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Wednesday, April 19, 2017

Strategies for bringing wellness to people with cognitive decline

Changes in cognitive processes are a normal part of aging. However, when cognitive changes become sufficiently severe and interfere with the ability to perform activities of daily living, then individuals may be beginning the journey along the stages of cognitive decline and dementia.
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To address such concerns, the International Council on Aging on Active Aging has released a new blueprint that lists 14 strategies with the aim of providing the most positive experiences for people with mild-to-moderate dementias. Both family members and and colleagues are considered within these implementation tactics, which include suggestions for programs and services, staffing, and physical environment.

The resource can be accessed here: http://bit.ly/2oLsod0


Monday, April 17, 2017

The Dementia Learning and Development Framework

The Dementia Learning and Development Framework was set in motion following an extensive regional scoping exercise which collated information on the type and volume of training currently available to staff in the region (North of Ireland). The exercise included an examination of the cost and accessibility of training programmes and existing levels of accreditation.

This Framework was also informed by best practice guidance and literature reviews, reviews of other frameworks and a programme of consultation and engagement with key stakeholders from June 2015 until January 2016. This included people living with a dementia, carers, professionals, academics and regulators who represented a range of agencies and professions.

To view the Framework, click here: http://bit.ly/2p9Rq6W

Wednesday, April 12, 2017

New Toolkit helps Canadian Long-Term Care Homes create palliative care programs

Tools for Change is a resource that was created by the Quality Palliative Care in Long Term Care (QPC-LTC) Alliance to guide long term care homes in Canada that are creating their own formalized palliative care programs.

The Alliance members developed a model of care for palliative care in long term care that is supported by multiple quality improvement interventions for implementing education, direct care, community partnerships, and policy and program development.

The toolkit outlines a model of care that was developed using literature on innovative practices and guidelines for providing palliative care and research data indicating the successes of the four long term care home that volunteered to be study sites.

In areas where long term care homes choose to do quality improvement, resources are offered to help homes develop or enhance their structures and processes and improve the delivery of palliative care.



For more information about the QPC-LTC Toolkit, click on the following link:



Wednesday, April 05, 2017

New study questions the use of antipsychotics to manage delirium in the terminally ill

The benefit of antipsychotics for the management of delirium in terminally ill patients has been called into question by a randomized trial in which 247 inpatients of a hospice or palliative care service with mild to moderately severe delirium were assigned oral risperidone, haloperidol or placebo every 12 hours for 72 hours.
Patients who received antipsychotics had more severe delirium, worse delirium-associated distress scores, more use of midazolam, more extrapyramidal effects and worse short-term survival.
The authors conclude that “antipsychotic drugs should not be added to manage specific symptoms of delirium that are known to be associated with distress in patients receiving palliative care who have mild to moderately severe delirium. Rather, management relies on ensuring systematic screening (given that two-thirds of people with delirium are not diagnosed on referral to palliative care), reversing the precipitants of delirium, and providing supportive interventions”.
To read the full study, click on the following link: http://bit.ly/2p0Dsjx 

Wednesday, March 29, 2017

AHRQ toolkit for hospital-acquired infections in long-term care

The updated AHRQ Toolkit To Reduce Catheter-Associated Urinary Tract Infections (CAUTI) and Other Healthcare-Associated Infections (HAIs) in Long-Term Care Facilities is designed to help long-term care providers improve practices that prevent these infections.
The toolkit includes instructional materials and resources on infection prevention best practices, including foundational infection prevention strategies, CAUTI prevention and antibiotic stewardship. Other topics are related to resident and family engagement, quality improvement and sustainability.
The toolkit includes the following sections:
  • Implementation
  • Sustainability
  • Resources
Each section of the toolkit contains customizable resources that can be used by long-term care facilities. These guides, tools, slides and video are all publically available and downloadable online.
To learn more about the toolkit and how you can use it in your organization, visit the following website: http://bit.ly/2o7qJid

Wednesday, March 22, 2017

Alzheimer’s Association offers online tools to empower people to live well with dementia

