Nursing home boss takes novel tack in finding ways to help residents

The night that Dave Stieglitz fell asleep on the job, he exchanged his office wear for a T-shirt and shorts and climbed into bed at the Elgin nursing home where he works.

Stieglitz takes his job seriously, after all. Signs placed throughout Apostolic Christian Resthaven, where he serves as administrator, remind staff that "They (residents) do not live in a facility. We work in their home."

After he began wondering how much residents were actually experiencing the comforts of home, Stieglitz undertook a little experiment to find out.

"I just happened to think that it may be a good idea to stay overnight to see what it's like for the residents," he said.

"When I was trained, the protocol included spending a little bit of time in each department. So I know what the housekeepers go through; I know what the people in food service go through. I began thinking 'I wonder what the residents go through?'"

Since he eats lunch there every day and already knew the meal quality, Stieglitz was particularly interested in night sounds and other distractions at the 50-bed nursing home. Were hall lights keeping anyone awake? How noisy did it get? Were the residents who suffer from dementia crying out at night?

Only one way to know for sure. A bed had been open for a while in Room 5, which happened to have another male resident, so Stieglitz seized the opportunity and informed staff he would be spending the night.

"In an experimental situation like that, ideally you wouldn't even tell them," he said. "But I didn't want to scare any of them to death, either, by them coming into the room and seeing somebody in that bed that was supposed to be empty."

The overnight nurses and certified nursing assistants were instructed to go about their normal routines and ignore the fact that their boss was sleeping in Bed 1.

Something of a light sleeper, Stieglitz used earplugs so he could better match the nighttime experience of the residents, most of whom have a hearing impairment.

"If some noise wakes me up," he reasoned, "the same thing might not bother our residents."

Even with earplugs, Stieglitz did awake briefly when his roommate turned on a radio in the middle of the night. And he awoke when staff came in to care for the older man but, like any roommate used to interruptions, merely continued his quest for more shuteye.

"He needed some help," said Stieglitz, unsure of the reason for the commotion. "They were providing for him somehow."

Later, he thought maybe staff should be advised to tone down their volume during the wee hours. But then he decided the resident had probably removed his hearing aid, so the nurses had no choice but to speak louder.

"It underscored the importance of having private rooms," Stieglitz said.

The night was otherwise quiet, and the dimmed lighting was fine for sleeping. But there were a couple of other things the administrator was checking out.

"I have back problems, and so I fully expected the mattress to be uncomfortable," Stieglitz said. "The mattress was not bad at all. The sheets were kind of scratchy, but that may be a laundry problem more than the thread count."

Having slept restlessly all night, he finally woke at 9 a.m., surprised to find he was too late for breakfast.

"I didn't hear all the noises of the staff getting the residents ready," he said.

The upshot of the experiment is that Stieglitz would like to see more private rooms available for residents. There are currently four, and Stieglitz has asked Resthaven's governing board to think about converting some of the 23 semi-privates so more residents can get undisturbed rest.

He's not sure yet how many single-dweller rooms he wants; he'll have to look at how much revenue would be lost by reducing the population and how that would affect staffing needs at the nonprofit ministry.

But Stieglitz, at the helm for 11 years now, is committed to working out a plan. He said the idea fits with current trends in elder care.

"The nursing home profession, in general, is trying to move away from the institutional model, get away from the cookie cutter model, and move toward the personal care model," he said.

Rather than assigning residents shower times, for example, more staff are giving choices: Would you prefer a shower or a bath, and when are you used to taking it? And, what would you really like to eat for breakfast?

Stieglitz said the staff has to take into account menu standards set by state regulators. But, "it's a waste for us to put down a plate of eggs and bacon, knowing that all they're going to do is eat the toast and drink the coffee," he said. "Wasting food is also an insult to the Depression generation. We're just ignoring their life experiences."

One thing he's not ignoring is his own experience as a bunkmate in Room 5. Stieglitz had thought about private rooms before, especially since he believes that "Baby Boomers and younger are not going to take easily to the idea of rooming with a complete stranger."

So the idea was already there, but after just one night of going undercover -- literally -- "this makes it more urgent."