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Briefing sessions. We all have them. Usually first thing in the morning. Of course, planning is an integral part of working in a long-term care community, but let’s add a little fun to your briefing sessions.

During your morning briefing sessions, staff has the opportunity to discuss issues, concerns, and expectations. Everyone can share and update information before starting the day. So, how can you make a briefing session more efficient, effective, and fun?

Are you on the edge of your seat yet? Good.

Let’s go through the CareStory approved checklist together:

Ice-Breaker! — We know time is of the essence in a long-term care community, but a quick ice-breaker will help to ground the team and get everyone focused. Maybe a quick movie recommendation or an opportunity to share a story.
Team Members and Their Roles — We have a lot of colleagues. Sometimes we are on the same team, sometimes we are not. We should always check in to see who is on the current team and what his/her specific role is.
Shared Goals — Always discuss what the team should achieve before working. All team members need to understand, agree with, and work on the same goals so that you can ensure that everyone’s contribution adds up to the maximum value!
Agreed Workload — Make sure all team members identify the tasks they need to achieve, their responsibilities for the day, and their hours of work (including shifts). Work Breakdown Structure Diagrams, Task sheets, and Gantt Charts are some great team management tools!
Team Building Exercises — End the meeting with a quick team-building exercise (for example, dance part or cheer) that gets everyone up and moving and brings high energy out on the floor.

Want to know more long-term care Teamwork and Communication tips? Keep following CareStory; we will not let you down!

REFERENCES:
https://www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module4/mod4-facguide.html
https://www.iadvanceseniorcare.com/12-steps-to-qapi-step-2-teamwork/

How long has it been since you’ve had a decent sleep? Are you too busy? Too stressed? Drank coffee a little too late?

For those of us in the caregiving industry, sleep often falls by the wayside due to the vast array of caregiving tasks.

Insomnia sets in, and it often becomes a vicious cycle. Caregivers who have depression and anxiety are more likely to suffer from sleep disruptions, and those who experience sleep deprivation may have severe distress. Because of this, it is salient for us to take care of ourselves while caring for our seniors!

Here are some tips for you to help manage your insomnia and have a good night’s sleep:

Limit caffeine intake – We know that caffeine helps us stay more awake and less tired, but try to avoid coffee and tea past noon (LOL—I know, right?!). Too much caffeine doesn’t make you more awake, it gives you headaches!
Quiet your body and mind – Close your eyes. Focus on relaxing yourself rather than the environment around you. Start at your toes and keep breathing deeply, relaxing each muscle group for 3-6 seconds. You can also listen to calming music, for example, rain sounds or hearing the waves crash on the shore.
Try 4-4-4 breathing exercises – Inhale through your nose for a count 4. Hold your breath for a count of 4. Exhale completely through your mouth for a count of 4. Repeat it several times until you feel drowsy.

We sincerely hope that stress and insomnia stay away from you all. And us too (we wrote this at 3am).

REFERENCES:
https://www.mskcc.org/cancer-care/patient-education/managing-insomnia-caregivers
https://ontariocaregiver.ca/sleep-q-a-answering-caregiver-questions-about-insomnia/
https://ontariocaregiver.ca/10-tips-for-a-good-nights-sleep/
https://www.healthline.com/health/caffeine-effects-on-body#Central-nervous-system

Do you ever feel guilty that you’re not doing enough for the seniors you need to care for? Maybe (and by maybe, we mean definitely), you also feel that there aren’t enough hours in the day? Yeah, us too.

The Guilt

We’re in the caregiving industry; we try our best to take care of our seniors. However, sometimes, it just doesn’t work out the way we want it to. Unfortunately, sometimes, the seniors we care for may get worse, and we attribute that to things we coulda shoulda woulda done.

Just so you know, you’re doing amazing.

Letting Go of Said Guilt

Just so you also know, guilt is an insidious feeling that can make you even more stressed! It’s time to release it. Here’s how:

First, recognize the guilt. It’s common for caregivers to feel guilt. Acknowledge it and send it some love. It’s just here to remind you that you’re a good person.
Next, accept that we have imperfections. All people make mistakes, even professionals. Recognize your strengths instead of fully focusing on your weaknesses. Not good at handling emotional issues? That’s ok! You probably excel at the physical aspects of caregiving!
After acceptance, understand that you are making the best decision for the seniors you care for. You are skilled, experienced and professional! Trust yourself as much as the seniors and their family members trust you, and remember, you are doing the best you can with the resources you have.
And finally, and maybe most importantly, reach out for support. Don’t be hesitant to seek out caregiver support resources to address your feelings of guilt. Caregivers need care as well.

