Category Archives: Compassionate Touch®

The Importance of Education for Informal Caregivers

Members of the First United Methodist Church in Arlington Heights, IL attend an Eldercare Educational Program about Understanding the Continuum of Eldercare.

Today, family members and other private individuals provide the bulk of care for frail older adults. According to The National Alliance for Caregiving, approximately 34.2 million Americans have provided unpaid care to an adult age 50 or older in the prior 12 months.  The assigned dollar value of unpaid caregiving is a staggering $470 billion.

Informal caregivers are a critical link in the system of eldercare. The care and support that is provided delays, and may even prevent the need for institutional care. Equally, we must acknowledge the financial impact that the informal caregiving system has on our nation. Consider the increased stress on the Medicaid system without these caregivers.

The American Association of Retired Persons offers a terrific directory of resources available to family caregivers. There are many agencies, both public and private, that exist to provide resources for family caregivers. To that end, caregivers can access website links, pamphlets, resource guides, and a plethora of other informational sources.

Importance of Education for Caregivers

Yet, with all of these resources, so many family caregivers still feel lost and overwhelmed. I have observed many caregivers who don’t know what they don’t know.  In addition, it is paralyzing for them to know where to start.

Caregiver education should be a more robust component of our eldercare system.  Education that leads to increased knowledge is necessary so that people can feel empowered and access the correct resources.

Caregivers need to understand the process of aging.  As astutely stated by The Age-u-cate Training Institute, it is hard to care for someone that you don’t understand.  Consequently, when caregivers feel like they are in the dark, stress, and frustration ensues.  Therefore, helping caregivers to understand what is going on will better equip them to find the right resources and ask the right questions.  Knowledge is empowering.

To list, a sample of educational topics for caregivers:

Creating opportunities to provide knowledge will increase understanding and compassion, reduce stress, and strengthen the process of caregiving.  In addition, it will improve the relationships between caregiver and receiver.

 

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving for family and professional caregivers.  She is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.

Person-centered programs

Innovation in long term care communities: early versus late adopters

Innovation in the long-term care setting can take many forms. It can be a novel technology, an inventive volunteer program, or an innovative training class. No matter what the offering is, the willingness to try something new to benefit elders in the long-term care setting is always worth attempting.

In exploring new, innovative projects in the long-term care setting, there can be two types of adopters: early and late. Those communities who are early adopters want to be the first to try something new. They are not afraid of risk or to make mistakes. They will test new approaches and identify ways to refine the process as needed, developing best practices to help build upon lessons learned.

Bringing a new, innovative project into the long-term care setting can also provide a competitive advantage by distinguishing a community as one that offers services that other communities do not. Elders, families, and staff will recognize the community’s commitment to trying new concepts and projects to enhance and improve resident care and quality of life.

The drawbacks in being an early adopter can include the emergence of unknown, unexpected costs to make changes and adaptations to test a new, unknown project. There are also risks involved, especially in the potential unknown effects on residents and staff of a new project. Additionally, the implementation of a new, untested project can affect the workload of employees who are likely already over-burdened while being asked to try a new project.

There are also benefits and drawbacks in being a late adopter. By adopting a project or idea late, the existing kinks likely have been worked out, making it easier to implement and potentially less costly to undertake. The benefits for implementing a project may be well known by the time a late adopter brings it to the community which may make the implementation process more worthwhile. Drawbacks to adopting late include the delay in providing elders with the benefits of an innovative program. Further, there may be more costs to elders that might have been avoided if the program had been attempted.

Despite the benefits and challenges in being an early or late adopter, there are some programs which are beneficial to adopt early. The National Partnership to Improve Dementia Care in Nursing Homes (Partnership) works to improve the quality of care for individuals with dementia who live in nursing homes. Part of the Partnership’s mission includes a focus on addressing the amount of antipsychotic medications individuals with dementia are prescribed. According to a memo from the Centers for Medicare & Medicaid Services’ Center for Clinical Standards and Quality/Quality, Safety & Oversight Group , from 2011 to 2018, there has been a national decrease of nearly 40 percent (38.9) in the number of nursing home residents receiving an antipsychotic medicine; however, more work can be done to reduce the use of antipsychotic medications in nursing homes.

As recently as December 2017, there were 1,500 nursing homes identified by the Partnership as late adopters, which are nursing homes with a sustained high or relatively unchanged rate of antipsychotic medication use, or their antipsychotic medication usage continued to be above average without a high percentage of schizophrenic elders in the nursing home.

