Senior Housing Management
Title: Orientation and Training ManualTable of Contents
I. Introduction
II. Review
A. Values of Community Based Care
B. Resident Rights and Responsibilities
C. Abuse and Reporting Requirements
D. Standard Precautions for Infection Control
E. Fire Safety and Emergency Procedures
F. Facility Fire Evacuation
G. Job Descriptions
H. The Role in Service Plans in Providing Individualized Resident Care
I. Providing Assistance with Activities of Daily Living
J. Changes Associated with Normal Aging
K. Identification of Changes in the Resident’s Physical, Emotional and Mental Functioning
L. Documentation and Reporting on the Resident’s Change of Condition
M. Conditions that Require Assessment, Treatment, Observation and Reporting
N. Understanding Resident Actions and Behaviors as a Form of Communication
O. Understanding and Providing Support for a Person with Dementia or Related Condition
P. General Food Safety, Serving and Sanitation
Q. Abdominal Thrust and First Aid
INTRODUCTION
Our facility is an assisted living or residential care facility, providing residential living space under a lease agreement and also providing our residents assisted care that promote the available of wide range of individualized services for elderly and persons with disabilities, in a homelike environment. The standards of assisted living and residential care is designed to enhance the dignity, independence, individuality and decision making ability of the resident in a safe and secure environment while addressing the needs of the resident in a manner that supports and enables the individuals to maximize abilities to function at the highest level possible.
VALUES OF COMMUNITY BASED CARE
The Facility is dedicated to the advancement of good health and independence for all of its residents.
The Facility believes in and recognizes the physical, emotional, spiritual and behavioral needs of its residents and respects their rights as human beings. The goal of the Facility is to promote each resident's self direction and participation in decisions that emphasize choice, dignity, privacy, individuality, independence and a home-like environment.
Each of the Facility employees is dedicated to good health in all areas. Our employment of personnel is based upon qualifications and not race, creed, color, sex, age, disability or national origin. Our personnel must be of good character. They must also agree to uphold our code of ethics, abide by our standard of behavior and promote the principles of assisted living. Orientation and ongoing education are important to the development of our staff. All education programs are open to residents and family. By sharing ideas and discussing issues we can all work and live in closer communication and understanding with one another.
The Facility dedicates itself to these philosophies. This is a benefit not only to residents but also to the advancement of our home.
The Six Principles of Assisted Living and Resident Care
Underlying independence as the goal for assisted living are six key philosophical principles that are the foundation of all that we do.
These six principles are part of the laws that govern assisted living and residential care and make it unique. The six principles are:
1. Privacy
Means a specific area or time over which the resident maintains a large degree of control. Privacy is supported with services that are delivered with respect for the resident’s civil rights.
2. Choice
Means a resident has viable options that enable the resident to exercise greater control over their life. Choice is supported by the provisions of sufficient private and common space within the facility that allows residents to select where and how to spend time and receive personal assistance.
3. Dignity
Means providing support in such a way as to validate the self-worth of the individual. Creating an environment that allows personal assistance to be provided in privacy supports dignity, as does delivering services in a manner that shows courtesy and respect.
4. Independence
Means supporting resident capabilities and facilitation the use of those abilities. Creating barrier free structures and careful use of assistive devises supports independence.
5. Individuality
Means recognizing variable in resident’s needs and preferences and having flexibility to organize services in response to different needs and preferences.
6. Homelike Environment
Means a living environment that creates an atmosphere supportive of the resident’s preferred lifestyle. It is also supported by the use of residential building materials and furnishings.
RESIDENT RIGHTS and RESPONSIBILITIES
Because we are human, we have certain rights. Because we are citizens of the US, we have certain rights. Rights by themselves are adversarial. That means that the rights of one person conflict with the rights of another. In other words, the right to swing your fist stops at the point of another person’s nose. Because rights are adversarial, we must balance them to form a sense of community. We balance rights with responsibilities. This is especially true in community based care facilities.
What Kind Of Rights Do Our Residents Have?
All of our residents are guaranteed the same civil rights that the law guarantees to all citizens. In assisted living and residential care facilities, our residents also have the right to be:
1. To be treated with dignity and respect;
2. To be given informed choice and opportunity to select or refuse service and to accept responsibility for the consequences;
3. To participate in the development of their initial service plan and any revisions or updates at the time those changes are made;
4. To receive information about the method for evaluating their service needs and assessing the costs for the services provided;
5. To exercise individual rights that do not infringe upon the rights or safety of others;
6. To be free from neglect, financial exploitation, verbal, mental, physical or sexual abuse;
7. To receive services in a manner that protects privacy and dignity;
8. To have prompt access to review all of their records and to purchase photocopies. Photocopied records must be promptly provided but in no case require more that two business days (excluding Saturday, Sunday, and Holidays);
9. To have medical and other records kept confidential except as otherwise provided by law;
10. To associate and communicate privately with any person of choice, to send and receive personal mail unopened and to have reasonable access to the private use of a telephone;
11. To be free from physical restraints and inappropriate use of psychoactive medications;
12. To manage personal financial affairs unless legally restricted;
13. To have access to and participate in social activities;
14. To be encouraged and assisted to exercise rights as a citizen.
15. To be free of any written contract or agreement language with the facility that purports to waive their rights or the facility’s liability for negligence;
16. To voice grievances and suggest changes in policies and services to either staff or outside representatives without fear of retaliation;
17. To be free of retaliation after they have exercised their rights provided by law or rule;
18. To have a safe and homelike environment;
19. To be free of discrimination in regard to race, color, national origin, gender, sexual orientation or religion; and
20. To have proper notification if requested to move out of the facility and to be required to move out only for reasons stated in OAR 411-054-0080 (Involuntary Move-out Criteria) and have the opportunity for an administrative hearing (if applicable).
