New CMS dementia training regulations to enhance person-centered care practices. Any new regulation makes us quiver. More paperwork, increased oversight, complex guidelines. But the new CMS dementia training requirements under Section 483.95 is one step closer to creating communities focused on person-centered care.
Training will be extended beyond nurse aides to include all staff.
This is huge! It only makes sense that if nurse aides receive quality dementia training that this include therapy, social services, dietary, dining services, management, volunteers and contracted employees. When everyone who interacts with that resident or patient is trained in communications and responding to behaviors, we will see culture changes taking place, more accurate accountability and outcomes tracking and a more satisfied workforce.
Innovative dementia training across the long term care spectrum is growing exponentially as eldercare becomes more about dementia care.
Leaders should be looking not only at core competency training but how their education and training will be integrated and serve as an ongoing team building and staff development tool. What measures will be established to ensure that staff empowerment is taking place, particularly in the challenging areas of communications, understanding resident rights, abuse prevention and behavioral health.
Workforce retention is a hot topic and promises to be at the top of the list for many years. If training programs do not tools and techniques that will empower and instill confidence in skills, encourage new ideas (that we listen to and implement!), we will see far too many front line workers leave the senior care industry. None of us can afford to see this happen.
What a great time to reassess where we’ve been in the areas of staff training and ongoing education for all of our stakeholders, and we include families and our local community when we look at the far reaching effects that dementia has at all levels of our society.
New regulations are the impetus for us to change our thinking and this is exciting!
Healthcare is quickly becoming dementia care. Whether you work in a clinic, long term care, home care, or hospital, you will interact with people dementia. And these people will likely have speech and language challenges. Dementia care training often focuses on the underlying impairment when care partners really need practical solutions. Easy-to-learn dementia communication skills, save both parties frustration. Here are a helpful strategies.
When she has trouble finding the right words to tell you want she wants to say or you can’t understand her because of “word salad” or slurred speech.
She may understand more than she can express with words.
Listen for a key word or phrase to give you a clue about what she is telling you and repeat the word to let her know you are paying attention.
Remember the emotions behind the words are more important than the words. Validate the emotion. Mirror the non-verbal expression: facial expression, movements or sounds.
It is easier for her to answer yes or no questions or those requiring one word response rather than open ended questions.
When he has trouble understanding what you say:
Use touch to engage his attention.
Supplement your speech with gestures.
Be patient. Allow time for him to absorb what you said.
Pay attention to your non-verbal expression. It “speaks” when words are lost.
Point to objects that will clarify the message – or act out what you are trying to say.
Ask one question at a time.
When you feel confident in your ability to handle dementia communication challenges, you’re more at ease. You can then shift your focus away from the physical condition to what is even more important—the person you are serving at the moment. You will be freer to connect with the person as a human being, a form of communication that speaks louder than words ever can. Isn’t that what person centered care is all about?
I had the privilege to lead a session on our Dementia Live™and Compassionate Touch® person-centered care programs at the recent American Health Care Association National Convention in Nashville last week. As part of the Dementia Education Track faculty, it was such an honor to speak to so many passionate leaders who are stepping out of the box and doing amazing things to transform their communities. I love to listen to the success stories and challenges as it helps us grow as an organization in helping those we serve.
Kenneth Gronbach’s fantastic keynote address was a clear reminder to us all that the Age Curve is not going to happen – it’s here. And the numbers speak for themselves. It is a clear reminder that as we face the aging tsunami we as leaders, MUST look forward in the way we will care for our aging population.
The medical model of care is shifting – albeit a bit too slow for those of us with a mission to see person-centered care become the standard. But let’s focus on the good things happening. One is the new federal and state regulations that require higher standards of training across the spectrum. This is going to have a great affect on pushing person and patient centered care initiatives to the forefront.
The big question is how we will move the Mission Forward to produce real culture change in our organizations. This takes much more than goals of teaching core competencies. It’s a matter of prioritizing the quality of training, how it will be integrated and the big challenge – how it will be sustainable within your organization. Culture change happens when everyone – those who live in, work and visit your communities – think, feel and act differently.
We are moving to fast on the Age Curve to rest on what we’ve been doing and look at what CAN be done. I look forward to sharing in future blogs the incredible work that is being down around the world to transform eldercare. It’s an exciting time to be working together in moving the mission forward!
Technology can boost quality of life for people in assisted living. As baby boomers age technology will take a much bigger stage, as suggested in some consumer trends.
A Few Real Life Examples
I once volunteered at Rowe Sanctuary, a nature center along the Platte River in Nebraska where thousands of Sand Hill Cranes gather on their way to points north. People of all ages from around the world visit the sanctuary to witness this spectacle of nature. I operated the Crane Cam, a remote camera placed on the river. The camera sent images to the National Geographic website. While operated the camera, a couple approached, curious about what the process. After I explained how it all worked, the woman told me about her mother who was in a nursing home in another state. Evidently her mother had been to the sanctuary several times in the past. She had been an avid bird watcher for many years. But since in long term care, she no longer participated in bird watching. The daughter became so excited because she had recently set up a personal computer in her mother’s room at the facility. It was possible for her mother to peek in on the Cranes via the internet and reconnect with her love of bird watching.
A gentleman in memory care used a PC to write poetry and letters to his family. In his career he’d been a successful business man, therefore the desk and computer in his room helped him retain an important part of his identity.
One young man with cerebral palsy resides in assisted living. He plays keyboard and records music on his PC. Sounds like a typical twenty year old, doesn’t it? His keyboard was modified to compensate for poor coordination, so he managed independently. He proudly played his musical creations for guests.
We surely can expect more people in community care with their own computers. It might serve as one way to lessen the feelings of isolation and boredom that plague so many who must reside in assisted living.
What are your thoughts about the link between technology and quality of life?