In 2004 I accepted a position at a skilled nursing facility (SNF) as a maintenance assistant. I was excited to have this new job as I felt the experience of being in an environment among senior citizens would be very rewarding. I had previously assisted the elderly and I remembered how enjoyable it was. The job however, was challenging, but I loved the work and it was a great job.
For the first 18 months I worked under a maintenance director whose favorite answer to almost all issues was “fix it,” and he would further go on to add, “I don’t care how long you take just fix it.” Well, one of those issues happened to be me constantly replacing the over-the-bed light switches. The problem was that the residents would tie the string that activated the light switch to their bed rails, electrical cords, bed sheets, stuffed animals or to anything they could reach easily due to their limited dexterity. Whenever these items were moved by the staff or sometimes by the residents themselves, they would inadvertently rip the string from the light switch damaging the switch, making it inoperable. Now the maintenance director had a problem with not just me spending the time to replace the switch but also incurring the cost to replace the damaged switches.
I did not like his solution to the problem. My boss had made a decision that all strings that were tied to bed rails, etc., be cut loose immediately. Unfortunately for me, I was instructed to carry out this unpleasant task. To this day, it remains among one of the most difficult things I have had to do. Residents begged and pleaded to me, used vulgarity, cursed me and even tried to bribe me not to cut their strings loose.
Then the company promoted me and moved me to another facility. I was now the maintenance director and the “string problem” existed here too. The strings were tied to call cords, bed rails, stuffed animals and even towels. I have further come to recognize that not only do the residents have limited physical dexterity; they also have a problem gripping the very thin strings that come with these light fittings. This is a common problem. I have seen it in every SNF I have visited. Some buildings were new and the residents had those silly strings tied to anything they could reach.
I had an idea and a friend of mine and I fabricated a bracket. We installed the bracket to the reading light in the nursing home and it WORKED!!!!. We then had a tooling company build 10 of the brackets and I installed some of them in my building. The residents loved them. The first resident that got a bracket for her light was Mrs. Pittman. I asked Mrs. Pittman to tell me in her own words what she thinks about the bracket. These are her words:
The new overhead light switch is great. It is easy to reach from my bed and to locate. The chain is a whole lot better than the string as it is clean and doesn’t wrap around anything. Just pull the chain and the light is there. Sure looks nice the way it is put up. Thanks so much.
I installed five more brackets after that and everyone thought they were great. When a resident would move to another room that didn’t have a bracket they would ask me to move the bracket to the new room. Family members would ask me if I could put one in their loved ones room. I even had a resident that intentionally kept breaking her light string in the hopes of us putting a bracket in her room. Unfortunately, my resources were limited. We only had 10 units. The residents that had a bracket in their room told me there is no way they could reach their light string without it. I’ve also been told by the residents how nice and clean they are.
I have since talked to nursing home owners, CEOs, administrators, designers, architects, builders and even the Department of Aging and Disability. Everyone thinks it is a great idea, but nobody wants to do anything about it. In the four years I have worked in SNFs, I have come to understand how things work or how the “game is played.” Things change only if the guidelines, rules or the code dictates it. The phrase, “we will wait for the state to write it up then we will fix it,” is commonplace in our business. In other words, we’re not going to spend any money until we have too. I think that is exactly the same mindset I’m seeing with this problem. Nobody wants to spend the money to address the problem until they have to. In the meantime the residents are the ones that are doing without.
The Texas Administrative Code, Title 40 Part 1 Ch. 19 Subch D Rule 19.334(a)(6) states:
Each room must have general lighting, bed reading light, and night light. …. A durable nonglare (opaque front panel) reading light securely ancored to the wall, integtrally wired, must be provided for each resident bed. The switch must be within reach of the resident in the bed.
I would venture to say that more than 80% of SNF residents cannot reach their switch from their bed.
Eric E. Smith is director of maintenance at the Winters Park Assisted Living and Memory Care in Garland, TX. For more information about the product, contact Smith at (682) 225-9535 or at [email protected]