We Understand

Understanding Elder Abuse

Definition:

A single or repeated act or lack of appropriate action occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person.

This can be done through:

· Physical Abuse

Physical abuse is the injury or mistreatment of an older person through the use of physical

force or the threat of physical force. Physical abuse can be deliberate or it can be accidental.

· Psychological Abuse

Psychological abuse can be any verbal or non-verbal act that inflicts emotional pain, mental

anguish or distress on the elderly person.

· Financial Abuse

Financial or material abuse includes the following:

· Theft

· Fraud

· Forgery

· Embezzlement

· Exploitation

· Pressure in connection with wills, property or inheritance or financial transactions

· Misuse or misappropriation of property, possessions or benefits.

· Sexual Abuse

Sexual abuse is forcing an older person to take part in any sexual activity to which the older

person has not consented or could not consent or into which he or she was compelled to

consent

· Neglect and acts of Omission

Neglect is failing to provide for the basic necessities and physical needs of the older person.

This includes ignoring medical or physical care needs; failing to provide access to

appropriate health, social care or educational services; withholding the necessities of life,

such as medication, adequate nutrition and heating. Abuse by acts of omission is a lack of

basic emotional support and respect.

· Discrimination

The nine grounds are:

• Race

• Traveller background

• Religion

• Gender

• Marital status

• Family status

• Sexual orientation

• Disability

• Age

The nature of discriminatory abuse often means that older victims of discrimination find it difficult to come forward as they have no way of knowing whether they will be listened to or supported in a sensitive way.

It is important to remember that an older person is very likely to be experiencing more than one type of abuse at the same time.

UNDERSTANDING RESIDENTIAL CARE FACILITIES

FIRST IMPRESSIONS:

Do you like the facilities location and outward appearance?

Is the facility convenient for frequent visits by family and friends?

Are you welcomed with a warm greeting from the staff?

Do the staff address residents by their names and interact with them during the tour?

Do you notice the residents socializing with each other and do they appear content?

Can you talk with residents about how they like living there and about the staff?

Are the staff appropriately dressed, are they friendly and outgoing?

Do the staff members treat each other in a professional manner?

Are visits with the residents encouraged and welcomed at any time?

Is there a waiting list? If so, what is the estimated time for admission?

LIVING AREA:

Is the floor plan well designed and easy to follow?

Are doorways, hallways and rooms accommodating to wheelchairs and walkers?

Are elevators available for those unable to use stairways and handrails to aid in walking?

Are floors of a non-slip material and carpets conducive to safe walking?

Does the Home have good lighting and clearly marked exits?

Is the Home clean, free of odours and appropriately heated/cooled?

What is the facility’s means of security if a resident wanders?

Are the common areas in general, attractive, comfortable and clean?

Is there a safe and secure courtyard or patio for residents and visitors, and is there assistance given?

Are private rooms available and /or double occupancy units for sharing with another person?

Does the Home have ample security and is there an emergency evacuation plan?

Does the Home have furnished/unfurnished rooms? What is provided or what can residents bring?

May residents decorate their own rooms? Is there adequate storage space?

Is a 24 hour nurse call system accessible from the facility?

Are bathrooms private with handicapped accommodations for wheelchair and walkers?

Do all units have a telephone and cable TV and how is billing handled?

‘MOVING IN’ CONTRACT AND FINANCES:

What’s involved with the moving in/out process? How is the initial needs assessment done?

Does assessment process include the resident, family, facility staff, along with the physician/GP?

Is there a written plan of care for each resident?

Is there an ongoing process for assessing the resident’s need for services and how often are those needs evaluated?

Is there a written statement available of the resident’s rights and responsibilities?

Is a contractual agreement available that clearly discloses healthcare, accommodations, personal care and supportive services?

Is a contractual agreement available that clearly discloses all fees, and admission and discharge provisions?

What type of insurance is required/accepted?

What are the specific costs for various levels of care including skilled/unskilled beds?

What additional services and staff are available if the resident’s needs change?

When may a contract be terminated and what are the policies for refunds and transfer?

Is there an appeals process for dissatisfied residents?

Is there any government, private or corporate programs available to help cover the costs?

Is there a procedure to pay for additional services such as nursing care when the services are needed on a temporary basis?

Do billing, payment and credit policies seem fair and reasonable?

May residents handle their own finances with staff assistance if able?

Must a family member/outside party be designated?

HEALTH/ PERSONAL CARE/ SERVICES:

What type of healthcare and personal care services are available?

