It has been a harrowing week but one with a good outcome. My mother in law has moved from a pleasant single bed ensuite room in one aged care home to a two bed ward with linoleum floors in another.
Don’t think that I dislike my mother in law and that, in some burst of vengeance after 36 years of criticism, wished to ‘place’ her in a ‘lower class’ shared room; because that is not the case at all. In fact I could not be fonder of her; she has always been a great gal and still is, despite her increasing dementia and frailty.
No, my wife and I and my sister in law are pleased she is in a shared room because she will receive more supervision, have more company and will be taken out into the communal areas to join in more activities. And this is all good.
Much ado about the single room
Single rooms with an ensuite in aged care homes is a relatively new situation. Many care operators will tell you the demand has been driven by the kids who want ‘the best’ for mum or dad. More than a few people who work in the aged care sector say ensuite rooms are actually more a matter of reducing the guilt for the kids about the parents being ‘placed’ in the aged care home.
Let’s not get into a discussion about the kids. It should all be about mum (or dad) – they are individuals and they should be catered for as individuals. And for many the shared room is a much better outcome.
For instance if they have dementia, the interior décor may not be of great significance, whereas companionship and the movements of twice as many staff and visitors in and out of the room, may be a major contributing factor to their safety and wellbeing.
If they are frail and prone to falls, they have the other resident who can potentially raise an early alert.
Statistical thinking
Reading the quarterly statistics on staff hours in aged care homes from the benchmarking accounting firm StewartBrown, I find that total staff hours per resident vary from 1.5 hours to 3.0 hours per day. This includes administration and maintenance.
In other words, the average resident may get one hour a day of personal attention from the care home staff. This is not a lot, especially when so many other residents may be also uncommunicative with dementia.
For anyone with a cognitive impairment, isolation is the enemy. Please don’t rush in to the ensuite single room without considering the individual – who are they, do they need company, are they at risk of a fall, are they social themselves? These are the considerations that need to be attended to the most, not privacy and prestige.
Discussion3 Comments
Hi Chris.
We did an analysis a few years ago of the difference between two bed rooms and single bed rooms, with en suites, in terms of building area, and, more importantly from a staff and resident perspective, corridor length. As would be expected, the two bed wings had dramatically shorter corridors, meaning less distance for residents to travel to communal living areas, or less distance for staff to assist residents, meaning a better quality of life for residents. This is mitigated somewhat if a two bed module is adopted which provides a window adjacent to each bed, however spatial efficiencies can still be achieved, which is very important as residents become more frail and dependent, promoting independence and better care.
Hi Chris
It is an interesting view; however from a care givers perspective having more communal spaces to enable residents to gather if they wish during their waking hours ensures company and quality of life opportunities. Sharing bathroom facilities is not ideal and upsets residents and their families as the bathroom is not always available or left in a state that is ready for use for another’s more specific needs. Night time is another concern although most of us do not appreciate the of times people need to use the toilet overnight ( this increases as we age) the disturbance to other occupants in a shared room can be very disruptive to other occupants. Residents with cognitive impairment can often end up in someone else’s bed by mistake. We have 30 of our 70 rooms with shared ensuites between two and though this was ideal from both environmental and saving distance for staff we are now refurbishing to have individual facilities. This will create challenges for staffing hours to be adjusted to manage distance but will alleviate anxiety for residents and their families. In a user pays system we are now entering we have to meet the expectations of new residents.
Thanks for your thoughtful article. Overall shouldn’t we say that a ‘one size fits all’ strategy is just not helpful and, as you say, we should simply be focussed on meeting the needs of individuals.