In order to address these findings, the Centers for Medicaid and Medicare Services (CMS) is providing technical assistance and support to late adopters. There will be enhanced oversight and enforcement actions to support these nursing homes in addressing their high rate of antipsychotic medication use. These strategies will be useful in helping these nursing  homes implement the changes and strategies needed to address the rate of antipsychotic medication use.  The return on that investment of time and personnel to implement programs like those can be significant, in terms of improving elder care, which is always worth attempting, whether early or late.

Kathy Dreyer, Ph.D., is the Director of Strategic Projects at AGE-u-cate® Training Institute, which develops and delivers innovative research-based aging and dementia training programs such as Dementia Live® and Compassionate Touch®, for professional and family caregivers;  kathy.dreyer@ageucate.com

 

Specialized Dementia Training and Employee Turnover

 

Specialized Dementia Training can have a positive impact on reducing employee turnover.

The AGE-u-cate Training Institute received encouraging feedback from a client, and it is worthy of a share. A home health agency that utilizes Dementia Live for staff training reported that their employee turnover is decreasing. Furthermore, the turnover correlates with their implementation of  Dementia Live, a simulation training experience of what it might be like to have dementia.

This news made us curious about the connection between specialized dementia training and employee turnover.

PHI is an organization with a mission to promote quality care through quality jobs. PHI identifies staffing in long term care a national crisis and reports conservative estimates of turnover across the long-term care sector ranging from 45 to at least 66 percent. In addition, one in four nursing assistants and one in five home health aides report that they are actively looking for another job.

The Dementia Care Foundation (DCF), based in Darwin, MN, studied staff retention and turnover in those working with persons with dementia. The research premise is based on findings by Brodaty et al., 2003 that turnover is particularly challenging in dementia care.

Effectiveness of Specialized Training

Researchers with the DCF also cited findings from Chrzescijanksi, et al., 2007; Coogle et al., 2007 that specialized training has been shown to reduce staff turnover while simultaneously improving the quality of care.

Relationships with co-workers was the most significant factor contributing to employment exodus.  However,  findings also reveal a connection in turnover and the lack of specialized training.

The DCF also uncovered a relationship between dissatisfaction with training about managing dementia behaviors and how likely respondents were to leave their job within the year.

Specialized is the keyword. Training for staff working with persons with dementia needs to heighten understanding and empathy. In addition, it should equip staff with knowledge and skills to respond to and reduce difficult behavioral expressions.

Something else to ponder is if and how employee relationships improve with specialized dementia training.

The training philosophy behind  Dementia Live is that it is hard to care for someone that you don’t understand.  Lack of understanding leads to stress, burnout, and ultimately turnover.

In conclusion, consider investing in specialized dementia training as a strategy to reduce employee turnover.  In addition, the impact on employee relationships following specialized training would also be an interesting aspect to explore.

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving for family and professional caregivers.  She is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.

Find Time for Compassion

Care of frail elders is often reduced to the completion of tasks. Caregivers caught in the frenzy of tasks should make time to provide the compassionate part of care- expressive touch.

I’ve been contemplating the chronic state of lack of time that so many feel these days.   We allow ourselves to think that more time will permit exercise or completing that project.

Lack of time is   a reason given for the inability to incorporate expressive touch into the care we provide our frail elderly residents.  Rachelle  Blough Kowalczyk,  Memory Care & Life Enrichment Consultant touched on the need for care workers to slow down.

Nursing assistants don’t have time to sit with a resident because they are always called away.  Nurses  have too much paperwork and medications to pass, and Social Workers have too many meetings.

These are the reasons expressive touch is mostly absent from the care we provide to our residents, yet it is such a necessary component of quality of life.   Making time is a big culprit.

Making Compassion a Priority

Many seasoned nurses state that at one time, back and foot rubs were a part of the care protocols.  One such nurse challenged her nurse colleagues during training to find the time to offer expressive touch to their residents.

This  nurse shared her experience  working in a large ward in England where she cared for over 50 patients.   Paper charts and hand-counted pills didn’t stop her from offering back rubs.  It was good medicine,  and would help her patients heal and feel better.

There are eye-opening moments in most Compassionate Touch training sessions when the learners realize how little time it takes to offer expressive touch!

Finding time is possible.   Consider a pocket of time 10-20  minutes before the end of a shift (when the cell phones usually come out). Think about the rest time after lunch and offer a back rub prior to assisting a resident to bed.

Ancillary personnel can also engage in expressive touch with residents if trained properly.   To that end, work together as a multi-disciplinary team to find time to improve the quality of life for your residents,  and your staff.

For more information about spreading the power of compassionate touch to your community, visit http://www.ageucate.com.

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving for family and professional caregivers.  She is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.