>>Valley Patriot>> |
As a result, new federal regulations authorize the use of “feeding assistants” to specifically care for the feeding and nutritional needs of seniors unfortunate enough to be stuck in a nursing home. But the regulation also mandates that feeding assistants be used to oversee residents who supposedly “have no complicated feeding problems.” According to the legislation enacted and released in September 2003 (and in December 2003), a feeding assistant has to complete a state approved training class of at least eight hours in feeding, emergency procedures and certain other areas. Feeding assistants will be paid minimum wage. According to the new regulation, feeding assistants must work under the supervision of a registered or licensed nurse. The legislation states “in an emergency, a feeding assistant must call a supervisory nurse for help on a resident call system.” However, there is no requirement that a state adopt the feeding assistant regulation, making the legislation irrelevant to those who are in need. A nursing facility cannot hire feeding assistants unless the state has adopted the "feeding assistant category" by approving standards set forth in the legislation for a training program. For the nursing home owners and administrators, this is a costly and cumbersome burden that they are not so eager to embrace. Are the feeding assistant regulations going to improve quality of care by ensuring that residents will no longer suffer from dehydration, malnutrition and weight loss? The answer is probably "no." However, short staffing in nursing homes is due to low pay and by paying feeding assistants minimum wage, this will do nothing to solve the problem. In addition, eight hours f training time is grossly inadequate for the complicated myriad of swallowing, digestive and medial needs of each nursing home resident. Moreover, allowing the use of feeding assistants only opens the door for the implementation of bathing assistants, transferring assistants, etc. (i.e. single task workers.) It sounds like a great way to give nurses and short staffed nursing homes additional workers to assist our loved ones. But, caring for a nursing home resident entails a big picture understanding of the nursing home resident, not a patchwork of single task workers who do not understand the resident's full range of needs. Nursing home care givers should know every facet of the medical conditions that afflict a resident. Lastly, the Nursing Home Reform Law that was in existence prior to thisfeeding assistant regulation, states that all “nursing and nursing-related” tasks be performed by a licensed health professional or a certified nurse aide. These single task caregivers do not qualify. Tom Duggan contributed to this story. David J. Hoey is a nursing home attorney in Reading MA. You can
email him at hoeylaw@earthlink.net Send your questions
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For years
nursing home residents have suffered (many have died)
from malnutrition, dehydration and weight loss in a
nursing home. Many of those who have suffered from this
problem have done so as the result of lack of adequate
staffing, poor staff training, poor training of
volunteers, and inattention to the individual needs of
certain residents with swallowing or digestive problems.