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

Person-centered programsThe 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™

 

Senior caregiving: Remember your why

lonely-old-man-in-senior caregiving

Anyone working in the field of senior caregiving knows how important it is to find meaning in our work and service. Author Simon Sinek tells us to Start with Why. I’m haunted by the memory of a man who reminded me of why I continue to love senior caregiving.  I met Frank in a nursing home where I was teaching a Compassionate Touch workshop.  I first noticed him because he wasn’t particularly old, at least not by senior care standards, and because he was tall and muscular. He was sitting in a corner in the hallway near the nurse’s station. By his appearance, I was pretty sure he had suffered a stroke some time back.

During the first two days of the training, my students and I went about our business interacting with elders and memory care staff. On the third day, I noticed Frank sitting in the same spot– for hours, just sitting there.  He didn’t interact with anyone and seemed frustrated. He restlessly pushed on the wheelchair footrests. The wheelchair was locked so he couldn’t go anywhere and I’m pretty sure he couldn’t propel the wheelchair himself. Lots of people passed by in the hallway, but no one paid him much mind. He seemed invisible. And lonely. And really frustrated.

Frank is exactly the person I love to seek out to serve.  So, on the third day I pulled up a chair and sat next to him, introducing myself and there was immediate eye contact. While he had trouble with speech, he still could carry on a conversation. He told me he was a veteran and grew up in Illinois. I also learned that he believed his age to be 37. Other signs of confusion were there, too.  I held his hand and arm  affected by the stroke. He was receptive to touch. I asked if his back was uncomfortable. He indicated yes, so I gently rubbed his shoulders and He told me it felt good and with very clear speech, thanked me.

The next day he was again sitting in the same spot. I asked him if he would like to sit somewhere else. He pointed to a spot about six feet
away that was near a desk. With a little effort, because of his size, I maneuvered his wheelchair around so he could reach the desk with his hands. He reached out took hold of a newspaper and proceeded to read it! Regardless of his reading comprehension, he engaged in something purposeful that clearly meant something to him.   The restlessness stopped.  I sat with him about five minutes and I saw a glimmer of a sense of humor. As I left, he took my hand and said “thank you for stopping.”

Now, Frank’s memory haunts me. In a bad way and a good way. Bad because his plight troubles me since I’m pretty sure that he is sitting in that same corner spot as I write this. Invisible again. However, good because Frank is a gut-check of why I do what I do.  Thank you, Frank, for reminding me of  why I love senior caregiving.

 

Senior Care – How Our Pets Teach Us Life Lessons

pet lossHow Losing A Pet Is Much Like Losing a Loved One

Our pets are like members of the family. Meet Sadie – our vivacious, furry family member pictured here at 3 months old. Labrador Retrievers at this age are a non-stop ball of energy. Leave a sock on the floor and it instantly becomes a pile of thread, or a new game of hide and seek. Strangers? I don’t think Sadie ever knew that word existed. Water? That’s meant for swimming.. endlessly.

Sadie was, as my son described her, the MVP of campers. In fact, our treasured family camping trips centered around Sadie. Will there be a lake or hiking trails? And Sadie always chose where and with whom she wanted to sleep at any given time. Since our activities centered around what Sadie would enjoy, it made things easy. She loved EVERYTHING about camping, especially being with us and meeting new friends. Sadie would always introduce herself to our camping neighbors. She would sometimes wander off to explore new trails, strange critters, and/or new scents but she always came back to her family because she loved us and she knew she was the queen bee.

Saying good-bye to Sadie

With the whole family present and a lot of tears, we had to have Sadie laid to rest last week. At over 14, she was in ill health; despite pain medications and other palliative measures, it was clear that every day was a struggle for her to get around. And while she couldn’t tell us what parts of her body were failing her, we could sense growing discomfort and complications taking place. Up to the very last second of her life, Sadie never stopped pouring out her boundless love and certainly relished the affection and trust we shared. Our relationship over the years was a bond that encircled our lives. Even as our children grew up and left home, that bond would be rekindled in an instant with Sadie when they came home to visit.

How pets teach us about life

Pets are soulful creatures that teach us about the importance of trusting relationships, comfort, touch, playfulness, love of nature and so much more. These traits never left Sadie.. not even when she was at the end of life. These intact abilities remain for us humans as we age. There are many good websites that deal with the loss of a beloved pet.  Here is a good blog that deals with pet grieving. It talks about pets in a very human way.

 

Mandatory Dementia Care Training: A Good Start

Dementia care training: learning is just the first step.
Learning is just the first step in dementia care training.

Many  adults with dementia reside in nursing homes or assisted living. Still others attend adult day care  or receive home care services. The need for caregivers to provide quality care has never been greater. Dementia care training standards is a hot topic since federal and state legislation established new mandatory dementia care training requirements.

The New Training Standards:
 Each organization is now tasked with ensuring that training requirements are met. This applies not only to direct-care staff, but ALL new and existing staff. Maintenance, dietary, office workers,  volunteers and contracted workers are included. The new regulations require a specific number of hours of dementia training when first employed, as well as annual training updates.

The Federal Register published October 4, 2016 provides only broad guidelines for training topics in Section 483.95. It states training topics must include:

  • Communication
  • Resident rights
  • Abuse and neglect
  • Quality assurance and performance improvement
  • Infection control
  • Ethics and behavioral health

For nurse aides serving  individuals with cognitive impairment, training “must address the care of the cognitively impaired.” Also required is training for feeding assistants.

Most who work in eldercare want to feel confident in their jobs and welcome training. However,  I think it’s time to leave behind the monthly required employee in-service model.  I’m sure I’m not alone in having presented at these meetings only to find a lethargic audience that was there only to pick up their paychecks after the meeting.  Consequently, nothing productive, let alone inspiring, results.  It begs the question: What kind of training truly leads to dementia care competency?  Furthermore, how can mandatory training reach beyond the basics to change attitudes and actions?

Re-frame Training: Now is the Time
In a series of posts I’ll explore components of core education that will help meet the new training standards. Especially relevant, training should lead to skills, knowledge and behavior expected for the delivery of dementia services.  What components do you think are essential?

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