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© 2018 Del Marie McAlister

Aged Care Services

           

Chaplaincy

Providing pastoral care services to help people feel comforted, cared-for, connected, and purposeful

Companioning

Offering support and friendship for people who are lonely

Counselling

Providing counselling services for seniors

Consultant

Pastoral Care, Grief, and Lifestyle & Leisure (Residential Aged Care)

Training

Workshops and seminars for employees on a range of aged care related topics (NEW ONE BASED ON APPLYING THE NEW ACCREDITATION STANDARDS)

Aged Care FREE Resources

Resident Survey (Based on the NEW Quality Standards)

Name: (optional) __________________________

 

1. I am treated with dignity and respect, my identity, culture and diversity valued

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER 

                                                                     

2. Care and services are culturally safe

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

3. I am supported to exercise choice and independence, including to: make decisions about my own care and the way care and services are delivered

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

4. I am supported to exercise choice and independence, including to: make decisions about when family, friends, carers or others should be involved in my care

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

5. I am supported to exercise choice and independence to make connections with others and maintain relationships of choice, including intimate relationships

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

6. I am supported to take risks to enable me to live the best life I can

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

7. Information provided to me is current, accurate and timely, and communicated in a way that is clear, easy to understand and enables them to exercise choice

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

8.  My privacy is respected, and personal information is kept confidential

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

9.  Assessment and planning, including consideration of risks to my health and wellbeing, informs the delivery of safe and effective care and services

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

10. Assessment and planning identifies and addresses my current needs, goals and preferences, including advance Care Planning and end of life planning if I wish

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

11. Assessment and planning is based on ongoing partnership with myself and others that the I wish to involve in Assessment, planning and review of the consumer’s care and services                                            ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

12. Assessment and planning includes other organisations, and individuals and providers of other care and services, that are involved in my care

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

13. The outcomes of assessment and planning are effectively communicated to the consumer and documented in a care and services plan that is readily available to the consumer, and where care and services are provided;

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

14. Care and services are reviewed regularly for effectiveness, and when circumstances change or when incidents impact on my needs, goals or preferences

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

15.  I get safe and effective personal care, clinical care, or both personal care and clinical care, that: is best practice

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

16. I get safe and effective personal care, clinical care, or both personal care and clinical care, that: is tailored to my needs

   ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

17. I gets safe and effective personal care, clinical care, or both personal care and clinical care, that optimises my health and wellbeing

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

18.  There is effective management of high-impact or high-prevalence risks associated with my care                                                ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

19. Deterioration or change of my mental health, cognitive or physical function, capacity or condition is recognised and responded to in a timely manner

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

20.  Timely and appropriate referrals to individuals, other organisations and providers of other care and services;             

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

21. I get safe and effective services and supports for daily living that meet my needs, goals and preferences and optimise my independence, health, wellbeing and quality of life

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

22. Services and supports for daily living promote my emotional, spiritual and psychological wellbeing

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

23. Services and supports for daily living assist me to participate in my community within and outside the organisation’s service environment

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

24. Services and supports for daily living assists me to have social and personal relationships

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

25. Services and supports for daily living assists me to do the things of interest to me

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

26. My meals are provided are varied and of suitable quality and quantity

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

27. Where equipment is provided, it is safe, suitable, clean and well maintained

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

28 The service environment is welcoming and easy to understand, and optimises my sense of belonging, independence, interaction and function

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

29. The service environment is safe, clean, well maintained and comfortable; and enables me to move freely, both indoors and outdoors

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

30. Furniture, fittings and equipment are safe, clean, well maintained and suitable

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

31. Me, my family, friends, carers and others are encouraged and supported to provide feedback and make complaints

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

32. I am aware of and have access to advocates, language services and other methods for raising and resolving complaints

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

33. Appropriate action is taken in response to complaints and an open disclosure process is used when things go wrong

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

34.  Workforce interactions with me are kind, caring and respectful of my identity, culture and diversity

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER


35. I am engaged in the development, delivery and evaluation of care and services and are supported in that engagement

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

36. The organisation’s governing body promotes a culture of safe, inclusive and quality care and services and is accountable for their delivery

ALWAYS | SOMETIMES | OCCASIONALLY | NEVER

 

Aged Care Articles

When a person is dying

The final stage of life on earth is a sacred and profound experience, that very few of us are prepared for. There is no specific path to follow, however there are some things we want to share with you that may shine some light on the pathway . We hope you find this helpful in explaining some of what to expect as your loved one is dying.

