A recent piece written by Susan Ely, CRNP, for KevinMD.com reveals the troubling issues that arise when a skilled nursing facility fails to deliver on its promises to patients.
Skilled nursing facilities, or SNFs, provide medical care beyond what assisted living facilities can handle. SNFs employ physicians and nurses that specialize in delivering medical care for elderly patients; as such, compassion and understanding are paramount to ensuring that patients feel comfortable and are given the best quality care. Ely’s piece recounts how the SNF where her father was treated lacked those key ingredients:
My dad hated the SNF. Not for the obvious reasons … It was the emotional environment that was lacking. As heartbreaking as it was to know my dad was dying, it was even more heartbreaking to walk in and see him wild-eyed and scared, lying on a pillow mattress on the floor. “They are killing me,” were the first words out of his mouth as he thrashed on the makeshift bed.
Establishing goals and understanding what is most important to the patient, as well as their family, is crucial to successful palliative care. So when caretakers turn a blind eye to the emotional needs of their patients, they are actively centering treatment around the disease, not the person. And that’s when further problems arise.
Only so much of care is about the specific medications and treatments. Helping patients retain their dignity, especially in their final days, is one of the most important aspects of compassionate care.
I feel we robbed him of his dignity. As I grieve, I am comforted by sharing my father’s story. My hope is that one family member, one health care professional will tuck this story away only to remember it the next time they hear a patient or father say “they are killing me.”