Caring for Seniors inResidential Care:dignity in theheart, mind, and action
Dignity “a state, quality or manner worthy of esteem or respect; and (by extension) self-respect. Dignityin care, therefor...
Culture of Caring“the past and the present don’thave to be the future” a process    “culture change is                  no...
Culture Change-         Positive Outcomes• http://www.pioneernetwork.net• http://www.edenalt.comQuality of Care: Improveme...
Culture Change-        Positive OutcomesStaffing Impact:  • Reductions in turnover and sick days  • Increased levels of st...
Culture Change-        Positive OutcomesLife Engagement:  • Increased levels of resident satisfaction  • Resident choice i...
DIGNITY        CULTURE OF CARERELATIONSHIPS AND MEETING NEEDS        MEDICATION USE   ANTIPSYCHOTIC MEDICATION
InternationalUK: Social Movement Call To ActionUS: Centers for Medicare andMedicaid (CMS)  • CMS National Partnership to ...
A Balanced Approach     To Antipsychotic      Medication Use
Antipsychotic Medication Use-        Current StatePoint prevalence: 35% (regular and prn)Behind the number - consideration...
THE CALL TO  ACTION    ~ WILL ~    ~ IDEAS ~  ~ EXECUTION ~
“The Up and Down”-       General Introductions•   People Affected by Dementia: Family, Friends•   People Working in Care F...
“The Up and Down”-            Provincial• MOH colleagues• Seniors Action Plan, Dementia Service  Framework, Dementia Actio...
“The Up and Down” -           Provincial• Shared Care-Polypharmacy, Transitions in Care• BCPSQ Council Medication Reconcil...
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Caring for Seniors in Residential Care: dignity in the heart, mind and action

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On January 18, 2013, the BC Patient Safety & Quality Council invited key stakeholders from across the province to join together in a day of meaningful discussion around:
1. The meaning of dignity in care, with a special focus on more appropriate use of antipsychotics;
2. The current state of antipsychotic use by people living in residential care in BC;
3. An overview of work currently underway throughout BC, nationally and internationally to identify opportunities for alignment as well as learning from others;
4. Envisioning an ideal state whereby more appropriate use of antipsychotic medications can be achieved; and
5. Framing a call to action that will ask teams from residential care facilities in BC to join our initiative.

This is a presentation from the event delivered by Chris Rauscher, who is the BCPSQC’s Clinical Lead for Seniors Care.

Learn more about this initiative at http://www.bcpsqc.ca

Published in: Health & Medicine
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Caring for Seniors in Residential Care: dignity in the heart, mind and action

  1. 1. Caring for Seniors inResidential Care:dignity in theheart, mind, and action
  2. 2. Dignity “a state, quality or manner worthy of esteem or respect; and (by extension) self-respect. Dignityin care, therefore, means the kind of care, in anysetting, which supports and promotes, and does not undermine, a persons self-respect regardless of any difference.” (Dignity in Residential Care-Resource Guide) http://www.scie.org.uk/Index.aspx http://www.dignityincare.org.uk
  3. 3. Culture of Caring“the past and the present don’thave to be the future” a process “culture change is not a program”• In residential care and in hospital (48-6)• Core person-directed values are choice, dignity, respect, self-determination and purposeful living• Changes in organization practices, physical environments, relationships at all levels and workforce models
  4. 4. Culture Change- Positive Outcomes• http://www.pioneernetwork.net• http://www.edenalt.comQuality of Care: Improvements in quality indicatorsmost correlated with person-centered principlesincluding use of restraints, weightloss, falls, agitation, pressure ulcers, medicationuse, time in a bed or chair and re-hospitalizations
  5. 5. Culture Change- Positive OutcomesStaffing Impact: • Reductions in turnover and sick days • Increased levels of staff satisfaction • Active understanding of culture change and person-centered principles • Self-motivation, critical analysis, and problem- solving by front-line staff to incorporate person- centered principles.
  6. 6. Culture Change- Positive OutcomesLife Engagement: • Increased levels of resident satisfaction • Resident choice in daily activities and routines (measured by care plans) • Increased levels of engagement (measured by MDS 3.0) • Emphasis by residents and staff on relationships and community; descriptions as “home” or “family.”
  7. 7. DIGNITY CULTURE OF CARERELATIONSHIPS AND MEETING NEEDS MEDICATION USE ANTIPSYCHOTIC MEDICATION
  8. 8. InternationalUK: Social Movement Call To ActionUS: Centers for Medicare andMedicaid (CMS) • CMS National Partnership to Improve Dementia Care in Nursing Homes • http://www.nhqualitycampaign.org/star_index.aspx?c ontrols=dementiaCare
  9. 9. A Balanced Approach To Antipsychotic Medication Use
  10. 10. Antipsychotic Medication Use- Current StatePoint prevalence: 35% (regular and prn)Behind the number - considerations: • Indications: (A) Psychotic conditions-Chronic: e.g. Schizophrenia (B) Psychotic conditions-Episodic: e.g. Delirium (C) Most often not psychotic-e.g. BPSD • Practice gaps to balance risk-benefit: (A) Dosages, prns (B) Monitoring and review (C) Involving resident and family
  11. 11. THE CALL TO ACTION ~ WILL ~ ~ IDEAS ~ ~ EXECUTION ~
  12. 12. “The Up and Down”- General Introductions• People Affected by Dementia: Family, Friends• People Working in Care Facilities• Health Authority Staff Supporting Care Facilities• People Working on Antipsychotic Med Use at Health Authority Level
  13. 13. “The Up and Down”- Provincial• MOH colleagues• Seniors Action Plan, Dementia Service Framework, Dementia Action Plan LINK – www.health.gov.bc.ca/library/publications/year/2012 /dementia-action-plan.pdf• BPSD Guideline and Rollout LINK – www.health.gov.bc.ca/library/publications/year/2012 /bpsd-guideline.pdf• GPAC Guideline-Cognitive Impairment LINK – http://www.bcguidelines.ca
  14. 14. “The Up and Down” - Provincial• Shared Care-Polypharmacy, Transitions in Care• BCPSQ Council Medication Reconciliation• Patient Voices Network: Pilot Project On Effective Involvement in Res Care-Providence Health, Vancouver• Alzheimer Society of BC• Work Safe BC• Professional and educational organizations• Other

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