Tag Archives: Training

Get Ready for Trauma-Informed Care

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:

  1. Realize that trauma exists and understand the impact and consequences of traumatic experiences.
  2. Recognize signs of trauma.
  3. Respond consistently using the principles of a trauma-informed approach.
  4. 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.

Rural Healthcare: Helping Caregivers and Persons Living with Dementia

Access to quality rural healthcare, resources, education, and support is a growing challenge in the US and around the globe.  What does this mean for the growing numbers of persons living with dementia and their families who are caring for them?  How does this affect the quality of care being offered by nursing homes and other care providers?

There are no easy solutions as options are dwindling for many rural communities.  Closures of hospitals mean less health care professionals to diagnose Alzheimer’s and other forms of dementia.  Community education for families, often a service offered by hospitals and clinics, is then not available.  When the infrastructure of healthcare, private providers and community-based services is compromised, access to much-needed support dwindles quickly.

I recently had the honor to work with the University of Waterloo School of Pharmacy who collaborates with the Gateway Centre of Excellence in Rural Health, both in Ontario Canada.  The University will be training its pharmacy students using our Dementia Live® and Compassionate Touch® programs and beyond that, they are will be working with Gateway to reach rural communities with desperately needed dementia education and training for families and professionals.

Reaching the indigenous people of the province will be part of this project.  In the 2016 census, the indigenous or Aboriginal peoples in Canada totaled 1,673,785 people or 4.9% of the national population.   Many of the indigenous peoples live in rural areas where access to services is limited.   Bringing dementia awareness and education to rural areas will help to spur collaboration amongst various organizations who need to work together to serve their aging populations and families.

Limited access to rural healthcare is a growing initiative in the US and other countries as the aging population swells.  Because family caregivers make up the vast majority of those caring for persons with dementia, providing quality training, support and access to resources is a top initiative for healthcare, long term care services providers and community-based organizations in urban areas who can collaborate with local services, faith communities and others who have a direct reach to many of the families who are struggling.

Finding local champions who see the value of collaboration, education and support services is ultimately the best measure of success, as the communities themselves embrace the challenges and solutions for their aging communities and the unique needs of persons living with dementia and their families.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and a passionate advocate for older adults and those who serve them.  

 

Improving Cultural Competence in Senior Care Through Training

The increasing diversity of the U.S. and other nations offers opportunities and challenges for senior care  care providers, health care systems, and policy makers to create and deliver services to culturally diverse patients and to train and increasingly culturally diverse workforce. Cultural competence refers to an ability to interact effectively with people of different cultures. Cultural competence comprises four components: (a) awareness of one’s own cultural worldview, (b) attitude towards cultural differences, (c) knowledge of different cultural practices and worldviews, and (d) cross-cultural skills.   Developing cultural competence through training can result  in a better ability to understand, communicate with, and effectively interact with people across cultures and can lead to a 15% decrease in miscommunication.  In senior care, this communications training can significantly improve outcomes, especially in caring for those with dementias, chronic illness, pain and at end-of-life.

Training the workforce on understanding cultural issues that are relevant to better understanding patient and family values and needs will.  Cultural competence enhances the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients. A culturally competent health care system can help improve health outcomes and quality of care, and can contribute to the elimination of racial and ethnic health disparities. Examples of strategies to move the health care system towards these goals include providing relevant training on cultural competence and cross-cultural issues to senior care and health professionals and creating policies that reduce barriers to patient/resident care.

Cultural competence training methods can enhance transparency between language, values, beliefs, and cultural differences. Training in cultural competence often includes careful consideration of how best to approach people’s various forms of diversity. This new found awareness oftentimes allows people to better establish  equity in their environments and enhances interrelationships between one another for increased productivity levels.

Pam Brandon is President/Founder of AGE-u-cate Training Institute, whose mission is to develop and deliver aging and dementia training to professional and family caregivers.  

www.AGEucate.com

The Transformational Power of Touch in Dementia Care

073b5c55b0caf45ad6bb584bf7d4ede6-2Touch is one of our most fundamental needs.

It is the first sense to develop in the womb and one of the last ones to go during dying.  Although our situation, age and condition may change the need for human contact does not.

Why, then is touch deprivation so real in old age?  

It occurs, in part, because of separation from loved ones but mostly because of fear on the part of younger people. Fear of looking at old age up close and personal. I think that if old people are thought of as former people the assumption is they no longer have the same needs as when younger. When it comes to touch this idea really misses the mark! According to  Jane A. Simington, RN, PhD conducted a literature review and her findings were published in Humane Medicine Journal. She reports:

Older persons report that touch conveys fondness, security, closeness, warmth, concern, and encouragement, and makes them feel an increased sense of trust and well-being. They report that touch helps them to develop close, trusting relationships with staff and other residents. As tactile sensitivity decreases, the need to receive expressive touch may increase. Nature can be cruel however, and the elderly person often may have no one to provide this increased touch. The children are gone and the partner has died. One elderly woman put it this way, “Sometimes I hunger to be held. But he is the one who would have held me. He is the one who would have stroked my head. Now there is no one. No comfort.”

Caregivers can be agents of change and have the power to profoundly impact quality of life for older adults by reversing the effects of touch deprivation. Of course there are physical benefits of skilled touch that  result in improved function in activities of daily living.  Proper touch alleviates aches and pains and improves circulation, resulting in greater ease of movement and the ability to perform physical tasks with greater comfort. It can induce a relaxation response, leading to improved sleep quality and feelings of calmness. But focusing only on the physical benefits adds to the medicalization of aging.

Rather than viewing touch as a treatment for ailments let’s look to it as a way to validate the human experience of aging. The gift of caring touch encourages feelings of self-acceptance and worthiness. But our influence goes even further. By literally reaching out to older adults we demonstrate wholesome attitudes about aging. Maybe by our own actions we will encourage others to be more willing to touch our elders. Society as a whole stands to gain.

Ann Catlin, OTR, LMT is an expert and educator in the field of therapeutic touch and the creator of the groundbreaking Compassionate Touch® program for those living with dementia or at end-of-life.  Professional and family care partners are witnessing transformational change by using the Compassionate Touch program to engage, connect and comfort.  Compassionate Touch is a program of AGE-u-cate Training Institute, whose mission is developing cutting edge aging and dementia training.  

www.AGEucate.com