Caring for Patients with Mesothelioma

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Mesothelioma is a rare and aggressive cancer most often caused by a long-ago occupational exposure to asbestos, typically striking those in the retirement stage of life.

Although there is no definitive cure — and a diagnosis is met with considerable gloom and doom — recent therapeutic advances have begun extending lives significantly, raising the importance of a primary caregiver at home.

Instead of the past cancer prognosis of 6-18 months to live, some patients today are surviving two, three, four or more years after finding a mesothelioma specialty center that uses a multidisciplinary approach to treatment.

Taking care of a mesothelioma patient might seem like a daunting task, but it also can be a richly rewarding experience if provided the necessary tools. Understanding the cancer is important.

Pleural mesothelioma, the most common type, begins in the thin membrane surrounding the thoracic cavity. It stems from inhaling microscopic asbestos fibers, which become lodged in the lining around the lungs. They slowly cause inflammation and scarring, and eventually lead to cancer several decades later.

Early symptoms may include tightness of the chest, a persistent dry cough and strained breathing patterns. The later stages of disease can be debilitating, often making the simplest of tasks impossible without a caregiver at home. An uncertain future only adds stress to the patient and family.

A mesothelioma caregiver might be dealing with medical and legal professionals, remembering medications and treatments, managing appointments and financial affairs. In the latter stages, the caregiver could be feeding and bathing the patient, too.

The caregiver can become overwhelmed, struggling to maintain his or her own life. To improve patient care, there are some important things a caregiver should remember.

Here are a few:

  • The better you feel, the better care you will provide. So take care of yourself physically and mentally. Even with a demanding schedule, find the time to recharge your own batteries. Eat right.
  • Accept help from others. Ask for it, too. Too often, a caregiver tries to go it alone, and becomes worn down. It may seem admirable to spend every last minute alongside your spouse, but that often backfires. Let other family members or friends help with daily chores and provide a break.
  • Explore alternative or complementary therapies. Think outside the box. It might seem odd, but homeopathic treatments like herbs and anti-oxidants can sometimes help. Mind-body therapies, such as yoga, and even energy therapies, including music, can help, too.
  • Talk to others dealing with the same rare disease. Join a support group. Those in the group may understand your questions better than a nurse or doctor would. It also takes away the isolation that a caregiver often feels. The Mesothelioma Center has a support group that meets by phone monthly to discuss various topics.

“Sometimes, I think caregivers are the forgotten casualties in all this,” said Linda Chitwood, who has been her husband’s mesothelioma caregiver in southeast Virginia for eight years. “There is such a range of emotions you have to go through. And it can be terribly isolating if you’re not careful. You have to take care of yourself, too, if you want to be a good caregiver.”

If you’re interested in reading more about her and her husband’s journey, she detailed it in her 2012 book, “Fear 2 Faith: Our Journey Through Mesothelioma.” It contains their highs and lows, as well as the heartaches and heartwarming experiences.

Learn What Fall Prevention Can Do For You

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Imagine it: you’re a caregiver in a nursing home facility, administering medication to one of your patients. It’s evening and the building has quieted down for the most part; many residents have already turned in for the night. As you finish with your patient and are gently closing the door behind you, you hear it. At first it’s a muffled thud – a sound you can’t quite place – and then it’s a throaty moan from down the hall. Your heart accelerates and fills with panic. You dart in the direction of the noise, desperate to find its source. When you finally arrive, you find a resident on the floor, tears of pain streaming down cheeks, bruises already blooming. You’re terrified and heartbroken as you kneel down to the floor and shout over your shoulder for backup.

Perhaps this is a scenario you dread of experiencing as a caregiver to the elderly – or perhaps it’s one you’re already familiar with. Whatever the case, falls in nursing homes is a looming and near-constant threat. It is estimated that 75% of patients experience a fall at some point. Injuries from falls can be devastating, and the facility often pays the price when they occur.

There have certainly been various types of fall protection plans that facilities have implemented over the years, such as walking programs or the use of companions. The use of call systems  is another idea that works in theory, though they fail to provide accurate and consistent fall intervention.

 

An Advanced Fall Protection Plan

Now imagine it: you’re assisting one of your patients when your pocket buzzes from your cell phone. You check it and receive an alert that one of your other residents is at risk of falling. It tells you which resident and which room number, so you pace quickly down the hall and find your patient fiddling around in his or her bed. You ask how you can help.

This advanced fall intervention technology is not just a whimsical thought – it’s an actual monitoring system brought to you by Hello Nurse. Our system is the only one of its kind that has the ability to notify caregivers of possible issues before the incident can occur.

 

How the System Works

Installation of the Hello Nurse system simply involves placing one pressure pad on a resident’s bed or chair. Each Receiver can monitor up to 30 residents at a time, and when someone is attempting to rise, an alert will automatically signal. These alerts can be sent to a pager or cell phone, providing immediate details to staff members that include the patient’s room number and name.

And one of the best parts is that the Hello Nurse system is always on and monitoring for specific events on residents. Because the technology works independently of facilities’ IT systems and does not require the use of Wi-Fi, caregivers can rely on it to constantly be effective. And since it operates on a pager system, the alerts are always instantaneous.  

The many benefits of a fall prevention system far outweigh the fear of a resident experiencing a traumatic – and potentially life-threatening – fall. Don’t let yourself or your facility live with that fear anymore. Look to Hello Nurse for more information and ways to learn about our product. Help is always on the way.

The Effects Of Falls – And How Plans Can Work to Prevent Them

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As healthcare providers in the geriatric field well know, falls sustained by the elderly are extraordinarily hazardous. The CDC has actually reported that between 50 percent and 75 percent of residents in nursing homes fall every year – a staggering percentage. Not only do these statistics mean horrible things for elderly residents: they can also prove exceedingly negative for the facility itself.

