependent elderly people.

            What sort of setting is suitable depends on the patient’s condition and the care involved as well as on many other factors. Foremost is the patient’s condition. Then comes family dynamics. Lastly, the financial aspects. Many chronic conditions and thereby interventions, cannot be managed in a home setting. If opt for a home setting as a convenience, then it can result in in inferior care. Resulting in more complications which could have been avoidable. Mostly patient’s with multiple chronicity need close monitoring and care and is mostly possible in a care home. Before selecting the care setting it is important to approach a social gerontology expert for a counseling session where he can guide you through the various care settings.

Monday, 10 July 2017



Several years into social gerontology practice in Bangalore, I helped adult children of my generation manage the myriad challenges of caring for aged parents. These long years I had the privileges of meeting women and men across the country about their struggles and successes. To fortify my assumptions, I did a study among the young people and the results were pointing to one fact, ‘when it comes to aged care, majority are clueless and ill-prepared’.

That now strikes me as a glaring omission, especially when this generation goes in detail to the extent of triviality when it comes to many other things. As parents get older, attempts to hold on to their independence is natural but can be at odds with even ‘suggestion’ from the adult child. Elderly parents want to be cared about, but fear being cared for. Striking a balance without hurting the sentiments is not an easy task.

So what are aging parents looking for in relationships with their adult children? While exploring the issue, the participants in a senior citizens group recently expressed strong desire to maintain autonomy and connection in relation with their adult children, mostly leading to ambivalence because both parties never discussed the expectations.

A daughter vehemently narrates her helplessness, ‘ I told my father not to go out for walks and errands because of his Parkinson’s and slight dementia, you assume that he’ll listen. It’s nothing but caution. But his response will be to go out. It’s away of holding on to a life that seems to be slipping away’. This is typical of many adult children.

But her story is also an eye-opener of a trend almost certain to escalate in the future: a growing population of the aged, particularly those over 80’s, a large proportion of whom are kept expensively alive by medical advances but who are often in bad shape. Perhaps a majority of those now moving into old age will also do so without adequate financial support from pensions or personal savings. At some point of time, we all sort of accept that a daughter or son will start becoming a parent to his or her parent. Are you prepared for this role reversal?

Caring for an ageing parent is a wonderful way to say ‘Thank You’ to Mom and Dad.