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Easing the Trauma of Placement

Clint Maun, CSP

Change and adjustment is difficult for many individuals. The situation magnifies when there is a major change or adjustment-taking place. I know of no greater adjustment or change than the placement process into a healthcare facility. This is a very difficult time for the resident, family or guardian and in many cases also for the facility.

This difficult time is largely due to the mind set that exists by healthcare customers. That mind set occurs because of the major changes in the health or mental condition along with a sense of frustration or failure. Frustration or failure is often felt as "we can’t handle our lives anymore" in our normal environment.

There have been issues (in many cases traumatic) that have caused the customer to involve themselves with healthcare facilities. The customer themselves are scared, and at the same time deeply concerned for themselves or their loved ones. This worry is due to many factors from perceived public image of our facilities, to cost. In addition, there is a strong worry that it is certainly not always the case, how we handle our thoughts and attitudes toward this difficult time can make all the difference in the world for our new residents and their families.

There are many things that must be done prior to an admission, which are required by law. Most facilities become very good at processing the paperwork necessary to admit a resident. This processing or "inquiry handling" is an important step in setting the tone for easing the placement trauma.

However, and even more important is how we handle ourselves when there is pre-admission contact. The way we answer the phone, give tours, answers questions, and send messages of confidence, hope and peace of mind become extremely important in our effort to develop a customer satisfaction process with the individual resident and their family.

In many healthcare facilities today, the medical needs for the resident encourage us to be more concerned with the families during the placement time. The family has become smarter shoppers and they have become more aware of consumer issues. They certainly are beginning to understand the cost and competitive forces associated in healthcare. In fact, in assisted living facilities, the residents are rapidly becoming better shoppers themselves.

All this boils down to how well we have an on-going program in our organization to deal with the placement adjustment process. We as providers must be able to focus on transition and satisfaction. Transition and satisfaction begins with the pre-admission items as mentioned, during any direct contact times (tours), and developing a sound orientation program for the new resident and their family.

The new resident needs to feel welcome. From the moment they enter the building, the welcome wagon committee should have developed a specific method for welcoming them. In-room welcome signs would greatly add to the ease of placement. By in-room signs, we’re talking about flowers, cards, and the staff stopping in to say hello.

The families should be allowed plenty of time to assist with the placement. If they desire, they should be involved in helping design and customize the orientation process for their loved one. That orientation process should include important areas such as, schedules, significant personal contacts, locations, introductions to roommates and so forth. It is important to allow the family member to help design a customized understanding of what is important for the resident so we can make those early documentation into our individualized plan of care.

We should have a very specific program for the families. We definitely need to tell them about their rights according to law and we also need to school them about their responsibilities. We want to ease any abnormal behavior that occurs with some families as they visit their loved ones. It’s important to begin early by setting the tone for the relationship. We believe the relationship should be a 50/50. It is important to not only talk about all the areas that are required, but to go beyond the minimal requirements for resident rights and discuss:

  1. It is normal to have problems, but how to address those problems to other individuals and to the appropriate individuals.
  2. If we fix that problem, it is appropriate and necessary you tell us we have taken care of it to your satisfaction.
  3. When you’re in the facility, that you should talk to us about the things you like, not just what you dislike.