If your loved one died in a facility what physical features of the room did you find to be positive, or wish could have been different?
When we sit vigil with the dying the last thing on our minds is room design, but immediately after my mother's death I made a list of things I saw that made the experience more uncomfortable than it could have been. At the time I was busy with grieving and unwilling to follow through but on this one year anniversary it is on my mind. Some of the negatives I noticed:
The room was furnished with donated cast offs that were not necessarily practical of comfortable.
The bedside chair where I spent my time could have benefited from a foot rest and a recline feature would have been very appreciated.
The closet held a mish-mash of supplies, dated reading material and assorted cast offs. It wasn't until the final hours that I discovered a handbook that I should have been brought to our attention on day one.
I'd done a lot of reading in preparation for end of life, if I hadn't been self informed I probably wouldn't have had a clue what was happening. For example when I called my sister to tell her there was mottling she asked "what is that?".
Although we were offered coffee or something to eat nobody told us it was all complimentary. I doubt we would have eaten anyway but...
Did I mention that bedside chair??
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But as for the room. It was old, had that old smell to it. Just functional, (barely). A small square chalkboard across from the bed with mom's name on it. A bed with a small bedside thing with a drawer. No pictures. A old, old, washroom which was cold and dank and depressing. When I had to use the washroom I went and used the one in the main hospital area. There was a sliding glass door to gain entry to the room. The window looked out on a dirty parking lot. So all in all, quite depressing. To be honest it could have been the Ritz and I wouldn't have noticed. And since my mom was unconscious her whole time there it didn't matter to her.
The staff had very poor communication with me and with each other. One nurse would come in and tell me mom was scheduled to get another morphine shot in a half hour, then 5 min. later a different nurse would walk in and give her morphine. So, I finally stopped asking cause I'd get different answer each time. The night mom died I was talking to the lady at the desk about transferring mom's body to the morgue when the charge nurse came running over saying "oh, did she stop breathing?" Like I said, incompetence!
I had just arrived home from holding vigil at his side throughout the day when his nurse called to tell me that he had passed away. I’ll never forget walking up to the nursing home entrance late at night and seeing two CNA’s standing outside waiting for us like an honor guard, so we would not have to walk in alone. In their room, they had brought in several chairs, a tray with coffee, cups, a pitcher of water, and some snacks. My father had been bathed and put in a clean nightshirt. We were left to say our goodbyes and pray until we signaled to them that they could call the funeral home. They were there within minutes and we were then led to another room while the funeral home prepared to transport my father’s body. They draped an American flag over him.
My only criticism is that it would have been nice to have a cot to sleep in for a family member who wanted to stay the night. I spent the night with my mother and they provided me with a reclining chair that was so uncomfortable that I ended up crawling into bed with her, which comforted us both emotionally, but made it impossible for me to sleep at all.
A nursing facility is like a small village. It begins to stir around 4:30 in the morning as they start their rounds and begin getting residents up. My parents were usually the last to get up, so around 6:30, we started to get visitors as word spread throughout the facility that my father had passed away. I let my mother continue to sleep as I accepted the condolences of numerous staff members and residents. When my mother awakened later in the morning, the stream of visitors continued. I know that medical professionals are taught to not get emotionally invested, but it’s different when the patient lives there. I saw how my father’s death affected the members of this little “village” - from the residents, to nurses, CNA’s, laundresses, housekeepers, cafeteria staff, physical therapists, office staff, activity director, and regular volunteers and visitors.
I know this is more than you were asking for, but thanks for the question. It has helped me to write it.
Like most tvs in medical facilities though, it was mounted on the wall, so anyone watching it had to look upward. This always gave me a neck ache.
Good magazines on various topics (excluding politics) were available in lounges throughout the facility; we could take them to the room and read them, and leave them in either one of the main lounges or a small local lounge. Bookcases were also filled with various novels, etc. All lounges had exterior viewing access.
Windows in each room looking out on courtyards or the exterior of the building were very helpful for relaxation. Private rooms were also the best arrangement. Multiple halls, providing exterior viewing for rooms on both sides of the hall were best. Rooms with no exterior views sucked and were depressing and confining.
Some windows could be opened; others couldn't. Blinds had to be adjusted with changing positions of the sun.
As a visitor, one thing that always appealed to me was the free coffee and tea. It was very calming to have a cup of coffee while visiting my father or mother. One facility had a small "deli" which also provided reasonably priced meals for family.
Bathrooms in each hall made it easy for visitors, especially since the last facility Dad was in was very large, and sometimes a bit complex moving in terms of layout.
Perhaps one of the best and most unique was the closed circuit TV with half a dozen monitors in the entry lounge. From what I could see, each building in the complex was monitored. I was told that a security vehicle patrolled the premises.
The closet was actually an armoire, with ample room for hanging clothes and drawers plus shelving for stored items.
The bathroom was unique; the basin and mirror was in the room; only the toilet and shower facilities were in a private area. I think this made it easier for the residents and nurses to conduct business w/o vision being blocked by corners.
The best facilities had pianos and good activities. Pianos really made a difference. Top notch and very professional therapists were also a helpful element at the last facility. Their professionalism and maturity far exceeded one of the other facilities we had gone to several times, until it deteriorated and was no longer acceptable.
Courtyards with umbrellas, nice landscaping (absent in many places) helped make being outdoors or just watching outdoor activities pleasant and relaxing. One facility bordered on woods. Deer, multiple birds, and sand hill cranes entertained the residents.
We have a new 3 or 4 room hospice in town that was built and runs with donations, it would be wonderful if everyone could have such surroundings in their final days. When you consider that almost 100% of the people who are in long term care will eventually die there having an appropriate, caring spot dedicated to palliative care shouldn't be an afterthought.
I do believe you would make an excellent design engineer, or at least an OSHA inspector.
Wherever I go, I am thinking how to make changes or improvements to a room,
a building, etc.
And your desire for better hospitality in any place is always a good thing.
I wouldn't have even had her brought there but the nursing home had called the ambulance and this was the closest hospital. If I had thought transferring her wouldn't have caused her even more distress I would have.
For those of you who had someone die in hospital, IMO it is something to be avoided if possible. Although our little 20 bed hospital has a palliative room (again, funded by donations) most major hospitals - ironically - are not equipped to deal with death.
I only noticed how furnishings can change a feel in a room from when I performed my CNA practicals at a nursing home last year. Most rooms were basic hospital bed and furnishings, clean, but no particular person's soul. I walked into one room that was as if the elder [what this nursing home called their residents] would have in her own apartment: her own furniture, knick knacks, artwork, and reclining chairs! The calm and warmth of the room would make me never want to leave it.
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