While accidents can and do happen, preventing falls in nursing homes is exceptionally important today. This prevention is about more than providing good care to the people in your facility’s care. It’s also a necessity to ensure that your facility will not fall victim to negative consequences that occur following a fall. Consider these three possibilities that commonly affect facilities after a fall:

 

  1. Legal Backlash: In the best-case scenario of a fall incident – one in which the resident who falls does not sustain a serious injury – the staff members and facility must still handle the repercussions of the accident. In addition to paperwork and reports that inevitably detract time away from caretakers’ additional patients and duties, there is a potential for lawsuits and legal action from the resident, their family, or local or federal authorities. Aside from the actual fall itself, litigation is probably the last thing a facility wants to confront, as legal involvement can be a lengthy process and incredibly pricey.
  2. Repercussions to the Facility: Additional backlash to falls include both a decrease in of your facility ratings and poor survey results for the facility as a whole. These can ultimately affect your facility’s ability to continue working with residents, their families, and other members of the public.
  3. Additional Work for the Staff: Again, in the best-case scenario of a fall, the patient who suffers will still be required to receive additional care and monitoring after the incident to ensure it won’t happen again. Unfortunately, in a more serious fall, the resident could possibly be injured for life, which would necessitate another level of medical attention. For a facility that may already be understaffed, this adds additional pressure to its staff members.

Along with the harm caused to elderly residents in general, this brief list further illustrates how harmful nursing home falls can be. What this does not represent, however, are the number of deaths that these falls cause every year – which is around 1,800 according to the CDC.   

So what can be done to address this – and to address common causes of falls in the elderly? There are three key ways you can take action and work to prevent falls in nursing home:

 

  1. Carry Out A Risk Assessment: It’s important for caretakers to understand that there is not a single issue that causes falls in the elderly. Typically, falls occur because of a multitude of factors, so it is necessary to complete a risk assessment of each patient in order to determine whether he or she is a fall risk. Resources such as this guide from MedScape can assist caretakers in monitoring for signs of a potential fall in order to prevent the incident before it ever occurs.
  2. Create a Fall Protection Plan: Once residents are assessed, it’s time to take the next step in addressing any issues. Is the patient taking a high-risk medication? Are they experiencing continence issues? Do they exhibit a fluctuating mental status? If the assessment has determined that a resident is, in fact, in danger of a fall, then these are the type of factors that caretakers can look into adjusting in order to reduce that risk. Even though it might take time, it’s important to create an individualized fall protection plan for each resident who might be under threat of future injury. This additional time will make up for the aftereffects of a fall that impact everyone involved.
  3. Build A Culture of Safety: A nursing home facility must cultivate a culture of safety for both their staff members and their residents. Potential action plans include creating a fall prevention team and appointing staff to fill leadership positions. This team can work together to instate a system with regulations and procedures for the rest of the staff to follow. By creating accountability and strict rules on safety, caretakers can learn to work together and rely on one another to better secure and monitor their residents.
  4. Invest in monitoring tools that can alert staff to a possible fall before it occurs. No prevention plan is 100 percent foolproof, unfortunately. However, modern technology can provide staff with the extra resources they need to truly begin preventing falls in nursing homes. Hello Nurse, for example, can be set up to send out direct alerts to caregivers, facilitating a quicker response time when a resident is at risk of suffering from a fall. Our monitoring system is just one example of the tools available today that are designed to truly address falls before they ever occur – and in this case, it truly is an example of technology to the rescue!

Falls have a history of plaguing the nursing industry as a whole. However, they do not have to be part of your own facility. To continue to learn about fall prevention, we recommend reading about things that do – and do not – help to prevent falls. It also never hurts to research the best ways to instate your own plan and methods. And remember – help is on the way!

Remembering To Remember: Caring For Patients With Alzheimer’s

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Both the holiday season and the transition into a new year tends to revolve around nostalgia and fondly reminiscing on the seasons of our past. But what if you had no recollections of these previous periods? What if these warm memories simply eluded you?

 This is the tragic state of affairs for nearly 50% of nursing home residents in the U.S. who live with Alzheimer’s disease. It’s estimated that around 5.3 million Americans suffer from this disease, and that 1 in 3 seniors will die of Alzheimer’s or another form of dementia. Sadly, it is the only disease among the top 10 causes of death in America that cannot be prevented, cured or even slowed.

Due to the severity of this condition, it’s vital that facilities work to enhance the quality of life for both the patients and their caregivers in nursing homes today. Doing so can help staff provide the best care possible, even as facilities work to overcome staffing issues in busy modern nursing homes. We recommend the following for facilities looking to improve Alzheimer’s care in 2016:

Review the disease’s stages with staff members. Al nursing facility caregivers need to be properly prepared to handle the three major stages of Alzheimer’s care: early-stage caregiving, middle-stage caregiving, and late-stage caregiving. There are different expectations for each stage, as well as different patterns of behavior that residents are likely to exhibit during each stage. For instance, in the early stages, a patient might still exhibit independence and not necessarily show outward signs of the disease. In the late-stages, however, the patient might need assistance with even the most basic of functions, such as eating or swallowing. Understanding and clearly laying out the responsibilities of a nurse and of staff members during each stage will help your facility provide better care.

Help busy, frustrated staff accept the patient’s condition. Alzheimer’s disease, particularly in the more advanced phases, can be incredibly frustrating to deal with, even for the most experienced nurses. Many residents may even get combative and overwhelmed – projecting anger onto those around them. This is relatively normal, and should not be entirely reflective of the patient. Facility caregivers must also remember that people dealing with dementia often feel isolated and alone. Of course, good staff members will know this – but open communication with management, reminders about this fact, and resources for caregivers taking the full brunt of this stressful burden can go a long way in addressing the stress it creates in a facility’s nursing staff. It also gives management a chance to remind staff about good caregiving practices in these situations (i.e. accept that these behaviors are part of the disease and attempt to work through them; do not argue or convince a resident; try to both be the one in charge and treat your patient with compassion).