Remember that you have many positive accomplishments! Think about all the incredible achievements that you have done and all the barriers you have overcome. You’re fantabulous :)!

REFERENCES:
https://caregiver.com/articles/dealing-caregiver-guilt/#:~:text=Talk%20to%20a%20professional%20if,and%20the%20help%20is%20available
https://dailycaring.com/7-ways-of-dealing-with-caregiver-guilt-that-improve-health/
https://caregiver.com/downloads/228/download/50100764_web.jpg?cb=f0b7f624f03ab72e18180c3870ade2ed

What is the most important element of successful teamwork in long-term care communities? The answer, although obvious, is easier said than done—Communication.

Teamwork Training

According to the AHRQ (Agency for Healthcare Research and Quality), effective communication is CRITICAL for efficient teamwork. Furthermore, research conducted by Salas E & Frush K. (2012) notes that developing communication skills for the purpose of teamwork can improve resident safety in long-term care communities. Therefore, teamwork training is well worth the effort!

In fact, teamwork training is not that complicated. Even a little shift in technique can make a huge impact!

The SBAR Technique

The SBAR technique (Situation, Background, Assessment, Recommendation) is a structured form of communication for healthcare professionals to discuss a resident’s condition. Consequently, the SBAR technique has been successfully applied in many different healthcare settings, which not only improves team communication, but also improves resident safety.

When you need to communicate with another team member, consider framing the conversation in the following format:

First things first, you want to identify yourself. Then, you will begin with the Situation by stating the problem. What is happening with the resident? Next you will communicate the clinical and personal (yes, personal) Background of the resident. Give pertinent information related to the situation. After that, you will provide your Assessment of the situation. What do you think the problem is? Finally, make your Recommendation. What action would you recommend? Describe what the resident needs and what you want. Also, make sure that you are speaking clearly and concisely. That way, it will prevent miscommunications and misinterpretations.

Below, you will see an example of how to properly use the SBAR technique to communicate information in long-term care communities.

Practice communicating in the SBAR technique with your team, and watch team communication challenges quickly dissolve!

RESOURCES:
https://www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module4/mod4-facguide.html
https://eklavyaparv.com/content/communication-skills/400-nursing-notes-and-sbar-technique

Music has become an increasingly popular therapeutic method in long-term care communities. But do you actually know the power of music? Do you know that music has a significant effect on seniors? Let’s dive deep into the music world.

What is Music Therapy

According to the Canadian Association of Music Therapists, “Music therapy is a discipline in which Certified Music Therapists (MTAs) use music purposefully within therapeutic relationships to support development, health, and well-being.”

Knowing this, music therapists can use music to address human needs in the following domains: cognitive, communicative, emotional, musical, physical, social, and spiritual.

Fun Facts about Music

Do you have any fun facts about music? We do.

To start, music helps seniors recall old memories. Why? Because strong emotions are often associated with music, and music can support seniors in retrieving these memories. When was the last time you listened to a song and it took you down memory lane?

Furthermore, when seniors receive one-on-one personal care, music may facilitate their cooperation with caregivers. Research at the Journal of Advanced Nursing found that listening to seniors’ favourite music while receiving care may help reduce care-resistant behaviours.

Finally, music not only helps elders resist loneliness, boredom and isolation, but also alleviates feelings of sorrow and abandonment. Therefore, music can provide additional companionship, especially for seniors with dementia or sensory issues.

So get out your blue suede shoes and put on a little Elvis. Besides person-centred care and communication, music can also play a prominent role in a resident’s day!

REFERENCES:
https://www.musictherapy.ca/about-camt-music-therapy/about-music-therapy/
https://musicheals.ca/music_therapy/long-term-care-music-therapy/
https://www.thehamletsatpenticton.com/benefits-of-music-therapy-for-seniors/
https://www.mcmasteroptimalaging.org/blog/detail/blog/2016/11/15/3-simple-ways-to-manage-challenging-behaviours-associated-with-dementia
Konno R., Kang H.S., Makimoto K. (2014). A best-evidence review of intervention studies for minimizing resistance-to-care behaviours for older adults with dementia in nursing homes. Journal of Advanced Nursing, 70(10), 2167-2180. doi: 10.1111/jan.12432

We’re in the long-term care and hospice care industry because we care about our seniors, however, do we, as care staff and caregivers, care enough about ourselves too?

