For many reasons -- from difficult working conditions to low wages, the inevitable result of inadequate Medicaid reimbursements -- most nursing homes are understaffed these days. And there's doesn't seem to be much hope of improvement in sight.

If you're involved with a nursing home in any way, how can you help change the situation? Perhaps it would help in the long run to contact your legislators and make this issue a priority in your future voting decisions.

But for now, you can help prevent the loss of more employees, from nurses to CNAs, by being patient and understanding, and encouraging residents and family members to be, too.

To give you some insight into exactly what nursing-home caregivers are facing each and every day, here is a brilliant, anonymous essay posted on Facebook by Cindy Shepard, and reproduced here with her permission. Please give these words careful consideration before complaining to or about anyone involved in direct care-giving; I know I will.

Imagine this.......

You walk onto the floor and you have 25 patients. 25 humans you are responsible for, 25 humans you will have to know everything about. When they eat, if they eat, how much they pee, what color it is, when their last bowel movement was, what color, shape, and consistency it was, what their labs look like, their cognitive status, if they have wounds, what meds are due, what are their vitals.

You get to the floor and get report on these 25 people. All not well, some with orders that need completing. One has bladder scans every 6 hours and has to be cathed if they are over a certain limit; one is on an IV infusion every 6 hours and frequent monitoring. 5 ARE aggressive and need to be kept away from others. At least one had a fall requiring neuro checks every hour; one is dying with no family at their side.

Then imagine being short staffed.

Then imagine the family calling wanting a check up on their family members and complaining when you can’t get on the phone right now. Imagine that you are in the middle of cleaning up a patient, alone, when the family calls and you can't stop to take the call but will call them as soon as you're done. Imagine your manager reprimanding you for not taking the call as the family is angry and complaining.

Then imagine 6 of those 25 calling out for pain meds every 2 hours. Some of it is pain seeking, some of it is actual pain from the cancer or other causes. Then the one that is dying needs pain meds for comfort every hour and just wants someone at their bedside.

Oh, and don't forget the high fall risk patients that you have circled around your station so you can keep an eye on them.

Then imagine doing everything you can for all these humans you are responsible for and getting cursed out, talked down to, criticized for not being “fast enough,” asked “where were you?” and told “I’ve been on the light for 20 minutes?!”

NOW imagine also not having a enough CNA’s - the backbone of the skilled nursing system! So now, with all of that, you’re also TRYING to help respond to call lights, bathroom calls, changing patients, turning patients every 2 hours, getting water, getting snacks, emptying catheters, measuring intake and output, bathing, and more changing. Imagine a patient getting upset because you didn't bring them coffee and snacks quick enough and giving meds for comfort to your dying patient.

And now… you have a new admit coming to the floor with a wound vac, needing pain meds that you don't have. Another human, another life to take care of.

Now imagine administration always complaining you never do enough, dressings aren’t changed on time; tubing isn’t labeled correctly; rooms are messy. Charting isn’t done, write ups are threatened.

This is Nursing.

This is Why we are burned out.

This is Why we are short staffed.

This is Why Nurses and CNA’s are leaving the profession.

Too often, nursing homes are thought of as a despised final stop before death. Which is really sad, because they can be centers of heartwarming fellowship and welcome spiritual growth for those who need a certain level of care -- more care than can be summoned in assisted living, for instance, and more than can be found in "aging in place" schemes, some of which can lead to extreme isolation.

Giving readers a glimpse of this truth was one of my main reasons for writing the novel The Song of Sadie Sparrow; here's a short passage illustrating the affectionate fellowship that can be found in such living arrangements. It's my prayer that the best of these homes will still be available by the time my generation needs them -- and yours.

 
“It’s too bad you didn’t go to Bible study,” Sadie said to her tablemates after the teacher had left.

“He limps,” said Gladys. “Did you know that? Why does he limp?”

“I don’t know,” Sadie said, “and frankly I hadn’t noticed. What difference does it make?”

“I already know all about the Bible,” Catherine said. “I just wish someone would study Mrs. Eddy’s writings with me.”

“How about that practitioner of yours?” Gladys was looking down her substantial nose at Catherine, not really very interested in ultimate truth herself, but apparently sure that Catherine’s idea of it was wrong. “You’re always sending her money. How come she never comes to see you if she’s so great?”