Know your resources. It’s not uncommon for caregivers and staff who work with multiple Alzheimer’s patients to experience occupational burnout – especially when more than one of your facility’s residents exhibits difficult behaviors. It’s incredibly helpful for your staff to know that there is help out there for you. For example, there are groups specifically designed for caregivers dealing with dementia that provide advice and support. Even if a staff member just needs to vent to someone else who deals with the same issues, it can be helpful to reach out so that you can get encouragement and feel less overwhelmed. Encourage your staff to find groups in your area that they can meet with, or even online forums to contribute to – it may very well be what makes their new year at work more productive and manageable.

Alzheimer’s will remain one of the constant diseases prevalent in nursing home facilities. Make sure that you, your facility, and your staff continue to be connected to both information and help when it comes to caring for patients with this and other forms of dementia. And remember, if you need additional help monitoring these specialized conditions, feel free to contact us with questions on how Hello Nurse can help.

6 Fun & Seasonal Activities for Assisted Living (That Your Staff Can Plan!)

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The day-to-day responsibilities of operating an assisted living facility can sometimes feel more burdensome than rewarding – particularly if the facility is understaffed. As a staff member, it’s easy to get dragged into an unstimulating routine of caring for your patients. Now that the holiday season is here, though, our traditions of decoration and celebration could give facility staff the perfect opportunity to recharge – all while benefiting their residents!

Not only do holiday decorations brighten up a facility – but organizing fun activities for assisted living residents can also be a simple way to breathe some excitement back into the job. Plus, by bringing a bit of holiday cheer into the facility, staff can create a happier environment for residents, and therefore provide better quality care!

Even better, holiday decorating doesn’t need to rob too much time from the schedule. Here are a few seasonal suggestions for great activities you can put together for your residents:  

  • Start A Baking Club. Gathering residents who can safely work in the kitchen and allowing them to try their hands on a fun recipe or two is a great way to empower them. Depending on your facility, you can organize and have a baking day weekly, biweekly, or monthly – whatever will suit your staff and residents best. Some great ideas to make around the holidays could be eggnog cookies, a classic fruitcake, or even gingerbread cutout cookies that residents can personalize.
  • Throw A Hot Toddy Social. Invite residents to gather in a common area and serve up delicious hot toddies. You could even make it a themed event and celebrate December as the month Prohibition ended. Play some Sinatra records, or some tunes by the Andrews Sisters, to complete the perfect afternoon in your facility.
  • Plan A Holiday Trivia night. Put on a trivia night this month and invite residents to play as teams. Be sure to ask holiday themed questions (and don’t forget to include Hanukkah, Kwanzaa,and New Year’s!) that will not only fit the theme of the season, but which will have residents using their noodles!
  • Organize An Afternoon to Record Memoirs. Giving residents the opportunity to sit down and tell some of their favorite – and maybe even secret! – stories is an excellent way to engage their minds and to help them build relationships and friendships among their community members. By recording these tales, you can also provide a wonderful gift for their families.
  • Start A Walking Club. Keeping your residents fit can certainly be a challenge. If you don’t already have one in place, a Walking Club could be an easy way to encourage people to start healthy habits by making it a social event. The benefit to this idea is that you can continue it year-round (and while it won’t necessarily help to prevent a fall, it will certainly help to keep your residents a little healthier!).
  • Put On A Reading Series. Another great way to engage residents without having to resort to the television is by reading aloud to them. Have one of your staff members choose a seasonal book to read from and start a series – read a couple chapters every day, or every few days. Encourage this staff member(s) to be lively and interactive with the residents and turn it into a fun event.  

As you can see, while it’s tempting to make the holidays a momentous celebration, organizing facility events doesn’t have to be complicated or costly. They can even serve as a way to avoid burnout in staff and idleness in residents; because of this, we recommend thinking of of holiday ideas as a way of providing quality care, rather than as an annoyance. So go ahead, use these ideas or brainstorm your own, and make this holiday season at your assisted living facility the best one yet!

4 Ways To Give Your Facility A Competitive Edge

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Operating a nursing home facility is a complex business. Staying compliant and cost-effective is a challenge in itself, particularly when combined with the need to remain patient-focused. It can be a difficult balancing act to ensure you are running a successful business – which includes keeping your staff happy – while still providing high quality care.

But it can be done! Here are a few ideas to consider that should help improve the processes you already have in place, and thereby help you build a stronger business and care model overall:

  • Communicate with residents. It sounds incredibly simple, but communicating with the residents in your facility is very important if you hope to improve care. Currently a number of experts are calling to shift the old culture of nursing homes to a new one that would emphasize encouraging both facility staff and family members to have a dialogue with their elderly patients. “Rather than assuming they need one thing, a better idea would be to simply ask them,” states Atul Gawande, author of Being Mortal. A simple question could be all it takes to boost resident satisfaction – as well as patient care.
  • Engage with their families. Involving residents’ family members is another simple trick that can help improve the success of a facility. As discussed in a previous post, the quality of a facility’s care efforts is very important to families as they choose a home for their aging relatives. But in addition to care, families are also interested in accommodating visiting policies, as well as the facility’s overall guest environment. If relatives are encouraged to visit and share meals or activities with patients, then resident satisfaction will likely improve – and so will the reflection on and reviews of your facility.
  • Restructure your care model (if possible). Depending on your facility’s budget, this may be a difficult goal to achieve, but new versions of nursing homes are starting to take hold across the country. One of the biggest differences between these new facilities  and traditional facilities is that patients have private rooms and staff can concentrate care on small groups of residents, rather than distributing generic care to a multitude of patients. If you cannot afford to restructure, then it’s important to take a strong marketing approach by highlighting the advantages your facility offers that others do not. By sharing information on how you provide quality care and work with other healthcare providers, you can increase your competitive edge in the industry.
  • Implement modern care assistance technology. One of the best ways to better your facility is to invest in competitive technology that will improve the quality of your care. For example, wireless patient monitoring systems are able to collect data on residents and send warning signs to staff before an injury can occur. When incidents and reports are prevented, patients receive better care and facilities receive better reviews and reputations.

