DEMENTIA CARE - A TEAM APPROACH

I asked a colleague of mine if occupational therapy could be utilized to improve the lives of residents with dementia, she quickly and loudly answered “YES!”  Lynn Dennie, COTA, was kind enough to provide the following description of the vital role therapy can play in managing the care of dementia clients at the same time addressing the potential of increased revenue through therapy.  Following are her thoughts....

How many times has it been heard: “John is being treated...but he has dementia.”?  What is being said when this statement is made?  When a statement is made is there limitations made in client care and the revenue that can be generated as well?  As the awareness of dementia grows, so does the cost in caring for clients with dementias, but are we leaving health care dollars on the table?

The Risk Factors involved with dementia care are falls, skin integrity, dehydration/malnutrition and decreased socialization/interaction with others just to mention a few.  These risk factors can all add up to added health care costs for all involved whether in nursing facilities, assisted living environment, or in a client’s home.

The costs related to care for the client with dementia can become a burden for all involved, causing us to work “harder instead of smarter”.  With increased risk factors, the cost of care for dementia clients also increases.  For example, risk factors lead to increased risk documentation (incident reports), increased need for safety equipment, increased use of medications (as warranted through documentation), and can ultimately increase the need for more staff to monitor the dementia clients safety, producing a feeling at times of “chasing the tail”.  Not only do cost accelerate, but slowly the approach of staff/care givers become reactionary instead of proactive.  This can lead to loss of staff retention due to “burn out”, and costs associated with proper replacement of staff.

So the question remains, what can be done?  It begins with accurate assessment of the individual with dementia.  Therapy can be utilized to assist in decreasing associated risk factors, such as falls; thereby strengthening the components associated with therapeutic interventions with set protocols, and staff/family education. Decreasing risk factors has the potential, then, to decrease healthcare costs.

What is the result of Instituting Dementia Interventions?  Through consistent dementia assessment and programming, there can be a decrease in cost factors, a staff focused on being proactive, increased client/family satisfaction which will lead to increased in overall reputation and as an end result enhances census development.  Finally, a facility’s financial performance is enhanced by revenues obtained by therapy. 

So are we leaving those health care dollars on the table?  We are when we do not meet the needs of the dementia client.  However, when therapeutic interventions address risk factors as well as when specialized dementia programming is implemented, a facility’s revenues can be enhanced and in turn operational costs reduced.

MAKE PHYSICIAN CALLS PRODUCTIVE

I want to tell you about another great tool to assist you in assuring that the information you share with physicians is accurate and valuable.  In a previous blog I told you able the KNOW IT ALL BEFORE YOU CALL tool from AMDA.

They now have a companion piece called KNOW IT ALL WHEN YOU'RE CALLED.  This excellent tool contains the same questions you will be answering enabling the physician to follow you and get all of the information you are sharing.  Take a look at both tools at http://amda.com.

These tools will empower both the nurses and the physicians to communicate effectively with the desired goal of addressing the clinical needs of the individual without rehospitalization.
  

Long Term Care: THEN AND NOW

Ever said, “Just give me back the good old days”? Let’s take a look at what was good about those old days.

The year is 1990. The “new” OBRA regulations had just gone into effect. Our world of long term care was reeling and we were very busy trying to get our hands around what were the items the surveyors would be asking. Sure, we had regulations, but we were pretty comfortable with them and had learned how to work with surveyors successfully.

We were giving good care with the knowledge we had at that time. Most of the elderly folks presented with physical limitations. Those limitations were in ambulation, transferring and eating and we knew how to help them.

Many nursing homes were small and family owned where everyone knew the residents and their families from their community. Often the owner and the staff were personal friends with the folks from the community. The care was truly focused on the person.

Times have changed...or have they?

Contact us today to receive a complimentary copy of Long Term Care practices still used today! Clearing out my VHS tapes and would like to see them used if you still have a VHS player!

REGULATIONS: The laws governing nursing homes haven’t changed since 1990. We have learned how to meet those requirements. We have learned how to support our practice with evidence-based information. I often hear caregivers agree that the regulations speak to the kind of care they want for themselves when and if they become “residents”.

KNOWLEDGE: Sure there are new techniques and new approaches that we have learned. But we now have computers where we can find information with the click of a key. We have education available from a much wider variety of sources to keep us “up to date”.

STAFF: As I travel the country I continue to find the vast majority of staff members do care deeply for those entrusted to their care. Yes, the facilities are now owned by big companies, but the staff are still from the community they serve; they still know the folks as the people from their community.

RESIDENTS: Sure, the physical acuity of our residents has increased drastically. The number of residents with cognitive loss has compounded the challenges we are now asked to meet. But they are still folks from our community. They still are seeking to be known as individuals.

WHAT HASN’T CHANGED? We are still people caring for people. The residents are still looking for someone to know them and provide care that meets their needs.

The “good” we talk about from the “old days” is the same now as it was back then. I believe if we focus on our service to the people we will find the exact things that were important “back then” are still the things that make the difference.

In the final analysis it’s not about focusing on meeting regulations but on meeting the needs of people. That focus worked back in 1990 and it works today.

Clearing out my stock of VHS tapes - so contact us today to receive a complimentary copy of Long Term Care practices still in use today.

KNOW IT ALL BEFORE YOU CALL

The time to "know it all" before you consider readmitting a resident to the hospital is here.

I want to share with you a wonderful tool that will empower your nursing staff to effectively communicate with the physician regarding the resident's condition prior to the consideration of readmission.

A review of the new publication from AMDA entitled KNOW IT ALL BEFORE YOU CALL reveals a step by step approach to gathering the vital information the physician needs to determine their course of action. It provides an easy to follow list of data that needs to be provided during the nurse-physician collaboration.

If I ran the world (always keep hoping!) I would highly recommend a copy of this dynamic tool be available on every nursing station. As a fellow nurse, I appreciate the need to share appropriate, to the point resident information with the physician. It can reduce "call backs", frustration and most importantly decreases the time needed to explain the resident's medical status.

Simply click on the tile of this blog to be connected to the AMDA products page for this publication.

Knowledge is power and sharing it is rewarding to nurses, physicians and the resident.

Get your copy now!