Archive for the ‘Person-Centered Care’ Category
Posted on May 8, 2013 - by Nurse Virginia
CULTURE CHANGE, PERSON-CENTERED CARE IN HEALTHCARE, LOOK TO THE RESTORATIVE NURSE
Healthcare is moving in a more holistic system of care. The definition of “holistic” is: to treat the whole person rather than just the symptoms of the person’s disease. In the field of nursing care, the restorative nurse and restorative care would qualify as “holistic nursing.”
Restorative nursing uses routine activities of everyday life: eating, bathing, dressing, walking, getting in and out of a chair, brushing your hair, brushing your teeth, even turning and repositioning yourself in bed to improve the individual’s physical function, promote independence, improve safety and self-esteem. Helping the elder continue at their highest level of independence increases the elder’s self-esteem.
Just as in the area of holistic healthcare, restorative care is a philosophy. A philosophy of individualized care, rooted in getting to know the person for whom you are caring. There is no such thing as one size fits all about restorative care. No ridged rules to follow, the individual you are caring for determines the care based on their needs.
The restorative nurse is the last one to look for an answer in a medication; this is the nurse who is a detective looking for a reason based on the environment, and the individual’s abilities. Restorative nursing stressing abilities, not disabilities, and that is always the focus of restorative nursing. The restorative nurse is the true problem solver; changing the environment when needed to make it more user friendly, building balance and strength as indicated while supporting sensory systems.
Restorative nursing had its beginnings in the 1940”s and remains a belief system of care. A belief that every individual wants to be known by their caregiver, wants to be as independent as possible as long as possible despite their diagnosis, and maybe most of all wants a relationship with those that care for them.
With the current culture change movement in healthcare, as well as the changes in regulatory systems and reimbursement for services, restorative nursing will become an even more important area of nursing. This restorative nurse thinks that is a good thing.
Virginia Garberding RN
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on September 28, 2010 - by Nurse Virginia
ELDERSPEAK – HONEY, SWEETIE, GRANDMA – WHEN THE CAREGIVER JUST DOESN’T TAKE THE TIME TO LEARN THE ELDER’S NAME
Everyone’s name is important to them. There can be power in a name. There is power in the name “Jesus”. I remember when it was in the news that Elvis was in a concert and a row of girls held up a banner saying “Elvis is King.” Elvis stopped the concert and said “No, Jesus is King.”
A person’s name and title are important to them. Does it become unimportant just because you are now old? Andy Rooney was just on 60 Minutes saying he doesn’t like the nickname Andy. He ended the piece saying “Just call me Andrew.”
When a caregiver hasn’t taken the time to learn an elder’s name (or like Andrew Rooney their preferred name) and calls that elder “sweetie,” the caregiver is indulging in ageism. They would not call that elder’s visiting daughter or son “sweetie.” It just wouldn’t sound right, or be right. But somehow once you reach a certain age – or enter a nursing home – all of a sudden it’s OK to call everyone by some generic term assigned to the elderly.
How much more dignity would be directed to an elder when you use their title – Mr., Mrs., Pastor, Doctor, Judge, – whatever title they have earned. When you see elders lined up in a row of wheelchairs, how is the elder supposed to still feel like an individual? When staff know, and use each elder’s name and title, every woman goes from “Grandma” to Mrs. Peterson, or Mrs. Jones.
My Dad told me once it was hard for him when he moved into Assisted Living to have everyone there call him Martin. He was only “Pastor” to a few visitors and when he attended Church from then on. He felt badly losing that title he had carried for over 60 years.
I can imagine a day when it just doesn’t sound right to call every elder “sweetie.” When caregivers take the time to learn an elder’s name. When the elder feels empowered to say, “Just call me Mike, that’s what everyone calls me.”
When you hear someone using elderspeak – be proactive – stop the concert – and tell them how important a name is.
Virginia Garberding, R.N.
Author: Please Get To Know Me – Aging with Dignity and Relevance
www.pleasegettoknowme.com
Posted on May 25, 2010 - by Nurse Virginia
PERSON CENTERED CARE CAN BE PROVIDED AT HOME BY THE FAMILY, BY A PAID CAREGIVER OR IN A NURSING HOME
Whether you are a family member giving direct personal care, a private caregiver in the home, or a caregiver in a Nursing Home you can provide “Person Centered Care.” Person centered only means that you have taken the time to really get to know the person you care for.
Being a “Person Centered Caregiver” means the caregiver knows:
- Does the person they care for like to take a bath or a shower – or maybe for the last 10 years they couldn’t walk up the stairs to the bathroom with a tub – so they have been taking sponge baths at the bathroom sink ever since, and that is what they are comfortable with now.
- Is the person they care for an early rise or do they like to sleep in? I knew a man that was so hard to get going in the morning, till the family said their Dad always had a cup of coffee in the morning before he got out of bed. Adding the cup of coffee in bed to his routine made all the difference to him.
- Does the person you care for like to take a nap in the afternoon, if so for how long and where – in bed or on the couch? Makes a difference.
