Consistent Assignment: Insuring Quality & Belonging for Residents & Families

1. Consistent Assignment: Insuring Quality & Belonging for Residents & Families Presented by: Mary Pike, Consumer Representative Advancing Excellence Campaign, Coalition for Person-Directed Care Rosemary Sarkis, Consumer Representative Coalition for Person-Directed Care Kim Marheine, Board on Aging and Long Term Care

2. Presentation Objectives • Participants will recognize the value of relationships with residents and families and their impact on the caregiving process. • Participants will be sensitive to the lasting emotional aspects of long term care residence. • Participants will identify the importance of the use of familiar and preferred language in communication and personhood.

3. Goal of Consistent Assignment • Consistent assignment is a key component of culture change. • Being cared for by the same caregiver is critical to the quality of care and quality of life, and maximizes resident, family and staff relationships. • www.nhqualitycampaign.org

4. What do residents & families tell us… • About the transition to a Nursing Home, • about initial experiences and first impressions, and • about the importance of being cared for by the same persons consistently?

5. Things that make a big difference… • Communication • All staff knowing resident care plans • Between shift reports and communication • Follow Up

6. Consistent Staff • Many challenges can be alleviated by having consistent staff • A longer time is needed to accomplish the tasks associated with helping a resident with intimate tasks, or to get ready for the day or for bed if the caregiver is unfamiliar with comforting routines

7. From Our Residents… • We do not “cease to exist” when we live in a nursing home • We need to be heard not just listened to • We should be treated as partners in care, not just recipients

8. From Residents about Consistent Staff • Appropriate and resident-centered training when starting in a new facility • It takes time to get to know the preferences that can make or break a day • New staff need to have access to resident histories and care plans, but also need time to just “be” with residents to get to know them

9. Attitude & Familiarity Matters • Attitude matters, especially with persons with special needs and those new to long term care • We communicate • 7% with words • 38% by voice • 55% by body language

10. Consequences of Unfamiliarity • Excessive disability (functional decline) • Dehumanization • Feelings of isolation, alienation • Depression • Withdrawal • Anger • Anxiety

11. Benefits of Familiarity • Enhanced communication of desire and needs • Experience range of emotions, instead of mostly negative • Increased social awareness, comfort with social contact • More responsive to humor, kindness • More open display of pleasure, contentment • Feelings of relaxation, belonging, worth, trust

12. Residents & Families Deserve: • To be empowered with choice and participation • To be heard in their input regarding their care and lives, both constructive and positive • To be treated as people not numbers, assignments or diagnoses • To be not only cared for, but also cared about

13. Old Language Caregiver Alzheimer victim Impairment, problem list Difficult or problem behavior Manage, control New Language Care Partner Person with AD Remaining abilities, strengths Symptomatic behavior Assist, support Language Matters…

14. When you change the way you look at things the things you look at change. Source unknown

15. “You have to know who I was in order to understand who I am. I am not the disease.”Credit source: “A tip from a person newly diagnosed with Alzheimer’s disease.”

17. Connections to Personhood • Our “person” is more than a physical presence • A “person” is connections: to one’s life story, family, community (big C & little c), own sense of being & self • If we offer care to & through a person’s heart, mind and soul we are truly honoring personhood

18. Watch… Watch your thoughts; they become words. Watch your words; they become actions. Watch your actions; they become habits. Watch your habits; they become character. Watch your character; it becomes your destiny. Author unknown

19. www.wisconsinpdc.org

20. LANE Conveners Contact Information Mary Kay Scheller-Suitor MetaStar, Inc. Continuing Education Program Director (800) 362-2320 or (608) 441-8245 mschelle@metastar.com John Sauer Wisconsin Association of Homes and Services for the Aging (WAHSA) Executive Director (608) 255-7060 jsauer@wahsa.org This material was prepared by MetaStar, the Medicare Quality Improvement Organization for Wisconsin, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.  8SOW-WI-NH-08-12.