Elizabeth Newman

Hearing the phrase “root cause analysis” always strikes a bit of fear into my heart because it always seems to be a complex process. In long-term care, this is often framed as not only knowing that a resident fell, for example, but why she fell.

There could be multiple problems: A resident needed to use the toilet and no one answered the call button. She had a new medication that made her dizzy. Perhaps the resident was “found down,” as opposed to someone witnessing her falling down, in which case a caregiver should ask if anyone pushed her. The spiderweb of possibilities grows bigger, not smaller, with proper investigation.

Even after determining the conclusive “how” and “why” of a fall, fixing a problem is often one step forward and two steps back. Which is why I submit to you the case of Kitty Katz and the smelly office.

With multiple cats, we have the miraculous litter robots in our home. You can see a video of how it works here.

These robots cycle and drop used waste into a litter bag below. They have done a phenomenal job of keeping odors under control for the past four years.

But nothing perfect lasts forever. Last week, the office containing a robot had begun to smell, even with the robot cycling regularly. Anyone in long-term care knows the horrible feeling of fighting the smell of urine. It’s not only a turnoff for people coming into your house or building: It’s the difference between residents wanting to move in or not. In our case, it’s a question of killing this odor problem before my mother-in-law comes to visit next week.

We changed the bags in the robot, we added new litter, we readjusted the mechanics. We mopped the floor and washed the mat under the robot. Nothing worked.

Finally, late last night, I realized clumps of litter were getting stuck in a compartment of the litter robot, and they had to be dug out with paper towels. I’m not going to lie: It was incredibly gross. But I dumped in new, fresh litter, repeatedly tested running the robot and went to bed happy that I had solved the problem. I had the answer to the “why” in the question, “Why does our office smell like a decrepit subway station?”

Then we walked into the office the next day and it still reeked. My solution hadn’t worked. I wanted a gold star for effort, but my husband’s more of a results-oriented type of guy, and he also spends all day working in the home office. Which still smelled badly enough that it would make you gag.

Unbeknownst to me, my husband also had spent time searching for a solution. That day he removed a heavy desk sitting next to the litter robot, threw out a tablecloth covering the desk, swept and mopped, and used a Pet Odor spray with abandon. Then he sprayed Febreze all around the office.

It’s better, but not great. Even with new litter or constant surveillance, our efforts couldn’t fix the root cause of our problem.

That’s because the real cause of the problem is the cat. Kitty Katz is 17 years old, begging for water repeatedly and urinating more. Her kidney disease, which has been slow, is likely now progressing. Her frequent use of the litter robots means the other cats want to cover her scent, which collectively adds up. I love her, but there’s no way to make the issue go away permanently without her moving to the Rainbow Bridge in the Sky. It’s a little like a problematic resident: Apart from death or discharge, there’s no way out.

So what are our options? We’ll dismantle the litter robots, hose them down with vinegar, and maybe try a new litter. We’ll consider adding a totally new, traditional litter box. Perhaps we’ll give Kitty Katz more time in a solitary room where she doesn’t have to worry about a line at the toilets. I’m open to suggestions.

And that’s something we have to remember: Root cause analysis doesn’t always lead you to an easy fix. But providers have to keep trying.

Follow Elizabeth Newman @TigerELN.