The 15 Little Things That Matter Most: Nursing Home

By: Wendy Wu, R.D., M.S.

Mrs. Sanchez is a vibrant, eccentric, rambunctious schizophrenic patient who can be spotted a mile away with her rosy cheeks, red lips and blue eye shadow. Her favorite outfit is this flower pattern dress (with one strap that somehow always end up falling off her shoulder) paired with white sandals. She never leaves her room without her beautiful rings, bracelets, watch and layered necklaces. Her hobby includes strolling around the nursing home checking out the young men at work by the lobby, chit chatting with her sisters on the payphone, attending recreational activities like the baking club, music, or piano playing and going to Catholic church services. Most of the time, Mrs. Sanchez will walk around the nursing home, but once in a while she will try to walk out the front door to “go shopping”. The nursing home will be in big trouble if any of the patients goes missing. So in order to prevent patient elopement, wander guards are placed around the ankle (or wrist) of patients who have attempted to leave the building or are at high risk. When a patient with a wander guard passes the front door, bells go off alarming the security guards.

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When the nurses told Mrs. Sanchez she had to wear a ugly white box around her ankle, she was furious! Many attempts were taken by her to remove the annoying white machine. One day, a nursing staff came up to me (as she knows I am quite crafty) and asked if I would be willing to decorate the wander guard. I thought, what a wonderful idea! And I jumped at the chance to help. I took some leftover rhinestones and hot-glued them on…now it might look tacky to some, but Mrs. Sanchez LOVED it, and that’s all that matters. We face many challenges when working with the elderly each and everyday. It’s an easy way out for us to document “patient non-compliant” but we need to take some time out of our busy day to think outside of the box. It would be wonderful if we can all do more of the little things that matter most.

happy dietitian  happy dietitian     happy dietitian

If you’re a nursing home staff, family member or would like to volunteer at a nursing home, here are some suggestions for putting a smile on a patients face (most of the time):

1) Read jokes and moral stories. Suggestions here, here, and here.

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2) Give them crossword puzzles or word search hand-outs. Make sure to get one with LARGE PRINT.

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3) Tell them what’s going on in the world. Read the newspaper to them (it may be best to skip bad news which may cause them to worry).

happy dietitian

4) Dig out their inner talents. Get Crafty. Knit a scarf. Make a tissue paper vase. Draw. Be creative.

happy dietitian

happy dietitian

happy dietitian

5) Play Cards with them. Teach them UNO! Be flexible with the rules.

happy dietitian

6) Perform-Sing. Dance. Do Magic. Read a Poem.

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7) Clean their glasses. They get dirty often. With soap if it’s greasy.

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8) A simple Good Morning, Good Afternoon, Good Evening or even a wave of acknowledgment.

9) Photos are one of the most prized possessions for the elderly. With fading memory, they rely on photos to fill in the gaps. Ask family to bring in photos and surround the room with family love. Decorate the walls but also have a album handy for the moments when family are not around.

happy dietitian

happy dietitian

10) Give them a heads up on everything you are about to do will decrease anxiety dramatically. Ask for permission. Give them choices. Get them involved in their own care. Encourage independence.


Mrs. Jones, What would you like to wear today?

It’s time for breakfast, may I wheel you into the dinning room?

May I help you open that drink?

Would you like coffee or tea? Milk and sugar?

What would you like to eat for lunch today?

Can I cut that up for you?

11) Music to sooth the soul. Ask the patients to list their favorite songs, musicians, etc and search for them on pandora (you may need to ask for permission to use cellphones) or see if the recreation department can provide some CD’s.

This one brought a BIG BIG Smile to a very special patient.

12) Get them involved. Give them a little push. Go over the calendar of recreational activities, highlight some of the events the patient may enjoy and let the staff know to encourage patient involvement. You’d be surprised at how the patients spirit can be lifted. Pet Therapy is my favorite!

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13) Check to see that their belongings are labeled. Clothes. Socks. Eyeglasses. Bag. EVERYTHING! If it’s not labeled, it will be lost.

happy dietitian

14) Help them make a phone call. Most of the elderly have poor vision or failing memory, so dialing a 10 digit number may be difficult. For the Nursing Home Administrator: It would be a good idea to purchase large print telephones with extra loud volume setting. Speed dialing would be great too!

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15) If permitted by the nursing facility, it would be wonderful to set up a day where the patient can go home to visit, out to their favorite restaurant, get a manicure, go to their favorite park, watch a movie, go to a ballgame, or even just to get some sun. Just ask the nursing staff if its possible.

Beautiful family takes their mother out for her birthday

Related Posts:

25 Things You Learn When Working in a Nursing Home

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Why Nursing Homes are Not as Bad as You Think

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What People Think Dietitians Do

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13 thoughts on “The 15 Little Things That Matter Most: Nursing Home

  1. What an amazing inspiration you are. Wow!!! This sucker’s getting reblogged and stashed away in my files. This information is useful on a professional level, on a volunteer level and on a personal level. I worked as a Dietetic Technician in a nursing home a few years ago and I sure could have used these tips. Love the wander guard. Can I have one? 🙂 Brilliant solution. Thank you for the colorful inspiration and genius problem solving.

  2. Amazing post. I loved all the tips and the personal example you used from your experience! I work with seniors every day and I know it is important for them to have a stress free environment. The company that I work for helps cover the out of pocket gaps brought on by government medicare. Check out our new website if you get the chance, We’d appreciate the feedback! 🙂

  3. Do dietitians know anything at all about living food compared to bland, canned food? My mom is in a nursing home and she is never served fresh fruits and vegetables. I think the food served there would make healthy people sick. I tried eating it and felt myself getting weaker so I stopped. But what can I do to get her better food?

    1. Sigh* Unfortunately, fresh fruits are expensive and perish so most food service directors (not all are RD’s) will opt for canned fruits. The veggies are usually frozen which may be even better (nutritionally) than fresh. In my perfect nursing home, food would be cooked by executive chefs using produce picked that morning from a nearby organic farm. Residents are offered meals and snacks 3x a day but may order room service if they wish. Haha you just inspired me to write a post titled “My Perfect Nursing Home”.

      1. Most of your concerns can be easily taken care of. 1) speak to the RD or leave the RD a note about adding more water and fresh fruits to her tray (if she can chew them). 2) ask her aide if she’s drinking enough fluids with her meals and snacks and just hint to her about maybe offering her more. 3) speak to the charge nurse on the unit about providing more water. Liquid requirements are calculated for each patient so they should be getting enough (unless they are on a fluid restriction)…however, my usual concern in the nursing home is if the patients are drinking them. Don’t be afraid to ask for the dietitian. They’re hired to take care of your mom! =)

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