How do you really know if you are in compliance?  Every director needs this tool....Population and Calendar Analysis Tools

Activity Department Survey Compliance Tools
The Comprehensive Activity Department Audit Tool provides the Director or consultant a valuable tool to identify area's within the Activity Department that are not compliant. The Comprehensive tool includes, Audit Tool (24 pages), Explanations and Objectives Form.

Social Service for LTC Manual

Volunteer Policy and Procedure Manual

Care Plans for Culture Change™ Interdisciplinary and Resident-Directed

Resident Rights Prints

Sensory Enrichment Activity Calendar

Dementia Activity Calendar

Best Friends Book of Activities

Psychosocial Care Planning Almanac

Dementia Care Plan Dictionary

Staff Inservices

Innovations in Activities for the Elderly

Spiritual Care for Persons with Dementia

Therapeutic Interventions for the Person With Dementia

Giant Photo Crossword Puzzle Book

Word Search for Seniors

Memory Triggers: Remembering the 1940’s

Alzheimer's Disease DVD

National Council of Certified Dementia Practitioners

NCCDP Lapel Pin
show your pride in being a certified Dementia Practitioner!
only $18.00

www.activitytherapy.com
www.activitytherapy.makesparties.com - 10% corporate discount
activitytherapy@aol.com
973 729 6601 Office 973 729 1560 Fax

"A meaningful activity enables the person with dementia to feel needed and useful by having a positive impact on other people's lives. The difference between a meaningful and meaningless activity can be very subtle and lies not in what we say or do but in how we engage the person."

From spark of life newsletter of Australia

In This Issue

Sex Offenders in Long Term Care / Sexuality / Intimacy Education is Key For Staff Education!
MEPAP 2nd Edition 180 hours. Registration now open and classes filling up fast! NJ Classes
Alzheimers and dementia course
Are You Survey Ready?

Sex Offenders in Long Term Care / Sexuality / Intimacy Education is Key For Staff Education!

Oklahoma Sex Offender Long Term Care Facility Bill was passed. Bill number 2704.  This bill was passed and approved the building of a long term care facility that would house elderly sex offenders.  They are currently waiting for a company to step forward who is interested in building a long term care facility specifically for this group.  Years ago, we did not have registries that held the names of convicted sex offenders.  We did not have the web to do a search of where sexual offenders are living. You might have a convicted sex offender in your facility. 

A Perfect Cause web site provides information about this topic. They conducted a study about the number of convicted sex offenders living in a long term care setting. Every facility they are placed in leave vulnerable elderly dementia residents at risk.

One advice strongly recommended is a “no touch” policy for any child visiting your facility. The first and most important issue to consider is that we do not know if the resident is a convicted sex offender. Secondly, residents and children can pass/transfer infections and/or illness to one another just by doing something as innocent as shaking hands. The only other solution is constant supervision and monitoring by staff when children are present.

At no time should children be left with any resident unsupervised.  Families that bring their children to visit relatives must provide supervision at all times. The person sharing a two bedded room with their relative may be someone that has a criminal record. Definitely remind families to wash their hands upon arrival to the facility and upon leaving.

If you bring in children’s groups and pre schools into your community, there should be a no touch policy. The activity staff should be present at all times when children groups are in your facility and at no time can the group be left unattended.  Remember, not every child wants to be touched by a stranger.

Every facility should provide sexuality and intimacy education to their line staff. Many facilities admit that they do not provide any kind of sexuality, intimacy or sexual abuse education for their staff.  Staff  need to understand appropriate responses and interventions for a wide range of situations, behaviors, family concerns and staff concerns. They also need continuous education on gender and lifestyle issues. In order to provide compassionate care, staff  need continual education.

Sexual abuse is any form of nonconsensual sexual contact, including unwanted or inappropriate touching, rape, sodomy, sexual coercion, sexually-explicit photographing, and sexual harassment. It would include situations where the nursing home resident was forced, coerced, tricked, or manipulated into unwanted sexual contact and where the nursing home resident is too ill, frail, or mentally incapacitated to give consent. A nursing home resident can be sexually abused by a nursing home staff member, another resident, a stranger, or a family member in a variety of situations. (source: nursing home abuse resource center)

Sexual abuse may be by family, visitors, staff, stranger, volunteers or other residents. Dementia residents are the most vulnerable because often times they can not effectively communicate their experiences. Staff should be aware of signs of sexual abuse and take immediate action and report immediately. “To date, we have located approximately 1,600 registered sex offenders living in long-term care facilities across America” From A Perfect Cause.

