Meeting Residents’ Expectations in Aged Care Homes

As an Aged Care Placement Consultant I find  clients always ask me about two main issues. The first is staff ratios, which has become a hot topic in aged care. This is a difficult question to answer since the introduction of Ageing In Place, because most Aged Care Homes now have a mixture of high and low needs and staff numbers are rostered according to care needs and work load at any given time. I find the most helpful question to ask of an aged care facility is the availability of Registered Nurses on each shift, including overnight, as well as the availability of Doctors on weekends and overnight.

The second most often asked question is about the quality of food, which is another big issue in aged care homes.  I can understand why it’s so important. Apart from the nutritional value, food plays a major role in the daily life of a resident. The anticipation of meals is an important focus and having a good feed leaves them satisfied. Everyone enters a home anticipating the food will be up to standard and palatable; some are disappointed at the quality, while others find the meals delicious.

Earlier in my career when I worked in Aged Care Facilities I was amused that it was often the people who had lived alone surviving on toast or crumpets who complained the most about the food. I would hear the complaints the Chef received and they were often contradictory, some thought the soup too hot, some too cold, some found the gravy too thick, some too thin. I realised how difficult it was to deliver meals for such a large and diverse population, also taking into account medical conditions, and still please everyone. I can assure you there are many residents who do enjoy their food.

In my experience, the people who choose to enter residential aged care and embrace their new lifestyle thrive and are mostly content. It is a big challenge for providers of aged care facilities to meet the expectations of residents and their families. I seek aged care facilities for my clients that suit their needs and will deliver quality service.

 

 

New Aged Care Facility in Greensborough

 

Trinity Manor Greensborough frontAs an aged care Placement Consultant I am, at times, invited to visit new aged care facilities prior to their opening. Recently I was invited to visit Trinity Manor Greensborough to view the facility before it opened its doors to residents yesterday (16th May, 2019).

Trinity Manor Greensborough reception

There are 112 beds, including 12 in the Memory Support section for those living with dementia needing a secure and safe environment.  They offer these residents a specialist dementia care support program. All residents have access to care by qualified registered division 1 nurses, available 24 hours.

The chef prepared a lovely lunch for me so that I could sample the standard of meals that will be served to the residents. They will have a plentiful supply of food throughout the  Trinity Manor Greensborough meal

day, with a continental and hot breakfast followed by a main meal at lunch with offerings such as Rogan Josh, roast leg of pork with apple sauce, crumbed fish and beef and shiraz pie served with a varied range of vegetables daily followed by desserts such as mango panna cotta and apple strudel. A soup is served in the evening followed by a light meal and dessert. Cakes, devonshire tea or biscuits are served at morning and afternoon tea and supper.

It was intriguing to see a robot in action in an aged care facility; its role is to take the load from carers and kitchen staff. Able to deliver to rooms and various departments, the robot accesses the lift to reach different floors.

Trinity Manor Greensborough robot 2

The robot stops when a resident is near and plays music as it goes along. In my role as a Placement Consultant I have to confess this is the first time I’ve seen a robot in aged care. The facility is using the Lamson Robo, which is easily operated with an IOS mobile app, allowing the operator to call and send the robot via a mobile device. Whilst I was visiting they were mapping the building with the robot. The new residents will be involved in naming the robot, with a competition for its name.

The facility has many great features, with a hairdresser,

Trinity Manor Greensborough haridresser

massage room, gymnasium, cinema,

 

private dining rooms for family meals, outdoor bar b q, multiple dining and lounge areas and balconies and terraces off rooms. The décor and furniture is all modern and tasteful.

Is The Banking Sector Age Friendly?

piggy-bank-1595992_640

Image by Andreas Breitling

Following on from my last blog Aged Care Services Not Age Friendly (12th April 2019 ) in which I wrote about the Financial Capability of Older People report by the University of SA, examining how the aged in home care and the banking and finance industries were not age friendly, this blog will look at the banking and finance sector. This sector came in for criticism too for not being age friendly, with researchers finding older people faced numerous problems in their financial dealings. This ranged from having trouble understanding foreign voices at overseas call centres and reading tiny print on documents to complicated terms and condition, poor communications by staff and high pressure sales techniques.

The researchers believe both the in home care and finance/banking sectors were in need of an age-friendly revamp with more older-customer focussed services and better staff training.

So it is encouraging to read an article from the Canberra Times that Alzheimer’s Australia has begun rolling out “dementia-friendly” banks with a pilot program beginning in Beyond Bank branches across Canberra.