Pros and Cons of Caregiving

Caregiving is rewarding, but also stressful. It is truly satisfying to provide assistance to another person in need, although at the same time, the emotional and physical stress of caregiving is prevalent, especially when caring for a loved one.

According to Lawton and his colleagues in the Journal of Gerontology (1991), caregivers may experience prolonged physical and emotional pain, which can lead to depression, anxiety, and other mental illnesses. Therefore, it is crucial for leaders to recognize pain when they see it, and help caregivers receive the mental health support they need to maintain their health and wellness.

Stress Looks Different On Everyone

What does pain and stress look like? Well, it’s different for everyone.

Some may constantly feel worried, depressed and overwhelmed, and therefore miss work or “check out” during the day. With others, you may see a loss of interest in activities they used to love, or notable weight gain or weight loss. Some people may be sleeping too much or too little but still feel exhausted during the day, while others will experience headaches or other physical pain that was not evident in the past. Of course one of the most common signs that someone is in pain or under a lot of stress is how easily they are to become annoyed or angry.

How do you respond to stress?

Let’s Talk About Mental Health

Mental Health needs to be a topic of discussion. Let’s start the conversation, and battle depression and anxiety in the workplace together. Together, we can provide resources for all, and help each other get the mental health treatment and support we deserve. Together, we are strong.

SOURCES:
https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/caregiver-stress/art-20044784
https://www.apa.org/pi/about/publications/caregivers/faq/health-effects
Lawton, M.P., Moss, M., Kleban, M.H., Glicksman, A., & Rovine, M. (1991). A two-factor model of caregiving appraisal and psychological well-being. Journal of Gerontology, 46, 181-189. doi:10.1093/geronj/46.4.P181

Attention all care staff, caregivers and CareStory followers! You really care about residents’ wellness, and you have checked blood pressure nearly thousands of times for seniors…but how long has it been since you checked your own?

Studies at BMC Public Health have found that the prevalence of hypertension was significantly higher among caregivers than non-caregivers. Even some small adjustments can make a huge difference in your blood pressure readings. Here are some tips for you:

Drink Wine! — Just kidding. That’s not recommended, but it does pair nicely with a bubble bath on stressful days.
Shed a Couple of Pounds! — We promote body positivity here, however, studies at Harvard Health Publishing show that the most effective way to reduce elevated blood pressure is to lose weight.
Go with a DASH (Dietary Approaches to Stop Hypertension) Diet. — Choose food that is rich in potassium, calcium, magnesium, fibre and protein. Also, choose ingredients low in saturated fat and sodium
Exercise. — Aim for a half-hour exercise daily. It could be running, biking, dancing, or any activities you love.
Limit Alcohol Intake (so much for #1). — Drinking too much, too often, can increase blood pressure. Try to drink in moderation by limiting your intake to 1 drink or less per day.
Meditation. — Research at Harvard Health Publishing also found that stress hormones can constrict your blood vessels. Over time, stress can lead to chronic hypertension. Meditation techniques help to reduce stress and lower your blood pressure.

We need you! So please take care of yourselves.

REFERENCES:
https://www.health.harvard.edu/staying-healthy/6-simple-tips-to-reduce-your-blood-pressure
https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303565/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340290/#:~:text=Results,27.6%25%2C%20respectively

As professionals in the long-term care industry, have you ever heard residents complain about their unpleasant experiences while receiving care? If the answer is yes, we have a question for you. Do you think the caregiving team was working as a unit? Today, CareStory is going to discuss team collaboration.

The Bad News

Based on research published at NCBI, if care staff don’t work smoothly as a team, the community will begin to notice challenges with day-to-day care as a result.

First of all, caregivers may unintentionally overlook symptoms, such as unmanaged pain, dietary issues, sleep patterns, etc. This not only decreases the level of trust between the resident, the family members, and the staff, but it also greatly reduces the resident’s quality of life. Another issue that will present itself due to poor team collaboration is that Nurses may mix up medication among different residents. This happens more than you think, and is a mistake that could cost someone their life. Perhaps the issue we are currently seeing the most of in communities is that residents are being ignored and experiencing limited companionship and interaction.

These scenarios are very real, and may potentially lead to conflicts between residents, their families and everyone else involved in their care.

The Good News

However, if your long-term care community does have challenges with team collaboration, there are things you can do to improve, and quickly at that.

