When nurse Janette Nelson has trouble falling asleep at night, she recalls the names of the four dozen or so residents at Parkview Senior Living.
“I’ll start with Room 101 and go all the way through the building, naming everybody in each room.
“And they all know me because I’ve been here so long.”
Indeed, in an industry notorious for high employee turnover, Nelson has been a fixture at Parkview the past two decades.
During a recent interview, she discussed how to choose the best assisted-living fit and what happens when residents’ needs change.
S-R: Where did you grow up?
Nelson: I was born and raised in northern Minnesota.
S-R: Back then, what did you consider “elderly”?
Nelson: I remember hearing that my aunt had turned 29 and thinking, “Wow, that’s old.” (laugh)
S-R: Were there any truly elderly people in your life?
Nelson: Yes. My grandparents lived into their 80s and were very important to me.
S-R: Did you have a favorite class or activity in high school?
Nelson: No. My high school days weren’t so great.
S-R: What was your first job?
Nelson: When I was 16, I made salads at a little restaurant in Colorado Springs.
S-R: What other jobs have you had?
Nelson: A lot of babysitting. I sold shoes in a department store. Just odds and ends.
S-R: How did you end up in nursing?
Nelson: My older sister was a nurse, but I never thought that was for me because I couldn’t handle blood and guts. Then when I was 29, my next-door neighbor came over and said, “I’m going to the college to sign up for the nursing course. Do you want to go with me?” I said yes, and I’ve never regretted that decision one day in my life.
S-R: Why assisted living?
Nelson: I have always been drawn to the geriatric population, even in nursing school. My instructor noticed that and would assign me older patients.
S-R: What brought you to Colville?
Nelson: I moved here to be closer to family. My sister was the administrator of a local nursing home. This building was brand new, and they went through a couple of other nurses the first year. Then I was hired, and I’ve been here ever since.
S-R: Did any skills learned in previous jobs help you as a nurse?
Nelson: Yes – working with the public and being empathetic. I enjoy listening to people and visiting with them. The elderly don’t always have that ear.
S-R: How has Parkview evolved since the late ’90s?
Nelson: We’ve gotten better at bringing in the appropriate type of residents. Early on, the focus was filling rooms. Over time, we’ve become more selective.
S-R: When assessing a potential resident, what are your criteria?
Nelson: I look to see if we’re able to meet that person’s needs. I evaluate them for memory, depression, pressure sores, those sorts of things. I rule them out if there are issues I know we can’t deal with.
S-R: What happens when someone starts out a good fit but over time their condition deteriorates?
Nelson: My goal as a nurse is to help people age in place. So, for instance, while we don’t admit people who require two people to move them, if they require two-person transfer assistance later on we try to accommodate them. But if they start wandering away from the building and don’t know where they are, it would be time to look for an alternative. We’re not set up for memory care.
S-R: What’s the difference between assisted living and nursing homes?
Nelson: The main difference is we do not have round-the-clock skilled nursing staff. We have one caregiver per floor and a med tech for each shift, but I’m only here 16 to 20 hours a week.
S-R: What sort of activities are available to your residents?
Nelson: Some like to go fishing. Others play pinochle or bingo. We have three residents who are wonderful artists and offer painting classes. We host community events such as antique car shows, and have a bus that takes residents on country drives. We don’t go as far as Spokane for entertainment, but we have the little Woodland Theatre in Kettle Falls (8 miles north of Colville).
S-R: How about exercise?
Nelson: We have some exercise equipment and a sidewalk looping around the property. But we’re not like some fancy facilities in Spokane with swimming pools. That would be nice.
S-R: Are most of your residents from the community?
Nelson: Yes. And if they’re not, typically their children live here.
S-R: How would you describe the local labor pool?
Nelson: For a rural area, we do very well. We’ve never been understaffed and are fortunate to have some long-term employees. Partly that’s because in rural areas, people who job-hop may burn their bridges.
S-R: How big is your staff?
Nelson: Between 30 and 33 employees.
S-R: Are there enough physicians in town?
Nelson: We have quite a few, but a lot of them are resident doctors, and once their residency is up they leave. That’s one of my frustrations as the nurse. This morning I went to fax a doctor about a lady who had fallen, and her doctor had moved on.
S-R: Are assisted-living facilities licensed?
Nelson: Yes, and we’re very scrutinized. State surveyors come in for two or three days a year to see what’s going on.
S-R: If someone is looking for an assisted-living facility for themselves or a relative, what should they consider?
Nelson: There are so many options today. You can start in a little cottage where you don’t need any help at all except maybe meals, then move on to something more like this setting, where you have a little apartment and help with things like tying your shoes or remembering to take your pills. I think one of the most important considerations is the food. I recommend people who are shopping around to visit facilities and sample a couple of meals.
S-R: What are other considerations?
Nelson: Cost is definitely up there. Also staffing – is there a revolving-door problem? And you can ask to see the state surveys, which are public information.
S-R: Who adapts best to an assisted-living environment?
Nelson: People who decide to come here on their own, and their family supports their decision. People pushed into this situation reluctantly have a harder time. Assisted living works best when residents feel they have choices – whether or not to come here in the first place, and choices once they move in. We allow pets. Some of our residents still drive. They take vacations.
S-R: What do you like most about your job?
Nelson: I love the residents, and I love the flexibility. My husband and I own a 15-acre orchard, we have some rentals, and I’m trying to develop a couple of little Airbnbs.
S-R: What are you most proud of?
Nelson: Making sure the staff treat residents with dignity and respect.
S-R: What has this job taught you about yourself?
Nelson: It’s taught me to not fear aging.