This seemed to work quite well until one day Dad was exhibiting strange behavior. Instead of opening the car door as usual and getting in, he grabbed a hold of the car’s headlight and tried to open it. When Mom asked him what he was doing, he simply replied “I’m trying to get in the car.” This behavior was quite odd for my Father, and immediately we knew something was wrong. But, what was it? It was first thought that maybe he was experiencing a mini-stroke.

Since Dad did not want to go to the hospital that night, he decided to see his cardiologist the next day. The doctor couldn’t find anything wrong, but decided to do CAT scan anyway. After a week went by, they received a message from the doctor’s office that there was a small legion shown in the brain. They didn’t think it was of any great concern, but he should eventually go see a neurologist.

A couple weeks later, my Father experienced a similar episode again. Mom immediately rushed him into the hospital. And it was only then, the ER physician noted he had two cancerous brain tumors. Dad later died two weeks later from the cancer which had already spread throughout his body.

The reason why I tell this story is to help others realize the importance of a primary physician. If you have a cardiologist, that is wonderful! But, you should also have a primary physician who generally understands the whole body.

Here are some tips to live by:

• Don’t settle on a doctor you are unhappy with. Find a physician who will listen to your needs and address your concerns.
• It is also important to find a doctor that stays up-to-date in the medical field. Yes, continuing education is required for doctors. But the question is, do they apply it?
• Because your health has been “good” so far don’t assume that everything is perfect. Assumptions can be disastrous. Go in for yearly checkups. If you are notice a medical change, contact your doctor right away.
• Get educated. Read articles and attend lectures, so you can make informed decisions, especially if you are aware of a medical issue.
• No one knows you, like you. Verbalize your concerns to your doctor. Don’t expect he or she will notice something is wrong. Your physician may see hundreds of patients a week. Unless they know you personally, it is unlikely they will notice a change.

I encourage everyone to get involved with your medical care. If anything, it may save your life one day.

This information was a lot to take in, especially since he entered the emergency room for mild confusion and dizziness. Up to a few weeks before this awful news, he was out golfing and mowing the yard on a regular basis.

I still remember that day vividly, when the ER doctor walked in and abruptly told us that he had Stage IV Cancer and he had only a few months to live. Not only did it catch us all off guard, there was no warmth or sentiment there. It was just cold hard facts. Even for me, someone who works in health care, I was stunned by how matter of fact this physician was with us. If I hadn’t been involved in the conversation I would have thought he was diagnosing a common cold or some other minor illness.

Shortly thereafter the physician referred us to a radiologist that met with this family member and his wife, who began the treatment process. Later the wife called and told me that she had a horrible experience. Supposedly, while her husband was working with the nurse, she had a candid discussion with the radiologist who admitted that there was a slim chance of recovery. This of course we already knew. However, he went on to say “you should be happy, because he has lived a long life.”

I was stunned when I heard this. Telling her that she should be “happy” that her husband has lived this long doesn’t make it any easier. In fact it came across that the radiologist wouldn’t be try as hard because of his age. Since cancer is more or less “expected” at the age of 85.

In the end, the cancer won over within less than three weeks from diagnosis. This period was emotionally draining on us all, especially the rapid decline. My very dear family member who was diagnosed with this dreadful disease had always been the rock of the family. But when the ER doctor came in that first horrific day and gave us the shocking news, it was the first time I had ever seen him cry.

I sometimes wonder if the situation could have been better if his doctor had been more empathetic. Maybe not…I don’t know. However, I do feel that more attention should be given to a patient and family when delivering such a significant blow. Because I can attest, he was never the same after he heard those few abrupt words.

On a more personal note, I would like to share that this family member was my Father, who is and always will be deeply missed.

There is a lot of trust involved with caring for another human being, especially in the home health care field. Employees are sent out to client’s homes and are expected to provide quality service. I believe home health companies need even greater screening of staff because of the lack of daily supervision. In a nursing home, there are many “eyes” watching over employees including the director of nursing and the nursing home administrator.

This week I was given a web address for the Florida Worker’s Compensation Claims. On this website, you can type in the name of a person (even the way it sounds) and it will give any previous compensation history of a person living in Florida. You may ask why is this important? As I mentioned earlier, there is a lot of trust between management and staff to provide quality care to residents and/or clients. The more you know about a person’s work history the better.Check out this website.

