Person Centered Dementia Care - The CMS Hand in Hand Toolkit
Karen Schoeneman
+Hand in Hand – What is it?
n Training toolkit: 6 hour-long training classes n 4 on person-centered dementia care n 2 on abuse recognition and abuse prevention n Instructor orientation guide
n Consist of video clips shot in a nursing home, along with instructor notebook to guide discussions
n Focus is nurse aides but all staff would benefit
n CMS has distributed the kit to all nursing homes or it can be purchased from the government if you don’t have it
n Especially for residents with dementia, but really for all residents, the way staff interact can either bring great quality of life or can result in loss of dignity and self-esteem
n All staff would benefit from looking at some of the videos and reviewing their own style of interactions
n Managers, supervisors, leaders can model this person-centered style and see that their staff have good interactions with residents
n Social Service workers and Activity Directors are specialists in Quality of Life
n You are cued in to dignity and how we “come off” when we interact; it is easy for staff to get in a rut and “come off” as hurried, harried, disinterested, even rude, without even intending it
n You are natural models and teachers of the best styles; you can point out problems and solutions and this course can help.
+Course Stresses Person-Centered Care “Person centered care is an approach to care that
honors and respects the voices of residents as individuals and those working closest with them. It involved a continuing process of listening, trying new approaches, seeing how they work, and changing routines and organizational approaches in an effort to individualize and de-institutionalize the care environment.”*
* Ohio Person-Centered Care Coalition
Leaders can make sure their organizational routines can adept to resident needs and preferences
n Often communicating is difficult, so we need to pay close attention to facial and body language as well as words that are being attempted
n Course DVD Module 1 shows deterioration of brain tissue – point is to realize a resident isn’t being difficult, but is having trouble understanding you and remembering
+ Once We Guess Why a Resident Periodically Becomes Upset . . . n We can try out techniques n To mitigate n To head it off at the pass n To get them busy doing something else n To reassure/give comfort, a sweater, etc. n To give needed food or drink or toileting
+Use the 3 P’s – Prepare, Prevent, Present n Prepare – by knowing what is likely to start
happening and what triggers it
n Is it related to time, or place, or task?
n Is it related to general loneliness, homesickness, or something else?
n At 3pm most days Mrs. Caputo tries to leave the home. She thinks she needs to pick up her children from the school bus. If thwarted, she fights back. Knowing this, what skills can staff use to mitigate the agenda? Here are two techniques.
+Summary – Key Skills You Can Foster and Model n See and Say – show what you want while saying
it
n Ladies and Gentleman – politeness runs deep – shaking hands, having a gentleman help a lady, every interaction should be like you are greeting the Queen of England
n Don’t mention failures, just offer help
n Don’t talk down to a resident or treat like a child
n And so am I, that nursing homes will want to have most of their staff and supervisors take this training, so everyone who interacts with a resident with dementia can have a toolkit of “behaviors” that can help life go smoothly for everyone.
n Families and volunteers need some of this education so they acquire skills they need too. The Council might like to see some of Module 1 so they can learn about dementia.
n The videos can be shown from the DVDs for those not needing a whole hour long classroom experience
n Hand in Hand: A Training Series for Nursing Homes is available from National Technical Information Service for $100.00 plus S/H. The product number is AVA21573CDRM and can be ordered by telephone at 1-800-553-6847.
n Alternatively, you may download the series and create your own toolkit from the website below.
n http://www.cms-handinhandtoolkit.info/Downloads.aspx
