Welcome!

1. Welcome!

2. Q: HOW CAN I KEEP IT POSITIVE? Even patients who are normally calm may quickly reach the boiling point when illness threatens their health, mobility, and independence. Pain and fear can lead to increased stress, anxiety, and frustration, which can result in anger and even loss of control. But do you know how to spot your patient's anger early and defuse it?

3. STRATEGY: WORK TOGETHER • Look for the signs (body language, voice tone/volume, demanding attention) • Show empathy (“I understand…”) • Keep your cool (don’t set limits, maintain eye contact) • Acknowledge feelings • Express regret about the situation • Try to find some point of agreement • Ask for the client’s solution to the problem. Use phrases like, "Can you tell me what you need?" or "Do you have some suggestions on ways to solve this problem?" • End the conversation by trying to reach an acceptable arrangement. Offer options by saying, "Here's how we could handle this."

4. Q: HOW CAN I SAY GOODBYE? Your client loves you so much they never want to see you go at the end of your shift. In fact, they become upset, angry, difficult in those final moments before you walk out the door. How can you turn a painful goodbye into a graceful exit?

5. STRATEGY: CREATE A ROUTINE • Plan ahead • Start winding down (30-minute rule) • Create a routine • Read a book • Sing a song (goodbye song) • Client will come to rely on and expect that your departure follows a pattern and they begin to accept it as part of the routine. • Give it time (it takes 2 to 4 weeks to establish and accept a new routine)

6. Q: HELP! I’M LOCKED OUT! It’s great when a client shows off their independence, but not at the risk of their safety. We want our clients to get washed and dressed on their own, but we also need to reach them if there’s a problem. How do you get your foot in the door when it’s locked?

7. STRATEGY: WORK TOGETHER • Understand and respect your client’s right and need for privacy • Be honest and up front about your concerns • Ask for your client’s help • Work together to create a safe plan (For example, Mary will leave the bathroom door unlocked, but you promise not to enter unless she calls for help.)

8. Q: WHO DO I LISTEN TO? Sometimes there is a disconnect between directions from family members and the receiver.   What is the best way to handle this without disturbing relationships? For example: Family member instructs that receiver should not be taken food shopping and yet she insists she wishes to go along and choose her items.

9. STRATEGY: START A DIALOGUE • Case-by-case basis (going along for food shopping vs. driving the car) • Understand the family’s concerns • Be honest with the receiver • Work together to create a plan (if she really can’t go food shopping… sit down together and create a detailed list… or try virtual shopping on the online grocery) • Consult the office for ongoing issues

10. Q: CLIENT’S FAMILY HAS UNREALISTIC EXPECTATIONS Nearly all caregivers have experienced some version of family denial in regard to their clients. Whether the denial is the subconscious need to ignore that fact that a parent is declining, or they want to pretend that caring for a declining parent isn't all that big a deal so they don't have to get involved, denial is rampant.

11. STRATEGY: FAMILY MEETING One of the best ways to prevent or overcome denial is the family meeting. The sooner everyone realizes the issues their loved ones are having or will have in the future, the less denial will be brought forward. Explain that denial or doing nothing is actually doing something; and that doing nothing is going to cause more pain for all involved.

12. Q: HOW CAN I TURN A NO INTO A YES? One of the most common frustrations among caregivers is the propensity for people with dementia to say “No!” Caregivers can’t understand why people with dementia so often say no and refuse to do the very things they’ve done willingly and eagerly in the past.

13. STRATEGY: THIRD TIME’S A CHARM Try three times, in three different ways, to turn a no into a yes. Let’s say you are trying to get ‘Mary’ to sit in the garden on a beautiful day. • One: Ask her the way you always have. “Mary, it’s a lovely day out. Let’s go out to the garden to look at the roses.” -- She declines. • Two: Use some information from her life story to make a more personal request. “Mary, let’s go out to the garden and see your roses. I need your advice on how to prune them properly and you are a master gardener!” -- She declines.

14. STRATEGY: THIRD TIME’S A CHARM • Three: Take her hand into your hand and point to the garden (to give her physical cues) as you say, “Mary, it’s a lovely day out. Let’s go to the garden to look at the roses.” Then pause. • “I really appreciate your help in the garden. After we’re done, let’s get some strawberry ice cream.” • This time you are giving her a physical cue to the desired response and offering your hand for support. • Adding another sentence showing that you admire her willingness to help you and offering a favorite reward afterwards both increase your chances of success. -- This time she says yes!

15. Q: Care discussions with terminally ill customers It can be difficult to be with someone who is terminally ill; it isn’t always clear what to do, or say. How should I approach discussing care, emergencies, notificationsare often questions you may have.

16. STRATEGY: Your presence and intention matters! • Know that your mere presence matters in their life • Intention is everything - work towards making the person feel encouraged, cared about, or simply try to put a smile on his or her face • It is so important to make sure you are in a place of peace before the visit. Take a few minutes to calm down before your visit • Always approach the person slowly and quietly

17. Q: Care discussions with terminally ill customers • Tell them if you are going to do something, even if it is as simple as holding their hand • Listen - If the person talks about being anxious, listen quietly. When he or she is finished sharing concerns, encourage him or her by asking, “What do you want to achieve now?” • Then you can gently shift the focus of the discussion to that goal rather than the prognosis or condition. • For instance, if a person says she wants to live to see her grandbaby born, ask her how they will celebrate when the baby arrives. Try to keep the conversation positive.

18. Review of Emergency Handling Dial 911 for ALL emergencies such as: • Uncontrolled bleeding • Injury to the head • Chest pain • Unresponsiveness • Falls where receiver is unable to get up and/or reports pain • Sudden, unexplained change in mental status Then call the office when the situation has calmed down enough to phone us. We will notify family members

19. INCIDENT REPORTS What to Do: • Call 911 if an Emergency • Always notify the office Examples of Incidents : • Medical issue - requiring emergency services or hospitalization • Problems with medication • Fall or other injury • Abusive behavior • Property Damage • Theft • Provider fall or injury

20. ERSP – Viewing schedule & hours worked • ERSP is the name of the software system we use to track providers, receivers and all schedules. • Providers are able to login 24 hours a day, 7 days a week to view: • Monthly schedule • Report of hours worked including any mileage entered in telephony • A detailed guide is available in the Providers Portal

21. ERSP – Employee Portal • The employee portal contains: • announcements • copies of previous employee newsletters • important employment information • helpful reference materials • copies of orientation materials including the most up to date orientation power point and employee handbook. • In your web browser enter: www.homecarebyseniorsnj.com/portal • You will be asked to enter a password which is: employee

22. Contacting Seniors Helping Seniors – Review of Phones • If you have an urgent issue please call 800-481-2488 or 973-435-4873. Tell the operator the nature of your urgent issue and someone will get back to you within 30 minutes during the week and within 2 hours on the weekend.  •  Emergencies when you are with a client.  if it is a life threatening emergency such as an injury, serious fall or medical issue - call 9-1-1 before calling us! • Client's family is present and would like to speak with someone urgently • You are experiencing an issue that will preclude you from completing your shift  • You need to cancel or you are running late for an assignment TODAY • For all non-urgent issues please call our dedicated caregiver line: 973-975-0057

23. Questions ???? Thanks for your attention