The bank has begun making changes to its physical environment, considering things like colours, lighting, signage and even the type of fonts it uses to make the branch environment less intimidating. Staff will receive special training to learn about the various obstacles those living with dementia face when doing their daily banking.

Beyond Bank state manager Chris Blight said they wanted to make it easier for people with dementia to stay independent.”We’re working towards having really clean spaces and that welcoming personal tailored solution to help them access their funds,” he said.

The full report The Financial Capability of Older People can be read at: unisabusinessschool.edu.au/financial-capability

Aged Care Service Not Age Friendly

elderly lady at home

Extraordinarily, Australia’s aged home care sector has come under some strong criticism for not being age friendly according to a report from the University of South Australia . Older Australians have been left feeling disempowered and lacking in confidence due to its complexities. Research explored the ability of people aged 65 plus to select and financially manage their home care packages;

“Home-care packages support people to stay in their own homes for longer, so they are a really appealing option for people as they age or become less independent,” said lead researcher, Braam Lowies “But our research found that older people felt insecure about their capacity to manage home-care packages to their best advantage and we wanted to understand why.”

What they found was that, although the government had recently increased total aged care spending to $662 million, including the release of 10,000 additional home-care packages, the environment in which the packages are provided was so complicated that many older Australians were unsure of which options best suit their personal situation.

Clients of mine are currently dealing with this very situation. A 96 year old couple are in need of support, having stayed independent until this year. The husband had a bad fall and is now in a rehabilitation unit and will probably need my help as a placement consultant to find accommodation in an aged care facility. However, his wife is keen to stay at home with support. She has found she needs help from her family to even begin the first step of applying for assistance. Without their support she would not be able to access the service on her own.

“We found a host of problems from a general lack of confidence and lack of knowledge of the system among older people, to overly complicated communications, high staff turnover and inadequately trained staff providing in home care, inconsistencies in package administration, confusing fee structures and even inaccurate billing processes” Dr Lowies said “Unfortunately, the more complicated and inaccessible the programs are, the more it creates a lack of confidence and motivation for older people accessing services.”

The banking and finance industry was also examined in the Financial Capability of Older People report and it came in for criticism too for not being age friendly.

 

Improving the Quality of Life for Residents in Aged Care

allity-templestowe-indpendent-living-manor

Many approaches are being tried in aged care facilities to improve the quality of life for residents. As a Placement Consultant I like to know that my clients will enjoy a contented and engaging life once they move into an aged care home, that not only will their physical needs be taken care of but their emotional, spiritual and intellectual needs too. Some fine examples of programs that help provide a good quality of life are discussed below:

Music therapist Heather Seyhun at ACH West Park Adelaide, brought in her own collection of drums from Africa and Brazil to begin a music trial she devised. Three months on, she says she’s amazed at how the group has evolved and the positive changes she has witnessed.

“When we started out, people were a bit unsure, because most had never hit a drum before, and felt outside their comfort zone,” she says. “Now they’re loving it, and they’re getting really good.”

Heather has seen improvements in wellbeing, socialisation, self-confidence and mobility. “You can see the enjoyment, the new friendships – playing music with others creates a special bond.” she says “Watching people with physical limitation participating, growing in confidence and supporting each other is so rewarding.”

A Zen Garden has been created at St. Patrick’s Green, Kogarah, NSW, based on the philosophy that a bit of nature is good for the soul and will allow residents to relax and meditate, among the sounds of a water feature and rustling palms.

Other wellbeing rooms are the Spa Room and Reflection Room. Residents can enjoy a soothing massage experience, complete with lavender essential oils, calming music, facials and other beauty treatments for a complete pamper experience.

The Reflection Room provides a tranquil space for residents to reflect on life, away from the bustle of communal areas. It also acts as a private space for residents to meet with the manager of Spiritual and Holistic Care if anything is troubling them.

Some therapies that research have found to be effective are:

Animals and pet therapy;Aromatherapy; Art therapy and craft; Behavioural activation and pleasant events; Bright light therapy; Cognitive behaviour therapy; Cognitive and memory skills interventions; Companion robot; Dance and movement;Dementia care mapping; Humour therapy; Laughter yoga; Life review; Life review therapy; Massage; Music and singing; Person-centred care; Restorative approaches; Simple reminiscence;Yoga.

More indepth information is available in the studyWhat works to promote emotional wellbeing in older people: A guide for aged care staff working in community or residential care settings. Melbourne: beyondblue by Wells, Y., Bhar, S., Kinsella, G., Kowalski, C., Merkes, M., Patchett, A., Salzmann, B., Teshuva, K., & van Holsteyn, J. (2014).

