Tag Archives: Person-centered

Get Ready for Trauma-Informed Care

August 8, 2019 Ann Catlin Leave a comment

Beginning November 28, 2019, the Centers for Medicare & Medicaid Services will require nursing homes to provide trauma-informed care. Consequently, they must “ensure that residents who are trauma survivors receive culturally competent, hence minimizing triggers that may cause retraumatization.”

What is Trauma?

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) describes the “Three E’s of Trauma.” First of all, the person is exposed to an event such as loss, violence, a natural disaster, or abuse. Next, he experiences the situation as physically or emotionally harmful or life-threatening. Finally, she has lasting adverse effects on well-being.

People express trauma differently, and some are more resilient than others. Furthermore, the impact of trauma is often confused with other conditions, such as depression or even dementia. Symptoms may have a delayed onset and include:

Physical: Aches and pains, poor sleep
Psychological: Anxiety, poor emotional control, flashbacks
Cognitive: Difficulty with memory and attention
Social: Poor trust in others, isolation
Spiritual: Lacks meaning in life

What is Trauma-Informed Care?

According to SAMHSA, trauma-informed care rests on a set of critical concepts referred to as “The Four R’s. These assume that all people within an organization:

Realize that trauma exists and understand the impact and consequences of traumatic experiences.
Recognize signs of trauma.
Respond consistently using the principles of a trauma-informed approach.
Resist the re-traumatization of people with traumatic histories.

Therefore new regulations for trauma-informed care expect facilities to:

Assess each resident’s exposure to traumatic events in their life.
Train staff in the impact of traumatic experiences.
Incorporate trauma-informed approaches into care plans.
Use strength-based interventions that maximize trauma survivors’ resilience to avoid retraumatization.

Acknowledging traumatic experiences and providing care that is sensitive to each individual is essential. However, I question how realistic this new regulation is for many nursing homes faced with high staff turnover. As a result, limited resources go to basic care and training in practical approaches.

In conclusion, how do you perceive the future trauma-informed requirements?

Ann Catlin, OTR, LMT: For twenty years, Ann led in the field of skilled touch in eldercare and hospice. She has nearly forty years’ clinical experience as an occupational and massage therapist. She created Age-u-cate’s Compassionate Touch program and serves as a Master Trainer and training consultant.

Family Caregiver, Hospital Professionals, Senior Care Professionals

How Five Minutes a Day Can Transform Care for Older Adults

August 8, 2017 Pam Brandon Leave a comment

Time is precious. Staff is in short supply. Family caregivers are stretched to the limit. Just taking care of the basic needs is hard enough, so five minutes a day seems – IMPOSSIBLE!

Humanizing care is the core of the person-centered philosophy initiative sweeping this country. Dignity, respect and understanding the needs of any aging person is a culture change that I believe with enough stakeholders will transform care from the medical model that has driven our health care system for far too long.

If holistic care is the core of this belief, then education and tools for those who care for our older adults is paramount. Tools that are feasible, effective, and will be sustained within the organization. So, how can five minutes a day change someone’s dignity or sense of respect?

Engaging and communication are absolutely essential elements that must be integrated into our staff training and family education plans. These tools are incredibly simple to use, yet often overlooked because we are concentrating on the box checking (aka meeting regulations and requirements). While charting is certainly important, let’s not overlook the essential elements of engagement and communication.

Here are 10 examples that can transform a person’s dignity, self-respect and value in five minutes a day:

Remove words of endearment (honey, sweetie) and refer to them as they would like to be: Mrs., Mr. Sarah, Fred. This takes one minute to ask another staff member, family or even the patient!
When speaking, look at the individual in the eyes, talk clearly and slow down! You don’t have to shout (no one likes being yelled at!). This small gesture tells another person you are engaging with them because you want to engage.
Use gentle touch on the hands, shoulders, arms or face to develop trust and show the person you genuinely care. Touch will induce chemical changes in the brain that induce relaxation, reduce stress and many other benefits.
Ask a person something about them. It may be about their family, or what they did in their career, or a hobby. Learn one new thing about them every day.
Compliment and smile! “You have a lovely blouse on today, Mrs. Smith. I love the spring colors”. “Mr. Jones, I appreciate your smile – it really lights up my day!”
Practice mindfulness – being centered and in the moment when you are with your care partner. When one is distracted or stressed, it shows! Deep breathing or meditation can and should become a part of every caregiver’s daily de-stress routine.
Pay attention to your body language and expression. Clenched teeth, rolling eyes, closed arms all tell another person you don’t want to be where you are.
Learn what music your care partner enjoys and throughout the day, play this music to set the tone for whatever the circumstances.
Take a 5 minute walk outside and enjoy nature – it calms the soul, reduces anxiety for both care partners, not to mention the healthy shot of Vitamin D!
Accept the moment and that no matter what positive things you do as a caregiver may not always be helpful that day. Tomorrow, however is a NEW day!

