holistic approach to admission
TRANSCRIPT
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Three Parts of the Equation
A holistic approach to admission in Long-Term Care
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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.
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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.
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Problem
What is Admission to Long-Term Care?
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Family
Caregiver stress is not automatically relievedGrief and lossGuiltUnknownConflict
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Resident
Relocation Stress SyndromeLoss of identity Loss of independenceFamily conflictPhysical decline Loss of life as they know it
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Staff
StressFeeling of incompetenceInability to meet complex needs of families
and ResidentsLack of time and resourcesIncreased risk for errors and
miscommunication
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Facility
Increased likelihood of complaints “Unreasonable” requests and complaints from
familiesTime away from direct care Staff stress and burnoutErrors and incidents
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Intervention
Working with all three parts of equation. Counselling professional with long-term care background (LPN).
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Intervention
Resident• Assessment of needs• Counselling to address relocation stress• Education to address unknown• Follow up• “Friendly face”
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Intervention
Family • Utilize family as a “hidden workforce”. • Education to address unknown. • Counselling to address crisis.• Integration. • Follow-up
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Intervention
Staff• Communication training• Admission support training• Collaboration and coaching • Support
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Results
Outcome measures:Family surveyStaff survey Management survey
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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.
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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”
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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”.
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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”
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Challenges
• It was challenging to convince medical staff that psychological needs are important.
• Establishing a new practice.
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Challenges addressed by:
Staff education:- Communication Bootcamp- Transforming Admissions- Person-centered interventions for difficult behaviors3 Cs:- Communication- Collaboration- Compromise