long-term care Archives

In the long-term care industry, teamwork is key in offering consistent as well as high-quality care to our loved residents. Based on findings at Health Services Research, long-term care communities with a better teamwork structure and good staff communication are more likely to provide better senior care!

So if we want to create a high-performing team, we must have a clearly defined team structure. Among various team structures, CareStory recommends that caregiving communities should adopt a multi-team system (MTS) team structure. It consists of 6 smaller teams: the Administrative Team, the Core Team, the Coordinating Team, the Emergency Team, the Ancillary Team, and the Support Services Team.

Multi-team System (MTS) Caregiving Team Structure

The Administrative Team includes the medical directors, the nursing directors, and the administrators. The Administrative Team has 24-hour accountability for the overall nursing home’s management. Administrative team members need to ensure that all teams at the caregiving communities understand their role, responsibility and specific tasks.

The Core Team has leaders and members who provide direct care to the residents: for instance, nurses, restorative aides, attending physicians, etc. Members in the Core Team not only need to be fully aware of the overall caregiving performance, but also need to have good communication skills to keep all team members on the same page.

The Coordinating Team consists of nursing supervisors and heads from different departments. Coordinating team members are responsible for the daily operational management and coordination functions in the organization. Moreover, they also provide the maximum support to the Core Team, and they are responsible for resource management as well.

The Emergency Team is responsible for immediate and emergent situations. It’s is important to make sure that the Emergency Team always composes members from different teams so that they can respond to different types of crises. Possible emergency team members can be emergency response members, care planning professionals, etc.

The Ancillary Team also provides direct and task-specific care to residents, but in a supporting manner. Ancillary team members provide specific services that support the care of residents, and members can be X-Ray technicians, pharmacists, and laboratory professionals.

The mission for members of the Support Services Team is to provide safe, comfortable, and clean environments for residents. Possible members can be volunteers, housekeeping staff, gardeners, etc.

The structure of the MTS team can vary from long-term care community to community, as long as all members in the communities have specific responsibilities and close ties to the team members.

REFERENCES:
https://www.belbin.com/media/1818/belbin-team-work-in-care-homes-cmm-april2012.pdf
https://seniorhousingnews.com/2012/06/21/better-care-found-nursing-homes-with-good-staff-communication-teamwork/
https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/longtermcare/module2/igltcteamstruct.pdf

So now you’ve gone from agitated to angry, and you have a resident with dementia in crisis mode. What do you do?

Let’s start with what you don’t do. How many times have you calmed down when you were upset just because someone told you to. Never, right? Us either. When my great grandmother was trying to flee the home because she felt like someone was after her, she certainly didn’t calm down when the nurses told her to.

Seniors with dementia are more likely to show agitated and aggressive behaviour. This we know. They may swear, scream, or even hit and bite others. These behaviours may be triggered by various factors, such as pain, changes in the environment, and being ignored. The key is knowing these triggers (enter CareStory ;)).

People with dementia may not understand how they can express their needs, and aggressive behaviour is one way to release frustration.

Here are some methods we have found to calm aggression in older adults with dementia:

Music!

A nice piece of music can help seniors calm down and activate more positive memories! Research from the Alzheimer’s Association also shows that music helps people release dopamine and ultimately triggers happiness :).

Aromatherapy!

We aren’t joking! It is scientifically proven. According to a study published by Cambridge University Press, using scents like lavender and lemon can significantly decrease behavioural issues in patients with dementia. These pleasant scents can help seniors become more focused and reduce their anxiety and hallucinations.

Touch and hold their hands!

As one of the most effective methods to increase trust, touch can build a warm relationship between the caregiver and the senior. With just a gentle hand pat, seniors suffering from dementia can perceive your kindness, slowly calm down and reduce their agitation. Moreover, holding hands can help seniors relax and feel more comfortable. You can either take their hand in a natural manner or offer your hands for them to hold.

Remember, be patient, and smile :). Try these methods; they will definitely aid your efforts to comfort seniors with dementia.

Here is also a fantabulous video we would like to share with you. Let’s check how Teepa Snow successfully de-escalates a dementia care crisis in a positive and empathetic way

REFERENCES:
Alzheimer’s Society
Five Star Senior Living
Alzheimer’s Association
Holmes, C. & Ballard C. (2018)
DailyCaring

Morning administrators! Have you ever found that your colleagues don’t have enough motivation for their work and are less connected to each other, especially during the pandemic? Today, CareStory is going to provide some engagement strategies for your colleagues and caregivers:

Firstly, involve caregivers in decision-making!

As the administrator, your proposed changes will directly impact your caregivers, which may have positive or negative influences. So before you actually implement these changes, please, listen to your colleagues — What feedback do they have? Any better ideas? Give them a voice in how plans are implemented, and make them feel deeply involved! Trust me, they may surprise you with incredible suggestions!

Besides, ask for feedback and improvements!

