Showing posts with label Ombudsman. Show all posts
Showing posts with label Ombudsman. Show all posts

Saturday, June 26, 2010

Long Term Care Ombudsman Musings


June started off with presenting my information on Culture Change in Long Term Care at our local Care Connection Meeting headed up by Liz Cohen. I was surprised to see how many showed up and the way they seemed to eat up the information! It was a lively meeting with many comments by the audience. I love it when I can see sparks flying through a group knowing that they won't soon forget some of what I find worth sharing.

I have been energized by that Ombudsman weekend in Portland. My next step is to share my workshop on abuse in long term care. Abuse is such a gray issue. Sometimes I find myself not sure whether something should be reported or not. When in question, report. That gives the question to those much more qualified to decide whether abuse has taken place. I will share this next presentation once I get it typed up here on my blog.

We have a new Long Term Care facility here in Brookings, Oregon community. Sea View is like entering a fine hotel with a huge gathering place immediately upon crossing the front door. There are always groups of people at the many tables. Some are investigating whether or not to take up residency and some are residents enjoying getting together over lunch or listening to a talk or performance that has been brought in.

My friend Elmo Williams told me yesterday that he had given a talk there. Elmo is someone who recognizes good food and his report on the food was heartening. I find that I often do not even recognize what residents are being served in some facilities and here the food is presented as if it were a nice restaurant. I hope in a year or two I won't witness the food becoming much the same as anywhere else. I would love the cooks in all Long Term Care facilities to go to Sea View for lunch to see what is possible.

As an Ombudsman I need to stay objective. I will stay alert and not assume that all is perfect just because the food and facility is pretty!

Chetco Inn, a Residential Care Facility, is having a pot luck today. I've been invited to bring my mother. I think we will swing by as I hear it is always a good time. I like to see my residents having a good time.

The least favorite thing about being a Certified Ombudsman is writing up the reports. I find if I keep a running commentary on my computer with dates and times, I can assess whether a report should be written up along with notes about my residents helps me remember them and special information to help me serve them better. I feel good getting to know everyone better the more experience I have.

While I was at Sea View the other day, I sat in Memory Care with a resident sharing a cup of coffee and just chatting mostly about what she wanted to talk about. I feel I know her in a personal way. If I saw her at the grocery store, I would now feel she was like a neighbor eager to greet her and even give her a sincere hug. I'd like to have relationships like that with each and every resident I represent.

I have a male resident at one of my facilities that initially pretty well told me where I could go in no uncertain terms. Through meeting with him several times now, I feel he now even likes me and I have learned to like him. I think I might be a bit testy if I had lost my ability to communicate effectively and was stuck in a wheel chair somewhere I didn't really want to be. It is always good to put myself in their shoes before I go off thinking they don't deserve my attention.

I am sharing this stuff on my blog in a casual manner using no names or private information so that you out there bothering to read this might just spend some of your time being a friend for someone in long term care. Everyone deserves a best friend to off load on or just share with. Wouldn't it be special if each long term care resident had a "best friend"? The sad truth is many of them have no family, no friends and find themselves staring at the walls wondering why life ended up like it has. Now, some are still very much involved with life making the best of their situation and maybe even choosing to be where they are. Not all are suffering, but many are. I see dull eyes, lack of interest in much while hating the food, resenting sitting for way too many hours with nothing to do that interest them and missing their former lives. As human beings I feel we have a mission to make life better for those in need. I hope you find yourself motivated to stop by your local "old age home" to volunteer. Thanks for doing this! We never know if we will be one of them any day now.

Friday, June 04, 2010

Culture Change Movement in Long Term Care

I recently attended a meeting in Portland, OR, regarding long term care as an Oregon State Certified Ombudsman for Long Term Care. There is a movement in long term care to make long term care change from just caring for a resident into having the resident experience life much like they did before being forced into having others care for them. Residents haven't changed from who they were all their lives just because they are now living in an "institution". This movement addresses residents as individuals instead of the usual group getting all the same food, activities, care and environment. Here are some of the ideas I heard as suggestions for making this change for residents of long term care.


Life story questionnaire is a way to get to know each resident about their lives before long term care. How did they spend their day? What was their joy?

* Favorite music
* Favorite meals
* What did they see all day at home?
* did they have house cats?
* Were there live plants in their homes?
* did they enjoy a fish tank?

Some of the best practices to make a day better for long-term-care residents is to remember:

* Patience is needed
* Make repetitive - repeating is really O.K.
* Answer as first time you have been asked the question. Keep it fresh
* Jokes in morning set mood for the day
* Agitation spreads so defuse it before it goes further
* Validate even senseless. Everyone needs to be validated no matter what else is going on.
* Coloring outside the lines just fine as perfection is not really that important

Games:

* O’ho
* Roll dice to spots
* Trivia
* Songs
* Life style stories
* Grab bag poetry
* Good news stories

Activities:

* Garden time
* Walks
* Bible study
* Pet therapy
* Interact with music
* Laughing Yoga

Restorative Activities

* Blend home in the institution.
* Therapeutic needs
* Entertaining
* Meaningful fun that suits residents
* Geared for options and abilities
* Create what they want
* Know what builds their soul
* Life enrichment Dept.: Laughter, fun and interacting with purpose


Other things that can make life like it was before someone had to be a resident of a facility

* Choice as to when residents get up i.e.: 7:30-9:30
* Buffet style meals instead of trays
* Consistent staffing with staff meetings sharing ideas in a learning circle
* I also read that having a staff member be assigned to a resident as a "best friend" can make life have more meaning. We all need a best friend even when old and sick.