After a long day, some nights I come home practically comatose to the world. On these occasions, there are times when my husband may start a conversation. Suddenly, midway through I realized I only caught parts of what he was trying to tell me. Some people may call this typical to married life. Ha. Anyway, this got me thinking about how often this happens everyday….to many people. It reminds me how valuable a person who truly listens.

When I was a Masters in Social Work Intern in Austin, Texas, I had my own clients assigned within a couple of nursing homes. A lot of time was spent with each one of my clients, since I didn’t have other work related obligations. As a result, I knew their intimate frustrations, worries and fears, and was able to better assist them with this knowledge.

Some of my clients had no family, or if they did, they were rarely in contact. Often after having an hour session, they would want to continue longer. These individuals were by far the most likely to develop signs and symptoms of depression. However, it was noticeable by their reaction that having someone that would listen, meant the world.

Nursing home staff, family and friends of nursing home residents, also have hectic lives. Often it may inhibit them from being able to slow down long enough not to miss every other word of a story. It’s extremely hard to always be an active listener. For me, it is a work in progress….but, an effort that’s truly worth making.

This test is only a snapshot of what the Nursing Home Administrator (NAB) exam will cover. It should ONLY be considered supplemental to the many resources available–books written by individuals that know the NAB exam far better than I do. (Check out my other recent post on recommended books for NAB exam). These questions may not even be similar to the ones you receive, but it is my hope that it assists you with learning this vast amount of material.

The NAB Exam Study Questions & Answers (at the end):

1. When the power at your facility goes out, the emergency generator needs to reestablish it in:
a. 10 seconds
b. 1 minute
c. 20 seconds
d. 2.5 minutes

2. A major issue in malnutrition is a result of:
a. Poor tasting food
b. Poor dentition
c. Lack of assistance
d. Meal times

3. The daughter of a female resident tells a CNA about a male resident who supposedly has been sexually harassing her mom. Who should the CNA report this incident to?
a. Charge Nurse
b. Administrator
c. Activity Director
d. Social Worker

4. Definition of working capital is:
a. All assets less all liabilities
b. Fixed assets less fixed liabilities
c. All current and fixed assets
d. Currents assets less current liabilities

5. A full time social worker is required when there is:
a. 120 residents
b. 121 residents
c. 60 residents
d. 61 residents

6. The main components of the risk management program are:
a. Liability control
b. Preventative measures and case management
c. Unionization
d. All of the above

7. Type A Fire Extinguisher assists with what type of fire:
a. Chemical/Flammable liquids, no residue
b. Electrical
c. Metals
d. Materials that burn to ash

8. A facility must not serve morning meals more than ___ hours after the evening meal.
a. 12 hours
b. 13 hours
c. 14 hours
d. 15 hours

9. The comprehensive MDS assessment is required within ___ days of admission:
a. 7
b. 10
c. 15
d. 14

10. Who established Theory Z:
a. Dr. William Ouchi
b. W. Edwards Deming
c. Dr. James E. Allen
d. Dr. Roberta Greene

11. To operate a fire extinguisher, you must:
a. Pull, Aim, Squeeze, Sweep
b. Pull, Aim, Squeeze, Spray
c. Push, Aim, Squeeze, Spray
d. Push, Point, Release, Sweep

12. Person who implements resident care policies and coordinates the medical care in the facility is the:
a. Administrator
b. Director of Nursing
c. Medical Director
d. Social Worker

13. A facility should conduct a minimum of ____ fire drills annually:
a. 15
b. 12
c. 10
d. 14

14. The theory “hierarchy of need” was founded by:
a. Douglas McGregor
b. William Ouchi
c. A.H. Maslow
d. Dr. David Snowdon

15. A 3rd party used to advise or counsel in the negotiation process is considered:
a. Arbitration
b. Conciliation
c. Mediation
d. Total Quality Management (TQM)

16. Hematology is the study of:
a. Diseases of the blood and blood-forming organs
b. Disorders in the endocrine system and its specific secretions
c. A “holistic” approach to medical care
d. Disorders of the rectum

