The hAT AdvAnTAge by Rebecca Adelman

ABUSE RISK PREVENTION,PLANNING AND STRATEGIES - Part 2

By including a comprehensive abuse prevention program with on-going assessment and training as part of your organization’s Quality Assurance/Performance Improvement, incidences of abuse can be reduced and quality of care improved. In Part 1, we reviewed generally the Facility risk factors to be

identified in an individualized way with each organization, along with ideas for developing a collaborative task force to evaluate resources for developing a comprehensive abuse prevention training program. Our next step is to identify other risk factors and offer strategies to consider for your specific program. Through the commitment to this process, your organization can build a strong foundation and establish exemplary programming and training for abuse prevention and improved quality of care now and well into the future. Visit the National Association of State Units on Aging for more information of Nursing Home Abuse Risk Prevention.

Resident Risk Factors - In evaluating residents that may be more vulnerable to abuse, the most significant risk factors are behavioral symptoms associated with dementia, unmet needs, and high degrees of dependence (social isolation).

Relationship Risk Factors - Understanding the quality of relationships residents have with others, including family and caregivers, plays an important role in resident safety. Residents who receive visits and have attention to care may be less vulnerable than residents who have no one to care for them. There is a balance, however, as we are all aware that the over-involved family member may actually create obstacles to caregiving. Similarly, in order to reduce risk of abuse, resident-staff interaction and management of conflicts should be encouraged as well as cultivating personal relationships.

Strategies for Abuse Prevention - As we discussed in Part 1, for a meaningful and effective abuse prevention program, collaboration is important along with identifying the necessary resources. Combining knowledge, perspectives and skills to reduce risks will be determinative of success. Strong leadership from providers and staff is the key to success. Chances of success are enhanced if others are engaged in the process including licensing and certification, adult protective services and the ombudsman program.

Strategies for Leadership - An abuse prevention policy should include protocols on how to care for combative residents while providing continuous in-service training to staff on the protocol. Study workforce shortages and develop initiatives to address the problem in your area.

Continued on page 3

“ N E W S A N D V I E W S Y O U C A N R E A L L Y U S E ”

Nursing & Assisted Living Facility Professional N O V E M B E R 2 0 1 3

I S S U E 11 , V O L U M E 3

Kessler’s Cornerby Chip Kessler

“A Time for Thanks”

It’s hard to believe but in just a few short weeks another year will have come to a close. I know that I’ve written this statement before as it’s something I’ve come to realize and accept: with each passing year, time goes by faster and faster.

And so it is as the year 2013 slips away. And as we’re now into the month of November and with the Thanksgiving holiday not too far off, it’s a perfect opportunity for me to send out some well deserved ‘thanks’ to several

Continued on page 4

2

o u r p a r t n e r s h i p p r o m i s e i s

o u r p a r t n e r s h i p p r o m i s e i s

E x c e l l e n c e i n r e h a b i l i t a t i o n

E x c e l l e n c e i n r e h a b i l i t a t i o n

ELITE people who give ELITE resultsELITE care and produce

C

M

Y

CM

MY

CY

CMY

K

2

“Pet Power”There is an intrinsic connection between human beings and animals. During the course of our lives many of us experience the love of a wonderful pet. When a person is placed in long term care, often the family pet must be left behind. This can be experienced as another loss and often results in additional anxiety and increased difficulty adapting to the new environment for the resident. Ongoing research indicates that having a pet can be beneficial for a person’s general health and well-being. Pets can help diminish feelings of loneliness and isolation and encourage people to be more active, participate in therapy and provide a purpose in life as we age. In the event that the beloved pet cannot come to live with the resident, regular visits should be encouraged. Of course, communities must maintain the safety and health of all residents so policies must be in place to ensure that the visiting pet has appropriate inoculations, shots, etc. and does not exhibit threatening behavior towards others. There are also many organizations that will provide pet therapy visits to long term care centers and these entities have stringent guidelines on the type of animal that will make the visits. Usually visits are made by trained handlers using dogs and cats, but there are many other types of animals that can be used. Many facilities now have bird aviaries and fish tanks to keep residents entertained. So, what are the benefits associated with “pet therapy”…………….. • Socialization: Often residents are unwilling to share their thoughts and feelings with caregiving staff and at times, even with family members. Pets offer unconditional love and acceptance and will “listen” without making judgments! Since most folks love pets it also breaks the ice and will generate friendly conversation for increased socialization opportunities. Research indicates that people with pets engage in more frequent conversations then those who do not. • Improved Mood and Behavior: Residents who symptoms of depression and withdrawal have been shown to significantly benefit from visits with pets. Not only does the resident look forward to the visits but they tend to maintain an improved sense of belonging demonstrating increased motivation to participate in facility activities, including therapy. Many facilities allow pets to be used directly in the provision of therapy services!! • Benefits to overall Health: Residents who are able to participate in pet therapy or have their personal pet visit regularly have been noted to have decreased blood pressure. Stroking a pet has also been noted to produce increased levels of serotonin, providing an elevated feeling of wellbeing and happiness! Earlier in my career I was able to experience the ultimate in pet therapy! The rural long term care facility that I worked in had admitted a resident who had been a farmer all his life. He also raised horses and had done so right up to the day of his hospitalization. It was not possible for him to go home again so the facility became his “new home”. He was very depressed and not adjusting well having been so independent all his life and had made numerous comments about how he missed his horses. The facilities activity department went to great lengths to have his prize horse brought to the facility for a “visit”! The look on this resident’s face was priceless and afterwards his overall demeanor and satisfaction increased exponentially. It was