Our Residents Have Responsibilities to Themselves
The rights that we have just described are rights that the resident has for his/herself. They are rights that we must honor and ensure that the residents can use. However, rights by themselves can breed dependence. These rights must be balanced with responsibilities to help themselves. By balancing these rights with responsibilities to themselves we are encouraging our residents to be independent. One of the principles of our facility is to promote independence. Our residents have the responsibility:
1. To provide accurate medical, physical, and social history so that therapeutic care plans may be formulated by the healthcare team.
2. To communicate honestly with staff regarding changes in your condition so that adequate and necessary care may be given.
3. To cooperate with the prescribed plan of care.
4. To follow instructions in regard to the plan of care.
5. To accept responsibility for your actions if you refuse treatment or medication.
6. Resident will use the premises in a reasonable manner considering the purposes for which they were designed and intended.
Our Residents Have Responsibilities to Other Residents
A community is made of many different individuals who live and work together. Each one of these individuals has a stake in their community. For a community to function all of these individuals must feel as if they are a part of the community. They must feel as if their rights are balanced by obligations that others have to them as well as those they have to themselves. By incorporating this sense of responsibilities that our community has, as individual members, to other residents, we build on this sense of belonging. Our residents have the responsibility to other residents:
1. To be cooperative and respectful in your behavior toward other residents.
2. To be non-critical and tolerant of others' handicaps or disabilities.
3. To allow free expression of the opinions or feelings of other residents.
4. To respect the right of other residents.
5. To practice safety measures if you are permitted to keep medications in your room for self-administration.
6. To keep your personal living space in a healthful and neat condition.
7. Resident shall conduct him or herself, and require other persons permitted on the premises with his or her consent to conduct themselves in a manner that will not disturb the neighbors’ peaceful employment or the operations of the facility.
8. To ensure that the rights of your roommate (if applicable) are not infringed upon by your furnishings, clothing, or other personal possessions.
Responsibilities to the Staff and the Facility
Another group of stakeholders in the community are the individual members of our staff. Each one of these people brings a special expertise to our community. They are unique professionals who take a special interest in the resident who live here and who develop special relationships with them. Because of this, each resident must take into account the responsibilities that they have to our staff. Another stakeholder is the facility itself. Though the facility is not a human being, it is still an integral part of our community. Indeed, without the physical structure we wouldn’t have a community here at all. Our facility allows us:
1. To have a shared sense of pride in its appearance
2. To have a common feeling of belonging to a group yet remaining an individual
3. To have a feeling of commitment to the group that lives and works here
4. In short, to be a community
Without the facility we would not exist as a group. Hence, our residents have a responsibility to our staff and to the facility:
1. Resident shall use the compact kitchenette (if located in the unit) for light cooking only, and the facility may remove it if it is determined that it cannot be operated safely by the resident.
2. Resident shall provide himself or herself with suitable and sufficient clothing and personal necessities.
3. Resident shall notify the facility of any anticipated absences form the premises.
4. To cooperate with the staff's efforts to help you as they provide care and treatment.
5. To be respectful of the rights of staff members in your words and actions.
6. To report unsafe or unsanitary conditions immediately so that they may be corrected quickly.
7. To protect and preserve the furnishings and equipment owned by the facility for your use.
8. To meet your financial obligations to the facility in a timely manner as necessary.
All of these rights and responsibilities are important in any community setting. We expect our staff to recognize the rights of the residents as rights that are guaranteed to them by law and by our policy. It can be very easy for staff to ignore, or to “do what is best” for the resident in violation of the residents rights and / or expressed wishes. This is not acceptable, and we should make a conscious effort to change that way of thinking. Too often we unintentionally violate a resident’s rights because it is easier and more efficient for us to do so than it is to take the time to work with the resident. Listed below are a few of the “traps” we can fall into which would violate a resident’s rights:
1. Talking about a resident’s physical or mental condition or care in a public area (whether or not there are other individuals in the area).
2. Addressing a resident using “terms of endearment” such as “sweetie” or in any other manner that the resident feels is demeaning.
3. Telling a resident, “let me do that for you”.
ABUSE & REPORTING REQUIREMENTS
Abuse is prohibited. The facility employees, agents and all other associated with this community shall not permit, aid or engage in the mental, physical or verbal abuse of our residents. Administrative staff is to assure all requirements from the Oregon Administrative Rules concerning the reporting of abuse or suspected abuse are met.
All persons are encouraged to immediately reporting abuse or suspected abuse. Including events overheard or witnessed by observation. When abuse is reported or suspected, administration shall immediately initiate an investigation. If the investigation yields reasonable cause for substantiated abuse, then Senior and People with Disabilities is to be notified immediately. If there is suspected abuse believed to be a crime local law enforcement agency is called first. Physical injury of unknown cause must be reported to the local SPD office, or the local AAA, as suspected abuse, unless immediate facility investigation reasonable concludes and documents that the physical injury is not the result of abuse. If an immediate investigation reasonably concludes that abuse did occur, these finding and the procedure taken shall be documented. In cases of incidents that are not abuse or injuries of unknown cause where abuse has been ruled out, the facility will respond appropriately, which may include such things as re-assessment, monitoring, or medication review.