 

COMMUNICATION

Family members and friends may experience a number of emotions including sadness, helplessness or awkwardness. And that’s okay. Even if your loved one’s eyes are closed and they are unresponsive, it is most likely they still can hear you. I encourage you to say meaningful things such as expressing your love, thanking them for what they’ve done and sharing precious memories. When words fail, be assured that your presence alone can be meaningful, comforting and reassuring.

 

ATMOSPHERE

Music is a wonderful way to create a peaceful atmosphere. A fragrant oil diffuser can also help with the ambience. Photos and items of interest can be arranged beside the bed and comforting items can be placed in your loved one’s hands. Other considerations are, fresh air, light,  flowers, and having a pet present. This is a time for family and close friends,  however it is not uncommon for staff to pop in and pay their respects.

 

 CHANGES

There will most likely be a number of physical changes. Some of these may be:

Appetite: There is little or no appetite for food and fluids. Nursing staff will provide a small sponge. Feel free to use it to keep your loved one’s mouth moist.

Failing of organs: Organs such as the kidneys, the liver, and the lungs, are slowly shutting down.

Less alert: There is usually a decline in alertness. They may sleep a lot. Sometimes there is an unexpected rally. They may go in and out of consciousness.

Confusion: Sometimes the person becomes confused; this is called a ‘delirium’.

Restlessness: The person may make repetitive motions such as pulling at the bed linen or clothing or reaching out.

Circulation: Their circulation will slowly shut down, which causes their hands and feet to feel cool and sometimes there will be patchy purplish or blue colours on the skin. You may notice a blue tinge around their mouth.

Breathing: There are often changes in breathing when someone is close to dying. There may be increasingly long pauses in breathing. There may be a build-up of secretions in the lungs, which can be noisy (rattling or gurgling).

Sometimes there is a bowel and / or bladder movement. Sometimes they may vomit.

During this process try to remain calm and let them know they are not alone. Hold their hand, stroke their hair, and rearrange bedding so they are comfortable.

 

Nursing staff will administer pain relief, and take care of the clinical needs. Please don’t hesitate to ask them questions. Please don’t hesitate to press the ‘call’ buzzer for assistance at anytime, or the ‘assist’ for urgent assistance.

 

EMOTIONAL CARE

Every person’s dying experience is unique, so there are no specific expectations. Some of the common emotions are fear, uncertainty, regrets etc. It is important we allow them to express their emotions, and if necessary, ask someone you trust to help navigate these conversations.

 

SPIRITUAL CARE

If your loved one is associated with a particular faith group, ask the staff to arrange for a representative of that group to visit.

 

CULTURAL CARE

We respect each person, and understand their culture is very important. Therefore,  we encourage  placing items of cultural significance near your loved one, playing  specific music, and following their particular traditions surrounding death. Please communicate with staff to ensure these needs are being met.

 

SELF-CARE

It is important that during this time, and afterwards that you focus on looking after yourself. Some of the things to be aware of is to try to drink enough water to feel sufficiently hydrated, eat healthy food, exercise, and try to get plenty of sleep. We care for ourselves by doing things that bring comfort and nurture to our souls.

 

AFTER YOUR LOVED ONE HAS DIED          

The Registered Nurse will be summoned to the room to listen for the lack of the person’s heartbeat with a stethoscope to confirm the passing. The Doctor will be called to confirm the death and do the death certificate noting a funeral or cremation. The funeral director who has the government contract to transport people who have passed away, will take your  loved one to the morgue or the funeral home the family has chosen. The funeral director collects the information needed to register the death, and will send the relevant information to government departments.

 

EMOTIONS                                                                                                                                   You will most likely experience feelings of sadness. Some people feel relieved. There are numerous other emotions that people experience after the loss of someone they love. There is no particular sequence to them. No two people will grieve in the same way, with the same intensity, or for the same length of time. We all grieve differently and that’s okay.

 

We encourage you to find ways to feel supported and comforted. Another way to gain healing after experiencing such a sad loss is to find ways to tell your story. This can be done through journaling, art, social networking, attending a support group, chatting with caring friends or by seeing a counsellor.

