RC Kit & Dementia Training
Summary
1
The Recollection Collection Kits and Specialized Training for Nursing Homes
June 30, 2015 --- Ten (10) Nursing Homes Visited
Summary
Nursing Homes Visited:
1) Marrero Healthcare;
2)St. Anthony Healthcare/New Orleans;
3)Cornerstone Village/Lafayette;
4)Northpoint Healthcare/Baton Rouge;
5)Uptown Healthcare/New Orleans;
6)Port Allen Care Center/Port Allen;
7)Metairie Healthcare/New Orleans;
8)The Care Center/Baton Rouge;
9)Heritage Manor/Baton Rouge;
10)Courtyard Manor/Lafayette
In accordance with the Cooperative Endeavor Agreement by and between Department of Health and Hospitals, State of Louisiana and Alzheimer’s Services of the Capital Area, our organization completed the distribution and subsequent training of nursing home personnel in ten (10) nursing homes in the Baton Rouge, Lafayette, and New Orleans areas in the period from April – June, 2015.
With 80 participants, an average of 8 per session, we found each nursing home to be very welcoming and attentive to the training. All of the employees were most excited to receive the Recollection Collection kit and learn how to use the activities in it with all the residents in their respective homes.
Our organization had selected these nursing homes using the data from the CMS third quarter reporting of the nursing home’s percentage rate of use of antipsychotic medications. We found that many homes’ “high percentage rates” related to the high number of psych patients enrolled in the facility. For instance, one of the participants in the session at Port Allen Care Center in Port Allen, Louisiana (percentage rate of 65%) noted that the nursing home had received a high volume of patients from the Greenwell Springs Mental Hospital when it closed in the spring of 2012, thus the rate of antipsychotic medication was high because of the care and treatment of those particular patients. Likewise, Cornerstone Village in Lafayette, Louisiana; an outstanding facility, has a mixed dementia and psych population, and its percentage rate of antipsychotic medication is elevated. Employees at both nursing homes made a strong recommendation that the populations not be mixed in one environment.
Project Coordinator, Effie Marcantel, and Trainers, Dana Territo and Katherine Schillings, LMSW, spent five hours at each nursing home, providing tips and strategies not only for using the RC Kit and various activities, but also “coaching” the attendees in ways to communicate, redirect and find the root cause when residents are experiencing behavioral expressions. Additionally, the team covered ways to communicate among staff members and with family members. The course concludes with instruction on a Person Centered care philosophy. Through demonstrations, role play and interactive discussions, our team felt confident that the participants gained a greater knowledge and understanding of Alzheimer’s disease and dementia and learned positive ways of care planning and treatment. (The results can be seen on the pre and post survey results) The positive outcomes of the trainings and comments rendered are reflected in the evaluations summary which is attached.
Because most of the trainings were intimate gatherings, so to speak, our team sat with the participants and facilitated discussions on various issues and challenges they face. The majority of the attendees in these sessions were CNA’s, and, of course, we received many negative and many positive comments about each one’s workload. From these discussions, we identified several common “threads”:
- CNA’s should be part of the interdisciplinary team, i.e., a Representative
CNA should be invited to all care planning sessions. (CNA’s spend the
most time in direct care with residents, therefore, their input is invaluable
regarding resident care). Only two individuals from each home out of the ten nursing homes responded that a CNA is allowed to attend care planning sessions.
- Staff should be aware and trained in Person-Centered Care. At each nursing home
facility, when asked if the staff knew what Person Center Care meant, no more than
two people raised their hands. This was part of the instruction, but it was surprising
that the participants had no understanding of the term or philosophy. Additionally,
one individual who spoke to our team after a session noted that it was almost impossible
to integrate person-centered care in an environment of low staff-resident ratio and the
number of psych patients being treated.
- When CNA’s were asked, “What would make your job better or more satisfying?”
some responded, “Nothing. Caring for the residents makes us happy.” However,
further discussions revealed, as stated by one participant, “We just want to be
acknowledgedfor the work we do. If I don’t brag on myself, no one will.” Our team
came to the conclusion that job satisfaction with CNA’s is not a matter of higher wages,
but a matter of respect and acknowledgement of the frontline work they do. For the most
part, they do not feel part of the “team” caring for the resident, though they are in direct
care of that resident.
This project has been very gratifying, amidst the challenges. We would have preferred a larger attendance in the sessions and always expressed our recommendations to the nursing home administrators in that regard. Some employees were less than enthused to attend the training sessions, but afterwards were pleasantly surprised at the content and the way the training was conducted. Overall, the attendees unanimously agreed that all work was on behalf of the resident in their respective homes.
After each training session, the team sent a follow-up letter to the nursing home administrator, acknowledging him/her for the opportunity to provide this training and also to include some recommendations based upon our training discussions. A sample letter is attached.
The team looks forward to the next 15 trainings, and is hopeful our work and diligence with this project makes a difference in the lives of the residents with dementia in these nursing homes, especially in the reduction of the use of antipsychotic medications with these residents.