Overall, running a good business and prioritizing patients can – and should – go hand-in-hand. When you implement strategies that boost both goals, you should be able to see success.

To learn more about an easy way to invest in your facility, be sure to download our brochure and to explore the benefits of Hello Nurse’s own wireless monitoring technology tool.

Why They Care: What Motivates Nursing Home Staff Today?

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Working in a care facility today is growing more and more difficult for the caregivers and nurses who have risen to meet the challenge of providing care for an aging population. Right now, nursing homes must prepare for the day when the Baby Boomers require the help of professional caregivers. At the same time, ongoing changes within the healthcare field in general mean that facilities are constantly experiencing fluxes in industry rules, budgets, and even staffing demands. Add in the fact that consumers today are quick to look for signs of neglect – whether intentional or accidental – and it’s easy to see that caregiving staff today have been given quite a headache to manage.

So why do they do it? Despite the fact that many facilities are vastly understaffed and nurses often report that they feel underpaid, these brave individuals continue to come to work and find the silver lining in what is truly an incredibly stressful job. For them, working within the industry is not just rewarding – it’s beneficial on a personal level. Here’s how:

The job helps to keep them prepared for their daily life. Many individuals currently have an elderly family member involved in their lives somehow – whether that be a grandparent, a parent, an aunt or uncle, or an older friend. By working in a nursing home, nurses have the ability to witness and work with the aging process firsthand. The result? They are often able to give better recommendations to relatives or friends about what to do to address their own aging needs. This ability to provide advice – and even to help friends and loved ones navigate the nursing home system during an incredibly stressful time – is a very valuable skill that staff can use to benefit the people in their lives outside of work as well as within it.

The job helps to make them comfortable. Many caregivers will testify that working in a nursing home can help them grow more comfortable with the idea of the aging process. After all, growing older is almost a universal fear. It’s something that everyone thinks about eventually – it’s something that worries many people, too. It can feel particularly daunting and highly isolating if someone does not know exactly what may happen to them over time. As a geriatric caregiver, though, individuals have the opportunity to help patients face these obstacles. This allows staff to demystify the aging process – thereby removing a major source of this fear.

They enjoy (aspects of) the nursing home environment. While they face many challenges within their facilities, many nurses or caregivers who work in a care facility prefer this type of environment over other caregiving settings, such as a hospital. Care facilities give staff members a chance to grow familiar with the residents they care for. The possibility of building relationships can certainly make the job easier, particularly as staff learn how to work with each patient individually. The ability to build a repoirte – instead of being forced to simply treat a patient and send them home – allows staff to enjoy connecting with another human being. And in many cases, this is what the staff in a care facility want! After all…

Caregiving allows nurses to work with a population that needs their help. With over 1.4 million men and women residing in nursing care facilities, it’s clear that the need for caregivers is not going anywhere. Ultimately, working with the elderly can be rewarding simply because it is a job that requires kind act after kind act. It calls on staff to provide comfort and support to another human being. And for many nurses and caregivers, meeting this need – and taking up the mantle of treating consumers as an extended family member – is what brings them the greatest level of satisfaction at work.

Unfortunately, as changes in the industry continue to impact nursing homes, even these benefits of working in a care facility cannot always prevent caregiver burnout or other serious problems. Ultimately, it’s just as important to provide staff with tools that will make their jobs easier, from EHR usage to the implementation of patient monitoring technology. The right tools will allow staff to continue to focus on their reasons for working in the industry, instead of possible reasons to leave it.

呼叫系統落伍，現代科技湧入— — 在看護機構防止跌倒

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的機構已經用過居民啟動呼叫系統嗎? 如果是這樣，你並不孤單。許多長期照護機構曾經有可能投資于呼叫系統以增加安全和提升的消費者對其運作的意見。

今天，然而，普通護士呼叫系統已經被證明並不總是對居民病患最有效也是最實用的工具。現在許多人對於呼叫系統反應度是強烈皺眉 — — 並不是積極主動 — — 針對跌倒安全的預防方法。 並在系統的地方，越來越多的行產業領導者選擇使用一個新的現代安全工具，更有可能向居民提供他們需要的安全與保護: 自動監督。

呼叫系統的缺點

呼叫系統確切地的問題是什麼? 曾經是一個長期照護機構有展望的工具，居民啟動呼叫系統已經不能持續地提供保護和援助當居民可能需要在緊急情況下，尤其是涉及跌倒。

即使使用正確，呼叫系統不能保證居民在發生跌倒時將能夠獲得幫助。如果居民跌倒無法無法摸觸到呼叫系統以便求救，他們會立即失去他們的能力即使使用他們的系統來求救。此外，呼叫系統依賴補丁，吊墜或可穿戴設備不一定有效，居民可能不總是記得穿上它們當每次他們準備離開他們的床。

更重要的是，經由呼叫系統並不能幫助預防跌倒放在第一位。這是不能被忽視的需要。疾病控制和預防中心目前報告說”介於一半和四分之三的養老院居民每年跌倒”和”約有 10%至 20%的養老院居民跌倒造成嚴重傷害”。更糟的是，每年約 1,800 位在養老院的老年人因跌倒造成死亡。這僅只是在養老院裡的數字 — — 這一數字不包括那些缺乏全國性監督的輔助生活或其他照料類型。