certainly an act of dedication on the part of this facility to ensure this resident’s individual needs were met by not underestimating the power of pets!

For more information, please contact Cherie Rowell, Director of Clinical Services Functional Pathways at crowell@fprehab.com. You can also discover more at www.functionalpathways.com

Pathway to Rehabilitation

ExcellenceBy Cherie Rowell, COTA

Director of Clinical Services

Nursing & Assisted Living Facility Professional Presents …“The scramble game”

Below are five names of some ladies and a gentleman who portrayed nurses on well known television shows. Match the names and characters with their corresponding shows and be eligible to win a $25.00 Wal-Mart Gift Card. We’ll select ten people from the correct entries, plus pick another correct entry to receive a $100.00 Wal-Mart Gift Card. You may e-mail your entry listing the characters and shows to chip@ecpnews.net, or draw lines to match things up, cut out this form, and mail to Nursing & Assisted Living Professional, P.O. Box 4852, Johnson City, TN 37602.

Make sure to include your name, address and e-mail address with your entry, whether mailing or e-mailing.

Entries Must Be Received no Later Than November 30, 2013 to be Eligible to Win

Ms. Loretta Swit/Major Margaret Houlihan General Hospital

Ms. Michael Learned/Mary Benjamin Private Practice

Ms. Linda Cardellini/Samantha Taggart M*A*S*H*

Mr. Chris Lowell/”Dell” Parker Nurse

Ms. Rebecca Herbst/Elizabethton Webber E.R.

3

outstanding individuals and businesses who play a major role in making this newsletter possible.

To begin with, there’s the young lady you read each month in these pages, Rebecca Adelman of the HAT Law Firm. If you’ve been receiving (and hopefully enjoying) Nursing & Assisted Living Facility Professional for any length of time, I trust you’ve come like me to appreciate Rebecca’s key insights and valuable information in her areas of expertise. As one who’s involved in the creation, production and development of risk management programs for our nation’s assisted living and nursing facilities, I can tell you first-hand how difficult and ever-changing these waters are to navigate. And yet through it all, Rebecca remains steadfast to do the very best she can for her clients, and the readers of this newsletter. I hope you’ll join me in thanking her for her tireless efforts and her contributions over the years.

When I first conceived of this publication, I wanted to seek out an innovative leader in its field. I knew that for this newsletter to grow and become accepted as a welcome addition, it needed to align with a top-notch company serving the healthcare profession. Around this time, I’d become acquainted with DART Chart Systems via our Extended Care Products MDS 3.0 Education Coordinator Joel VanEaton. Upon further investigation, I knew I’d found who I was looking for. After speaking with the company’s co-founder and President Dr. Linda Kunz and Vice President of Business Development Jane Burch, I was even more convinced. That’s why I was and continue to be so thankful that DART Chart Systems has played such a major part in this newsletter’s success. Hopefully, you read my column last month to gain greater insight into this outstanding organization. The best thing I can add here is that several of the long-term care facilities I consult for use DART Chart and are extremely pleased. I know I’m pleased to have them on board right here.

Another outstanding company that I can also personally attest to is Functional Pathways. Several of my consulting clients also use this company’s services and have achieved superior results. Best of all, since joining Nursing and Assisted Living Facility Professional in January of this year, you’ve come to read all about their expertise in the monthly column “Pathway to Rehabilitation Excellence.” Here Vice President of Clinical and Compliance Services Sheila Capitosti and fellow staff members such as Cherie Rowell, Gina Tomcsik,

Strategies for Increasing Resident/Family Involvement - Enhancing relationships with residents, families and caregivers promote a safe environment. Survey residents and partner with family councils to identify the types of choices residents want and make changes in nursing home and assisted living policies and practices. Residents and families can participate in developing strategies for the changes they wish to make in the facility. Develop a visitor volunteer program and train volunteers to understand how to report care problems they encounter.

