Long Term Care

After reading Danielle's post about Reese's cups, I had to add to it. I went to an LTC facility today too, and one of the first stories I heard was also about Reese's cups. Apparently they are used in LTC, who knew? There is a pt at this LTC facility who just hardly eats and has a really poor appetite. When the RD asked her what she would eat, she told her Reese's. So the RD ordered some for her and has kept them on hand, but apparently the patient isn't eating them like she promised she would. Now the food service manager is having trouble with the employees eating all of the Reese's, and he wants to make sure he has them in case this pt ever says she'll eat them. I guess he has to keep a pretty close watch over them....
The LTC facility was pretty impressive. They had all sorts of activities and areas set up for the patients. There was an assisted living wing as well as a skilled nursing wing. The thing I was most impressed with was the fact that the nursing home had pets. There were cats and dogs roaming the halls and birds in the rooms. I was looking through a chart and I looked down and there was a dog sitting next to me. All of the animals were pretty overweight, since I guess a lot of the patients feed them the meals they don't want to eat, or give them treats all the time. I just thought it was great that they had these pets available for the pts.
We spent most of our time in the skilled nursing wing assessing pts that had been newly admitted. We mainly just went over their charts and then made sure that they weren't having any problems, or if they were on tube feeds, that they regimen was appropriate. We also talked to each patient. For some of the patients, they had pretty severe dementia, so it was really hard to communicate with them, making writing the assessment of them pretty hard. The RD says she just does the best she can with the chart notes for these patients, and always includes the fact that there are communication problems in any of her notes.