The first thing you can do is learn more about the residents. Get to know their life stories. Even the process of discovery will personalize interactions. Next, administrative staff can set long-term and short-term goals for the team. It is also important to identify how all team members can work together and help each other accomplish these goals. Another thing you can do is set up and consistently update records of important information, such as milestones, setbacks, and achievements. Everything should be easily accessible and in one place so staying up-to-date is simplified. Finally, to improve communication between seniors, the caregiving team, and family members you can adopt CareStory (we had to say it) to make sure everyone is on the same page about everything that matters.

Just know, team collaboration is an ever-changing and ongoing journey that makes the world of difference in any long-term care community.

RESOURCES:
https://www.ncbi.nlm.nih.gov/books/NBK2665/

How to Help a Senior’s Caregiving Team Work Together

https://www.seniorsmatter.com/caregiver-team-planning/2492267/
https://www.aplaceformom.com/caregiver-resources/articles/caregiver-duties
https://www.agingcare.com/articles/create-a-care-team-in-5-steps-195525.htm
https://www.brynmawrterrace.org/sites/brynmawrterrace.org/files/LTCcommunication_Tips.pdf

Long Term Care Staff Study - Part 1 - PSW

Introduction

Long-term care is in a state of crisis, but you may have known that already. Nothing new. Before COVID-19 made its mark on the world and the industry, the tragedies within long-term care finally fell under scrutiny. At least here in Ontario. Due to the actions of a few bad actors, now tried and convicted, and the resulting investigation, the relatively new Ministry of Long Term Care (MLTC) issued the request for an investigation into the staffing situation within the industry. In the span of 6 months, despite the 1st wave of COVID-19, a 50-page document was produced. We have taken the numbers and compared them to the source where ambiguous and condensed them into a visual guide. In this 1st part, we will be looking at the state of Personal Support Workers (PSWs). Part 2 will explore the state of Nurses as outlined in this study into long-term care in Ontario.

Staff Distribution

At first glance, the above data may seem promising, but it’s far from the truth. One staff member per resident may seem like a dream come true, everyone has one, and there are a few to spare. Where’s the problem? Why is everybody screaming that we need more PSWs? They make up 58% of the hired staff of a home?

Mental health and chronic conditions can’t wait 12-16 hours until a caregiver is back on shift. It can’t wait over the weekend or when a caregiver has to take time off. With less than half (PSWs, Practical Nurses, and Registered Nurses) working full time, you can be sure that 1 staff to 1 resident becomes 1 staff to 2 residents if we talk about 1 shift a day.

Despite being more than 1 hired staff per resident, despite there being more than 1 trained PSW in Ontario per resident in long-term care, residents still receive on average 2.3 hours of attention from a PSW in a 24h time period. This is on par because, when talking about long-term care PSW, it employs only half of all the PSWs in the province. Clearly, not the 1 to 1 days we are hoping for.

Long Term Care Staff Study - PSW Demographics

Demographics Unpacked

Although anecdotal, regarding demographics, many of the homes we work with also tell us that the first language of close to half of their caregivers is not English. This is not to say they lack fluency, but an indicator of them being 1st generation immigrants; this in part can be correlated with age and sex distribution. Healthcare and Education being female-dominated industries, both preferred choices of new immigrants who may lack the transferable work or educational experience, or Canadian accreditation may come at a higher cost than that of transition.

Long Term Care Staff Study - PSW Enrolment Programs

Enrollment

Although an attractive job for newcomers, and a position in high demand, there is not enough incentive to become a PSW. At the time of writing, we did not receive a number for the available enrollment positions across the province, but the long-term care study describes it as “consistent.” Across the years, a visible drop of students is visible from 8000 in 2016 to 6500 in 2019. Of note, the same document also mentions the industry losing on average 9000 PSWs/year as of 2011.

Long Term Care Staff Study - PSW Depletion

Drop out, burn out.

Caregiver job satisfaction is the leading cause of burnout and them fleeing the industry. The lack of attractive wages does not help the situation either.

Understandably, staffing can be the largest cost of a home. Hiring more people may mean that everyone gets fewer hours or a smaller hourly pay. It’s not fair.

Without a top-down reform, attractive salaries, and industry recognition, there are few options to go with. Among them is to invest in technologies that can better the lives of caregivers. Enhancing communication for everyone will result in a better environment to work in and better care outcomes. We’ve actually written about strategies a home can adopt to avoid staff burnout. Free online resources and working with as opposed to ‘around’ or ‘against’ the families is a great first step. You can read it here.