這數字是太高了 — — 單單以呼叫系統是無法解決預防跌倒的需求。

 

對於在輔助生活的社區甚麼是重要的

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what families look for in assisted living為所愛的年長者選擇長期照護的機構並不容易。

消費者要知道他們的需要是如何被滿足及潛在的居民患者將能夠在你的社區享受高品質的生活。

雖然養護院評級可能幫助居民患者家人看到你的配置不同於你的競爭對手的職員水準和成果，社區的訪問通常對他們的決定是產生最大的影響。

這裡有一些是居民患者家人當他們訪問你的社區時會尋找的關鍵要素:

噪音及臭味

當新的居民患者或居民患者家人經過你的大門時，他們不只是觀看環境 — 他們會專注於他們的感官。

高功能、 組織護理設施往往要更安靜及不混亂。

頻繁的、 大聲的廣播都是一種警訊 — 消費者期望一個更現代的通信系統，和會注意到它是否產生不愉快的氣氛。

對於阿爾茨海默氏症和老年癡呆症的老年人，嘈雜的環境可能會對居民患者有特別的壓力 — 他們的親人知道這一點，也會根據此來選擇一家養護院。

不愉快的氣味是一個很大的問題。訪客會立即嗅覺到一種不同於正常的人體的衰老氣味。

真相有關於”老人體味”(也稱為壬烯醛的身體氣味)是: 它是自然的老化過程中，沒有人需應該為此事感到羞愧。

然而，這些氣味會因為尿片未更換, 皮膚感染和不經常的沐浴而加劇其味道。

由於我們的嗅覺很敏感，所以氣味會強烈的留在我們的記憶中，壞氣味會對參觀者留下非常負面的印象，將難以抹去。

參觀政策

多年來，這已是一套為長期的看護機構設定的拜訪時間政策的標準。

但事情已經改變。讓訪客於凌晨2點來訪, 雖然它可能不是明智的，因你居民患者的訪客應該會覺得他們可以來來去去，參與活動，並與他們所愛的人一起進餐。

如果你將探視時間限制在一個時段裡，居民患者家人會想，”探視以外的時間居民患者的情況如何?” 和可能會懷疑當居民患者訪客不在時候的職員配置水準和護理的品質下降。

對每一個人的尊重

你的社區文化說明了關於在您的機構的生活的型態。尤其是，注意你的員工相互之間以及與居民患者之間是如何交互作用的。當護士不知道居民患者的名字，可能會以粗厲的語氣對居民患者和其他居民患者說話，或反之亦然 — 居民患者家人可能假設工作人員並不是以他們為最優先。

價值

甚至在一個下午的過程中，潛在的消費者將瞭解您作為照護年長者的護理機構的價值。

他們會問你機構的規劃是將如何照顧他們所愛的人的具體條件和滿足他們的需要。

他們會想知道什麼樣的科技系統裝置在你的機構，以防止可以預防的事件，例如褥瘡、 跌倒、 感染，和更多的問題。

如果你不準備回答這些問題，那是一個警訊 – 幸運的是，如果你正在積極尋找這些問題的答案，幫助是咫尺可及的。

如何改善養護院的皮膚照顧

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ELDERLY_RESIDENT_OF_MULKY_SQUARE_MUST_SOON_FIND_NEW_LODGING._HER_PRESENT_HOME_IS_IN_THE_PATH_OF_I-635_-_NARA_-_553482-1你知道褥瘡是可預防的, 而這也是養護院最常見的訴訟來源之一嗎?

Image courtesy Wikimedia Commons

作為老年人的健康照護提供者，它是你的責任以確保您的居民患者在你的看護下不發生褥瘡或潰瘍。因而，這也正是每個養護院或長期照護機構必須處理的重點。

預防性皮膚護理是養護院對居民患者健康照顧上最經常忽視的重點之一。

如果你不確定的這些問題如何影響你的底線，只需要求從護理人員提供機構內傷口報告的副本，並調查與治療褥瘡和潰瘍相關的成本。

極為重要的是要為你的居民患者設置有一個結構化的皮膚保健的方案, 這樣你就可以避免一些常見的缺失:

投資于優質的產品

你會驚訝有多少機構採購預算水準乳液、 沐浴乳、 肥皂和洗髮水。投資于高品質的產品對於採購決策者是重要的 — 老年皮膚不同於 30 歲的皮膚，應以不同樣的方式來照顧。

老年人的皮膚處於退化階段。便宜的護膚產品通常並不具酸鹼值平衡功能且以酒精作為一種主要成分。這就像是一個配方作為給乾燥的皮膚、容易眼淚、 皮膚破裂，褥瘡和/或潰瘍等。

與您的供應中心協調員和管理員購買護膚品，此應為特別設計專為醫療保健應用 — 和確保他們在每個時段隨時可供應。

衛生程序

許多長期照護的社區做到正確地使用護膚產品，但並不應用于居民患者洗完澡後 — 這是適用任何種類的洗劑或產品的理想時間。

很多機構還在使用會陰沖洗以預防患者使用便盆的感染。然而，即使會陰沖洗不是”非沖洗”種類, 很多照護之家並沒有在使用沖洗後立即清潔該便盆。

甚至有的用抗菌肥皂來替代會陰沖洗 — 這又是另一種造成皮膚乾燥和後續併發症。

 

