1 ENSURING QUALITY CARE ADULT FOSTER/CARE HOME BASIC TRAINING KEY TERMS MYTHS AND FACTS ABOUT AGING Ageism Stereotyping RESIDENTS RIGHTS Advocacy Advance Conservatorship POLST Power of Attorney Representative SCREENING Activities of daily living (ADLs) Behavior Management License classification Screening Transfer 2 ADMISSION Assessment Confidentiality Medical orders Medical visit report Private pay contract NORMAL AGING AND IMPLICATIONS FOR CARE Long-term memory Memory loss Hearing loss Visual Bladder capacity Incontinence HEART DISEASE Angina Blood Pressure Congestive heart failure (CHF) Digitalis toxicity Diastolic and Systolic Blood Pressure Myocardial infarction 3 STROKE (CVA – CARDIOVASCULAR ACCIDENT) Aphasia Dysphasia Expressive and receptive aphasia Neglect of side Spatial Perception Transient Ischemic Attack (TIA) DIABETES Blood sugar testing Diabetic Ketoacidosis Hyperglycemia and hypoglycemia Insulin and oral diabetic agents ARTHRITIS NSAIDS Osteoarthritis Rheumatoid PARKINSON’S DISEASE Anticholinergic effects Bradykinesia Delusions Hallucinations Rigidity Tremors 4 ALZHEIMER’S DISEASE Definition Catastrophic reaction Dementia Sundowner’s syndrome OVERVIEW TYPES OF DEMENTIA Behavioral symptoms Delirium Dementia Depression OVERVIEW OF CHALLENGING BEHAVIOR Wandering Anxiety Agitation Pacing Physical Aggression Yelling 5 COMMUNICATION SKILLS Active listening Assertiveness Communication stoppers External interference Internal interference “I” messages Non-verbal communication COMMUNICATING WITH RESIDENTS, FAMILIES AND THE CARE TEAM Adjustment Grief/loss Care Team Family Support Families in conflict/crisis Mourning Long Term Ombudsman Office PROBLEM SOLVING AND CONFLICT RESOLUTION Conflict Mediator S.T.O.P. 6 CREATING ALTERNATIVES TO MEDICATIONS AND RESTRAINTS Antecedent ABC Model Consequences Restraints Psychoactive medication PERSONAL HYGIENE Assistance Independence Self-care Self-esteem Transferring SKIN CARE Epidermis Dermis Subcutaneous tissue Thinning Circulatory changes Skin breakdown Friction / shearing Pressure sores 7 FOOTCARE Bunions Corns Calluses Ingrown, thick or brittle toenails TOILETING Assessment Care plan Incontinence Toileting Schedule NUTRITION AND SPECIAL NEEDS Carbohydrates Fats Proteins Minerals Nutrition Vitamins MENU PLANNING Diet Website: Choosemyplate.gov (formally the food pyramid) Menu plan 8 FOOD HANDLING Food safety Food temperature Food poisoning Foodborne illnesses SAFETY IN THE HOME ENVIRONMENT Accommodations Barrier-free Privacy needs Social needs FIRE SAFETY Code requirements Construction Evacuation drills Flammable material Fire evacuation plan R.A.C.E. EMERGENCY PREPAREDNESS CPR Disaster preparedness Emergency procedure plan Natural disaters Power outage Sheltering in Place 9 CARE PLANNING PROCESS ADLs Care Plan Narrative Hands on / standby assist Verbal cuing Reminiscence Resident choice (person centered planning) RESIDENT RECORDS Confidentiality Long-term care assessment Mandatory forms Physician or NP’s orders BUSINESS RECORDS Accountant AFH required records Attorney Income Tax Insurance agent Labor laws Payroll Payroll tax Property tax 10 REQUIRED POSTED INFORMATION Resident’s Bill of rights Complaint procedure Inspection report Ombudsman poster AFH license Emergency evacuation plan / floor plan Weekly menus House rules MANAGING YOUR TIME Time management Setting limits Prioritizing Goals HIRING STAFF Criminal background check Caregiver Job description Qualifications Recruiting References CARING FOR YOURSELF Burnout Respite 11 Organization Expectations DISPENSING AND ADMINISTERING MEDICATIONS Six rights Time-critical medications Dispensing medications Medication storage Advanced set up OTC house medications Medication disposal SPECIAL CONSIDERATIONS (Medications) Psychotropic medications Behavioral symptoms Chemical restraint Age-related changes Refusing medications MEDICATION ADMINISTRATION BASICS Medication errors Prescription OTC drugs Medication routes Food and drug interactions Side effects 12 MEDICATION ADMINISTRATION RECORD (MAR) Medical order MAR PRN medications Parameters Self-medicate RN CONSULTATION Assessment Basic Tasks Consultation Home Health services P.R.N. Written parameters DELEGATION FOR LAY CAREGIVERS Lay caregiver Periodic inspection Rescinding RN delegation Supervisory visits Written instructions