Category Archives: Senior Care Professionals

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?

Dementia Care: How to Make Magic Connections

Dementia care magic-wandWhen visiting someone with dementia, be ready for anything. Things can change day- to- day, even moment- to- moment in dementia care. A little preparation can go a long way to help create a positive experience in dementia care. Have a “magic bag” ready that you can pull things out of that may reach through the dementia to the person inside.

The magic begins by interacting with all the senses. Though some senses may have diminished from effects of dementia, other senses may still be sharp. In previous posts, we suggested pictures or items to bring back memories. There’s memory magic in senses beyond just vision.

The key to creating magic is to learn what the person did in the past or what was happening in the era that they grew up in, and then recreate sensory experiences to evoke memories.

Sound magic is not limited to just music. You can find recorded sounds of just about anything online, especially on Youtube. Here are a few favorite examples.

Familiar sounds often help to recall memories and evoke emotions and stories are sure to follow.

Touch magic is made with texture of familiar things from a person’s life. Present different textures of things such as fruits, fabrics, sand, beans, string/yarn, seashells, leaves, doll babies, tools, engines, aprons. Explore with many objects to discover which ones bring comfort or trigger memories.

If your magic bag contains objects to see, hear and touch, you’ll be equipped to conjure special moments. Care partners become detectives as we look for pieces of life. Because you never know what that one thing will be that reaches a forgotten piece. The magic happens while taking the journey together.

Dementia Training Regulations – Positive Changes in Resident Care

Dementia Training RegulationsNew 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!

https://www.gpo.gov/fdsys/pkg/FR-2016-10-04/pdf/2016-23503.pdf

Federal Register

Dementia Communication: Learn how to understand

Dementia trainingHealthcare 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.
  • Use skilled touch to reassure her.
  • 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?