緩衝墊降低風險

理想情況下，任何是坐輪椅的居民患者應該要安裝卸壓墊。T-凝膠，基恩或其他專門的卸壓墊都是理想的產品。

此外，任何居民患者有褥瘡風險者應該要使用減少壓力的床墊。傳統的彈簧床墊已知是將壓力放在身體的小面積上，急劇增加的褥瘡的危險。

許多養護院也會在居民患者的床上加上覆蓋物，用來增加居民患者的舒適性。然而，當用來幫助傷口癒合的時候使用空氣床墊是最理想的。

最後，作為一名養護院的管理員，你應該每週檢查你的員工對於居民患者的皮膚報告— 如果這些報告有被完整的紀錄。

找出第3-4 階段壓力領域的高頻率，看看您的機構對於皮膚保健的檢修是否已過期。此外，為所有你的居民患者使用 Bradens 計量器預測壓瘡風險，無論他們的病史如何。

長期照護機構必須依照預算進行運作是相當普遍的。然而，很多人沒有意識到的預算緊縮的原因是因為他們沒有投資于高品質的居民患者患者的護理。所以，購買這些高品質的產品是必要的。

使用床墊旨在促進癒合。使用居民患者患者的監測技術，以密切留意居民患者患者發生褥瘡及潰瘍的高風險。藉由改進您的員工為護對居民患者的皮膚護理程序，此即保護您的機構 — 無論在在財務和法律的層面。

當居民患者跌倒後如何處理

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你認為導致養護院居民患者損傷主要因素是什麼? 如果答案是跌倒，那你就猜對了!

當在你的社區老年居民患者跌倒，損傷的嚴重程度可從輕微擦傷到頭部嚴重創傷，甚至死亡。更令人擔憂的是，你可以裝置最有效的居民患者患者監測系統以減少跌倒的風險 — 但如果你沒有設置回應的方案，跌倒的後果可能打擊到你的機構的底線，償還和病人滿意度指標。

AHRQ 已經發展一個 “什麼是跌倒有效應對的戰略” 全面審查 — 有多少的這些程序是已經在你居民患者社區裡實施?

警報護理人員

只要居民患者跌倒，護理人員應立即來評估情況。居民患者不應嘗試起床或移動直到護士評估完畢。這種評估應包括測量生命跡象，問居民患者如果他或她有沒有疼痛 (和嚴重的情形，從 1-10 範圍內)，以及檢查有瘀傷、 擦傷、 割傷或者任何類型的出血。為手臂和腿部的運動範圍也應進行評估，以確保沒有脫臼。

應用急救

如有必要 (及居民患者是能夠站立或坐起來)，護理人員應於評估後適用急救。而即使骨折的跡象並不明顯，如果護士懷疑居民患者可能有骨折情形時應該執行X光片的照射。如果病人是仍然無法移動，應該用擔架或救護車於運輸居民患者至適當的救護機構。當然，所有這些活動和評估結果都應記錄在居民患者的檔案中 — 並應通知他們的家人。

監督

如果沒有發生骨折情形，護理人員應在跌倒以後幾天監測居民患者健康 — 尤其是最初評估時沒有察覺對因跌倒造成行為或傷害等在的任何變化。

很多時候，當居民患者跌倒時並沒有人在那裡，從頭部受傷的神經損傷因沒有發現而將無限期地未經治療。當跌倒沒有被看見或頭部受傷被懷疑因任何理由時，也應於此監測期間進行神經的評估。

重組與重新評估

最後，一旦居民患者是在穩定的條件和所有即將發生的健康問題都得到適當的處理。養護院工作人員應評估跌倒發生的原因和制定計畫以防止未來的跌倒 — 它新科技投資到警報護理人員當居民患者開始移動，移除障礙，重組某些元素，使環境更安全。

當跌倒發生時，不僅應該有徹底回應協定的設置，更應認真評估養護院工作人員的疏忽的可能性。

如果此疏忽是因其他因素造成的結果，那些因素也應予被說明。

養護院董事應徹底檢討 AHRQ 跌倒回應準則 — 和如果當前資源不允許工作人員的結構改變、 護適通將提供給您及時的幫助。

5 件事無法避免養護院的跌倒事件……有一件事可以做到

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每年，典型 100 床養護院報告有 100-200 起跌倒，此根據美國疾病預防控制中心(CDC)的資料。當然，那些數字僅僅只是來自那些已經報告。

這些跌倒並不是一種”滋擾”— 每年近 2000 名養護院居民患者因跌倒而死亡。10 至 20%的所有養護院跌倒的居民患者造成嚴重的損害。

更不用說，護養院處理跌倒的成本 — 在時間、 資源、 直接成本 (比如，居民患者損傷治療) 和間接成本 (比如從跌倒所引起的訴訟)。

多年來，養護院和有經驗的護理機構已實施了一系列措施目的在於減少居民患者跌倒風險的下降。不幸的是，並不是所有的措施皆有作用。

長期的醫療決策者注意: 這些預防策略並不被證明可以預防老年人跌倒:

1比1 的同伴

當居民患者的跌倒風險評估表明他們處於高風險的跌倒時，一些養護院分配那居民患者 “1:1 的同伴”— 在任何時候都是與居民患者患者一起的護士或照護人員。根據 2010 年的護理管理論文，雖然，不只是這種策略使護理人員效率低下 — 1:1 的同伴並不能預防跌倒。例如，一名 82 歲的居民患者患者仍然跌倒當護士正在為他準備茶的同時。

甚至最受監控的情形下，病人可能遭遇嚴重的跌倒。取而代之這種方法，論文的作者推薦進行跌倒風險評估伴隨降低跌倒風險的護理計畫。

維生素D

研究顯示，維生素 D 具有很小，但對老年人的骨質密度的積極影響。然而，很多人斷然做出結論，維生素 D 可預防老年跌倒 — 事實並非如此。

雖然維生素 D 可能減少跌倒受傷的嚴重性，研究表明它並不是可以防止跌倒。 2014年Lancet糖尿病及內分泌發表文章總結了一項研究 在29,535 人跨越 20 隨機控制試驗中，發現使用維生素 D 補充劑並不減少跌倒的機率達 15%以上 — 在統計學差上的差異極度微小。