Regularly send out surveys to your employees; anonymous ones are recommended. Find out what resources they need, what resources you don’t currently provide but would help them develop their competence and confidence, their motivation, and their job satisfaction. You can also schedule one-on-one interviews and connect with your team members. Sample questions can be:

What are your recent goals?
What is going well so far?
Any obstacles or challenges are you currently facing?
What else do you expect from the company?
How can I better support you?

Keep doing that and show that you really care about them!

Moreover, launch wellness and fitness programs and promote staff well-being!

We all know that caregivers are more likely to experience stress, and the admin staff should help them stay healthy and positive! For instance, providing information about mental health, hosting workshops and webinars on how to regulate negative emotions, offering meditation training, creating peer support groups, etc. But trust me, this will gradually build a positive work culture!

To fuel motivation, one of the most effective ways is to show caregivers they are supported by their CEOs, executive directors, and administrators. Let’s work together! So if you have thoughts or ideas of strategies that can keep caregivers engaged, feel free to share with CareStory below in the comment section!

REFERENCES:
https://www.celltrak.com/blog/10-ways-to-help-home-health-caregivers-feel-connected-as-an-agency-team
https://www.relias.com/blog/refuel-your-caregivers-with-these-engaging-strategies

The New Normal

Since the pandemic, we have been relying more and more on technology, therefore changing our day-to-day routines. Change, while scary, can also be good, and as a result, be exactly what we need.

When introducing new technology into any long-term care community, certainly, there are going to be some challenges. On the other hand, once you get the hang of it, there is no going back. In many ways, incorporating technology in senior living has become the new normal. Let’s take a look at four popular trends we have seen in caregiving technology since early 2020.

Interactive Platforms

Firstly, let’s discuss Interactive Platforms.

As professionals in senior living, we collect a lot of data. This data can consist of seniors’ personal information, health records, medications, and physical examination reports, for instance. Interactive platforms store and organize data for you, and as a result, can improve care management efficiency!

Voice-Enabled Interfaces

Let’s move on to Voice-Enabled Interfaces.

“Hi, Siri!” “OK, Google!” Sound familiar? These devices can comprehend, interpret, and even anticipate our needs. Yes, we said anticipate. Creepy? Definitely. Convenient? Definitely. Seniors need the convenience of speech recognition technology just as much as we do. According to a report published by Orlov’s Aging and Health Technology Industry in 2019, speech recognition technology will continue to be be everywhere in senior living because voice-enabled interfaces help seniors and caregivers have a better understanding of the seniors’ health conditions.

Remote Monitoring/Telehealth

Next, let’s discuss Remote Monitoring and Telehealth.

As you know, it’s the remote work era. How many Zoom meetings have you attended wearing pyjama pants? The correct answer is “all of them”. Currently, Telehealth technologies can monitor and manage health records at a distance, so caregivers can not only provide diagnoses remotely. Furthermore, care staff can also quickly access resources and documents they need, such as video conferencing, virtual reality training programs, and online chatting and booking systems.

Assistive Technologies

Finally, let’s review Assistive Technologies.

Research at the National Academies of Sciences, Engineering, and Medicine mentioned that assistive technologies have a great effect on those involved in senior living, especially in the care of people with disabilities. This technology can support people with vision, hearing, and mobility limitations. Common devices include smart glasses, which provides navigation for people with vision impairments, and smart hearing devices, which adjusts the sound of the environment around the user.

Now What?

Have we missed any?

In short, technology is currently shaping our experiences of living, ageing, and caregiving, and consequently, will help to change the narrative and perception of long-term care. CareStory believes that senior living will continue to evolve with emerging technologies, and therefore update outdated policies and procedures.

REFERENCES:
https://academic.oup.com/gerontologist/article/60/Supplement_1/S41/5735605#198949062
https://betterhealthwhileaging.net/tools-for-caregivers-keeping-organizing-medical-information/
https://pubmed.ncbi.nlm.nih.gov/31107599/
http://www.seniorhelpers.ca/blog/new-technology-making-seniors-safer-at-home

Good morning care staff! Did you get enough sleep last night? Did you eat a hearty breakfast? (No, coffee is not an adequate breakfast). We know that you have designed plenty of tailored care plans and activities for seniors, but what are yours? What are your self-care techniques?

The Facts

Research conducted by the Ontario Caregiver Organization mentioned that 77% of caregivers are dealing with challenges in their mental health, however, it’s difficult for them to find mental health support. As a result, 43% of caregivers are dealing with feelings of isolation and loneliness, which drastically increased during the pandemic. Now is the time to start taking better care of your body, soul, and mind, so we have some self-care tools you can check out to relieve some stress.

Mindfulness

First, let’s talk about the practise that seems to be one of the main focuses right now when it comes to self-care and self-awareness: mindfulness. Mindfulness can help individuals regulate negative emotions and build emotional strength, which is exactly what we need when we are taking care of others.

As an effective stress-management tool, studies at The Gerontologist, Journal of Consulting and Clinical Psychology show that mindfulness meditations can improve negative emotions experienced by caregivers all over the world. For instance, depression, stress, anxiety, isolation and sleep issues can all be improved with mindful practises.

