While I hope to lower this number, most of my efforts have not yet reached fruition. Not Another Nursing Home Many of the problems I have encountered relate to my inability to detach myself from my nursing home background. In the unregulated world of assisted living, everything from charting expectations to use of forms from the nursing home setting have met with resistance. Limited staffing seems to assure that this will be a long-term problem. Routine vital sign information is not recorded consistently.
Dietary restrictions are difficult to implement.
Diabetic diets are provided routinely, but not low-fat ones. Since the family must pay for laboratory assays for patients without adequate insurance coverage, the cost attached to a drug assay becomes a major impediment to therapeutic drug monitoring. Another area of concern lies in the training and education level of personnel working in assisted living facilities. In Tennessee, licensed nurses are required to administer medications. Since assisted living residents are able to leave the facility and purchase nonprescription or prescription medications without staff's knowledge, the role of the pharmacist becomes more important-and more difficult.