Small group activities that:

* Engage
* Innovative
* Inspire

Here are some fun activities that bring smiles and a sense of what life was before being in long-term-care

* Pie eating contest
* Dog shows
* Brewing beer
* Wine tasting
* Pajama day for staff
* Make dog biscuits
* Have car washes
* Husk corn
* Make salads
* Make pies

* Have evening activities. Not everyone wants to just sit in front of the TV or go to bed. Older adults do have social lives and activities after dark when they are home. They should also have this pleasure in long term care.

Volunteers need purpose to keep them, so don't give them silly meaningless activities. I have volunteered often where I know if I were to stop tomorrow, no one would even miss me. Make the volunteer an important member of the team and they will stay.

Have more moments

* On the day of each resident's birthday have the resident have their own gift and their own cake. In "real" life we don't have a group birthday cake at the beginning of the month. We wake up to the joy of our own special day. Residents of long term care deserve the same.

We all need something to:

* To do
* To care for
* Care about
* To love
* To hope for

In Foster Homes some of the activities could be:

* Real life activities like polishing the silver, combing the dog etc
* Scrabble
* Cooking fun where "usual" life returns
* Copy what we do at our homes like making a bed, feeding the bird and more
* Ask residents what they like and incorporate those likes into their lives

Monday, May 24, 2010

Trying to Find Retirement in Brookings, Oregon



I've closed my website for Winchuck River Store, pulled out of a local shop where I was selling and compromised by placing my items in an antique mall where working time is minimal. I can now spend more time with mom, work in my garden and enjoy our home near Brookings, Oregon.

The reason for all of this movement or lack of movement is that I brought my mother home from Long-Term-Care. She was on 5 mind altering drugs. I had lost all trust that she was taken care of in a dignified and even sound medically manner. I am now responsible for the care of my mother. I have hired a friend to watch over her when I need to leave; which is working out very well.

My mother's "sitter" loves to chatter and mom loves her for chattering. What a union made in Heaven! Taking all but one mind altering drug away from mom has restored her memory and level of function. She is no longer in need of "memory care"!

I have become a Ombudsman for the state of Oregon as a result of my frustration and need to learn all that I could about long term care. I am glad that I have had the experience I did with mom, as it makes me more alert to potential problems in long term care. I do not assume that all is well. I'm more likely to say...hmmmm...what is really going on here? I'm here for anyone who may be searching for answers to any long term care problems. If I cannot personally help, I do have some sources that possibly could.

We lost two of our labs to illness and old age this past year. In late December, we found a girl in need hanging out in Gold Beach at the dog shelter. Marley, a Wired Hair Pointing Griffon, is now just 2 and beginning to simmer down. Her previous family apparently spent a fortune on her (her breed runs 1K or more), didn't socialize her or train her and gave up after 1.5 years. I imagine she was stuck in a small backyard alone and ate it for something to do and chewed on their smaller dog! She was very aggressive with our other dog, Maggie, which shows her lack of socialization let alone good manners. I rushed to learn all I could about getting rid of anyone's need to eat another living being. Maggie was also guilty of wanting to rid the world of Marley's presence. I rushed to get on Cesar's website, read other internet information and bought two books one on dog body language and one on aggression. It paid off, with two girls that actually play together and enjoy a run in the woods together. I got the help of my husband and the two of us did not let a side glance go unattended to. We were on those dogs like glue for well over a month...and then to less than glue and more relaxed even today! We both agree that the trick was also to walk and run those dogs together each and every day to get them bonded into our cohesive pack with us as the leaders. What power! I am a pack leader!!

Brenda Atwood's great book, Aggression in Dogs, which saved us from death on the Winchuck, can be found on Amazon.Com. I found much of what she wrote in her body language book repeated in Aggression in Dogs. I've learned to speak "dog" . It actually works to go into their world to communicate in a way that is very clear and not a bunch of run on sentences in our "foreign" human language hoping they get the meaning. I've learned to lick my lips and yawn to help a stressed girl relax a bit. I'm not yet sniffing butts and scratching my behind! LOL

and now that I am back on the blog, I will make an effort to update more frequently with what is going on in and around our world here on the Wild River's Coast of Southern Oregon.

We Welcome You to Our Blog!



We blog about our rural area in the Pacific Northwest . This blog is all about my life and the places where my mind wonders from day to day. Have fun reading and looking at pictures. We welcome comments.

Be sure to watch, just above this blurb, my husband, Jim, using his 10 foot hands-free electric fishing kayak

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Be sure to check out the separate blog to find out about our electric kayak, Kingfisher 10! You can find the blog at http://electrickayakkingfisher-10.blogspot.com . You can also read the features list on this kayak and purchase building plans and building kits at www.winchuckriverstore.com .

About Me

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We moved to our current home on the Wild River Coast of Southern Oregon from San Jose, CA. Our family consist of Jim and Karen, two dogs and two cats. Karen's passion is gardening. Jim's obsession is building electric powered fishing kayaks and fishing.