We would like to extend our heartfelt condolences as you grieve the passing of your loved one.

Del Marie McAlister (Chaplain, Aged Care Consultant)

A sense of purpose

When a prominent rugby player retired, he became very depressed. I remember seeing him next to me in a car at the traffic lights and he looked really sad. Everyone couldn’t understand why such a popular man could feel so unhappy. Then it dawned on me. A contributing factor would most likely have been that he’d lost his sense of purpose. Thankfully he bounced back and became a mentor for young men who were struggling with depression.

If we haven’t a sense of purpose, life becomes dull and aimless, and there is the potential of social isolation, loneliness, and even depression. On the other hand, a sense of purpose boosts self-esteem, causes positivity, and makes people feel happier. It gives them a reason to get out of bed in the morning.

One of my first observations when I embarked on a career in aged care, was the feeling I’d entered God’s waiting room, and people were biding their time until they passed away. Studies have revealed that half of all the people in residential aged care homes have depression. This culture disturbed me. From that moment on, I decided to focus my career on helping the aged find a sense of purpose.

So how can we provide our clients with a sense of purpose? The only way to do this is by getting to know the residents, listening attentively to them, and having conversations with them and their relatives. I would like to share some of the ideas I have found successful in achieving this. They are so simple, yet really effective.

1. The knitting group was floundering and I wanted to provide the women who were involved in a project that would give them a sense of purpose. I phoned the local men’s homeless shelter to ask if they’d appreciate some blankets and they said they definitely would. We had lots of scraps of wool and plenty of knitting needles, so we embarked on a project on making knitted squares for blankets for the homeless. The group swelled in numbers, and even people who were not part of the group jumped on board. They gained a sense of purpose by doing something for others.

2. Small jobs like settling and clearing the tables, and folding tea towels give some people a sense of purpose.

3. When the Postcard Exchange idea was launched, I asked one of our residents who was very interested, to be in charge of it. The smile on her face was priceless. She really enjoyed looking after the mail that came, sorting it out and finding suitable cards and postcards to send.

4. One man who loves music was severely depressed. I gave him the responsibility of choosing a musical DVD for each of our ’Musical Movie Evenings’ and he dramatically improved. Even a mental health professional who visited him was impressed with how happier he was due to his new role. He had found a sense of purpose.

5. We had a resident who after her morning walk would come back carrying a bunch of flowers in her hands. An event was coming up where we needed some floral arrangements. We asked her if she could be in charge of the floral arrangements and she was so happy. She is usually someone who sits on the fringes of activities, but not this one! She literally blossomed!

6. A new lawn had been laid and a new resident was very active and a keen gardener. She mentioned that no one was watering the grass. A quick word to the gardener, and a suggestion that she take on this role, provided her with a sense of purpose. (By the way the grass is looking great now).

7. I had planned an activity one morning that was more suited to residents who were cognitively able to participate when I looked up and realized the staff from the dementia area were bringing their residents to join in. Not wanting to exclude them, I had to think fast. I remembered we had some boxes of donated cards (birthday, Christmas etc.). I gave each resident a pile and asked if they could please sort them out.  They thoroughly enjoyed this task. They felt like they were doing something worthwhile and important. They spent over two hours looking, sorting, and chatting.

8. We had a resident who would often say “I can’t” due to mobility and cognitive issues. One day we were playing balloon table tennis with noodles and I suggested she join in, and she replied with “I can’t”. She is usually then taken to her room by care staff, or plonked in front of a television. I thought it would be better for her to be involved in a social activity, as some behaviours associated with social isolation were beginning to manifest including shouting out ‘nurse’ from her room constantly. I suggested she become the supervisor. She told everyone that morning that she was ‘the supervisor’ with a big smile on her face. This made her feel really important.

“The mystery of human existence lies not in just staying alive, but in finding something to live for.” Fyodor Dostoyevsky

We started a choir

I'll never forget  the exact moment. It was my first week of working as a recreational activities officer, and I heard a man singing in one of the lounge rooms. I walked in and sat down and listened. A few other residents gathered around; some joined in singing along with him. After a few numbers, the group who’d gathered enthusiastically applauded the singers. In the spur of the moment I blurted out ‘Let’s start our own choir’ and the response was a resounding ‘Yes’!  The management, staff, residents and of course our leading singer were thrilled when I presented my proposal.

