Residential Care Facility for the Elderly (RCFE)
Author: Rosalyn Neranartkomol M.Sc. in Gerontology from USC
6th year medical student
Origin/affiliation: Medical University of Silesia in Poland
Curious about what it is like to operate a residential care facility for the elderly (RCFE) in California, I proceeded to take the licensing course and examination. Currently, to become a licensed RCFE administrator in California the interested individual will have to take an 80-hour initial certification course from an approved vendor before taking the state exam. The state exam consists of a one hundred questions exam that lasts for two hours and after passing the exam then the individual has thirty days to go through the process of applying for the license. After becoming certified, to keep the license valid the individual must take a recertification course every two years to collect forty hours of continuing education units (CEU’s) from approved vendors. Again, after finishing these hours then the individual must send the application to the Department of Social Services Community Care Licensing Division. It is my opinion that as the population age and people live longer in frailer conditions, there will be an increase in RCFE’s; furthermore, RCFE’s will become more medicalized as the residents will require additional care for more health conditions.
What is valuable about doing this training and becoming licensed is that I get to meet people who work in this field and get a better understanding of the rewards and difficulties of being an administrator. Being exposed to people who care for elders daily as opposed to seeing elders during acute illnesses or during medical appointments gave me a perspective on what the day-to-day challenges are. For example, I was introduced to Teepa Snow’s Positive Approach to Care as part of the required training in Alzheimer’s disease. As a medical student, I was immersed in the clinical side of dementia; however, I was never exposed to the behavioral side of dementia. I believe that we can all benefit from being educated on methods to deal with sundowning, to deal with wandering, to dealing with anxiety in patients with dementia. How do we calm down our patients when they are feeling disoriented in an unfamiliar place like the hospital? How do we stop our patients from wandering out of the ward by using behavioral modification techniques?
Having some training around behavioral aspects will at least provide us the benefit of being knowledgeable enough to advise families and other caretakers on methods or resources that they can research. Nevertheless, cultural appropriateness must be considered; therefore, the behavioral approaches such as that of Teepa Snow’s may only work with a certain North American demographic. My own experience of acquiring an RCFE administrator license begs me to wonder about whether parts of a geriatrician’s curriculum and training should entail being exposed to certain aspects of these training as well. Can a geriatrician’s practice be improved by being exposed to an administrator’s outlook?