- If the person you care for is a man – does he like to shave with a straight razor or electric?
- What kind of music does the person like?
- What kind of personal products do they like to use? I know my mother always used LUX soap, most people don’t even know that soap – but for my Mom LUX is important. So whether it is soap, shampoo, deodorant, shaving cream – whatever the product- person centered care means knowing the favorite product and using that person’s favorite product.
- Is the person they care for a sports enthusiast? If so what sports, what is their favorite team. If they are one of those die hard Cubs fans, does the caregiver make sure when the Cubs are playing that the TV is on?
All you need to provide person centered care, is to care enough to get it right!
Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
www.pleasegettoknowme.com
Posted on August 8, 2009 - by Nurse Virginia
Caregiver Tips: How did he do it? How did this elderly man take care care of his wife with Alzheimer’s disease so well so long?
The daily care of the confused spouse with Alzheimer’s disease was just too much.
I could easily understand that the daily care of Alice was now too much. What was hard to believe was that this pleasant, friendly, outgoing elderly man in his early 80′s had provided all the caregiving himself this long. Alice wanted to constantly be moving, the problem being she was now somewhat unsteady having been in the hospital for some time. She needed some strenghtening from physical therapy but didn’t understand that, she just knew she wanted to get going now.
It was now taking a team effort, working 24 hours a day around the clock to provide the constant monitoring that Alices’s spouse of 60 plus years had provided. When I met this remarkable man I told him someday we will sit down and you can tell me how you did it.
After a few weeks Alice’s balance was so improved – I witnessed her walking unassisted down the hall with only some verbal cueing as to where to turn. Her husband Chuck Chuck was no longer stressed about her condition and we could talk.
Start with what you know about the person.
Chuck shared that Alice had always liked going places. Alice didn’t like much sitting around the house. So when she was diagnosed with Alzheimer’s disease, he decided to take her out everyday. It wasn’t that hard to get her ready because she wanted to get going. They would drive around the Chicago suburbs or sometimes into Wisconsin, for about 3 hours a day. They always found a nice place to eat lunch and then got back out on the road. When they got home Alice was tired out – a good kind of tired – till the next day when she was ready to go again.
The essence of person-centered care.
Chuck really knew Alice and her love of getting out and going places. Instead of having her frustrated and trying to leave the house, they burned up the road for years. Years spent looking at people, places, having good conversation, eating good food – living.
Posted on June 4, 2009 - by Nurse Virginia
Caregiver Tips: Making morning care easier for elder with Alzheimer’s disease
Person centered care for the confused elderly.
Everyone has a morning routine, their personal way of getting
going in the morning. But for the elderly who many times suffer from chronic pain, stiffness, constipation and confusion, morning routine can pose a challenge.
Morning care, involving getting up, going to the bathroom, washing up, brushing teeth and then dressing requires moving, moving and more moving. If the elder is suffering from arthritis, back pain, headache, osteoporosis or pain from a past injury or fracture all that moving makes morning care difficult.
5 Ways to start a person centered morning routine:
• If the elder suffers from chronic pain, a half hour before starting morning care give their pain medication.
• Know you’re elder; be flexible with their get up time. If they have always been a “rise and shine” person greet them, open the curtains, put on the radio, tell them what the weather is going to be. If they have always had a hard time getting going in the morning they will want a slower and quieter pace.
• If there is a routine to getting going in the morning – putting on a bedside lamp, opening the curtains, a certain greeting – maintaining that routine helps and cues the confused elder as to what is going on.
• How about coffee in bed and a little time to relax before you start. A hot beverage will many times assist an elderly person with moving their bowels in the morning.
• Take breaks; maybe have breakfast in the bedroom during morning care.
My mother starts her day singing a little song to her caregiver, that she learned in kindergarten.
Good morning to you, good morning to you,
We’re all in our places, with bright shiny faces.
Good morning to you, good morning to you.
Posted on April 22, 2009 - by Nurse Virginia
Caregiver tips: person-centered elder care in the nursing home or in your home, can be as simple as red hair.
It was red, it was orange, it was some color in-between, it was red hair I wouldn’t forget. And then, I saw it again on a 90 plus year old woman coming down the hall of the nursing home in a wheelchair. It was Clarisse, and I never would have recognized her, except for that hair.
It was twenty odd years since I had seen her. When I was a young bride my husband was taking banjo lessons from Harry and I would visit with his wife Clarisse. My husband never really took to the banjo, but we became good friends with Harry and Clarisse.
They were in “show business” and their claim to fame was the one time a year when Harry played the BOZO Show. Clarisse told me all about the traveling they had done and the shows they had played. Harry’s career always was very much Clarisse’s, they were a team. Show business never paid very well and they lived in a modest home. Harry made most of his income giving banjo lessons.
Clarisse and Harry never had children and looked on his students as the children they never had. So when Harry went hunting and they hosted their annual “pheasant feast”, we were included. They had students coming over all the time and music filled that little home.