Even if meditation isn’t your thing because you find your mind takes you too many places (yes, it is a skill), you can try simple things to get you started and self aware in the present moment. For example, have a look around and start naming everything you see, hear, and smell.

Thymus Thump

Next, let’s talk about the Thymus Thump. Have you heard of it? We haven’t up until recently. The best way to describe it would be to call it the happiness point. The happiness point can assist to release fear, neutralize negative energy, and relax mentally and physically. How? Well, simply tap the thymus point (under the collar bone, in front of the heart, behind the sternum) for about 30 seconds to receive new energy! Amazing right?

Acupuncture

Finally, let’s take a look at acupuncture. Acupuncture, is a traditional Chinese medicine practice. It inserts thin needles into specific points to stimulate nerves and muscles, which can seem daunting, but honestly, you can’t feel a thing. The pressure caused by the needles helps the body to balance and heal itself, and relieves stress, anxiety, depression and insomnia.

Have different self-care techniques? Please feel free to share your techniques with CareStory! Want to become better at caring for others? Start with caring for yourself first!

REFERENCES:
http://www.balancedhealthclinic.co.uk/articles/19-the-thymus-thump
https://ontariocaregiver.ca/about-oco/about-ontarios-caregivers/
https://ontariocaregiver.ca/wp-content/uploads/2020/12/OCO-Spotlight-report-English-Dec10.pdf
https://ontariocaregiver.ca/whats-your-self-care-plan/
https://vimeo.com/443464579

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/

Feeling Forgetful?

Have you ever walked into a room and forgotten what you went in there for? Yeah, us too. It’s normal. You may have even heard of “senior moments”, and probably have experienced them. As a result of getting older, we will all see more and more memory issues, but how do you know if your memory loss is part of the natural ageing process, or a symptom of dementia?

The fact is, early-onset dementia does often goes undiagnosed because initial symptoms are too similar to those of senior moments to be distinguished. As a result, when people experience memory issues, they are often very fearful that they are experiencing dementia.

Senior Moments vs. Dementia

Again, memory loss is quite normal, and the incidence of dementia is low. According to the World Health Organization (WHO), nearly 40% of the elderly population will experience some form of memory loss after 65 years of age. However, only 5 to 8% of them live with dementia.

As we age, our memories may start to get foggy, and some may even begin to fade. If seniors find themselves experiencing a bit of memory loss, misplacing items and forgetting names here and there for instance, you can assure them that they are most likely not experiencing dementia. Forgetting the name of an old friend is not a sign of dementia, but forgetting who your son is might be. Moreover, if your friends and family are more aware of your memory issues than you are, it might be a sign of dementia.

How to Differentiate Between Normal Ageing and Dementia

Let’s compare some signs of normal ageing memory loss and signs of dementia together so that we can have a clearer picture. Now, we are not doctors and by no means experts in dementia so these are just guidelines. If you really are concerned, please visit your doctor to have further discussions!

Signs of Memory Loss Due to the Natural Ageing Process

Unable to recall the content of conversations or details of events that took place a long time ago.
Fail to recall the name of an acquaintance.
Forget and slowly recall dates, things and events occasionally.
“Tip of the tongue,” trouble finding words in conversations.
Executive functions remain normal, but have longer cognitive processing and reaction time.
You are worried about your memory, but your families and friends are not.

Signs of Dementia

Forget recent events details or conversations content.
Repeat the same conversations.
Unable to recognize or know the names of family members.
Forget things, events and appointments more frequently.
Trouble coming up with the desired words in conversations and have frequent pauses and substitutions when finding words.
Unable to perform complex daily tasks
Your friends and relatives are worried about your memory, but you are not aware of these issues.

Attention! Not all symptoms are listed here. If you find yourself having some of the signs, please visit professionals and ask for help!

Preventative Measures

According to the American Academy of Neurology’s practice guideline, aerobic exercise is one of the best methods to maintain brain health. Take 30 minutes out of your day to exercise! Swimming, brisk walking, jogging, gardening, and cycling, for instance, are some recommended aerobic exercises for seniors.

Cardio workouts not only help seniors with memory loss, but also help lower blood pressure, enhance the health of the heart, and improve sleep quality. It’s never too late to start exercising, and there is always time to stay up-to-date on the latest resources of geriatric diseases. Together, we can beat this.

REFERENCES:
https://www.retiredbrains.com/senior-moments.html
https://www.bridgesbyepoch.com/resources/educational-resources/day-life-someone-dementia-1537298462
https://www.helpforalzheimersfamilies.com/learn/preserve-memories/capturing-memories-someone-alzheimers/
https://www.bayshore.ca/resources/dementia-strategies-tips-for-communication/
https://www.who.int/news-room/fact-sheets/detail/dementia
https://alzheimer.ca/en/about-dementia/do-i-have-dementia/differences-between-normal-aging-dementia
https://my.clevelandclinic.org/health/articles/11826-memory-problems-what-is-normal-aging-and-what-is-not

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

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

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