It’s 7:00 AM, and an older woman in a nursing home wakes up and has to go to the bathroom. Whether she lives in Chicago or Copenhagen, that’s the same. Her body couldn’t care less about borders.
The thing that’s different is what comes next. If she’s in Denmark, there will probably be a trained aide who’s scheduled to get there in the next 10 to 15 minutes because there’s enough staff for them to be able to do that.
But that’s not how it goes in the U.S. That same woman would wait 45 minutes or even longer for someone to finally show up and help her, and that someone has most likely had only minimal training, and they’re rushing because there are 15 other residents waiting for them. It might seem like the result here would be a frustrated resident, but it’s much worse.
If an elder doesn’t get to the bathroom on time, they might slip and fall while rushing or get a UTI if ignored.
How come things are so different in these 2 countries?
How the Day Is Structured in Denmark
Things aren’t perfect in Denmark because they’re not perfect anywhere, but the day here isn’t one big crisis that people are scrambling to handle. It’s planned, and each action naturally leads to the next one.
And that’s extremely important in a setting of this kind.
In Denmark, the average resident gets to know 2 or 3 caregivers at a time instead of constantly having to deal with strangers.
This is a huge plus because it means that caregivers can actually get to know the people they’re caring for. The morning aide knows the resident has a weak left knee or wants to brush their teeth standing up. They’re familiar with all of it, and because of that, the routine is comfortable and predictable.
Afternoons are a time for the so-called small checks.
So, what happens here is that the caregivers will use this time to look and see if someone has a red spot on their skin, if they’re sitting differently, can they stand up properly, and it’s all built into the way the day flows.That way, the staff catches small issues and handles them before they become lawsuits. Nighttime continues on a schedule, and it includes turning residents who can’t move on their own, so they’re not stuck in the same position for hours upon hours.
The thing that stands out so much in the Danish approach is that tasks are part of the living system, meaning they don’t get done because they’re urgent.
And since there’s not a lot of room in between tasks in the schedule, no elder has to wait too long to have their basic needs met.
How the Same Day Goes on in the USA
On paper, this looks pretty much the same in the U.S.A.
There’s a time for when the staff wakes the residents up, when they get their morning baths, when breakfast is served, and there’s a plan for meals, medications, etc. In practice, though, it all breaks down, and the quality of care depends on how many staff members show up for work and how many residents need help at the exact same time.
Nursing homes in the U.S.A. are chronically understaffed, so the morning already starts with delays. If there are 3 certified nursing assistants on the schedule, but only 2 show up, they have to stretch themselves really thin to cover everything that needs to get done. For the residents, it means that some of them will wake up at 7, and they’ll have to wait an hour or an hour and a half before they can go to the bathroom.
And even when someone does take care of their basic needs, it stops there because there’s simply no time for anything extra, like movement.
Mornings equal hygiene, and that’s it. Luckily, the kitchen runs on its own clock, so meals are usually served on time. The monitoring part, however, varies. Sometimes, there’s someone who has the time to watch the residents; sometimes, there isn’t.
Overnight care is full of gaps.
Someone who might need to be repositioned every 2 hours ends up waiting 3 or 4 hours on a bad night, so it’s really no wonder that there are so many stage 4 bed sore complications in nursing homes.
Conclusion
You might think that Danish workers are good and the American ones are bad, but that couldn’t be further from the truth. The American approach is the way that it is because there’s not enough staff to make the system work how it should. And that’s really it.
There are too many residents and too few staff members, so how could it be any different?
Neither country has the perfect system, but it’s very obvious that one has a clear schedule, where everything happens in order.
And the other has exhausted workers who constantly have to triage.
