CNA to Administrator

1. CNA to Administrator A Journey Worth Living! By: Cheryl Thrasher, ALA Ashton Gables in Riverchase, Al

2. CNA’s Perception & Priorities The Perception of a CNA is that they know the residents and that you don’t. • Changing our CNA’s perception is as easily letting them see you interact with your Residents more. • Listening to your CNA’s ideas and then implement at least some of them.

3. CNA’s Role • The Backbone of your Facility! • CNA’S Identify changes, often 1st in our residents. • Encourage eating, walking, attending activities, etc.

4. Friend to the residents. Helps with residents security, since old friends are disappearing

5. Growing CNA’s • Having our CNA’s participate in Care Conferences • Participate in an Activity Council and taught the proper way to lead an Activity • Lead an In-Service • Attend Out of Facility training seminars

6. Ability to use their gifts to benefit the Facility and the Residents

7. Vital Communication to our CNA’s • Diminish rumors throughout facility • Teachable moments • Staff Retention • Be Real!

8. Activities: It’s not just about having fun!

9. Principals of Activity –Focused Care • Sense of dignity and self-esteem • Structure to the day • Maintain self-care abilities and promote maximum independence • Intervention to challenging behavior

10. Principals of Activity Focused Care Assist in Managing Withdrawal & the Treatment of Depression

11. Meaning & Purpose to the Moment

12. Fulfills the need for enjoyment & Creativity

13. Achieves goals for individualized care….

14. Opportunity to Succeed at a Task!

15. Opportunity to interact with others

16. Person Centered Environment • Safe, comforting and calm • Simplify environment, avoid excess clutter and stimulation • Appropriate expectations of residents • Warmth, humor, and affection • Without judgment and criticism

17. Hallmarks • Cognitive/Intellectual • Socialization • Creative • Productive/Purposeful/Life Skills • Spiritual Enrichment • Emotionally Supportive/One to One

18. Hallmarks • Physical Activity/Exercise • Sensory Stimulation • Personal Care • Special Events • Intergenerational • Indoor/Outdoor

19. Who are my Residents and why is it important that I know them? • A Willingness to become involved with the person, to know the life story. • Convey a positive regard for the person. • Develop an atmosphere of acceptance. • Have the desire and capacity to Listen. • Communicate, empathetic, understanding. • Be Real!

20. Winning Over Challenging Residents • We must realize and accept that you cannot change others. • True, you cannot change other people, but it is also true that you can influence them. • The way to do that is to change the things that you say and do. • Get to know the person, where they have been and where they are now.

21. What bothers you? • Is their attitude affecting others? • Are they always disruptive? • Do they disrespect other residents? • Are they hurting themselves? • Is it that they do not participate in activities and yet always have negative things to say about the activities? • Is there actions hurting your facility?

22. Who Wins by Winning them over? • You • Your co-workers • Your other residents • Their family • Your census • And most of all the person you are trying to win over!!!!!!!!

23. Think about your most Challenging Residents!!!! • Where did she/he grow up? • Is he/she married? Is the spouse still living? • Does he/she have children? Grandchildren? Name them? • What type of job did he/she have? • Hobbies? • Collections and what are they?

24. Who am I, Continued….. • Travel? • Favorite and least favorite foods? • Dreams • Religion? • Board or word games, with others or alone, puzzles, etc. • What one thing do you see that brings them joy? • What one thing makes them upset or sad? • Did he/she participate in sports or enjoy viewing sports on T.V.?

25. Continued…… • Did he/she sing in a choir, Church, solo, etc • Did he/she play a musical instrument? • Did he/she volunteer? Write any other thing about your resident that you feel that would be pertinent…….. Knowing your Residents is the 1st step to Winning over even you most Challenging Residents!

26. When you and your staff build a better relationship with your Residents…. You can Achieve • Happy, Healthy, Fulfilled Residents • Satisfied, Secure Families • Staff Retention • Able to meet your Census Goals 100% is Easily Achievable!!!

