• Health officials concluded that the death was the result of the nursing home’s failure to properly assess the residents’ ability to consume solid foods
• The Jury felt there was confusion in terminology utilized for the types of diet available
• The resident choked to death before nursing home staff could dislodge the food – the jury recommended staff training after the resident choked to death

ASK THE FOLLOWING QUESTIONS OF YOUR FACILITY:

Q: Do your residents get put on vitamised diets and thickened fluids ‘just in case’ thinking that this is the safest option?
A: Depending on the type of dysphagia this can actually increase the risk of aspiration

Q: Are your nursing staff trained to assess the three stages of swallowing and to recognize the signs and symptoms of dysphagia?
A: Specific training is required in identifying the signs and symptoms of dysphagia, as well as procedures for practicing safe swallowing management

Q: Do your kitchen, nursing, and care staff have an understanding of the Australian Standards for Fluid & Food Modifications?
A: Resources (e.g. – posters) and training to ensure modified food and fluid terminologies are clearly understood should be used, as this can help ensure accurate preparation of texture modified food and fluid consistencies at each meal.

Q: Have your staff received training on safe feeding strategies and choking management?
A: W&L can provide training to increase knowledge of safe feeding strategies, which may prevent malnutrition, dehydration, aspiration, and pneumonia

FAILURE TO UNDERSTAND THE SIGNS AND SYMPTOMS OF DYSPHAGIA MAY LEAD TO ASPIRATION, CHOKING DEATHS AND NURSING HOME NEGLIGENCE… FOR WHICH FACILITIES AND NURSING STAFF MAY BE HELD LIABLE

Statistic: Between 40-60% of nursing home residents have swallowing problems… but only 22% are referred to a Speech Pathologist for an evaluation!

STAFF TRAINING INCREASES RESIDENT SAFETY AND REDUCES LIABILITY

Call Wellness and Lifestyles on 8331 3000 to book a speech pathologist or training session today!

Recently mobility scooter usage has come to the fore in the media, associated with terrible accidents and fatalities. In fact, 62 Australian’s, aged in their 60’s to 90’s, have died from mobility scooter collisions or falls, with the injury figures reaching into the hundreds each year.  Whilst trying to avoid the title of “a nanny state” and over-regulation, without suitable testing, or some degree of licensing, mobility scooter drivers can present significant dangers to themselves and other road users.

On the upside they can be customised to suit many conditions for those at risk of isolation in the community, including:

• Carrying oxygen cylinders
• Carry baskets for shopping/walking sticks
• Sun or rain canopies
• 4WD or uneven terrain options

A scooter permits the elderly, or disabled, to maintain a higher degree of independence through access and ease of movement within their local area, often covering a range of up to 40km. This allows users to access shopping centres, attend activities/ appointments or visit friends and neighbours.

However, to use a scooter safely requires a combination of good vision, hearing, balance, strength, concentration, situational awareness and co-ordination. It is recommended that potential users are able to:

• Control and steer the scooter
• Judge distances
• Recognise actual (and potential) hazards or obstacles
• Maintain balance on the scooter across different terrains
• Maintain a degree of comfort when seated for prolonged periods
• Concentrate for long periods of time
• React quickly to unexpected occurrences
• Demonstrate insight and patience (ie go slow when required)
• Be able to get on and off the scooter safely (and walk when off of scooter safely if required)

Risk factors such as medication that causes drowsiness will also effect whether the client is potentially safe to use a mobility scooter.

W&L offers both suitability screening and practical testing for mobility scooter and electric wheelchair users through our Occupational Therapists and Physiotherapists. Suitability screening will determine whether a candidate is appropriate to consider using a mobility scooter before any out lay of funds in required. Successful screening, allows you to move along to the next step.

Completion of the practical component will then provide you with an assessed recommendation regarding a clients safety level. This will ensure your duty of care is being maintained and reassure family members you are working in the best interests of your clients. Through W&L, scooter use is reviewed quarterly to our residential care clients with an annual re-assessment. This service can also be offered to those in the community for peace of mind regarding safety, whilst continuing to maximise independence.

W&L recommends once you’re safe to go, make sure to always:

• Stay visible to traffic
• Don’t drink and drive
• Wear a helmet
• Stick to the footpaths and use pedestrian crossings
• Drive to the conditions

Call W&L Australia for your assessment and training today.

Reference:

1. http://www.accc.gov.au/content/index.phtml/itemId/945577, Help cut scooter mobility accidents, accessed 03/01/2012

Read the rest of this entry »

Prepared by: Michael Peachey
Presented by: Wellness & Lifestyles Australia

Do you find that the way some staff are documenting is affecting your funding, or that they’re not always performing the interventions required? Especially when it comes to understanding the business rules, we commonly hear that carers:

• Can’t find the time
• They’re doing it but not documenting the interventions, or
• They just aren’t doing it as they don’t feel confident in providing these interventions

By keeping track of our sites’ validation results, we’ve determined that many sites do not have a good understanding of the ACFI business rules. This is a big concern, especially when a downgrade of only one category can result in a loss of between $9000 to $13,000 per year!