Catherine blinked hard and stared at her coffee.

“It was very interesting,” Sadie said. “He went over the history of the Bible—it’s just fascinating.”

“How many were there, dear?” Eva asked.

“Just me. I guess I have my own personal tutor, unless someone else decides to take the plunge.”

“Oh oh,” Gladys teased. “Looks like Sadie’s got herself a young man.”

They all laughed gaily. Laughter was becoming a habit for Sadie, it seemed, and it made her very happy.

From The Song of Sadie Sparrow, pages 89-90.

For some reason, during a recent sleepless night, I couldn't stop thinking about all the dementia "sufferers" I've known as a 21-year nursing-home volunteer. I put "sufferers" in quotes, because many of them have been perfectly peaceful, enjoying the moment while contentedly forgetting more and more of their pasts, until they're left with nothing but memories of childhood.

And indeed these dear people become like little children--often, delightful little children. It's really precious to have a sweet little old lady tell you excitedly that mamma would be there soon to pick her up, or to have a kind old man inform you that he will be singing in the children's choir at church on Sunday.  

My mind raced happily on, tumbling over dozens of such smile-worthy flashbacks. And then it occurred to me: These people had lost most of their memories to dementia. But what are we in this life, if not the sum total of our memories? Does this mean that dementia patients have lost their very identities? 

But of course, that wouldn't be the case for those who are Christian, would it? Because Christians do have identities--indestructible, eternal identities in Christ. What's more, like little children, these dementia patients have nothing to bring to the salvation table, no thoughts of being good people deserving of anything, least of all heaven. 

There was that thought again: like little children. And what did Jesus say in Matthew 18? "He called a little child to him, and placed the child among them. And he said: 'Truly I tell you, unless you change and become like little children, you will never enter the kingdom of heaven.'"

So perhaps Christian dementia patients are most blessed of all--doing nothing but trusting and enjoying the moment in this life, and then heading into eternity with hearts that are uniquely pleasing to the Lord. And perhaps that means they will be counted among Jesus' most beloved forevermore. 

I've thought for a long time that our pitying view of sweet and happy dementia patients is all wrong. Maybe this explains it.

It bears repeating: a powerful message from Chris Carrillo, delivered during the Care-age of Brookfield Christian Music Hour on April 29, 2018.

There are two kinds of Christian in this world.
 
There are those who believe, and those who believe in.
 
There are those who acknowledge, and those who trust.
 
There are those who believe there was, and those who believe there is.
 
There are hearers and doers. Pretenders and true.
 
Which are you?
 
 And where will you spend forever?
 
If you want to know that you are heaven-bound, please listen to and consider Chris's compelling call to action.
 
It’s just fourteen minutes, but its impact may be eternal. 

Would you like to hear more from Chris? Visit our Messages from Chris Carrillo page!

If you are reading this via email, please click on the title above to be taken to the message. ​

The Letter Exchange
 
It goes without saying, that 2020 was a taxing year for many of us. It's especially hard when you can't see your family as often as you'd like to. 
 
I'm a home-schooling mum (of the pictured children), and my parents live right across the road from Salem nursing home. 
 
One day during the 2021 Easter break, I was sitting on the front veranda at my parent's place, with my mum and sister when I noticed a couple turn up at Salem for a visit, but of course they had to be turned away, because we were under restrictions at that point. Seeing this, and also having being inspired by a friend in the USA, who for 20 years has been visiting the folk in the nursing home her mother used to live in, got me thinking. Visiting might be difficult, but we could write letters to the residents, which is one of the next best things to visiting!
 
So, I got on the Salem website and made contact, to see if this was a possibility. I was impressed at how quickly we found two very enthusiastic emails in response, saying they would love to be a part of this.
 
My girls in particular love writing letters to friends who are too far away to visit, so I shared this idea with them, and they were very keen to join in. We live just outside Toowoomba, but regularly come in for work, and visiting my parents, so we aimed to drop an envelope of letters to the residents in the mail box there, every Friday. Then Jo (the activities coordinator at Salem) works with the residents to write a combined reply, and drops it in my parent's mail box.
 
We have loved the letter exchange, sharing stories, getting to learn about life at Salem and hopefully we are bringing cheer to our new friends there, who may be feeling isolated at times. We're thankful for this chance to get to know you the family at Salem!
 
From the Cameron Family