27. Understanding Behaviors • Behavior is Communication • Caregivers can impact behaviors by understanding why a person behaves in a particular way. • Identify the possible causes/triggers of the behavior

28. Potential Causes/Factors that contribute to Behaviors: • Depression, anxiety, stress • Environment • Too large, too cluttered, too noisy • Excessive stimulation, or under stimulation (bored) • Lack of orientating or sensory or familiar cues • Glares and shadows • Misinterpreting stimuli (TV, radio) • “Mood” of the environment • Changes in the environment • Disease process affecting memory, judgment, impulse control • Person’s physical and emotional health A. Medication B. Sensory impairment (hearing, vision problems) C. Acute illness (UTI, pneumonia, fever) D. Dehydration, Constipation, Fatigue, Cold • Physical discomfort Caffeine, Hunger, Pain

29. More Potential Causes……………. • Task: • Too Complicated/ failure induced task • Too many steps • Task not modified for increasing impairment • Task unfamiliar • Difficulty initiating or completing a task • Feeling rushed • Fear of the task

30. Potential Causes Continued………. • Communication and /or our interaction • Not understanding what is being said • Inability to make themselves understood • Caregiver approach: impatience, tone of voice, being scolded, arguing, highlighting losses • Inconsistency of caregivers • Responding to caregiver’s “bad day”

31. Catastrophic Reactions………….. • Tense or irritable caregiver • Loud noise – Radio – TV – Staff • Multiple questions / Why questions • Insecurity – feeling left out • Small accidents • Being reprimanded • Arguments • Over extended capabilities • Changing living environments

32. Other Behaviors…. • Hallucinations & Delusions • Hostile & Demanding Behaviors • Angry, Agitated Behaviors (Physiological or Medical, Medication Induced, Environmental) • Repetitive Actions • Sundowning

33. Volunteering Everyone has a talent and a unique perspective and when shared with those in need, it helps to foster positive effects in their community and ours, Creating a new dimension in the Residents lives and the lives they touch.

34. Intergenerational Activities What is the Benefit?

35. Volunteer Opportunities • For the Community…….. • Churches • Civic Groups • Colleges, Schools, Day Cares, Homeschoolers • Women’s Groups (Quilting, Gardening, Knitting, etc.) • Hospice, Home Health, etc.

36. More Volunteers to think about… • Bikers • Car Collectors (Vintage) • Crafters & Artist • Symphony • Dance Schools, Dance Clubs (Ballroom, Shaggers, Square Dancers) • Cheerleaders • Culinary Schools

37. Volunteer Opportunities for your Residents………… • Organizations: Red Cross, Heart Association, etc. • For your Marketer • Local Churches • Hospice, Home Health • Children’s Hospital • Homeless Shelters, Women and Children’s Homes • In your Facility!!!

38. Administrator • How can we Communicate the Rules and Regulations to the Residents and Families? • Start at Tour • Admission • Resident Council • Day to Day

39. Rules and Regulations for Employees • Interview Process • Orientation Process • Continued Training • Day to Day

40. Rules and Regulations for Vendors • Meet with each Individually • Personalize • Prioritize Importance • Teachable Moments

41. Hiring / Training for Customer Service • Ask the Customer Service Questions! • Be Choosey: Remember you are selecting someone who will not only represent your facility well, but more importantly, will be taking care of your precious Residents. • Train, Train, & Train and set an example! • Don’t assume!!!!

42. Retaining Staff • Be fair. • All shifts and departments are equally important!!! • Fun at Work Programs • Acknowledge • Train leaders • Promote from within, when you can! • Be Real!

43. My Passion for Senior Care….

44. Resources: Adapted in part from: Robinson, A., Spenser, B., White, L., Understanding Behaviors: Some Practical Suggestions for Coping with Alzheimer’s Disease and Related Illnesses, Eastern Michigan University, Ypsilanti, MI, 1992, Jayne Clairmont, Jayne is a nationally recognized expert in caring for older adults and dementia care.