Pam Brandon is President/Founder of AGE-u-cate Training® Institute and a passionate advocate for changing how we care for older adults.

www.AGEucate.com

Senior Care Professionals

Senior Care Professionals- Four Tips to Develop Cultural Sensitivity

November 25, 2016 Ann Catlin Leave a comment

Senior Care cultural sensitivity

As the world becomes increasingly ethnically blended senior care professionals are called upon to care for people from diverse cultures. This is true in hospitals, clinics, long term care, hospice and home care. To create person centered senior care it’s important to develop multicultural sensitivity while respecting cultural differences of individuals, families and groups.

Decades ago I worked as an occupational therapist at an Iowa hospital. One day my supervisor called a meeting about a new patient—not something that typically triggered a meeting. But this was not a typical patient. He was the elder of a gypsy family. The hospital was making preparations to accommodate what tradition dictated in gypsy culture. The entire extended family would stay on the premises during the elder’s hospitalization. I admire the way the hospital handled the situation. For days this family lived in campers in the parking lot in addition to several people staying in the hospital room night and day. I was fascinated by all this even though I didn’t understand it. I’m glad the hospital set such a good example and honored the needs of this patient while demonstrating cultural sensitivity.

Cultural competence is the ability to relate to and provide services for people from cultures and traditions other than one’s own. Lots of things make up a person’s culture and world view. Ethnicity, family heritage, spiritual tradition, beliefs about illness and well being, views of death and dying, food beliefs, family structure, language and non-verbal communication are a few such influences.

Four Tips to Develop Cultural Sensitivity

Experts in the field of transcultural nursing as well as professional chaplains suggest we first identify your personal cultural identity. Recognize your social roles, spiritual self-knowledge, cultural heritage, personal habits and attitudes. Your own influences determine how you think and behave socially and in the workplace.
Identify the cultural mix in your own community. The cultural tapestry of Miami is different than in San Francisco or Des Moines or the Appalachian mountains. What shapes the tapestry where you live?
Generalize, rather than stereotype. To stereotype is to apply a belief or attitude to everyone in a cultural group, for example “all Hispanics do this” or “all Chinese think that”. To generalize is to have a basic understanding about a culture and use that knowledge as a starting point to then learn more about a person, family or group. You don’t have to be an expert about cultures to become more sensitive and competent. Accurate basic information is a good start.
Practice authentic listening. Listen with your ears, eyes, heart and mind. Authentic listening is paying attention in the moment. Information gathered in the moment guides right action.

Person centered senior care fosters a holistic approach. Factoring in the needs of people from a range of cultures seems logical. Do service providers encourage cultural competence and sensitivity? Share your experience!

Senior Care Professionals

Senior Care – We Need More Innovation, Person-Centered, Tools

November 15, 2016 Pam Brandon Leave a comment

The Message is clear. “We need more innovative, person-centered tools to help those who care for our elders, especially those with dementia.”
Our team returned from a whirlwind of fall conventions including the American Health Care Association, Leading Age, Harmony Healthcare International and many state conferences. Discussions among long term care leaders was a consistent theme of needed innovative tools.
While the industry is faced with many challenges, how we care for our elders remains a top priority. Thankfully, for many organizations the transformation to true person-centered care is taking hold. In order for successful integration and sustainable change, leaders must address these key areas:

Person-Centered Care embraces individuality, life experiences, human value and relationships. Does your model of care and training address these components?
Elder Care is Quickly becoming about Dementia Care. Is your organization realistic about how many residents or patients have some level of cognitive impairments?
Engaging care practices and integrating a program are two different models. Programs engage all staff, embraced by leadership and have a much higher sustainability factor than haphazard practices. Programs are articulated as part of the company mission. Do you have some great practices but weak programs?
Tracking competencies and performance is no longer an option. Programs that specifically address and provide innovation tools for improving communications and care processes must be measured. Is your organization prepared to track resident/patient experience, staff experience, family experience and business impact when innovative programs are put in place?
Programs can differentiate your organization from others. Niche messaging to your prospective customers and families can improve reputation as a respected leader, improve employee retention and census. Has your organization defined it’s niche with programs and education tools that set you apart from others?

Looking ahead to 2017 leaders across the spectrum are reassessing their program, practices, and how to best serve their customers, families and staff. Initiatives that incorporate innovation, creativity, provide strong outcomes and measurable tools are desperately needed in today’s fast changing senior care arena.

See: Dementia Live™