One must put in the fore of his activities: dedication, kindness, generosity, compassion.
Think of taking care of the elderly as a good deed.

I. General

It is known that in the United States of America where the living conditions, diet, sanitation, and other factors contribute to lengthening the human lifespan, the needs in skilled and non-skilled nursing care for the elderly keep increasing. The purpose of this paper is to share some experience in providing residential care on a non-skilled basis for the elderly.

Non-skilled services generally comprise assisting the client to keep clean in a clean environment, providing room and board, and assuring the safety of the client to the best of the provider's abilities, and exclude services provided in convalescent homes or hospitals by Registered Nurses (R.N.'s) or Doctors (M.D.). They are nevertheless regulated by state laws. The applicable laws cover a wide range of laws, statutes, and regulations tailored primarily to protect the older persons.

The elderly are people 60 years or older.

II. Sharing the Experience

A. The Facility

Most Residential Care Homes (RCH) in California are licensed to accept six residents. They offer either private or shared rooms. If licensed for non-ambulatory clients, new regulations require wider doorways (36 or 40 inches). Smoke detectors, fire escape routes and other requirements are required by the Fire Department which inspects the facility and clears it of fire hazards before a license is issued.

Suggestions Regarding the RCH:

1. Keep the house clean, odorless at all times. This is not easy, for some if not most of the clients are incontinent and may make a mess in the bathroom or elsewhere. Urine and stools must be removed and cleaned thoroughly before clothes are put in the washing machine and before deodorant and other chemicals are used.

2. Where possible, furniture should have rounded instead of sharp angles.

3. Doors cannot be bolted. Prevent wanderers to leave the facility unnoticed by installing door alarms.

4. Provide enough room and space for people to walk inside or outside the house (In winter, it's too cold to do outdoor exercise).

5. In cold weather, keep the house warm enough to prevent people from catching cold, chiefly when giving them a bath or a shower. Use an additional heater in these occasions if appropriate. Avoid letting an old person sit close to a draft.

6. The facility should offer a family atmosphere. When permissible, allow a resident to bring his own furniture. Make the facility attractive: plant flowers; keep front and back yards clean and well-kept at all times.

B. Staffing the Facility

The law states that any person working in a licensed RCH must be security-checked and have First Aid and CPR training (Cardio-pulmonary Resuscitation). Besides, the older person is protected by many laws and regulations which prohibit abuse in any form (mental, physical, etc.), violence, and the like.

The operator/owner of a RCH runs the facility not only for money alone. He and his employees must put in the fore of their activities: dedication, kindness, generosity, compassion. They should think of taking care of the elderly as a good deed. Therefore, the following suggestions aim at recruiting and training the personnel:

1. The care home worker must be strong physically.

2. The worker does not mind doing the dirty work. Most of the time, he has to clean up the mess which is no easy work.

3. The worker is patient. Communication with the resident is not always easy, for some may be hard of hearing, and others are confused and do not appreciate what you do for him/her. In worldly terms, there may be little reciprocity in working with elderly people.

4. The worker is a loving, compassionate person. He loves the resident as if the latter were his father or mother. Wear a smile at all times, including when cleaning up a mess.

5. The worker is attentive to the smallest details, chiefly when they pertain to the safety, well-being, and comfort of the resident.

6. Usually, the new worker goes through a period of probation in order to learn the House's rules and procedures, to familiarize him/herself with the do's and don'ts of the place, with the residents, and with the policies of the operator. After 3 or 6 months of probation, he would become a permanent employee.

To be continued