床欄杆

這個常識是正確的嗎? 如果你提高病人的床欄杆，他們因此不能離開他們的床上 — 並造成跌倒。

然而，研究顯示恰恰相反，據年齡與老化 2002年論文。床欄杆不僅提高因跌倒及纏繞欄杆所造成的傷害，更是增加他們也可能會連結到惡化攪拌、 恐懼和譫妄患者。事實上，不論是否加高床欄杆有50% 到 90%的病人跌倒是從醫院病床發生。

快步行走方案

它不是秘密，身體的活動，包括行走，是有益於身體健康。但是，它可能不是最有效的預防跌倒策略。

2011年的研究顯示，雖然行走，力量，和平衡訓練程式可以促進身體健康，高跌倒風險的患者，不應處方以快步行走方案。一項試驗事件發現快速行走方案對於高跌倒風險的人實際上會增加跌倒的風險。

物理束縛

甚麼事做到預防養護院的跌倒?物理束縛永遠不應該用於養護院跌倒預防策略。根據疾病控制和預防 (CDC) 的中心，他們不做預防養護院跌倒或摔傷。其實，使用束縛可以增加跌倒相關的損傷和死亡的風險。他們也可以導致肌肉無力和物理功能喪失。

雖然上述策略不預防老年人跌倒，疾病預防控制中心提供了一些建議做的策略:

  • 跌倒後立即評估患者的風險已指出危險因素及治療的基本條件。
  • 教育工作人員對跌倒的危險因素。
  • 檢視處方和分析這些藥物的潛在風險。
  • 改變養護院的環境。
  • 提供居民患者髖關節墊
  • 教育居民患者有關跌倒的危險因素

對高風險居民保持密切關注，設施可以形成整體跌倒預防戰略的基礎。它是一項大工作 — 但幫助是咫尺可及的。

若要瞭解更多關於護適通無線病人監護系統，請下載我們的產品手冊。

發現並指出養護院員工的工作倦怠

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平均而言，在養護院一年的費用是91,000 美元。這引出了一個問題: 長期護理機構應該做些甚麼事情幫助居民們和他們的家庭降低他們的成本，如果有的話? 在 twitter 推特社交網絡上，我們從一個護士那裡得到的一個反應是一個特別傷腦筋的問題: 在她工作的養護院裡每個房間有四名居民患者，每 20-25 名居民患者僅配有一名護士。

雖然此職員配置戰略很可能有效地維持成本避免上升或甚至更高，但這是為居民患者和他們的家人的最佳策略嗎?

護理人員負擔過重的後果具有重要意義: 降低病人的滿意度和護理品質的問題。事實上，賓夕法尼亞大學的研究人員最近調查發現，37%的護士在養護院裡感覺工作倦怠，(相比，22%的護士在其他設置中); 在47%的養老院護士說，他們的工作量對於他們的病人狀況導致了重大的改變， (相比其他設置 21%)。

連接來自醫療保險與醫療補助服務中心的壓力 (CMS) 經由通過”質量”以保持一流成果指標以便獲取最大的償還，養護院及熟練的護理領導者應如何對抗護士和照護人員的職業倦怠問題?

護士倦怠的跡象

照護人員壓力可以幾種形式表現出 — 藉由認知他們，你將會在您的設施更好以確定和解決工作人員效率低下，。如果你沒有能力或才能注意到這些症狀，考慮進行員工滿意度調查或個別訪談，準確地判斷你工作人員之間的壓力水準。

一些常見的護士和看護倦怠症狀包括:

  • 抑鬱、沮喪和煩躁不安
  • 精神和身體疲勞問題
  • 對於小問題的過度反應
  • 集中力有困難
  • 增加不健康的習慣，如飲酒、 吸煙，或暴飲暴食
  • 忽略或未能完成重要任務

在照護人員之間的壓力與職業倦怠可產生無數的影響，無論就個人和專業上。錯過藥物劑量或配藥錯誤。居民患者跌倒可能會被忽略，延遲回應注意或追蹤等。需要被翻身的居民患者沒有定時做到，從而導致褥瘡的昂貴治療 (或訴訟)。你還冒著失去你的照護人員的風險, 由於他們轉至其他的機構，從而導致人力的減少。這樣的職員緊張狀態是你可以承受的嗎?

關心照護人員

如果你發現你的員工顯示倦怠的症狀，請考慮實施下列措施:

持續的在職訓練

使用方針和培訓研討會以明確照護人員的職責和期望，包括如何確定優先次序的責任，減少時間的限制，並處理比較困難的居民患者。團隊建設活動也可以是一個非常好的方式來加強工作人員之間的個人聯繫以減少壓力。

重新檢視你的職員策略

當然，倦怠的工作人員在你對人員配置的方法上還可能顯示出多更大的問題。重新審視你的時程表是否一致 (不一致的任務可能對照護人員造成不便)，時間的調度和/或增加你的護士對居民患者的比例, 給與照護人員更多的影響。

榮譽與識別

員工識別方案是可以減少倦怠、 積極加強期望和優先事項，並為員工成功創造機會的超級工具。一個企業對於隨著時間推移居民患者健康自然下降，確認成功，無論多麼小的成就，可以有巨大的士氣鼓舞。

自動化

 

由於新的護理技術，很多佔用看護時間的任務現在可以自動執行。溫度、 空氣品質和居民患者室內照明現在可以依照每個人喜好自動調整。可以安裝無線監控解決方案來衡量居民患者跌倒的風險，當像跌倒或尿失禁的事件確實發生的時候,用於提醒工作人員。藥房機器人可以用於簡化處方填充和交付過程。