Download the infographic from here.

Lastly, if you wish to read the full study the infographic is based on, you can do so here.

Part 2 – Nurses coming in 2 weeks.

First off, if you did not know that the https://www.lgbtagingcenter.org/ exists… now you do, and you’re welcome. Furthermore the acronym has happened Intersex and Allies. Thus the current version is LGBTQIA+, double welcome.

Quick LGBT History.

So why is this important, you may ask. And it’s a fair question to ask. It’s 2021, most of us probably have that gay friend or relative and we know that they are ok people. We say this as we live in cities with active communities and neighborhoods. But it was not always like this. When it comes to long-term care, those who are now at the age where a nursing home or assisted living facility is something to consider still have fresh in their mind the events that lead to Pride from the 60s. Here I’m talking about the Stonewall riots, arguably the most significant event in the liberation movement across North America. The LGBT youngsters of the time, those struggling with their identity, or those born shortly after having memories of anti-gay legislation, violent discrimination, and the bloody clashes that happened in the summer of 1969.

Exactly one year after the riots, the first Pride event was hosted. With the aim to commemorate the events and show the community’s solidarity against oppression.

Aging

Yes, as fabulous as some of us may be, we still age. Often times with a dire need for additional care. And as mentioned above, the 2020 urbanite who has LGBTQI+ in their network may disregard one’s sexual preference and treat them like any other person. You know, like the intent behind the whole liberation movement. But now, think those aforementioned activists and rebels who were on the front line in 1969. The participants of the various initiatives shortly after. All these people harbor a strong distrust of government institutions, such as law and healthcare. Furthermore, legal recognition of same-sex couples is a recent development. They have been discriminated against by these systems for decades. Adoption laws did not recognize same-sex couples.

There is only one sad conclusion to be drawn. The aging LGBT community often ends being comprised of isolated, lonely, childless, and potentially impoverished individuals. The loneliness epidemic, which we wrote about in the past, is stronger felt by the aging LGBTQs.

Care

With the above in place, there is little to no support network for these individuals. This in turn makes care more challenging in some circumstances. Be it the embedded mistrust of the system, or the caregiver’s personal biases or expectations from LGBTQI+ individuals. Whatever the case, it remains important for the service provider/caregiver to educate themselves on the best practices to interact with individuals coming in with different backgrounds, histories, and trauma. When it comes to the LGBTQI+ there are plenty of resources on the internet to facilitate the institutional or individual’s educational process. On this topic, another great resource is The National LGBTQIA+ Health Education Center, specifically this practical guide.

The extra mile

If you’re reading this and know of people who are living relatively isolated lives be it at home or retirement homes, there are 2 ways you can improve their long-term well-being. The Advance Care Plan, and caregiver education.

The Advance Care Plan

This is the millennia of TikTok, YOLO, and Carpe Diem. But to Live Laugh Love long time, we need to take care of our future selves with some of the decisions we make today. The idea of an advance care plan is nothing new, it is something that gets missed. It simply implies writing down how we want to be cared for when and if we are no longer able to take care of ourselves. How do you want to be called? What are some of your favorite routines, music, shows? …when should they pull the plug?

We all die. Most of us will need some form of care before we get there. We should have a say on how that care is provided. And for members of a historically discriminated against group, such a plan will hold accountable those slower to change and ensure one’s wishes will be respected.

Caregiver Education

We’re getting there. Organizations such as the Registered Nurses’ Association of Ontario have dedicated interest groups to help bring awareness. But when it comes to personalized care, it’s also important to have some of the details of that Advance Care Plan or the input from the guardian/primary_caregiver at hand. Technology, such as CareStory, but not only, can help facilitate this. Consider what solutions would best help you, your home, your residents, your co-workers or your friends have a higher satisfaction when engaged in the care process.

Conclusion

Pride is a show of solidarity that was born out of a violent clash between the LGBT Comunity and the Police in New York in the 60s.
LGBTQ adults have experienced historic, systemic, discrimination. They are wary of trusting institutionalized care.
LGBTQ older adults are more likely to be alone and impoverished.
Awareness groups and professional organizations are making efforts to make the system more accessible and inclusive.
LGBTQIA+ individuals should consider the importance and creation of an Advance Care Plan.
Communicating care preferences directly or through proxy via technology such as CareStory will improve the quality of care one receives.

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