A good friend wrote the following:

There are important things you raise. I can still feel bad when I think about the nursing home my dad ended up in first.
Boring corridors with staff throwing out the cutlery, making noise at dinner, the nurse who said that dad didn't need physical therapy because he didn't have much time left anyway. It was terrible.

I regret that we waited almost six months before changing residences. We should have done it right away. I alerted the municipality and we had to change.
It was like coming to paradise. There were glasses of wine with the dinners, a homely environment, a physical therapist regularly, a caring nurse and fantastic staff.
Dad lived just over another year after the move, so I'm hugely grateful that the last year went well.
Which of the nursing homes do you want to live in?

Quality in elderly care is a fresh commodity

Unlike a commodity where quality is in the product, quality in elderly care is a fresh commodity. It is created in the present, in the meeting with the resident and relatives. A good basic structure increases the conditions for offering good quality care for the elderly.

Quality based on four levels

The first level we can experience with our senses.

The unit's design, accessibility, reception, smells, sounds, activity, decoration and other things that our senses notice contribute to a first impression of how the nursing home feels and seems to function.

The second level includes the course of care for a resident over time.

There must be content in the care, implementation plans, health plans and routines that the employees follow. Nursing care, oral care and everyday training as well as pleasant meals, medication management and much more must be carried out at agreed times and documented.

Third level includes how the business works at management level.

Adherence to statutes and routines, clear processes for handling complaints, deviations and improvement proposals, self-monitoring, risk analyzes and continuous improvements and more.

The fourth level includes measurement of results or outcomes of care and comparisons with other units.

Falling accidents that result in ambulance transport, use of anti-anxiety drugs, effects of function preservation methods can be measured and more.

If care staff, managers, nurses, occupational therapists and physiotherapists implement gradual improvements in their operations, they can make a big difference. Working in stages means that changes can be evaluated. The business does not risk destroying already well-functioning routines while freeing up time for the residents as less time is required to correct errors or deal with complaints and malpractices.

By using our senses, we can get a good picture of how the nursing home works. Deficiencies or the risk of deficiencies in the quality of care can be seen in smells, the order of the unit, the emotional climate or the staff's treatment. At the same time, we must be aware that despite all conceivable measures being taken, it is sometimes difficult to find a worthy solution to human problems.

If it were optimal to live collectively, we would all do it. Nevertheless, life can put us in a situation where we are forced to spend all our time with people we did not choose to hang out with. The problem has been noticed for many decades and much has been done to improve the situation.

Today, most nursing homes have full-fledged apartments where the resident does not have to share a toilet with others and can make a cup of coffee in their own apartment if they wish. In other countries, other preferences apply and it may even be more punishment than freedom to live alone.

The ambition of what I am writing is that if more people learn more about quality in care, care will be better. Improvements can often be made with small funds.

A dignified life

A "dignified life" can have many dimensions. It can be about being able to choose where I want to live and which people I enjoy spending time with. Opportunities to pursue my interests and to maintain relationships with loved ones. Maintaining habits and being able to continue doing things as I am used to can also be things that are important. What is perceived as a dignified life is individual. Those who are present and caring must therefore stop and listen to both what is said in words, what is expressed in other ways and what is not said but may be implied.

Small, simple, subtle signs, a signal that everything is not right, that there is a lack of routines, work management, the design of the premises or the like. If I, as an employee, resident and relatives, know what I should pay attention to and what is required for good care, I can, together with others, influence development in a positive direction.

My ambition is to contribute to the development of care in our nursing homes by inviting care staff, residents and relatives, managers, nurses, occupational therapists, physiotherapists to a dialogue and to give tips on how the quality of the business can be strengthened. The ambition is not to write a scientific book, although most of it has its origin in what is usually called science and proven experience.

I believe that you who work in nursing homes will develop knowledge and gain inspiration in your work with the residents. You will certainly be able to contribute to the development of the business. Likewise, get inspiration to develop the business and the opportunity to reflect on what you can do to strengthen your core areas and contribute to quality development.

For residents and relatives, I assume that knowledge is power. By knowing what quality the business should deliver, it is easier to express wishes for change or improvement.

My three messages

- Those who have knowledge are usually right
- Quality in elderly care is not rocket science
- Together we can make a difference.

Erland Olsson
Head nurse
Sofrosyne
Better care - every day