養護院運營者有許多的事務。但是確認工作人員工作倦怠和處理其症狀是建立一個受到居民患者和家人喜愛的至關重要的第一步，這也是醫療保健系統的報酬。

健康護理科技和最好的食物是養護機構新規定的目標

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在健康護裡面，於此基於品質償還的時代 — 如果建議給醫療保險和醫療補助服務 (CMS) 的改變獲得通過，長期護理機構會有更多鼓勵投資于其居民患者的保健改善。這些建議改變已於上周向白宮會議提出且相關於年長護理機構將在未來幾十年保持競爭力。

一旦實施，這項立法應該有對一大部分的美國人有重要和積極的影響。有 1 億 2500 萬老人、 殘疾人士、 或低收入的美國人目前參加醫療保險和醫療補助計畫。在該國的 15,000 長期護理設施中的所有居民患者，多數都是醫療保險和醫療補助的受益者。

當一個家庭決定要把心愛的人安置在長期的護理機構時，他們投入對該機構的極大信任 — 相信他們所愛的人的健康、 安全和生活品質將會是該機構工作人員, 從行政級別一路到入門級護理助理等的高度優先事項。但長期護理機構究竟應如何操作這些新法規的改變呢?

對健康護理技術資訊的承諾

年長者護理領導人多年來一直面臨採用新科技的壓力，但這些新變化，自 1991 年以來的第一個主要對 CMS 參與更新 — 旨在鞏固健康護理科技資訊和其他病人的護理增強功能作為一個優先事項。

具體來說，熟練的護理機構將面臨更嚴格的規則，使用電子健康記錄 (Ehr)，可以幫助健康提供者降低成本和節省時間紀錄病人的健康情形。以前，熟練的護理機構未列入補貼方案，旨在激勵 EHR 用法。現在，機構將有可能獲得所有線上的最大的激勵 — 即是由CMS 付款。

然而，它是重要的是注意到，這些建議修改均只是 — 建議。因此很自然，很多病人的宣傳組織正在努力進一步改進這些法規。LeaderAge 中心老化服務技術 (CAST) 是其中之一。他們正在推廣行動要求供應商提供更高科技的設備。

集團的執行董事，Majd Alwan 博士說: “從技術角度來看，我們將提倡為 CMS 來確定獎勵措施，確保所有供應商，包括較小和農村供應商，有正確的健康工具到位，以及積極參與有意義的健康資訊交流.

將居民放在第一位

提議的新法規超越醫療技術。其他就 CMS 付款在提案中的包括所需的變化:

  • 更大家庭參與護理規劃和出院規劃進程;
  • 強化感染控制協定;
  • 減少使用藥物如抗生素和抗精神病藥物，努力減少再次入院;
  • 更多顧問藥師參與在發展對居民患者的藥物治療計畫; 和
  • 改善用餐的標準 — 具體地說，提供廣泛的更高的品質，本地成分的食品。

這些新建議條例應被視為不造成對長期護理和熟練的護理機構的負擔，而是”大家幫幫忙吧”對病人護理的改進策略。無論是電子病歷使用，病人監督技術、 更好的飯菜或更多的以證據為基礎的藥物治療方案，所有這些潛在規則有著相同的目標 — 改善居民患者和他們的家庭生活。

您的護理機構負擔得起另一起的跌倒事件嗎?

分享:

居民跌倒是對養護院工作人員和管理員面臨的特殊挑戰。他們頻繁地發生，對於居民患者的生活品質及機構的運作可以有重大的影響。根據 CDC，有140 萬65 歲或更年長者住在養護院裡 — 預計到2030年養護院65歲以上人口預計將達到 300 萬。CDC 老人跌倒統計資料可以清楚看到，跌倒對於年長者是相當大的危險:

  • 根據有100 床規模養護院報告每年約有 100 和 200 起的跌倒, 有更多跌倒的事件事沒有被報告的;
  • 養護院的居民患者平均每人每年有2.6 次跌倒;
  • 35%的跌倒發生於居民患者不能走路;
  • 大約有 10%至 20%的跌倒造成嚴重傷害，有2%至6%造成骨折;
  • 每年大約有 1800 名的養護院居民患者因跌倒導致死亡。

跌倒倖存者往往患有殘疾和抑鬱、 無助，和隔離伴隨跌倒的恐懼。養護院設施治療這些居民患者和他們的跌倒的影響, 對非致命跌倒每起通常面對超越 7,300 美元的費用。平均每年每名居民患者的平均2.6 跌倒，這些費用迅速升級，可能會嚴重影響機構的運作。

電子跌倒干預

幸運的是，保健設施可以使用技術來改進跌倒干預和預測。電子健康記錄 (EHRs) 的執行可以加強跌倒預測，但是有很多改進的餘地。養護院的人口不斷增加和照護人員對居民患者的人數比例預計減少，機構必須採用新技術以幫助減輕他們的工作量，並確保最佳可能的病人護理。

而不是單獨依賴預測措施，機構可以主動監測技術顯著提高其跌倒預防努力。養護院的工作人員可以即時更新當居民患者離開椅子或床鋪石藉由壓力監測器的協助。這些壓力感測墊的壓力變化時會及時通知工作人員可能發生的跌倒，並允許立即回應。這種方式，跌倒的機會是從根本上減少或消除。在罕見的事件，居民患者發生跌倒，他們不會常間處於獨自一人的狀態並且可以得到快速的照顧。

此類系統甚至可以用於改進您的電子健康記錄 。資料會被這些感應器提取用於產生報告，使它更容易識別模式和預防高危患者跌倒。此資料將添加到設備的預測和預防電源。通過實施這些系統，行政管理者可以節省幾千美元的成本，並確保其居民患者更高的生活品質。