”In a way, the whole long-term care system is upside down,” says Celia Berdes, PhD, a gerontologist and sociologist at Northwestern University and director of research at Presbyterian Homes in Evanston, Illinois. ”The things that are the most important are the least valued, and the things that are the least important are the most valued.”

”All that care we’re giving is not documented in a chart, so it’s invisible. And it’s hard to distinguish between those who practice care in a caring way and those who do not. We’re not evaluated in those terms, except anecdotally — ‘Mrs. So-and-So really loves you.’ But that’s not part of the bureaucratic machine of care: It isn’t quantified, it isn’t measured, it isn’t valued, in some way. An aide is never asked to write down, ‘Today I was a friend to this resident.’ Yet that may be the most important thing anyone in that nursing home did that day — better than anything the nurses could do, better than anything the DON could do, better than anything a doctor could do.”

Berdes may work at a university, but she hasn’t forgotten what she learned from her years as a nursing assistant, an activities director, and an assistant administrator in nursing homes. Her research documents and attempts to measure those crucial but invisible parts of the long-term care process — the things that either facilitate or impede the delivery of true quality care. Continue reading ‘Celia Berdes: Making Direct-Care Work Visible’