Date post: | 20-Feb-2017 |
Category: |
Healthcare |
Upload: | bcpsqc |
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Three Parts of the Equation
A holistic approach to admission in Long-Term Care
Disclosure Statement
• I am a Registered Clinical Counsellor in private practice.
• I was hired by Fraserview Care Lodge to design and implement the program.
• I currently have a contract with Fraserview. • Limitation to evaluation of the project: limited
number of control group participants.
Context
• An admission support program was developed at Fraserview Intermediate Care Lodge.
• The program was developed as a response to feedback from families.
• The program piloted in September 2012. • The program is now a regular part of every
admission at Fraserview.
Problem
What is Admission to Long-Term Care?
Family
Caregiver stress is not automatically relievedGrief and lossGuiltUnknownConflict
Resident
Relocation Stress SyndromeLoss of identity Loss of independenceFamily conflictPhysical decline Loss of life as they know it
Staff
StressFeeling of incompetenceInability to meet complex needs of families
and ResidentsLack of time and resourcesIncreased risk for errors and
miscommunication
Facility
Increased likelihood of complaints “Unreasonable” requests and complaints from
familiesTime away from direct care Staff stress and burnoutErrors and incidents
Intervention
Working with all three parts of equation. Counselling professional with long-term care background (LPN).
Intervention
Resident• Assessment of needs• Counselling to address relocation stress• Education to address unknown• Follow up• “Friendly face”
Intervention
Family • Utilize family as a “hidden workforce”. • Education to address unknown. • Counselling to address crisis.• Integration. • Follow-up
Intervention
Staff• Communication training• Admission support training• Collaboration and coaching • Support
Results
Outcome measures:Family surveyStaff survey Management survey
Results
• Truly person and family-centered care. • More time for direct care duties. • Families trust that facility provides the best care
for their loved ones. • No complaints from families. • Residents adjust faster. • Staff are prepared and confident about admissions. • Commandments from Accreditation Canada.
Comments from Residents and Families
• “Very understanding and helpful”
• “Initial orientation and regular updates were helpful”
• “Alleviating my stress with counselling sessions”
• “We did not have this program at the other facility. It makes a huge difference in how quickly and easily my mother
and my family are adjusting to this facility”
• “The contact with Karyna was helpful”
• “Karyna was a life savior for me in helping address mom’s questions”
Comments from Staff and Management
• “I believe the program is efficient, personal, and as problem-free as
possible.”
• “It makes my life much easier. Residents and families are much more
relaxed and supported through the process”.
• “It is very helpful for us to receive information about new Residents before
they come in. It helps us provide person-centered care.”
• “I never worry about new admissions anymore”.
Comments from Staff and Management
• “Hospital information is often outdated or incomplete. It really helps
for us to get up-to-date, complete information before admission”.
• “Family members appear a lot more calm and relaxed. They do not
come to the nurses’ station with endless questions”
• “Residents and families trust us more”
• “It is great to have someone to advocate for the residents”
Challenges
• It was challenging to convince medical staff that psychological needs are important.
• Establishing a new practice.
Challenges addressed by:
Staff education:- Communication Bootcamp- Transforming Admissions- Person-centered interventions for difficult behaviors3 Cs:- Communication- Collaboration- Compromise