Does the facility have both short and long term services, such as routine physical and

dental/vision examinations as well as skilled nursing?

Can the facility provide a list of available services?

Are residents and their families involved in developing the care plan/ service agreement?

Who provides these services, what are their qualifications?

Are physical, occupational or speech therapy services available onsite?

Who coordinates these services and how are they billed to the insurance companies?

Is staff available to provide 24-hour assistance, with activities of daily living (ADL), if needed?

Does the residence have an Alzheimer’s programme or other dementia, and other, specialised areas?

How does the staff safely manage residents who might wander?

Are staff available to assist residents who experience memory, orientation, or judgment losses?

How are medical emergencies handled?

Does the residence have a clearly stated procedure for responding to medical emergencies?

Is there an arrangement with a nearby hospital ?

Are housekeeping linen services and personal laundry included in the fees or charged extra?

Does the residence provide transportation to doctors offices, the hairdresser, shopping and other activities desired by residents?

Are pharmacy, barber/beautician and / or physical therapy services offered on site?

How does staff safely administer, monitor and assist a resident in taking medication?

Does the residence’s pharmacy provide delivery, consultation and renewal of medications?

Does a staff physician/GP visit a resident regularly for medical checkups, or can a resident

have their own personal physician?

What is the nursing staff to resident ratio? How many registered nurses (RNs) are on staff?

How many per shift?

What is their training and education ?

What is the caregiver to resident ratio and how many are on staff? How many on each shift?

What is the history of compliance with staffing ratios? Are there incentives to help with staffing?

How does the residential facility / nursing home ensure that all staff maintain their individual qualifications / licence / certification?

Do staff they receive continuing education, and keep their knowledge and skills up to date?

SOCIAL AND RECREATIONAL:

What kind of group/individual recreational activities are offered and who schedules them?

Is there an organised activities programmes with a posted daily schedule of events?

Do volunteers and family members come into the residence to participate /conduct programmes?

Does the facility schedule trips or go to other events of premises?

Do residents participate in activities outside of the residential facility in the neighbouring community?

Are residents’ activity (social) areas appropriate and desirable to the prospective resident?

Are there supplies for social activities (games, cards, craft, computers, gardening)?

Are religious services held on the premises or arrangements made for nearby services?

Are there fitness facilities, as well as regularly scheduled exercise classes?

Does the residence crate a sense of community by allowing residents to participate in certain activities or perform simple chores for the group as a whole?

Does facility have pets? Who is responsible for their care?

STAFF:

Are nursing staff members courteous and friendly to residents and to other staff?

Do nursing staff respond in a timely fashion to residents’ requests for assistance such as help getting in and out of bed, dressing and going to the bathroom?

Which nursing staff members are involved in planning the resident’s individual care? Are they the same ones who give care to residents?

Is there frequent turnover among certified caregivers, Consider turnover for nurses and supervisors, including the director of Nursing and administration?

What is the nursing staff to resident ratio? How many registered nurses (RNs) are on staff?

How many per shift? What is their training and education?

What is the caregiver to resident ratio and how many are on staff? How many on each shift?

What is the history of compliance with staffing ratios? Are there incentives to help with staffing?

How does the residential facility/nursing home ensure that all staff maintain their individual qualifications/licence certification?

Do staff receive continuing education, and keep their knowledge and skills up to date?

FOOD:

Does the residence provide three nutritionally balanced meals a day, seven days a week, and how does the menu vary?

Observe meal times. Do all residents who need assistance with eating get help?

Do staff give each resident enough time to digest food thoroughly and complete the meal?

What about special diets – does a dietician plan or approve menus? Are residents’ weight routinely monitored?

Are residents involved in menu planning? Can they request special foods? Are snacks available?

Does dining room environment encourage residents to relax, socialize and enjoy their food?

Are water pitchers/glasses accessible in rooms and do staff assist with drinking as needed?

Are common dining areas available? Is tray service available when ill, and are staff available to assist?

May meals be provided at a time a resident would like, or are there set times for meals?

May residents have guests for meals in the dining room for an additional fee? Is there a private dining room for special events and occasions?

STANDARDS AND CERTIFICATION:

Is the facility compliant with regulatory and standards authorities?

Is this a skilled nursing facility and is a skilled bed available?

If the facility is sponsored by a non profit organisation and managed under contract with a commercial firm, what are the conditions of that contract?

Is there an Advocate, resident council or organisation though which resident/family have a means of voicing their views

What reputation does the facility have in the community?

