John and Terri Hale

No one in the nursing home field wants to read a story like the one we’re about to tell. But it’s real, it’s important, and it hopefully provides food for thought — or motivation for action.

Sheila was a long-time resident of a nursing home in Iowa until she died in September from complications of COVID-19 at the age of 68.

We never met her in person. We knew her only through phone calls — dozens of them. All on the same topic: her concerns about the inadequate care she felt she and other residents of the facility were receiving.

Sheila was, in the best sense of the word, an agitator. She would not accept poor care or excuses from nursing home leadership about that care. She would not accept being labeled a “complainer” or being told by nursing home management that if she didn’t like it there, she could move somewhere else. She also would not accept the ineffective performance of state agencies designed to ensure her care was acceptable.

She first contacted us in 2017 as a result of a column we had written about the inadequacy of the “15-minute rule” in Iowa. The rule says that once a call light for assistance in a nursing home is pushed by a resident, it is acceptable for a staff member to take up to 15 minutes to respond.

She called to tell us that in her facility, it was rare to have a call light answered in 15 minutes. She described situations where a response didn’t come for 45 minutes or more. She said that even when the response was tardy, an aide often came into the room, shut off the call light, and left – without providing any assistance.

In this, and every subsequent conversation, Sheila gave examples of delayed or improper care that she felt that she and other residents were experiencing and her theories why. They included:

  • Too few staff to serve residents
  • Staff inadequately trained 
  • High turnover of staff and high use of staff from temporary employment agencies, resulting in residents being served by people they didn’t know or feel comfortable with
  • Failure of facility management to truly listen to residents and act on their concerns.

Sheila was mentally sharp and an effective communicator. She took notes to document her concerns. She frequently contacted state offices, which sometimes visited her facility. She kept pushing. Her goal was to “get dignity and quality for everyone.”

Sheila’s story, unfortunately, was not a once-in-a-blue-moon occurrence.

The bottom line: The reputation of the nursing home industry is damaged every time intolerable care is reported anywhere. The industry, and all of us who care about it and the people it serves, must treat every situation like Sheila’s as a learning opportunity and have it motivate us to strive for high-quality care for everyone, all of the time.

John and Terri Hale own The Hale Group, an Ankeny, IA-based advocacy and communication firm focused on older Iowans, Iowans with disabilities, and the caregivers who support them. Contact: [email protected]

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.