On July 22, 2013, Melissa Riehl, Certified Occupational Therapist Assistant and Director of Rehab at Good Samaritan Society – Loveland Village, spent 24 hours as a resident. At the insistence of her Area Rehab Director – Ty Keeter – she took on the challenge in her spare time to gain a first-hand perspective of what life is like for the individuals she treats on daily basis. After communicating to her co-workers at the Loveland, CO skilled nursing facility about her educational pursuit, Melissa created a patient profile for herself.
Melissa chose to be non-weight bearing on her left leg, unable to walk and bound to a wheelchair, used an elevated leg rest, and ate a Level 3 diet, which is mechanically altered for easier digestion and to provide added nutritional benefits. Melissa sought to fully immerse herself in the life of a patient. She restricted her movements and relied on the full support of the care staff. During those 24-hours she kept a journal detailing her experience.
1:30 PM: Started 24-hour resident experience. Very nervous, anxious, excited!
Thoughts: I will miss my family and evening routine, but can do this for 24-hours! Dinner sounds good; something to look forward to. I think the staff has the same feelings and are already asking me if I am watching them. I will be a patient with L side NWB and be in a w/c with elevating leg rest for L side. Diet Level 3 with nectar thick liquids.
3:00 – 4:45 PM: Activities and Thoughts: Tired of wheelchair (w/c) already. Have to go to the bathroom, but am embarrassed to interrupt activity because I don’t want everyone to know that I have to use the restroom. I am also in the middle of the group, so it seems like I should wait. So far staff is friendly and helpful!
5:00 PM: Dinner—Chicken Caesar salad, looked gross, but tasted like I thought it should. The salad was pureed so it looked like spinach dip. Baked beans and Wisconsin cheese soup. Nectar tea – yuck!
My table mates were interesting with very little conversation. It was gross to sit next to resident who blew her nose into a tissue, then rolled it up, put into her mouth, then spit it out! Found myself turning away from her while I was eating. She did talk some, but kept asking the same questions. The dining room was also noisy.
7:30 PM: At this point, I really have to think about not helping myself. I wait for the call light to get help with all transfers and a couple of times I have started to just get up, but no cheating.
7:50 PM: Ready for bed in PJ’s. You can understand why residents might sleep a lot! Everyone goes to room after supper, nothing much to do that is social. All is quiet and w/c is not getting any better.
8:20 PM: 20 minutes are a LIFETIME! My roommate snores. Thought I was doing a good job occupying myself, guess not.
8:45-9:30PM: Told CNA I was getting bored. She asked me if I wanted to sit in the TV room. I sat on couch for 45 minutes, but not really private. Lots of activity, not able to relax and just watch TV.
At bedtime, the CNA set up toothbrush and warm wash cloth. It is hard to accept help, but kind of nice to get help. Tried to let CNA help with socks and shoes, I still think I did most of the work.
10:00 PM: Roommate snores, bed squeaks and hard, hallway noise. I am waiting for shift change, and then might sleep, but I have cookies to snack on! Tried nectar water with lemon through a straw, yuck!
10:40 PM: Lights out
11:20 PM: Time for vital signs, BP was low and nurse thinks I need to drink more. Thought I could hear a vacuum running?
1:40 AM: CNA comes in to turn roommate
3:30 AM: CNA comes in to turn roommate and help me to bathroom
6:45 AM: Time for vital signs, BP still low, drink more! Just so they know I am not drinking any more nectar water! Did not sleep well. I am tired. 6 ½ more hours to go. The room is warm, but the nurse offered to turn fan on.
Getting ready for breakfast now. The CNA combed my hair, ouch! I never comb my hair as it is naturally curly.
7:30 AM: Breakfast, yuck! Cream of Wheat – had to add salt – scrambled eggs, nectar-thick cranberry juice, ok. Nectar coffee, smelled good, tasted bad! Nectar water, yuck! Sat in dining room for one hour, same table mates as last night with a little more conversation. I could not have bacon on Level 3 diet, bummer!!!
8:30 AM: Time for physical therapy and occupational therapy. The Occupational Therapist got me a new cushion and Physical Therapist did a balance assessment. Lots of questions and do this, do that!
9:20 AM: Activities- movin’ and groovin’, fun and energetic!
10:50 AM: Devotions. Nice group of people from a local church. Met a resident who was born in my hometown.
11:45 AM: Lunch in 800 dining room. Had regular diet and liquids. This dining room much quieter and more conversation. Finally not hungry or thirsty after a meal.
1:30 PM: Time to check out. The door to room 701-1 was shut. I asked the CNA to open MY door. Was this Acceptance or was I being sad to FINALLY be done?
As I am into my last hour of my patient experience, I can’t say that I am sorry for the residents. They have a lot to look forward to. However, I can say that this is not like home and it would be tough to get used to living in LTC as a resident. I made friends and deepened relationships with residents and staff. The residents here accepted me. That felt good and helped. I spent A LOT of time sitting and waiting, minutes sometimes seemed like hours. I am a very social person and was lacking contact from others at times. All of the staff was thorough and kind.
Do I think I got the most out of my experience? well, I could have tried harder with the diet textures and I did wheel myself to activities vs. sitting and waiting for CNA’s to help? (It’s hard work to get to and from activities and you have to be motivated) I tried two different w/c cushions, both had little comfort quality. The w/c leg rest was hard and the back of my leg was getting sore. I am thrilled and excited to share my experience with others…. once I get some sleep.
Think About These Experiences:
1. Staff coming from behind and rushing me to the bathroom. Pushing me very quickly down the hall, only telling me what we are doing once we were going towards room. Staff did not introduce self.
2. Staff coming from behind and putting pills (actually applesauce) in my mouth. Did not introduce self and stated “Time for pills.” It was hard to swallow. The staff member then began to massage throat, while saying “swallow.” This made it very difficult to swallow.
A lot of staff members have asked me if I liked my experience. Like is the wrong word. It was a good experience. I only had one disability, I have been thinking a lot about not being able to speak up for myself. That would be hard.
I can empathize with those who are manipulative to get needs met. It did not take me long to try to get stuff from the staff, due to being hungry, tired, or thirsty. I cheated on the diet textures, but what if I couldn’t? I did not see myself from my nose down in a mirror for 24 hours. Again, Level 3 diet does not include bacon. SAD!!!
Did it kill me? NO! Am I a better person, probably? Will I think about the way I treat residents, YES!! I have already changed my approach in small ways to make myself a better caregiver. I am the only therapist who has done this experience at our building, but many of the CNA’s and therapists have said that they would love the chance. So I say, if you would love the chance then ask if it is a possibility!
PLEASE ask me what I have done to change the way I treat our clients. Daily, I use my experience to make myself a better caregiver.