Long-term care: Role of the nurse

Long term care is a type of service where individuals can receive assistance with their care while living safely and as independently as possible.

Long term care includes nursing centers, formerly called nursing homes, and assisted living facilities. As the nurse, you'll provide patient-centered care for your long term care residents.

Alright, so, nursing centers provide a high level of 24 hour care for residents with conditions that limit or completely impair their ability to safely perform activities of daily living, or ADLs like dressing and toileting.

Services usually include medical and nursing care such as medication management, self-care assistance, tailored meal preparation and feeding assistance, and recreational activities like music therapy.

Additionally, residents may receive routine and emergency dental services, as well as rehabilitation services like physical and occupational therapy.

Typically, residents reside permanently in nursing centers, however, some residents may reside in a nursing center temporarily as they regain function after a serious injury or illness.

On the other hand, assisted living facilities offer a more independent, home-like environment for individuals who are relatively autonomous but are not able to live independently.

Typical services include laundry, meal preparation, and housekeeping, as well as medication administration and personal care assistance like bathing and dressing as needed.

Residents usually have their own rooms and can keep their personal belongings, and they can attend group dining and participate in shared social activities like exercise classes or book clubs.

Lastly, memory care is a type of specialized assisted living where individuals with Alzheimer's disease and other types of dementia can receive care in a more secure environment with a focus on individualized cognitive support and structured routines to support quality of life.

When caring for your long-term care residents, your goals of care include collaborating with the healthcare team to provide high quality care and maintain a safe environment.

For your residents in a nursing center, you'll provide direct care, including conducting comprehensive and focused assessments, administering medications, and providing education on topics like safe use of assistive devices for your residents in an assisted living facility, you'll focus on promoting independence while providing support based on their functional abilities.

For instance, you may provide bathing assistance and encourage your resident to wash their face while you wash their back, or you might help set up their meals so they can feed themselves independently.

You'll also be responsible for performing indirect care for residents in long-term care settings by planning and coordinating the care provided by an interdisciplinary healthcare team.

This includes delegating aspects of direct care to licensed practical or vocational nurses and unlicensed assistive personnel, also called UAPs.

For example, you may create a toileting schedule for residents in a nursing center and delegate the task of toileting assistance to the UAP.

You'll ensure safety and quality care by ensuring tasks are appropriately delegated, which involves ensuring the UAP is competent to perform the task, evaluating the resident's response to the task, and providing constructive feedback to the UAP as needed.

You'll also create personalized care plans with input from interdisciplinary team members, such as spiritual care providers, nutritionists, physical therapists, occupational therapists, and speech therapists.

And work with the healthcare team to plan and organize social activities, to keep residents engaged, like arts and crafts projects or music and pet therapy.

Lastly, for your residents with barriers to care like financial constraints or difficulties with transitions of care, you'll refer them to the social worker or case manager.

Other nursing responsibilities can include taking on specialty roles and administrative responsibilities. For example, since infections can spread quickly, when people live in a group setting like long-term care, you may assume the role of an infection control nurse by implementing infection control protocols, tracking potential outbreaks, or organizing a vaccination event.

You may also handle administrative tasks, such as managing supply inventories and overseeing staff scheduling. Depending on the care setting, you might also be required to perform certain assessments and documentation to obtain reimbursement from funding and insurance agencies.

Also keep in mind that moving to a long-term care setting can be challenging and stressful for your residents and their loved ones.

Be sure to allow them an opportunity to verbalize their feelings and any concerns they have about the transition into long-term care.

Use therapeutic communication techniques like active listening and clarification, and provide emotional support as needed.

All right, as a quick recap, long-term care settings such as nursing centers and assisted living facilities offer a range of services for residents who require assistance with their care so they can live safely and as independently as possible.

Nursing centers provide 24 hour care for residents with physical and cognitive limitations, offering medical, nursing, and therapeutic services, often on a permanent basis.

On the other hand, assisted living offers a more homelike environment for residents who are relatively autonomous but not able to live independently.

When caring for your residents receiving long-term care, your goals of care include collaborating with the healthcare team to provide high quality care and maintain a safe environment.