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Autumn 2006 |
Volume II, Issue 3 |
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Ask Dr. Diane
Care Plans
Question: What’s a care plan? |
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Even when I receive the notice I have a hard time making it to my brother's care plan meeting. Doesn't the nursing staff determine the care anyway?
Answer:You and your resident have the right to participate in developing a care plan. When a resident enters the nursing home, the facility completes an assessment of the resident’s condition. This information is used to develop a comprehensive care plan. Every three months care plans must be reviewed, and if necessary, revised.
Care planning should be taken seriously. Some nursing homes may treat care plans as a meaningless formality, resulting in care plans that are almost identical from one resident to the next. To be meaningful, a care plan should address individual needs and preferences.
Prior to a care plan meeting, think about what your resident might want or appreciate. A nursing home is paid thousands of dollars monthly to care for a resident, and should be expected to provide personalized care. The resident or family member should ask that specific services be written into the care plan.
Nursing homes are required to schedule care plan meetings at a time that allows others to attend. Don't feel intimidated or shy at the care plan meeting, since you're likely to be outnumbered by nursing home staff members. And if you'd like someone to go with you, call the Ombudsman. In most cases, care planning decisions do not involve complicated medical issues. Make an effort to participate. Once the care plan is in place, you can use it as needed to assure that your resident receives the best possible care.
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Words for Thought
Trust others offering to
assist you
Arm yourself with medical
information
Keep up with your own
medical needs
Exercise and eat well
Create a support network
Allow yourself to use outside
resources
Recognize the signs of stress
and depression and seek help
Engage in a new activity,
like yoga or painting
Open your home to friends
and family
Family traditions are a must,
but let others help out
Simplify daily routines and
organize schedules
Encourage input from person
you are caring for
Listen to your heart
Facilitate family meetings to
coordinate responsibilities |
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Tips for Effective Complaining
Many family members feel no matter how much they complain, their concerns are not heard or addressed. Learning how to complain effectively may help in this ongoing battle. These are some important tips to increase the chances of resolving your problems.
• Complain in person, if possible. Letters can be dismissed and phone conversions are less direct.
• Have the facts handy. Documentation is essential in keeping names and incidents correct.
• Act assertive, not angry. By acting angry, it puts the other person in defensive mode. Instead, open the conversation with telling the person you have a problem.
• Go to the top. Find the right “higher-up” person.
• Always follow the Golden Rule. Treat the person with respect, even if you have complaints. Rather than accusing, let them know you have problems and need their help in resolving.
• Explain the consequences. If you're not getting a positive response, explain what will happen if things do not change. |
Finally, in your search for a solution to your complaints, be persistent! It may take several complaints and many avenues. For serious or unresolved complaints, please call the
Department of Aging and Disability Services (DADS) complaint hotline at
1-800-458-9858. |
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Need Help Finding or Evaluating Nursing Homes?
State and Federal SystemsDetermining where to place your loved one can be a lengthy and stressful event. Having the right information is important in planning for this transition. The Quality Reporting System (QRS) and Medicare Nursing Home Compare website allow you to compare facilities in a particular area and/or identify locations that may meet your family member’s needs. Please remember, the information that these reports provide is not a substitute for visiting the prospective facility, talking with staff and visiting with residents in order to help you make an informed choice.
Texas Rating System
How is this report helpful? The QRS report will tell you the type of ownership, total bed count, special services, overall rating, potential advantages and disadvantages, complaints, investigations, deficiencies, and compliance history. The range of rating for nursing homes is from 0-100, and the average for nursing homes that accept Medicare and Medicaid in Texas is 59. The overall rating is a number determined by four dimensions that depict the important aspects of quality. These dimensions include: the quality of care provided to residents, quality of life, ability to meet all regulatory requirements, and customer satisfaction. Be advised, the ratings are updated monthly and may not depict current performance.
Federal Rating System
The Medicare Nursing Home Compare system evaluates nursing homes that are Medicare and Medicaid certified. This website allows you to search for nursing homes by geography and/or name. A helpful aspect of this report is the quality of care, nursing staff and inspection results. For example, it compares the nursing staff hours per resident per day. These measures are ranked locally and nationally to give you a better understanding of the level of care. To narrow your choices of nursing homes, the website provides a nursing home checklist. The list includes factors that should be kept in mind when calling or visiting the nursing home, such as variety of activities or evacuation plan. |
| Remember, both of these rating systems should only be used as tools in comparing various nursing homes and the quality should be verified. By visiting, research, and persistence you can find the best fit for everyone.