I decided we would use a smaller room (not the main entertainment room) for our practices, as I wanted to make it really special for them as opposed to just having a sing along together, and besides it had great acoustics.

 

When we began, we had no instruments and no piano player. So instead, we would sing along with CDs. Eventually one of the choir members purchased a guitar for me to play, and a year later a pianist joined us. Additionally, I scoured the local op shops and garage sales for instruments and we purchased several bongo drums (which they really love playing!).

It didn’t take long for the word to get around, and now we have not only residents in the choir, but our choir consists of people from the independent living units and a couple of members of our local community. We meet every Monday afternoon and have a concert once every couple of months.

But this is no ordinary choir!  Our concerts are a variety show that include solo items and even drama! The best concert we ever did was for the Queen’s Birthday. We wore red, white and blue clothing and sang Rule Britannia, God Save our Gracious Queen, etc. We chose one of the ladies from our independent living community to dress up as the Queen. When I asked her, I had no idea what would happen. Well, she arrived on cue, all dressed up like the Queen in a lemon outfit complete with hat, gloves and pearls!  She even did the royal wave, which she’d been practicing for weeks! She was perfect for the role and everyone thoroughly enjoyed the event as they munched on their cucumber sandwiches.

 

The other highlight was our Christmas concert last year where we did a combined performance with a local school choir. It took a lot of organizing but on the day they sang so beautifully together that there were very few dry eyes in the large audience that attended.

 

Ideas to run a successful choir in residential aged care

Here are some ideas about starting and running a choir:

  • You will need other staff members and volunteers on board. It’s very difficult to conduct a song, turn pages of a song book and attend to other needs all at once!

  • We do not hold auditions. Everyone is welcome and when new people come to live at our care facility, we ask them when we do their assessments if they’d like to join the choir.

  • We choose songs from their era so they are familiar with them.

  • We promote each concert by including notices in the internal magazine, displaying posters and handing out individual invitations.

  • We provide the lyrics of the songs for the concerts in booklet form with big font.

  • The residents sit during practices and performances.

  • Water is always provided at all practices and concerts.

  • We never have too many songs as we want our residents to feel exhilarated not exhausted.

  • We always encourage the audience to join in and sing along with us at our concerts.

  • We sometimes include a themed afternoon tea after a concert.

  • We invite family members and friends to attend.

  • We include snippets of information as part of each performance (eg: for the ANZAC choir concert some choir members shared some memories.)

  • We asked the local op shops and members of the community for music books which they kindly donated. These are filed in labelled boxes for easy access.

  • It takes a team to run a successful choir. We now have a conductor and a pianist. We meet together to plan our concerts and they have come on board as volunteers and are just as enthusiastic as the choir members themselves.

 

Concert ideas

Some of the concerts we have done are:

  • Harmony Day (we sang songs from other countries)

  • Queens Birthday

  • Easter

  • Christmas

  • Our favourite hymns

  • Valentine’s Day

  • St Patricks Day (Irish songs)

  • ANZAC Day (wartime songs)

  • Country / Western

  • Australia Day

 

We also did a humour concert where we sang funny songs (such as ‘Old McDonald had a farm) and happy songs (such as ‘When your smiling’) and we are currently rehearsing for a concert based on colours.

 

Singing together is good for our residents. The benefits of singing in a choir are many. Not only are friendships formed and strengthened, but it also ‘fires up the right temporal lobe of our brain, releasing endorphins that make us smarter, healthier, happier and more creative. When we sing with other people this effect is amplified” according to research. (1) In her book ‘Imperfect Harmony: Finding Happiness Singing with Others’, Stacy Horn says singing creates ‘an infusion of the perfect tranquilizer – the kind that both soothes your nerves and elevates your spirit.’(2) I’ve seen this happen on our choir on a weekly basis. As soon as they start to sing there’s an atmosphere of well-being and happiness in the room. The smiles on their faces are well worth the effort.

Five years on, and I no longer work at this facility. I did however have the privilege of being a guest at one of their concerts. Yes, they are still going.

1. http://upliftconnect.com/neuroscience-of-singing

2. Ibid

MORE TO COME - PLEASE BOOKMARK AND VISIT THIS AGE REGULARLY