When elder care becomes person centered care.
Clarisse had shared with me that she needed a somewhat memorable appearance, them being in show business and all. So, many years ago she had come up with her own “recipe”, a combination of several colors to create her unusual red hair.
The years went by and my husband’s lessons stopped when our children came along. We lost touch with Harry and Clarisse, but I would catch Harrys’ act every once in awhile when, my children were growing up watching BOZO.
And now so many years later, here she was coming down the hall of the nursing home, with Harry by her side. Clarisse was in the late stage of Alzheimer’s disease and Harry had been her caretaker for years now. In all that time dressing her, bathing her, feeding her, Harry had taken the time to mix her “recipe” and color her hair.
Now it was our turn, we inherited the “recipe.” And while Clarisse spent her last year with Harry by her side playing the banjo. We now bathed her, dressed her, fed her and yes, kept that red hair going. Because, that’s person centered care, you know she was in “show business.”
Posted on April 17, 2009 - by Nurse Virginia
AGING: Person-centered care, the latest “Buzz Words” in elderly care.
“Person-Centered Care”, what does that mean?
Person-centered means that all of the care comes from knowing the care recipient well.
• Is the person an early riser or like to sleep in?
• Does the person like to take a nap – and if so, on the couch or in bed?
• If a man, do they like the feel of a straight razor or electric?
• What kinds of personal products have they used all of their lives? I know my mother always used LUX soap – most people don’t even know that soap – but for my Mom LUX is important. So whether it is soap, shampoo, deodorant, shaving cream – whatever the product – person-centered care means using that person’s favorite product.
• What kind of music does the person like?
• Does the person like sports – what is their favorite team – are they one of those die hard Cub fans. Do I take the time to see when their team is playing and make sure the TV is on for them?
Knowing all of these things about the person you care for and helping them live their life as closely to when they were self-care, this is person-centered care.
It might be the latest “buzz words” but it is just the same good old fashion care given by people who really know the person they are caring for.
See: www.pleasegettoknowme.com for person-centered care for the family.
Posted on March 28, 2009 - by Nurse Virginia
Caregiver Tips: For confused senior, person centered care might be riding a bicycle.
Excerpt from: Please Get To Know Me – Aging with Dignity and Relevance
My mother’s brother, Ed, once took a bicycle trip across the country. He traveled coast to coast, taking odd jobs to pay his expenses. When he was in his late seventies, his wife died. Uncle Ed was diagnosed with Alzheimer’s disease, and my mother became his legal guardian.
When Uncle Ed needed an assisted-living facility, mother wrote a short biography of his life and his lifelong interest in cycling. She always posted that biography in his room, where ever he was living. She also provided him with a bicycle.
As Uncle Ed’s disease progressed, he went from assisted living to total care. But during his journey through Alzheimer’s disease, his passion for cycling was supported by an informed staff. He began with independent biking around the neighborhood to having a nursing assistant accompany him on another bike, and finally he had a stationary bike in his room with a nursing assistant’s support.
By letting the staff know how important that exercise was to Uncle Ed, we were able to empower the staff and temporarily give back to Uncle Ed the life he was forgetting.
Instead of a life only of being kept clean, dry, fed, and visitor ready, the knowledge of his interest created conversation and encouraged the staff to think creatively of ways to enable him to continue his interest until his death.
Really get to know the person you are taking care of – remember my Uncle Ed.
Book excerpt from:
Please Get To Know Me – Aging with Dignity and Relevance
by Virginia Garberding with Cecil Murphey
available @ Christianbooks.com, amazon.com, barnesandnoble.com
Posted on March 19, 2009 - by Nurse Virginia
Caregiver Tips: Alzheimer’s Care from the Medical Model to the Social Person Centered Model
First Nursing Homes were modeled after hospitals.
The Medical Model of care came from patterning nursing homes and therefore nursing home care after the hospital. The first nursing homes were built just like hospitals and the treatment of residents was much like the hospital. Care revolved around the physical care of residents with their activities of daily living; eating, dressing, bathing, grooming and walking. Administering drugs and monitoring medications to control unwanted behaviors was also the focus.
The Medical Model of care has changed to a person-centered Social model. In the social model the focus is on building relationships with the person you care for. Caregivers offering emotional support and empathy for the person when needed.
7 Ways to create a person centered social model of care.
• Communicate with the person while you provide care.
• Use humor to create a friendly atmosphere.
• Show the person that you care about them by giving them your attention.
• Demonstrate respect for who the person is and what they have done.
• Show affection and kindness to the person you care for.
• Provide the person you care for with things to do so that they can feel useful.
• Help the person feel included – like part of a caring family.
Who wouldn’t want to live in a Social Model of care instead of a Medical Model?
- Help your elder find comfort, relevance and respect no matter how frail he or she is.
Find out why the quality of life depends so much on the family no matter who the direct caregiver may be.
Find out how to have a meaningful visit with your parent when they have dementia.
Testimonial:
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