Signs of Sexual Abuse

 It is important that those who are involved with elders, are able to recognize signs of sexual abuse, to aid in detection and treatment of victims. The physical signs include:  (source: A Perfect Cause)

• Bruising on inner thighs
• Genital or anal bleeding
• Sexually transmitted diseases
• Difficulty walking or standing
• Pain and/or itching in the genital area
• Exacerbation of existing illness
• Lack of appetite
• Unable to sleep

Additionally watch for signs such as:

• Genital infections
• Frequent urinary infections
• Bite Marks
• Refusal to be washed in genital area
• Difficulty walking or sitting
• Torn or stained underwear
• Suck marks on body

Emotional signs include:

• Scared or timid behavior
• Depressed, withdrawn behavior
• Sudden changes in personality
• Odd, misplaced comments about sex or sexual behavior
• Fear of certain people or of physical characteristics
• Usually sleeps with light off and now wants the light on

Additionally you might see:

• Increased wandering
• Increased outbursts
• Violent behavior / striking / hitting / spitting

For a comprehensive list of indicators see Looking Beyond the Hurt. This is an excellent training manual for your staff.

A Perfect Cause recommends Criminal Back Ground Checks of your residents so that you are aware of their back ground and weather you wish to admit them. At minimum, the question that should be on your admission paper work and is the same question that is on employment applications is: Have you ever been convicted of a crime? This is not a new concept. Many HUD subsidized senior housing buildings are required to ask this question. At minimum all staff should have a police / criminal back ground check conducted prior to employment.
Be aware of abuse indicators by an abuser. (Source: Looking Beyond the Hurt)

• Refuses to permit hospitalization / diagnostic tests or assessments by social workers.
• Ignores senior’s hospital admission  (doesn’t visit) or is always there so the senior can’t speak to a health professional alone.
• May refuse to participate in discharge planning to take senior home.
• Impatient with staff/ procedures
• Appears fatigued / stressed
• “Blames” senior (e.g., for incontinence, wandering, etc.)
• Responds defensively when questioned: makes excuses or is hostile, suspicious, irritable, demanding
• Does not want senior interviewed alone
• Excessively concerned or unconcerned about the senior
• Treats senior like a child or non person
• Has minimal eye, facial, physical or verbal contact with older person.

Because of lack of education dealing directly with sexuality, intimacy and sex abuse, caregivers are not able to identify sexual abuse. Additionally, they are not trained to report nor do they know how to handle the situation.  This continues the abuse due to lack of education on the part of the care givers. 

Should a sexual assault take place in your facility, remember that the elderly resident requires the same services as younger victims such as emotional support, medical attention, protection from the abuser and legal assistance. (Source: Article Base-Sexual Abuse in Nursing Homes)

Long term care settings must have policies and procedures regarding Sexuality, Intimacy and Sexual Abuse. Education of your staff is extremely important in providing compassionate competent care of your dementia residents.

Resources:

Oklahoma Bill 

Freedom of Sexual Expression: Dementia and Resident Rights in Long Term Care Video. A must for training staff  

Looking Beyond the Hurt. Huge 132 page download for training. Excellent.
Senior Resource Center Association of Newfoundland

CMS State Operations Survey and Certification Group Training Site
Includes satellite and internet broadcasts. Excellent resources in Archives as well. 
See Abuse and Neglect Surveyor Training and resources with this module.

Nursing Home & Elder Abuse Resources
Developing Elder Abuse Training Programs: Free Download

Wisconsin Coalition Against Sexual Abuse has free downloads for training

Widing The Circle Free 195 page training document

Department of Health and Human Services Medicare

Sexual Assault and People with Developmental Disabilities: A Guide for Family, Friends and Caregivers

Sexual Assault and Older Individuals: A Guide for Family, Friends and Caregivers

Preventing Elder Abuse free download

Office for Victims of Crimes - Elder Abuse

Nursing Home Abuse Resource Center

Nursing Home Abuse and Neglect Resource Center

National Committee for the Prevention of Elder Abuse

National Citizen's Coalition for Nursing Home Reform (NCCNHR)

National Center on Elder Abuse

American Bar Association - Commission on Law & Aging

American Association of Retired People (AARP)

New Jersey MEPAP 2nd Edition (Formerly 90 Hour Part 1 and Part 2)
Registration now open and classes filling up fast!

Now easier than ever. We now have evening and weekend courses.

Price:
Early Registration till September 1st.- $1250
After September 1st - $1375
Books - $150
Cancellation - $450
Once class begins, there are no refunds.

Are you a certified director or certified assistant? Increase your earning potential with certification.

This is the required course by the www.nccap.org for those pursuing certification. We recommend you down load the ADC and or AAC application to see which track you fall under.

This class recommended for activity directors, activity assistants and nursing assistants. If you work in a nursing home, assisted living, rehab center or adult day care, this class is recommended.

INVEST IN YOUR FUTURE!

MEPAP 2nd Edition 180 hour class and 180 practicum. Practicum may be completed at your long term care setting.

NJ classes beginning September.

Classes to be held at:

Seating is limited on a first come first serve basis. This class will not be offered again until fall 2010.

See web site for evening classes to be offered September at Daughters of Miriam in Clifton NJ. The instructor is Rhonda Brand ADC CDP CDCM.

This is also the MEPAP 2nd Edition 180 Hours.

The 90 hour part 1 and part two are now called MEPAP 2nd Edition and can only be taken now as one continuous class known now as MEPAP 2nd Edition and replaces the 90 hour part 1 and Part 2 classes.