That is why Wellness & Lifestyles have created the ACFI Mobility Definitions & Assessed Need, which helps to solve these issues and problems.

What this training can do for you?

• Get all levels of staff on board to help maximize ACFI funding
• Improve your staff’s understanding of documentation requirements to maintain funding at validation
• Ensure that your staff know how to correctly provide the interventions to improve compliance and clinical outcomes
• Gain a better understanding of the ACFI business rules – learn a proactive approach to maximize funding whilst minimizing documentation

Included in this training is…

• An overview of the ACFI
• Documenting assessed needs
• Level of assistance – ACFI definitions
• Level of assistance – Definitions for Q1 Mobility
• Specifying levels of assistance
• Maintaining OH&S requirements and providing opportunity for maintenance or rehabilitation

Who should use this training?

You should go through this training if you have clients at your facility that aren’t a Medium or High in Activities of Daily Living, you’ve ever been downgraded in Activities of Daily Living, or you’re just concerned that you might not be getting the funding for services you’re already providing to your clients.

Some of the sites we’ve provided training to have previously claimed poorly in Activities of Daily Living because they just weren’t confident… even though they were actually providing the services. Now nearly every resident is maximised. This often leads to an increase in funding.

We’ve realized that not all staff at facilities need (or want) the same level of training regarding the ACFI and it’s components; the needs of care staff and clinical staff responsible for submitting the appraisals are quite different.

This session is set-out in a progressive format, where ACFI Business Rules and strategies build upon previous information, and are left to the end. It’s important for all levels of staff to have an understanding of the basics and how to do the interventions too, because we’ve found that the RN’s and CN’s providing mentoring and guidance to the care staff helps with job satisfaction and compliance.

Read the rest of this entry »

Prepared by: Daniella Kittel

Explaining the anatomy and spine and the impact which posture can have on your spinal health.

Do you want to know about correct posture and how it is important for looking after your spine? Do you want exercises which can help relieve pain, stiffness, muscle tightness of weakness around your spine? Do you want to improve your posture and your ability to sustain it in order to prevent spinal injury?

Pain along the spine is a common issue whether it is from prolonged sitting, repetitive movement or lifting.

By ensuring that the spine is moving properly and is not restricted by muscle tightness or weakness is important for preventing injury and reducing the wear and tear experienced by your spine.

With this comprehensive guide to postural exercises and spinal health, you will have an all in one guide to looking after you spine and addressing pain causing issues.

What this e-book can do for you!

• Give an understanding of the anatomy of the spine and surrounding structures
• Explain what structures can impact the spine and how this causes your pain or other symptoms
• Treat the imbalances around the spine by performing strengthening, stretching and stabilising exercises
• Show how you can help to improve you posture and prevent injury by keeping your spine mobile and supported.

Included in this e-book is:

• Spinal anatomy
• Impact of posture on spinal health
• Exercises for the neck
• Exercises for the upper and lower back

Who should use this e-book?

Anyone who experiences pain or stiffness around the spine would benefit from this e-book. This e-book is also important to anyone who relies on their spine for their work or lifestyle and needs to protect is from injury. By understanding the anatomy of the spine and how different structures can cause pain you will be able to loosen and strengthen your spine with appropriate exercises.

Therapists should refer to this e-book as a guide to their spinal care treatment in consultation with clients so they are able to set common goals and programs to achieve them. Therapists can provide their clients with a guide to their exercises complete with demonstrative photos and exercise explanations. Of course, the program is able to be modified to your client’s individual needs.

We realise that by just reading this book you are not going to be proficient in all aspects of spinal care.  Practical training by a specialist physiotherapist or occupational therapist is always recommended. Wellness & Lifestyles Australia can provide you with these therapists if needed. The book should only be used as a resource document following some interactive training. E-learning modules by W&L are also available.

To read the Postural Health & Spinal Exercises E-book, please log in below.

Many Registered ‘Treatment’ Nurses are now receiving specific training in carrying out complex pain management interventions, and can carry these out in accordance with prescribed directives; as per the ACFI User Guide either a registered nurse or an allied health professional may provide complex pain management and practice for a Directive-4a.

Physiotherapists specialise in the assessment and provision of modalities for the management of pain, stiffness, immobility, loss of function, etc. In order to ensure that these assessed needs are appropriately identified, many organisations are maintaining the assessment and prescription of directives as the role of the physiotherapist, and referring some of these interventions to the Treatment Nurses. The ACFI User Guide states that it is permissible for the service to be provided by a different health professional than the one who gave the directive, provided they are included in the list of health professionals who can undertake the service and are operating within their scope of practice.

