Person Centered Care in Practice.

We were outside planting flowers the other day at St. Monica’s – it was a perfect spring day, not to hot and the sun felt great on everyone. I looked around and noticed how peaceful and happy those around me seemed. Over in the field I saw Kay pitching golf balls, he is 92 years young. Our therapy dog was lying down, waiting for Kay to take a break and rest with him. Around the corner, Frank was planting a few perennials while Rojean was busy directing maintenance men where she wanted shrubbery planted. Ruth and Elaine were reminiscing quietly with each other while keeping an eye on Frank. They both had great gardens in their day. Pretty soon Anne, Emma and Pietta migrated outdoors to soak up some sunshine. Helen brought Shari, who just moved in, outside to visit and see our beautiful back acreage. Marty wandered out with Don and suddenly we had a great group interacting with each other. We handed out hats and lemonade, as we didn’t want our nursing staff scolding us. Someone brought a Frisbee for Fritz, the dog, to chase. We asked if anyone would like some music turned on. The answer was a unanimous, “no.” They were enjoying our grounds and perhaps thinking of earlier days when life wasn’t so complicated and things moved slower.

Person centered care at St. Monica’s is about engaging our community members in things they are passionate about. So if our garden beds aren’t quite symmetrical, or our cakes are a little lopsided and our sitting areas are a bit mussed, it means you’ll find us engaged in life. Stop by for a visit and witness life here for yourself.

Love is in the Air

By Loretta Baxter, RN, Administrator
During February, we celebrate Valentines’ Day, recognizing the various individuals in our lives that we love and cherish—spouses, parents, children and dear friends. It is appropriate then to discuss the importance of relationships and socialization in our lives. Many studies have proven that socialization is important to all of us no matter whether we are young or older.
Lack of social support negatively influences our health and well-being. Having a variety of positive social supports can contribute to psychological and physical wellness. Support from others can be important in reducing stress, increasing physical health and defeating psychological problems such as depression and anxiety.
At St. Monica’s there are a number of ways to increase socialization such as meal time conversations with table mates, daily exercise class and special groups such as reminiscence, bingo, quarterly tea celebrations & dances, singing groups, and the baking class, just to name a few.
Seniors who live in retirement communities have the advantage of living close to many people, making it easier for them to make long-lasting friendships. According to Helpguide, socialization can boost self-worth; seniors can feel a sense of meaning and self-worth by sharing their lives with staff and other community members. (http://www.helpguide.org/articles/relationships/). Make sure to take advantage of all the activities St. Monica’s offers, its’ good for your health!

Person Centered Care at St. Monica’s

_DSC1554Someone asked me how does the Positive Approach to Care (PAC) fit into Person Centered Care? These are one of those questions where I respond, “I’m glad you asked”. Attached is our model of Person Centered Care and how I see the different components fitting together.   The overarching umbrella is Person Centered Care which describes our philosophy of care whether you are an individual living in the Assisted Living area of our building or the new soon-to-be-built Memory Care. Person Centered Care describes how we relate to one another too.

The Positive Approach to Care (PAC) are specific techniques utilized to help care for those individuals who suffer from Dementia-related disease or Alzheimer’s. This is the training that 5 of our leaders received from the Teepa Snow organization in Cleveland, Ohio in February.

What are Personal Detractors? One of the characteristics of our Person Centered Care is that we aspire to have few if any language or behaviors present that our Personal Detractors. These are described in detail in the attached document. These were first described by Thomas Kitwood, a British Sociologist, who first coined the term Person Centered Care. We have conducted training with all St. Monica’s Employees on the concept of Person Centered Care and the Personal Detractors. How does this impact our care? For example, treachery is a form of deception in order to distract or manipulate a person, or force them into compliance. At St. Monica’s we have made the decision that we will not use treachery or small white lies. An example of where this might be used is sharing with an individual that “their son will stop by later, when we know he will not”.

Another key is Engagement and we will be talking in more detail about this at our next Board Meeting. Lyn Geboy and Beth Meyer-Arnold have determined baseline measures that demonstrate the amount of engagement among individuals living at St. Monica’s. We have a baseline that was completed prior to the start of our formalized Person-Centered care training and we will work to increase this through programming and staff training and interventions.

The last category and the most important is St. Monica’s values. These values which are based on the Augustinian Community Values that formed the foundation of what the Sister of St. Rita used to establish and form the culture at St. Monica’s. It is this culture that has led to such an outstanding legacy of care for the past 45 years and that which we hope to continue for the next 45 years. These values include: spirituality, compassion, trustworthiness, respect, cooperation, competence, commitment and understanding.

Together these components make up the framework of our Person Centered Care philosophy of care.

