Nursing Home Noise

Nursing HomeShe can only talk in a very quiet, low voice. I can barely hear her when it is quiet – and it is never quiet in the nursing home.

It’s noisy whenever I visit, not just Sunday morning. On Sundays, though, you can hear three different preachers, on televisions in three different rooms, all with the sound turned up. They overlap in a sound stew of Jesus.

Add to that noise the sound of the call systems. When you press the button on a resident’s bed not only does the light in the hall outside the room start blinking but the alarm starts beeping. You can see the light down the end of the hall at the nursing station and you can also hear the alarm. So you get this alarm going off every few seconds and it continues until one of the aids has a chance to go to the room to see what the patient wants. They take their time. Most of the patients are calling for help to go to the bathroom.

Many TelevisionsThen you get the patient who starts yelling something – you can hear that in the entire wing.

There’s a TV in the community room showing some movie.

The visitors talking to their loved ones in their rooms think that they need to speak in a loud voice so that Grandma can hear. Everyone up and down the hall can hear.

Sunday mornings, though, are quiet compared to the activity that occurs most days and nights.

Most studies that discuss noise in nursing homes focus on the noise at night that disturbs the resident’s sleep. But it’s the noise during that day that is driving them crazy.

I volunteered three days a week with the local hospice visiting hospice patients in the nursing homes around town. Being in the place for a few hours drives me a little crazy. I don’t know what I would do if I had to live there.

Everything that contributes to the noise someone at the facility believes is indispensable and unchangeable.

Rolling ComputersThere are the wheels on carts and lift machines screeching up and down the halls. Then there are the floor buffers and cleaning carts. Nursing station noise: monitoring equipment and printers and telephones. The noise from the lounge areas: soda and vending machines and ice machines. There is the community room TV and the TVs in each room, overhead announcements, the beeping of call buttons, agitated patient’s shrieking their wants and needs and the normal talking of patients, visitors, care givers and floor personnel.

It is noise pollution in a big way.

Although I am there for only a few hours a day a few days a week, this must have some negative effect on the people who work there trying to cope and care for patients.

Wheels - squeaky or just rollingNoise stress has got to lead to some loss of effectiveness, causing errors and desensitizing caregivers, causing them to ignore alarm noises.

It has an effect on patient outcomes. Not to mention a lack of privacy for patients when the care givers speak up when talking to them.

If I were Nurse Ratched everyone with a TV or computer or music device would have their own wireless earphones. For those patients who cannot deal with earphones, I would install speakers in headboards or embed them in pillows.

Noise, for those who want it.

Why should you listen to Pink Floyd when I’m the only one in the room who likes their music?

There are a lot of other, institutional steps that can reduce the ambient noise.

room alarms, telephones, fire alarms, doorsBare floors and walls are easier to clean but echo sound. Curtains and pictures on the walls would help mute the sound.

Wrap the ice machines and vending machines. Put them in closed rooms with easy access for wheelchairs.

Use call systems that don’t make noise: calls directly to monitors carried by the aids, nurses, and other care givers – lights on panels and over doors. Lights unaccompanied by alarms.

Training for all the personnel: quieter conversations; quieter shoes.

Silence is not golden — some noise is necessary for comfort. Ambient noise is good. It masks other noise. Nature sounds: water bubblers, indoor water falls, ambient noise machines, or fans.

“Unnecessary noise is the most cruel abuse of care which can be inflicted on either the sick or the well,” said Florence Nightingale in her 1859 book, “Notes on Nursing”.

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