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Tennis Ball Craze
JEANETTE GETZ knew she wanted to volunteer for the Ombudsman Program, but she didn't know that through her involvement she would end up taking on a large community service project. On one of her |
first visits to the nursing home, Jeanette noticed tennis balls on the residents' walkers. To her surprise, she found out that residents had to purchase the tennis balls and that they only lasted a short while from wear and tear. Being a long time tennis player, Jeanette knew she might have access to old tennis balls. Sure enough, when she contacted her tennis club, they were happy to give her the used tennis balls they were going to discard. Facilities have been |
very grateful to receive the tennis balls to use on resident's walkers or to use in strengthening exercises. Jeanette has even teamed up with a teenage student working on a community service project for a local school with a high ratio of students with disabilities (who use tennis balls on their walkers as well). Jeanette found that through her volunteer work as |
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an Ombudsman, she could help many others with her tennis ball project. She has been able to take on this project with the generosity of the University Club, City Club, City of Houston Parks and Recreation Center , Houstonian Club, Chancellors, Jewish Community Center Tennis Facility, River Oaks Country Club and the Sports Authority, all in the Houston area. |
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What's Happening at
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The Family Council at Park Manor Cy-Fair held their Annual Staff Appreciation Luncheon on April 15, 2006. We raised money by having raffles at the Thanksgiving and Christmas dinners for the families, which are held every year. At Thanksgiving we raffled a handmade quilt donated by a family member. In addition, we held a silent auction with several donated items at the Christmas dinner. In January, letters were sent to all family members asking for donations to help support the Family Council project. We were very pleased at the amount of support. In return, we had a catered lasagna luncheon provided by Sicily Pizza and Pasta for the staff. The staff truly appreciated the food, fun and door prizes.
An advisory board runs the Family Council and we have planned our upcoming events, starting with a Potluck Dinner in September 2006 and ending with our Annual Staff Appreciation Luncheon in April 2007!
Furthermore, our summer mailing to the family members included a personal information form, so we can build a database of all family's addresses and phone numbers.
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Who Are You?
You tell me often that you love me. I look at you, but my mind's eyes don't see. I wonder, who are you?
I tell her often that I still love and care. She looks, a blank stare that doesn't share. She really doesn't know me anymore!
You hold my hand so gently and smile. I don't know why, let me think awhile. I wonder, who are you?
I hold her hand so that I might comfort her. She flinches, shows a baffling blur. She really doesn't know me anymore!
You take my arm to steady my walk. Where are we going? I don't like that talk. I wonder, who are you?
I take her arm for it is good to go on long walks. She always enjoyed walks, now in her mind she balks. She really doesn't know me anymore!
You hold me in your arms while I cry. Your gentleness makes me want to sigh. I wonder, who are you?
I hold her tenderly to console her in her fears. I try to comfort, but her mind no longer hears. She really doesn't know me anymore!
O, Lord, I cry out to You our only succor to improve. Her mind is going, but her soul is safe in the Savior. Someday we will know each other on that heavenly shore. For we will both be whole again and with Him forevermore.
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This information will be useful in contacting family members regarding upcoming meeting times and events. We would like to thank Tony Villanueva, our administrator, for helping us make the mailing possible.
We are looking forward to a bright and fulfilling future with the Family Council at Park Manor Cy-Fair. Top of page |
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Don't forget Grandparents Day:
September 10, 2006
Grandparents Day is a National holiday, designated as the first Sunday after Labor Day. This observance was issued in hopes that grandchildren would “tap the wisdom and heritage of their grandparents.”
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| Successful Nursing Home Visits What makes a visit to a nursing home resident “successful”? The resident feels “in touch” with the world outside the nursing home? The resident has a renewed sense of dignity and self worth? The visitor has a sense of significant participation in another person's life? How can you make this happen?
PLAN AHEAD. Ask staff or family what is the best time to visit. Generally, the best times are in the mid-morning from 10:00-11:30 am, in the afternoon from 2:00-3:30 pm, and sometimes in the evening from 6:00-7:30 pm. For someone with dementia, it may be best to avoid the late afternoon or early evening, “sundowning” time. Find a time when the person's mood and attention are at their best.
Older persons respond to things that stimulate their five senses. Answers to these questions will suggest items that you might take with you, or topics for conversation. What do you like to see, to watch? What do you like to touch, to feel? What are your favorite aromas, smells? What sounds do you like to listen to, to hear? What flavors do you like to taste? In response, you might take with you a videotape of grandchildren playing, a fragrant lotion to massage into the resident's hand; a recording of their church choir or congregation singing favorite hymns, etc. Be creative! You can stimulate positive, happy memories.
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THE VISIT. Begin by saying who you are. This is particularly important for the person with dementia. Call the resident by name, and say something like “I'm here to visit you.” Be at eye level with the person and reduce distractions to minimize the resident's confusion.
ADDITIONAL TIPS. Using your normal conversational tone (taking into account any hearing impairments); speak slowly, but do not be patronizing. Be patient, allowing time for the resident to absorb, understand, think and respond. |
| Caregivers
There are only four kinds
of people in the world:
Those who have been caregivers
Those who currently
are caregivers
Those who will be caregivers
Those who will need caregivers
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Be prepared that not everything the resident says will make sense. The resident may seem to be rambling, but respond not only to a person's words, but also to the emotional tone. You might acknowledge a feeling by saying something like, “You sound very sad”
You don't need to fill every moment with conversation. You might sing a favorite song together. Just sitting and looking out the window can be enough. Remember that even someone with serious memory loss can still enjoy the moment. Share the moment with a compliment, a joke, or a caring smile. Enjoy it together!
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