How long has it been in business? Is it in good financial health? Does the facility follow generally accepted accounting procedures?

Has the facility corrected any Quality of Care deficiencies in their Inspection report?

UNDERSTANDING ALZHEIMERS AND DEMENTIA

Dementia is a term which describes a range of conditions which cause damage to our brain. This damage affects memory, thinking, language and our ability to perform everyday tasks.

Early signs and symptoms of dementia may vary from person to person, and each type of dementia can have particular symptoms or characteristics linked to it. However, some general early signs and symptoms include:

  • Memory loss, particularly for recent events
  • Problems with language, difficulty finding the right word
  • Changes in mood and behaviour
  • Becoming confused in familiar surroundings or situations
  • Difficulty in following conversations, TV programmes or reading
  • Difficulty managing money and everyday tasks
  • Difficulty solving problems or doing puzzles
  • Loss of interest in hobbies and pastimes
  • Repeating a question or story several times without realising
  • Living with Dementia :
  • Key areas include when living with dementia
  • Staying active
  • Socialization
  • Build routines
  • Eating Well
  • Exercise your brain

Caring for a Loved One with Dementia or Alzheimer’s Disease :

Many family caregivers presently care for a parent or spouse who is suffering from some form of dementia. In fact, the frequency of dementia increases with rising age from less than 2% for 65-69-year-olds, to 5% for 75-79 year-olds and to more than 20% for 85-89 year-olds.

Caring for a relative with Alzheimer’s disease is particularly challenging because the disease is progressive and, eventually, completely debilitating. The person receiving the help may not be able to appreciate or acknowledge it or may even be verbally or physically abusive.

Caregivers often have a hard time dealing with the fact that their loved one eventually may not recognise them.

“Caregivers of senior relatives or spouses with Alzheimer’s disease and other forms of dementia are at great risk of suffering from depression, anxiety, frustration, stress and anger,” Research shows that caregivers of a family member with dementia face particularly stressful demands because of the length of period of care, the behavioral and cognitive problems associated with dementia, and the extreme impairment of patients with end-stage dementia.

Dementia / Alzheimer’s Fact Sheet :

What is Dementia?

The World Health Organisation describes dementia as:

“…a syndrome due to disease of the brain, usually of a chronic or progressive nature, of

which there is impairment of multiple higher cortical functions…”.

Such functions include:

  • memory
  • forgetfulness of recent events
  • comprehension
  • calculation
  • language
  • learning capacity
  • judgement

Types of Dementia :

  • Alzheimer’s Disease – Accounts for 50 – 70% of dementias Alzheimer’s disease is the most common form of dementia. It is an incurable, degenerative disease. Early symptoms of the disease include memory loss, such as forgetfulness of recent events. However, people with Alzheimer’s continue to recall distant events. As the disease progresses, symptoms include confusion, mood swings, and long-term memory loss.
  • Vascular Dementia – Accounts for 20 – 30% of dementias Vascular dementia is the second most common form of dementia. Those with history of stroke and transient ischemic attack suffer a high risk of developing vascular dementia. It results in memory loss, problems with concentration and comprehension. Disturbance in abstract thinking, judgement, impulse control and personality may also develop.
  • Dementia Lewy Body – Accounts for 15 – 25% of dementias. People with Lewy body dementia suffer an impairment in their perception, thinking and
  • behaviour. They also experience visual hallucinations, fluctuating memory and Parkinson’s-like symptoms such as tremors. People with lewy body dementia also suffer an increased risk of falls as a result of the Parkinsons-like symptoms.
  • Fronto -Temporal Dementia – Accounts for approximately 10% of all dementias. Fronto-temporal dementia is caused by the degeneration of the frontal lobe of the brain and may extend back to the temporal lobe. In the early stages of the disease, memory can stay intact but personality and behaviour change as people lose their inhibitions, act rudely or become easily impatient. People with fronto-temporal dementia are not aware of their actions and as the dementia progresses, memory loss and the ability to perform activities of daily living decline.

UNDERSTANDING HOME HEALTHCARE SERVICES

Each client has unique care needs. That is why we offer a full range of Home Healthcare services – to tailor care plans that provide our senior and other adult clients the right amount and types of help to support independent living at home.

Broadmeadow Healthcare Management can provide assisted Home Healthcare services in the home for you or a loved one. In addition to providing these services for older people, we also work with a variety of clients who need home care assistance such as those recovering from illness or injury and younger disabled people.