Using this approach aged care facilities dramatically benefit, both clinically and financially, by having a combination of interventions in terms of complexity and/or frequency. This often involves a mix of Directive-3’s, Directive-4a’s, and Directive-4b’s. To achieve the 6-points from a Directive-4b, this must be performed by an Allied Health Professional. By utilizing a Treatment Nurse to complete the Directive-4a’s, then this potentially allows the Physiotherapist or Occupational Therapist to provide more Directive-4b’s, allowing sites to improve both from a financial and resident outcomes perspective.

Reference: ACFI User Guide
http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-acfi-1007-userguide.htm

The way to ensure that your residents are safe on their modified diet is to have them reviewed regularly; even if they look like they haven’t changed, they could still be at risk.

A vitamised diet and thickened fluids are not always the ’safe option’… they can actually be worse!

Speech pathologists promote nutrition, hydration, and pulmonary safety by assessing appropriate diet and fluid consistencies… eliminating unnecessary costs and work for your staff!

For more information call W&L on (08) 8331 3000 or visit http://www.wellnesslifestyles.com.au/

Prepared by: Daniella Kittel

Explaining the knee arthroscopy procedure and providing all of the important details you need to know for a successful rehabilitation.

Do you want to prepare yourself physically and mentally for your knee arthroscopy? Do you find that you have questions about the procedure and rehabilitation?

Knee arthroscopies are a relatively non-invasive surgery and often do not require long hospitalization.

Having a guide on how you should be caring for your knee at home and when you should be introducing activities like driving will be useful for the safe recovery of your knee and your peace of mind.

By having an up to date and comprehensive understanding of knee arthroscopies, you will be able to achieve the best results from rehabilitation.

What this e-book can do for you!

• Give an understanding of the anatomy and biomechanics of the knee joint
• Provide an explanation on what knee arthroscopy surgery involves and give some common variations
• Have an all you need to know to rehabilitation

Included in this e-book is:

• Knee anatomy
• Knee arthroscopy – indications for surgery
• Knee arthroscopy – the procedures and variations
• Advice and information for after an arthroscopy
• Explanation of correct walking technique
• Rehabilitation exercises after surgery stages 1 and 2

Who should use this e-book?

Anyone who has a knee injury or degeneration and requires knee arthroscopy surgery would benefit from this e-book. By having a clear understanding of the anatomy of the knee, what the surgery involves and what to expect, you will to well prepared for your surgery. By having a rehabilitation program you will be able to ensure that your knee makes a quick and safe recovery.

We realise that by just reading this book you are not going to be proficient in all aspects of knee arthroscopy rehabilitation. Practical training by a specialist physiotherapist or occupational therapist is always recommended. Wellness & Lifestyles Australia can provide you with these therapists if needed. The book should only be used as a resource document following some interactive training. E-learning modules by W&L are also available.

To read the Knee Arthroscopy E-book, please log in below.

Prepared by: Michael Peachey
Presented by: Wellness & Lifestyles Australia

Do you find that the way some staff are documenting is affecting your funding, or that they’re not always performing the interventions required? Especially when it comes to understanding the business rules, we commonly hear that carers:

• Can’t find the time
• They’re doing it but not documenting the interventions, or
• They just aren’t doing it as they don’t feel confident in providing these interventions

By keeping track of our sites’ validation results, we’ve determined that many sites do not have a good understanding of the ACFI business rules. This is a big concern, especially when a downgrade of only one category can result in a loss of up to $13,000 per year!

That is why Wellness & Lifestyles have created the Aged Care Funding Instrument Overview, which helps to solve these issues and problems.

What this training can do for you?

• Get all levels of staff on board to help maximize ACFI funding
• Improve your staff’s understanding of documentation requirements to maintain funding at validation
• Ensure that your staff know how to correctly provide the interventions to improve compliance and clinical outcomes
• Gain a better understanding of the ACFI business rules – learn a proactive approach to maximize funding whilst minimizing documentation

Included in this training is…

• How funding is determined
• What are the ACFI Domains
• The ACFI Cognitive Skills & Behaviours Domain
• The ACFI Complex Health Care Domain
• Proactively using ACFI Business Rules

Who should use this training?

You and your staff should go through this training if you have residents at your facility that you think are not maximised, you’ve ever been downgraded in any domain, or you’re just concerned that you might not be getting the funding for services you’re already providing to your residents.

Some of the sites we’ve provided training to rarely were resubmitting residents because they just weren’t confident… even though they were actually requiring much higher care than they were getting funding for. Now nearly every resident is resubmitted in a timely manner. This lead to an increase in funding of huge proportions!

We’ve realized that not all staff at facilities need (or want) the same level of training regarding the ACFI and it’s components; the needs of care staff and clinical staff responsible for submitting the appraisals are quite different.

It’s important for all levels of staff to have an understanding of the basics and how to do the interventions too, because we’ve found that the RN’s and CN’s providing mentoring and guidance to the care staff helps with job satisfaction and compliance.

Read the rest of this entry »