Living a quality life in the early stage of dementia is an individual choice. With input from people living with the disease, the Alzheimer’s Association has launched a series of online tools to help individuals cope with and live a better life with dementia.
The resources are meant to address five key components of early-stage dementia:
·        Life After Diagnosis – Watch video clips from individuals with dementia who reflect on their emotions after receiving a diagnosis and explain how they have come to accept it
·        You Are More Than Your Diagnosis – Explore unique aspects of your identity and create a personalized word cloud
·        Live Healthy – Discover how you can lead a healthy and balanced life with dementia
·        Maximize Your Independence – Determine your strengths and learn strategies for living an independent life, such as by identifying how much you want other people to help you
·        Live In The Moment – View videos from individuals who share how their diagnosis changed their outlook on life
To view the resource, visit the Alzheimer’s Association website at: http://bit.ly/2o4t3Tl

Wednesday, March 15, 2017

What is the role of healthcare assistants in administrating drugs to nursing home residents?

Older people in nursing homes are one of the most vulnerable groups in our society. Their medical and support needs are increasingly complicated: most care home residents are over 85 years old and have multiple comorbidities, including dementia and frailty (Office for National Statistics, 2014; British Geriatrics Society, 2011). Many rely on nursing home staff to meet their everyday needs, including taking prescription medicines (Centre for Policy on Ageing, 2012).

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Thus, it is important to adopt appropriate medication procedures in care homes (Alldred et al, 2009). To reduce the risk of harm associated with medicine administration, it is recommended that care home staff undertake appropriate training and development, and care home providers are clear on staff's roles and responsibilities (National Care Forum, 2013; 2011).

The National Institute for Health and Care Excellence (2014) has published guidance on all aspects of managing medicines in nursing homes. However, the role of healthcare assistants in administering medicines to residents of care homes is poorly documented, and whether they should be performing this task has been raised by managers and staff. Often the concern is whether administering medicines is legal, or appropriate, especially if there is a registered nurse in the care home.

Some key points include:
  • Nurses can delegate the administration of medicines to a care assistant, but they are accountable for making sure those medicines are administered correctly
  • Care workers should only administer medicines they have been trained, and are competent, to give
  • Any HCA accepting the delegated task must take responsibility for ensuring their actions are carried out safely and correctly
To read the full set of guidelines, click on the following link:
https://www.nursingtimes.net/download?ac=3024062

References:

Alldred D.P. et al. (2009). Care home use of medicines study (CHUMS): Medication errors in nursing and residential care homes- prevalence, consequences, causes and solutions. Retrieved March 13, 2017 from http://www.birmingham.ac.uk/Documents/college-mds/haps/projects/cfhep/psrp/finalreports/PS025CHUMS-FinalReportwithappendices.pdf

British Geriatrics Society (2011). Quest for quality. Retrieved March 14, 2017 from http://www.bgs.org.uk/campaigns/carehomes/quest_quality_care_homes.pdf

Centre for Policy on Aging (2012). Managing and administering medication in care homes for older people. Retrieved March 14, 2017 from http://www.cpa.org.uk/information/reviews/Managing_and_Administering_Medication_in_Care_Homes.pdf

National Care Forum (2013). Safety of medicines in the care home: Final project report- Phase Two. Retrieved March 14, 2017 from http://patientsafety.health.org.uk/sites/default/files/resources/safety_of_medicines_in_the_care_home_0.pdf

National Care Forum (2011). Medication safety in care homes: Project summary. Coventry: NCF.

National Institute for Health and Care Excellence (2014). Managing medicines in care homes. Retrieved March 14, 2017 from https://www.nice.org.uk/guidance/sc1

Office for National Statistics (2014). Changes in the older resident care home population between 2001 and 2011. Retrieved March 13, 2017 from https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/ageing/articles/changesintheolderresidentcarehomepopulationbetween2001and2011/2014-08-01

Spilsbury K. et al. (2017). Guidance on administration of medicines by care assistants in nursing homes. Nursing Times 113 (2): 26-28. Retrieved March 13, 2017 from https://www.nursingtimes.net/download?ac=3024062