Lifelong learning plan and implementation

¶ … Nursing Home in Liberia

In the past, the need for nursing home facilities in Liberia was small because the culture demanded that immediate family members care for the elderly and given the relatively short life expectancies involved, few people lived long enough to require such care in formal institutional settings. Things are changing in Liberia, though, and improvements in healthcare and a reinvigorated economy following the cessation of a bloody civil war in 2003 indicate that more people are going to be living longer lives and will require the services provided by assisted care living facilities in the future. This paper outlines the plans for building such a project in Liberia, followed by a summary of the research and important findings in the conclusion.

Review and Discussion

Mission

The mission of the plan envisioned herein is to build a small 50 bed -- nonprofit nursing home facility in Liberia by 2019 (see map at Appendix A). The country does not currently have any such nursing home facilities. The construction of a nursing home facility in Liberia, though, can help the nation's elderly live longer and more fulfilled lives through the provision of timely and modern healthcare services and the provision of a nurturing environment that might not be otherwise available because of the devastation caused by the bloody civil wars that have wracked the nation in recent years, leaving many elderly without immediate family members who can care for them. As part of the mission of this plan, some of the specific steps that would be taken to ensure that the healthcare services delivered in the nursing home remained current and congruent with best practices in healthcare administration by following the accreditation criteria for such facilities established in other countries such as the United States and the United Kingdom.

Environment

Liberia's Constitution is identical to the U.S. Constitution and the country even uses U.S. currency as its medium of exchange. The similarities between Liberia and the more affluent U.S. end there, though. In this regard, Takahashi (2008) reports that Liberia is ". . . A small country on Africa's western coast with a population of about 3.5 million people, was founded by freed American slaves early in the 19th Century and declared independence in 1847. But much of its legacy in the West is related to the brutal string of civil wars that began in 1989 and left more than 200,000 dead and created 15,000 child soldiers" (p. 2). As a result of these events and the economic stagnation that followed, the unemployment rate in Liberia is a staggering 85% with an 11.2% inflation rate (Liberia, 2009). Other problems affecting the country today include the need for increased transparency and elimination of corruption in the national government and improved governance to attract private investment (Takahashi, 2008).

Vision

The guiding management book that will provide the basis for an understanding, approaches and actions for the appropriate management of the nursing home facility envisioned herein will be James E. Allen's (2007) Nursing Home Administration: Fifth Edition (New York: Springer Publishing Co.). This text includes the five Domains of Practice developed by the U.S. National Association of Boards of Examiners for Long-Term Care Administrators as well as a solid review of the core of knowledge of gerontological care issues.

Likewise, the guiding healthcare book that will provide the basis for an understanding, approaches and actions in the healthcare arena for this initiative will be Priscilla Ebersole and Patricia Hess's (1998) text, Toward Healthy Aging: Human Needs and Nursing Response (St. Louis, MO: Mosby). This text provides a comprehensive assessment of what factors must be taken into account in the delivery of healthcare services to the elderly in institutional settings and provides a wide range of useful and timely guidance concerning how to provide these services in a cost-effective manner.

Goals

The following goals will guide the implementation and administration of the nursing home project envisioned herein:

1. Secure adequate funding for the purchase of a sufficient amount of land for construction of the facility.

2. Secure the funding needed to construct the facility.

3. Recruit and training staff members including a professional nursing cadre for the specialized type of care required by the elderly using best practices identified in other countries with comparable cultural values.

4. Identify effective approaches to bridging the cross-cultural gap that may prevent families from using nursing home facilities when they are in the elders' best interests.

Strategies

The following strategies will be used to help achieve the above-stated goals:

1. Develop expertise in writing grant applications.

2. Identify nongovernmental organizations that provide funding for these types of social programs.

3. Formulate a community education program to inform the people of Liberia of the need for long-term care facilities for the elderly when immediate family members are unable or unavailable to do so.

4. Develop a training regimen that can be used to help employees become familiar with the day-to-day care needs of the elderly and what part they will play in the process.

Tactics

Given the current reluctance of the international community to make substantive investments in Liberia, the short-term tactics used to achieve the above-stated goals would require an aggressive public relations campaign to raise awareness among potential donor countries of the need for a nursing home facility in Liberia and the positive outcomes that could result. Assistance would also be solicited from accrediting agencies such as the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) in the United States to provide guidelines that should be followed in recruiting and training staff members and what factors should be addressed in facility design to ensure the safety and comfort of the elderly residents. Finally, a series of grant applications would be prepared and submitted to as many foundations as possible to gauge reactions and fine-tune the application process for future submissions.

Monitoring

Measuring the effectiveness of the funding received will be a fairly straightforward approach to monitoring the effectiveness of the grant application process, but there are other variables that can serve as metrics as well, including the percentage of beds filled in the nursing home, the turnover rate among staff and the number of patient-related incidents such as falls that occur. By keeping track of these statistics and developing trending graphs, problem areas can be identified and acted upon before they threaten the viability of the initiative.

Risk Factors