 

Caring for those with Dementia and Alzheimer’s

Dementia BlogAlzheimer’s disease is the 6th leading cause of death in the U.S. with more than 5 million Americans living with the disease. 1 in 3 seniors dies with Alzheimer’s or another Dementia. http://www.alz.org/documents_custom/2016-facts-and-figures.pdf

With these staggering numbers St. Monica’s has stepped forward to help educate families who often are in the position to be alerted to the problem and then also be in a care taking role.

We are offering classes for anyone who wants to learn more about dementia or Alzheimer’s. It might be someone who is spending more time checking on mom or dad or a spouse or loved ones who are deeply entrenched in a caretaking role. The classes are August 6th or November 5th. The cost is free and it is offered at St. Monica’s from 10:00 – 11:30 am.

Another type of classes we are offering are for professional Certified Nursing Assistants, LPNs, RNs, and Social Workers –healthcare professionals who would like to learn “Positive Approaches” that work in caring for individuals with Alzheimer’s and/or Dementia. They will receive Continuing Education credit for it. These classes cost $25 to cover the materials are offered from 10:00 to 11:30 on May 26th, September 8th and November 3rd.

The classes are taught by Certified Dementia Trainers who have gone through online and in person seminar classes and testing and have successfully presented before peer review certified presenters. The trainers have experience working in the healthcare field with individuals who have Alzheimer’s or Dementia.

One of the areas we describe in detail in the training is the difference between “what is normal aging” and “not normal aging”.   Briefly, it is normal aging to “not be able to recall a word” or “taking time to remember someone’s name”.   Often just giving those of us who are older a little more time will solve that issue; however, there are many symptoms that go along with “not normal aging”. One that we all are quite aware of is “not knowing how you got somewhere and not being able to find your way home”. Which is where the “Silver Alerts come into play for senior adults who are missing. There are many more symptoms that we discuss in the class.

One of the main precepts of our philosophy is focusing on the “positive” and what people have left versus what they have lost. It is easy to talk about Alice has lost her short term memory and she repeats herself all the time versus her positive attributes. Alice still has that positive attitude and loves to help people and let’s talk about those days when she worked as a nurse or how much she enjoyed being a mom to her 4 children.

The other aspect that we spend time on is the physical changes to the brain. The brain actually loses 1/3 of its mass during this devastating disease. Understanding what the various parts of the brain do and how this disease affects individuals is a key part in deepening our understanding which is crucial for us to maintain our compassion. For example, one of the first changes is loss of brain mass in the parietal lobe or the front of the brain. This is where our frontal lobe is located and where we make decisions and judgements. This is why we might say, “Oh, Alice has lost her filter”.   Before she would not have said, “you know Loretta, that dress really makes you look fat”, or she might start swearing when you never heard her swear before in your life”.

Again understanding how the brain works and the impact of this disease on the brain helps our understanding and this leads to greater compassion and patience.

If you have any questions, you can contact Dana Petit to sign up for the classes at St. Monica’s at 262-639-5050 or visit our home page for registration and more information.

Nurse at St. Monica's Racine assisting a resident.

Person-Centered Care

Person-Centered Care: The New Model for Senior Care

Like many models, it makes perfect sense and we wonder why it didn’t come along earlier.  Previously, care in Assisted Living, Nursing Homes and Adult Daycare Centers were given to clients but the processes often revolved around the needs of the institution or the caregivers.

Person-Centered Care is focused on the needs and desires of the individual.  The concept was originally coined in the 1990’s by English Sociologist Tom Kitwood.  According to Kitwood, “personhood is a standing or status that is bestowed upon one human being, by others, in the content of a relationship and social being implying recognition, respect and trust”.  The center of good dementia care is to “maintain personhood in the face of the failing of mental powers”.  †  Dementia care which focuses only on the disease and its treatment does not attend to patient’s personhood but treats the patient as a passive object, and is damaging to the patient”.

This change in culture requires transformation in all departments but is particularly evident in nursing.  Nurses are often guilty as relating to the diabetic in room C or the confused patient in room A.  Personhood relates to how that individual wishes to define oneself.  One of our residents loves to have conversations about her nursing days when she was a nursing educator.  A meaningful day to her is assisting us in some way to prepare for meetings or education sessions whether it is collating the handouts or sorting items for arts and crafts class.  The central part of this is the development of our care plans that can capture these important details such as when does the individual like to bathe?  In the morning, at night?

Person Centered Care is founded on the ethics that all human beings are of absolute value and worthy of respect, no matter their disability and on a conviction that people with dementia can live fulfilling lives. ‡

†Kitwood T. Dementia reconsidered: the person comes first.  Open University Press, Buckingham, 1997a, ps. 20, 7-8, 91.

‡ Epp, T. “The Canadian Alzheimer Disease Review”.  April 2003. P. 15.