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The Witching Hour: What to Do During the Dreaded Assisted Living Lunch Hours

3/24/2018

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A familiar experience to all home health clinicians is the avoidance of the 11am to 1pm zone of lunches at Assisted Living Facilities (ALFs) and Memory Care units.  This time zone is jokingly referred to as “The Witching Hour.”
 It can be challenging to steer clear of this middle of the day period as the location of your patients may not allow for treating a non-ALF patient during the lunch hours.  These are the metaphorical doldrums to all of us working in home health: physical therapists, occupational therapists, nurses, social workers, and certified home health assistants.  Whatever your discipline, a middle of the day no-go-zone is a major buzz kill!

I deal with this in one of two ways: either I take lunch at the same time OR I take advantage of the differences in lunch times of different patients and facilities. For instance, if one patient has an 11am lunch, i’ll see another patient at 11 and then switch once the other patient’s lunch begins at 12.  

Obviously, the most easy method to avoid this challenge altogether, is to simply treat a patient outside of the ALF.  That’s why I often see my ALF patients early and/or late (but prior to dinner).  One advantage to the managed care settings of ALF and memory care is that schedules are predictable and can be worked to your favor as most clients are awoken at precisely the same time each day.  They are dressed, bathed, and fed; often before 9am.  

The old saying, “the early bird gets the worm” is particularly true in home health, as seeing ALF patients early is both practical and convenient.  I have found many of my non-ALF patients to be most unhappy with appointments prior to 10am.  This situation is easily remedied by starting your day off early and treating your patients in facilities first.  Of course, like everything else in home health, exceptions exist.  How do you solve the problem of The Witching Hour?
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