Saturday, January 30, 2010

GeriPal: What a Nursing Assistant Will Tell Us If We Ask.

From fantastic GeriPal, a note of the changing culture of health care deliver and the increase of home health care. This is a must read for those of us who are paying attention to how patients' rights and needs will have to be met in the coming new reorganization of health care for the terminal and elderly.

It is projected that there will be a 50% growth in home health aide positions in the next ten years because of the expansion of home care for our geriatric population (US Bureau of Labor Statistics). How will we work with home health aides to increase retention? How can we argue for better compensation for such a demanding (physically and emotionally) position? And for those of us involved ingeriatric palliative care, how can we ensure that palliative care education is offered and encouraged for home health aides?

In the larger picture, offering continuing education and acknowledging specialized training is a start. I know that programs such as
ELNEC-Geriatric include specific content and attention to nursing assistants (self disclosure - I’m part of the team offering this course in Philadelphia in March-link above is for this, but see * below for more details). And in recognition of additional education and experience in palliative care, HPNA (through NBCHPN) offers certification for nursing assistants. These are a start—as was the public attention given to the role in the Washington Post articles. In my own practice, the same as with most of you I assume, I often elicit opinions and thoughts from the home health aides caring for an individual. But in the smaller, every day picture is this enough? How we can better include nursing assistants in palliative care teams? I don’t have the answer, but I do think that as we continue to consider how geriatric palliative care is delivered, we all need to advocate for nursing assistants as valued members of the interdisciplinary team.

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