Step 1. Assessment and Planning of Care :

Following an initial enquiry, one of our professional Client Care Managers who are from a nursing or social work background will come and assess your loved one’s individual needs whether they are at home or in hospital. They will advise on what level of care may be appropriate and the tasks and activities that the carer should carry out. At this time, family members can also discuss any concerns that they may have.

Step 2. Creation of an Individualised Care Plan :

An individualised care plan will be formulated by the Client Care Manager in partnership with the family. We aim to provide a person-centred rather than task-based approach to care and the individualised care plan is an important element of our vision for quality Home Healthcare.

Step 3. Client Carer Introductions :

After consultation with the family and client, the carer will be introduced. Our Client Care Manager is present to ensure everyone is aware of the care plan and any particular aspects that are unique to your loved one. This initial contact between client and carer ensures suitability for all concerned and an awareness of all the facts in the case.

Step 4. Monitoring :

Our carers log in and out through our telemonitoring system by our Strategic Partner Aramex which ensures that the carer arrives on time.

Step 5. Regular Reviews :

In addition to our telemonitoring system we also review each case on a regular basis. This review, carried out by our professional Client Care Managers or a specialised reviewer allows us to  monitor the quality of care we deliver and to adjust the individualised care plans to meet changing needs. This review allows the client or their family to discuss the care on a regular basis.

A Care Plan is maintained for each client and our carers document the care provided so as to keep families up to date on any changes.

Throughout the period of care we are conscious that we are in a person’s home and we ensure that care is delivered in a dignified and respectful manner.

Companionship and Homemaking Services :

Medication

Our carers can assist and remind clients in relation to their medication regime.

Conversation and companionship

Whether it’s conversation and company, or just eating a meal together, having someone to sit and visit with can help make for a happier, healthier life.

Specialized Care Services

Dementia Care

Broadmeadow Healthcare Management provide elder care for clients that are experiencing symptoms of dementia. Some clients may experience momentary confusion or lapses in memory, but others are dealing with advanced stages of dementia conditions. For those that provide this specialized care, specially trained BHI staff will provide activities that can improve a person’s quality of life such as music and other activities to stimulate the senses.

End-of-Life Care

Our compassionate care givers come to the aid of individuals who have been diagnosed with a terminal illness. We help them and their families with emotional and moral support as well as helping out around the home and providing personal and companionship senior care—whatever is needed.

Broadmeadow Healthcare Management can support the family directly or work in partnership with a hospice agency or medical provider to fully meet the family’s needs.

Our ultimate goal is to help families make the most of their time together, helping to lighten the burden at a very difficult time. Through respite care, we give family caregivers needed rest and we can continue to help after a loved one’s passing.

Personal Care

Bathing

Bathing is essential to an individual’s sense of well-being. It refreshes the spirit, provides relaxation while cleansing the skin and stimulating circulation.

Mobility

Activity and exercise are vital to a healthy lifestyle. The benefits of movement to both physical and mental health are seen in everyday life. Benefits include increasing stamina, strengthening the heart, lowering blood pressure, improving digestion and sleep. In addition it improves mood, releases stress and increases mental alertness.

Transferring and Positioning

Moving or placing a person into a correct posture position encourages the functional activity of the body’s many systems. It assists in eliminating pressure areas on the skin, reducing atrophy and stiffening of muscles, encourages proper breathing, digestion, and elimination.

Incontinence care

The inability to control urination or defecation is embarrassing to individuals and can become unsanitary if not taken care of correctly. Our caregivers understand the sensitivity of this situation and approaches to caring for individuals who need assistance.

Toileting

Elimination is an important and normal body function. However, it is usually an activity that is private and one that is not openly discussed. The individual often faces embarrassment along with a sense of loss of independence. We strive to provide an acceptable, comfortable and safe environment for all types of toileting needs.

Feeding

We understand that it is usually hard for an adult to accept the idea of not being able to feed themselves. The reasons are varied, however the sense of loss of independence is real.

We understand the feelings this can cause and take the extra effort to make the environment and mealtime special.

Oral Hygiene

Proper mouth, teeth, denture and gum care are essentials to good oral and dental hygiene.

Daily oral care can prevent bad breath, tooth decay, gum disease and assist in prevention of other diseases.

Special diet and meal preparation

We recognise that eating is a social activity and that good nutrition is important in order for people to live life to its fullest. It is especially important for a person whose body is in a weakened condition. Proper foods give us energy to carry out the day’s activities, are necessary to rebuild body tissue, prevent disease and are essential to any healing process.