Environmental Considerations

There’s no place like home,” except, perhaps, if you are a long-term care (LTC) resident. While some facilities are more home-like than others, the setting is still highly institutionalized and the comforts residents were familiar with at home are often lacking. Of course, the reason these patients are living in a dependent care setting is because they have sustained an injury or illness that has rendered them unable to care for themselves in their own home. While it is our job as healthcare providers to take care of these individuals until they are able to return to their own homes or reach the end of life, we should always remain mindful that the facility has become their home for the time that they are there. Nurturing that sense of home in the facility can lead to a greater sense of well-being for our residents, and small steps can sometimes go a long way toward accomplishing this objective.

In this month’s issue of Annals of Long-Term Care: Clinical Care and Aging (ALTC), Angela Champion, BSN, RN, discusses anorexia of aging, which is a common problem among older adults. The issue is complex, having physiologic, pathologic, sociologic, and psychologic components, all of which must be considered. However, the food presentation in LTC facilities is a small step that can make a difference. People often joke about hospital food, and food in LTC settings is often no different. Residents may receive their meals cold and mashed together, leading to an unappetizing prospect and a feeling of having no control. They may miss the ability to select what they eat, when they eat it, and how they eat it. LTC facilities can work on making meals more palatable by ensuring they are served at the correct temperature, seasoned (since taste and smell diminish with age), and that it looks attractive. They may also consider offering residents a more family-style dining experience, which may lead to a greater sense of community and make the resident’s time at the facility feel more home like. While addressing the quality of food that LTC residents receive won’t resolve the issue of anorexia of aging, it can certainly lead to a more positive experience in the nursing home.

In the article, “Healthcare-Associated Infections and Environmental Disinfection in Nursing Homes”, J. Hudson Garrett Jr., PhD, MSN, MPH, discusses the importance of proper environmental disinfection in LTC settings. He notes that protocols must be established for all surfaces, including noncritical, semicritical, and critical items to ensure residents’ exposure to harmful environmental pathogens such as Clostridium difficile and Escherichia coli are limited. He notes that each department and staff member has a responsibility in the cleaning and disinfection process and that proper education on the correct use of disinfectants is imperative to ensure the safety of residents and staff. While devising disinfection protocols, especially for noncritical surfaces such as tables and floors, staff should try to schedule these tasks when they are likely to be least disruptive to residents. For example, mealtimes would not be a good time to disinfect floors or other noncritical surfaces as it is distracting and the smells can detract from the meal, which can be more detrimental to the patient’s health than the small chance that he or she may pick up a pathogen from the dining hall. Since residents do not have the ability to control the cleaning schedule, as they could at home, taking care of such tasks when the impact on the resident is minimized is ideal.

This month, we are excited to announce that ALTC is making its way to the iPad and Android-based tablet devices via a free, dedicated app. The ALTC app delivers the practical clinical content of the print edition, along with video content and in-text Web links that can be browsed simultaneously, making for a more comprehensive experience. If you are interested in accessing ALTC on your tablet, simply search Apple’s App Store or the Android Marketplace for “Annals of Long-Term Care” and download the app. If you do, let us know what you think of it by emailing our editorial director, Christina Loguidice, at cloguidice@hmpcommunications.com.

Thank you for reading!