 

 

 

 

 

Montessori Method Helps Those Living With Dementia

7WaysMontessoriDementiaPatients

American Montessori expert Dr. Cameron Camp has developed a new approach to caring for persons living with dementia. This new approach is known as The Montessori Inspired Lifestyle ® (MIL). It is based on the philosophy and methods of Dr. Maria Montessori, the first female M.D. in Italy and world-renowned educator.

“Within this new paradigm, abilities, interests, and preferences will be respected, encouraged and maximized. Providing choice throughout the day is central to all interactions.” Said Dr. Camp “Central to MIL is the creation of meaningful activities and social roles within the context of a community. This helps to ensure that residents are engaged in life, have a feeling of belonging, have a sense of purpose, have access to meaningful activity, and can have a sense of control and independence.”

Having done a 3 week course with Omnicare Alliance to learn about Montessori and apply the principles and methods in her own home where she resides with her husband who lives with dementia, Susan was blown away by his progress.

“We have a bunch of signs around the house with cartoon pictures for Jim now that ask him questions. ‘Have you taken the bin out?’ or ‘Do you have your house keys?’ she explains “This actually gets him to think and engage with himself which is a big part of learning.” She has realised that if she communicates in a simple way with her husband he will understand and be able to help with chores. Rather than tell him to cut carrots into cubes, for example, she now models instructions, showing him how she wants them cut. He is then perfectly capable of carrying out her request.

The Montessori Method utilises simple, modifiable and practical tasks that utilise everyday items to re-engage individuals and help to retrain skills that may have diminished due to dementia. A person’s abilities are closely tied to their life experiences and passions, and identifying these passions and harnessing them to rekindle and engage a person is the essence of what makes Montessori training and learning effective. For instance, if a woman grew up playing the piano, music may be the key to her learning and engaging, but if she enjoyed gardening instead, then heading outdoors and incorporating seeds and plants into her activities, may be the key in helping her rediscover some old skills.

As an Aged Care Placement Consultant I would love to see this method used in more aged care facilities. With the current strong focus on the quality of care I hope providers are taking note of Dr. Camp’s new approach.

 

 

Latest in Technology Helps Those Living With Dementia

 

Some aspects of technology in our society can be concerning, however it is certainly here to stay and some of the innovations it is introducing to help those living with dementia are truly encouraging. As an Aged Care Placement Consultant I often help clients that live with dementia find suitable aged care accommodation and I see first-hand the difficulties they face in everyday life and receiving the level of support they need.

DRESS

A new assistive technology prototype called DRESS is being developed right now to help people with dementia dress themselves. It is designed for those who struggle with remembering how to perform day to day activities and will hopefully give them more independence and privacy.

dressing bedroom

The prototype – designed by NYU Rory Meyers College of Nursing, Arizona State University and MGH Institute of Health Professions with experts from gerontology, engineering, social sciences, nursing and psychology – uses a mixture of sensors on clothing and a set of dresser drawers. The drawers contain one item of clothing per drawer, in accordance with the Alzheimer Association’s dressing guidelines. It also combines automated vocal prompts recorded by the carer, to help correct dressing errors such as wearing a shirt back to front.

The carer initiates the sequence via a mobile device and the recorded voice prompts the dresser to start to dress, with red lights and prompts activated if the person dressing makes a mistake. Stress levels are also measured with an inbuilt soother if they rise too high.

Recorded messages

Using similar technology to the automated voice prompts reminders can be recorded on a device in the home and then played back out loud at the appropriate time. Messages can be set by time or activity, for example, a message can remind a person to take medication at a certain time or when a person leaves their home, a reminder message could tell them to lock the front door.

door-690704_640

Using this recorded message system can help people living with dementia to remain independent yet safe.

Home care robots

 

With Japan’s ageing society facing a predicted shortfall of 370,000 caregivers by 2025, the Japanese government wants to increase community acceptance of technology that could help fill the gap in the nursing workforce. One of these is a simple robotic device that helps frail residents get out of their bed and into a wheelchair, or that can ease senior citizens into bathtubs.

japanese robotics

The government sees a wider range of potential applications that could be developed to assist. Dr Hirohisa Hirukawa, director of robot innovation research at Japan’s National Institute of Advanced Industrial Science and Technology, said the aims included easing the burden on nursing staff and boosting the autonomy of people still living at home.