17. If an employee works 52 hours in a 7 day work week and is paid $10.00 per hour for regular time, the employee should be paid a total weekly income of :
a. $333
b. $580
c. $520
d. $780

18. In September, a facility had a total of 99 employees. Then, in October they had a total of 98 employees. By the month of December there were 100 employees. Over this 3-month time span, 10 employees were hired, fired, or laid off. What was the turnover ratio for the quarter?
a. 10%
b. 50%
c. 18%
d. 20%

19. A federally required screening for all future nursing home residents, to determine if they are mentally ill or mentally retarded:
a. MMSE
b. MAR
c. PASARR
d. HIPAA

20. Therapeutic diets are prescribed by a _____ and approved by a ________.
a. Physician and Dietician
b. Dietician and Physician
c. Nurse and Dietician
d. Dietician and Pharmacist

Scroll Down for the Answer Key
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_
_
_
_
_
_
_
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Answer Key:

1. A
2. B
3. A
4. D
5. B
6. B
7. D
8. C
9. D
10. A
11. A
12. C
13. B
14. C
15. C
16. A
17. B
18. A (Turnover ratio: # of employees who left divided by total # of employees in a given period)
19. C
20. A

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NAB exam, Nursing Home Administrator, malnutrition, working capital, social worker, risk management, MDS assessment, fire extinguisher

The other day I was talking to a friend who shared that he becomes depressed around the holidays. Over the years, he has lost many family members and friends. Growing up he celebrated Christmas with extended family–approximately 40-50 relatives. It has now dwindled down to a few people. Some family married or moved away, but the foundational members that originally brought everyone together, have long since died.

Holidays often remind people of the past. Some may be excited about the changes that have occurred in their lives, while others may wish to return to a happier time. One of my previous clients, often talks about her parents around the holidays. At 88, she still longs to return to the “good ole days” when she lived in Ohio and rode her sled on snowy days. These were happier times…before she and her parents had a falling out, and then she moved far away.

This client is one of many that have spoken out about their depression, especially around the holidays. Most older adults have lost some type of significant relationship over the years. Unfortunately,this is a normal part of growing older….for any age.

After talking at length to my friend about his “holiday depression,” we agreed on one point. The only way to manage the losses incurred, is to be open to new experiences. As he ages, he may one day be a foundational figure in his family. Where new family members come together, and spend quality time over the holiday season. One day his future grandchildren may look back at these times (like my previous client) as the “good ole days.” Happy Holidays to you all!

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depressed, holiday depression

I know quite a few people who begin to slow down in their fifties and sixties, especially after they retire. Sometimes then their health begins to deteriorate. What if retirement was only the halfway point? For Edna Parker at age 55, she hadn’t even lived half of her life. She truly is an inspiration to us all–proving there doesn’t have to be age limitations.

The full article can be found by clicking on this link.

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Edna Parker, wheelchairs, nursing home

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caregiver stress

The odd part was that we had a voting precinct available in our building. General public could vote, but we were registered at a elementary school across the street.

Learning of this problem, the nursing home looked into voting electronically, where a hand held device could be brought to each resident. After trying this machine out with one resident, we found out the device was defective. The only other option we had was to get the facility van and gather together all the residents.

Despite this inconvenience and waiting over two hours, some of the residents were still willing to wait so they could vote. However, as time continued to pass, more and more residents became tired and fatigued. In the end, we waited three hours and only eight of the seventeen residents who wanted to vote were able to sustain the process.

I also have a close friend who lives in a nursing home. She discussed on several occasions that she would like to vote, but did not know how to go about it. I assumed the nursing home would help with this process. After the election, I happened to ask her if she had voted. To my surprise the facility did nothing to assist her.

According to an article in USA Today, approximately 10% of the population live in nursing homes. So imagine if every facility had a similar issue. This would lead to a large percentage of people who did not get to exercise their right as Americans.

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nursing home residents

ADAES led by Terrie Hardison in Ocala, Florida, equips caregivers with the knowledge they need to manage the challenges associated with caring for a loved one. This organization has already helped hundreds of people this year, even while still in its infancy. Check out their new site at www.adaesinc.org.

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Alzheimer’s, Dementia, Ocala, Florida