Strategies for Building Skills and Competencies: Abuse Prevention Training and Support - Facility safety begins with an evaluation of the experience and skill level of staff. Additional training and education may be necessary. Offer an in-service training program on how to recognize abuse and the process for reporting complaints. Develop nursing home staff support groups and offer training for staff on conflict resolution strategies. New administrators and directors of nursing should be offered training on creating culture change and aging-in-place models.

Strategies for Increasing Awareness - Support facility efforts to recognize and support staff by participating in awards ceremonies or develop a competitive recognition award for outstanding care by staff.

Strategies for Collaboration - Develop a model abuse prevention policy. Develop guidelines on staff screening which nursing homes

The HAT Advantage continued from page 1

and David Higdon have delivered timely information on a variety of subjects of vital importance. I’m pleased to have these fine folks as part of our Nursing and Assisted Living Facility Professional family each month, and trust you our readers have found their contributions of great use.

Speaking of “you” I’d be remiss if I didn’t give you and the other great people who work in the nursing and assisted living profession a big THANKS for all of your kind words and support of this newsletter. I’ll give you some inside information when it comes to the world of publishing and for that matter in business … namely that there’s always a risk when you give something away and don’t charge anything for it. Here, quite often, because an item such as this publication or a service is ‘free” people don’t attach any value to it. The thinking sometimes here is that because I didn’t pay anything for it, then it isn’t worth anything. Indeed this may be true in most cases however I’m pleased to say it definitely isn’t when it comes to this newsletter. I’m delighted to report that I hear from people all over the country who look forward to receiving what we have to bring you each month and how they value this publication’s contents.

Regarding the contents you see and read each month within these pages, I’d be terribly shortsighted if I didn’t offer my thanks to the “glue” of this publication, my trusted layout and graphics whiz Lori Wilhoit who receives each piece of the newsletter puzzle each month and then goes about putting it all together. Lori is truly an unsung hero whose name you now know but have seen her outstanding efforts month after month.

Finally, I’d like to offer my sincere thanks to all of the clients who’ve put their trust in what we at Extended Care Products have to offer the nursing and assisted living community. You’ve made 2013 our biggest and best year yet, and for this I’m grateful. As we look forward to 2014 and beyond, it’s my pledge to continue providing the kinds of staff training/development programs, family educational, and risk management products and presentations that are welcome in our nation’s healthcare facilities Again, thanks for your business yesterday, today and hopefully tomorrow!

Chip Kessler has created over 20 staff training and development programs for use in our nation’s nursing and assisted living facilities. He’s also the author of two books on marketing. Chip serves as General Manager of Extended Care Products, Inc. Discover more at www.extendedcareproducts.com

Kessler’s Corner continued from page 1

may voluntarily adopt. Identify facilities with a high concentration of vulnerable residents (dementia, aggressive, highly dependent) and target those facilities for a mailing on abuse and abuse prevention and offer training and assistance. Develop a list of facilities with exemplary abuse prevention policies and make the list available to all nursing homes statewide. Use the list as a referral source for facilities that have a problem with abuse or want to reduce the risks for abuse.

Our professionals have a unique relationship with elders and have the best chance of identifying and addressing abuse and neglect. By having the most regular access to otherwise isolated residents, we can provide support for the physical and mental needs. By developing model abuse prevention strategies, there are improvements in quality care and safer environment for everyone. Evaluate your abuse prevention and training programs and identify any changes or collaborations that can be made to enhance your organization and relationships with residents, families and the community.

Ms. Adelman is a Shareholder of Hagwood Adelman Tipton, PC and practices in the Memphis, Tennessee office. She is a member of the Board of Directors and serves as the firm’s President. For over 20 years, Rebecca has concentrated her practice in healthcare law, long-term care assisted living and medical malpractice defense litigation. Her expertise and her scope of practice involve all insurance defense litigation areas including premises and product liability as well as employment law. Please feel free to contact her at radelman@hatlawfirm.com.

PRSRT STDUS POSTAGE

PAIDMWI

NAL ProfessioNALP.O. Box 4852Johnson City, TN 37604

NAL ProfessionalNot Coming Addressed to

You Personally?

We want to make sure you are personally getting this newsletter each month, not just have it forwarded to you because you’re now holding down the position of a predecessor! Let us know you now are on the job. E-mail your name, facility/company name and address to chip@ecpnews.net & we’ll update our records. Just put NAL Professional on the e-mail subject line and we’ll take care of the rest.