See web site link for details or call 9737296601 or email us at Activitytherapy@aol.com

If you completed part one but never took part two, we recommend you now complete the course. Please call for pricing.

CLICK HERE REGISTER FOR SATURDAY CLASSES
CLICK HERE TO REGISTER FOR WEEKNIGHT CLASSSES

OR CALL 973 729 6601. SEATING IS VERY LIMITED.

Alzheimers and dementia course

Are you a Certified Dementia Practitioner? Are you an approved Alzheimer's Dementia Instructor? Do you manage a dementia unit? Are you ready for the future of healthcare?

The seminar is recommended for all health care professionals.

Upcoming 7 ceus Alzheimers and dementia course. Approved CEUs for social workers and activity professionals. Please see www.Nccdp.org and click on courses and then NCCDP Alzheimers and dementia seminars.

The corporate staff has trainings in PA, Florida, CA Maryland and Las Vas.

If you are the nurse educator there are seats still available for Train the Trainer. For those managing dementia units don't miss the next Certified Dementia Care Manager course.

The NCCDP can bring this seminar to your state conference or facility training. Please call 877 729 5191 or email nationalccdp@aol.com for details. Our web site is www.Nccdp.org.

Mark your calendars for February 14th to the 21st is NCCDP Alzheimers and Dementia Staff Education week. Beginning November you will be able to download free in-services on Power point. See link for details beginning November.

This is a complimentary service beginning November.

If you are a NCCDP member the NCCDP is excited to offer it's members Liberty Mutual Group Savings Plus. Check out the potential savings for home and auto insurance. See link for details.

Sign up for the NCCDP newsletter at http://www.nccdp.org/newsletter.htm.

Are You Survey Ready?

Attention Administrators and Activity Directors!

How Do You Know For Sure That You Are Survey Ready?

As a consultant and corporate director with over a decade experience providing consulting  services to United States nursing homes, assisted living and adult day care, the very first question I ask the Activity Director is, “tell me about their populations and how the calendars are planned to fit the needs of the population.”  Most can’t tell me!  Some say they base their answer on visual observation. They can’t tell me how many dementia residents they have, how many men, how many NPO residents, how many low functioning residents, how many bed bound residents, room bound residents, etc.

Equally surprising is that many administrators don’t know the answer to this question either.  Visually, the administrator might be concerned that some residents are not in programs, residents sitting idle for long periods of time or lack of programming.  The administrator should require a population and calendar analysis as an annual Q/A or ongoing CQI from the director. The Administrator should have a general understanding of the types of programs offered in the facility, populations they serve and to feel confident that the resident’s needs are being met. Administrators should be meeting with the directors on a monthly basis and understand what programs are being developed and planned.

Most activity directors have never completed a population and calendar analysis. Many have never read the Quality Indicator report.  If you don’t know the needs of the facility and your residents, than how can the calendars be developed and implemented?

If you ask the director how the calendars are developed, most give several answers. Some directors develop the calendar based on the season and a theme while others may develop the calendar based on input from family, staff, volunteers and residents.  Both of these answers are important but most important is to develop the calendar based on the needs of the residents.

The population analysis will show the residents diagnosis, needs, disabilities, past pursuits, language, religion, cultures, etc. The calendar analysis will show what is currently planned and implemented such as large and small groups, men’s programs, rehab programs, religious programs, creative programs, etc.  It will also clearly show what is lacking. Many calendars are heavy in intellectually stimulating but lacking in dementia programs, low functioning programs, rehab programs, room bound programs, sensory enrichment programs, empowerment programs, wellness, self esteem, volunteer, pet therapy, intergenerational programs and community programs.

By completing the population and calendar analysis on a yearly basis, and as part of the required Q/A or CQI, the analysis tool will drive the development of the calendar and ensure that the director is not only meeting the state and federal regulations but the needs of the residents.  As long as the director implements the findings from the analysis, the director should feel confident in a positive survey outcome.    

The CMS web site archived section still has the training video for Surveyors and activities. It addresses the importance of completing a calendar and population analysis.  One important question that the surveyor will ask the director when programs are lacking is, “show me the tool you used to determine the types of programs you have developed and implemented?”  This is the calendar and population analysis. It would be embarrassing for any experienced and seasoned director to say to the surveyor, “I don’t do any type of Q/A , CQI or audit regarding populations and calendar analysis.”  The population and calendar analysis is not required by Federal or state regulations but it is best practice.  But every Administrator should require this and every Director should want to complete the population and calendar analysis.  

See this link for the Calendar and Population Analysis.

See this link for the CMS web site and click on archives for Surveying the Activity Department

One other suggestion is to use the surveyor questions from the Federal regulations book, “observation of a non interviewable resident.”  This tool should be used with any resident who can no longer communicate to verify that his needs are being met. This is an excellent Q/A and should be conducted on an annual basis. 

The population and calendar analysis is very easy to complete and worth the time and effort the director will spend in securing a positive survey outcome and most important, customer satisfaction.

Sandra Stimson CALA ADC CDP CDCM
Executive Director

Attention Activity Associations and TR Associations