Social Services

COVID-19 has presented many unique challenges related to the completion of the Minimum Data Set (MDS) and care planning in general. The unique circumstances brought on by the pandemic as it relates to the MDS will be discussed. There will be a review of the appropriate ICD-10 codes for various COVID-19 situations and symptoms, and the RAI manual instructions for capturing isolation. We will also explore unique care planning tips and considerations related to the pandemic.

This session will examine depression in the elderly and how it is commonly present among elderly residents. Studies indicate that between 40%-60% of residents experience depression. If depression is so common, why does it go unnoticed and untreated? With the implementation of the Patient-Driven Payment Model (PDPM), “mood state” becomes an even more important factor in the reimbursement process. It’s time to develop realistic care plans that address this area of care. We need to move beyond the standard “provide emotional support” care plans, and develop individualized, person-centered interventions. This session will review specific care plan interventions through the use of individual resident case studies.

Bullying can happen in any number of places, contexts or locations. Studies suggest that most senior-to-senior aggression in long-term care settings is verbal abuse, and that men and women are equally likely to be the victim as well as the aggressor. With the range and seriousness of diagnoses of which residents are now being admitted into our facilities, we are seeing an increase in more aggressive bullying and altercations between and among residents. So, what do we do? In this session, discussion will focus on the typical traits of bullies, causal and risk factors, guidance regarding developing a culture for a positive living environment and recommendations for responding to incidents.

Residents and patients refuse care for a number of reasons, sometimes to the dismay and frustration of the interdisciplinary team. Balancing a person’s right to refuse care with facility responsibility can be tough. This presentation will address the regulations associated with refusal of care, the difference between refusing care and resisting care and why it matters, capacity determination and harm reduction strategies that emphasize motivational rewards. We will discuss concrete strategies that leadership can incorporate into facility clinical operations that support staff with these sometimes-difficult situations. Participants will learn a paradigm shift for thinking about refusal of care – and a different word to use – and suggestions to achieve person-centered care and defensible outcomes.

What happens when resident choices and decisions, family desires and directives, professional staff protocol and even personal staff feelings, collide and conflict? What happens when emotions and policies are confronted with very real, human situations? Do you make the right choice or decision? This session will provide an overview of ethics and values for a long-term care professional in the provision of aging services. It will provide professionals with a framework for making ethical decisions. Participants will be provided with actual resident scenarios/facility situations and divided into small groups to evaluate and discuss the problematic area, determine the best course of action and the appropriate established ethic standard that will support their decision.

Residents who exhibit combative behavior in long-term care pose care challenges to facility staff and other residents. Resident-to-resident aggression is a serious issue that has a significant negative impact on all residents involved. A primary risk factor is cognitive impairment. Caregiver education and training can enhance knowledge in identification of certain behaviors, which may preclude an actual combative episode. Careful resident assessment, along with recognition of individual resident triggers and observation of extrinsic factors, should be carefully considered. This informative session will provide common sense approaches and tools to help prevent combative resident-to-resident behaviors in your facility.

Communication is one of the most basic skills that staff need in order to successfully collaborate with families to achieve the best possible outcomes for residents and patients. Unfortunately, there are many ways for communication to get derailed, especially in times of crisis like a pandemic. This 90-minute presentation incorporates principles of trauma-informed care and communication during a crisis. We’ll discuss the difference between essential and therapeutic communication, a different perspective on anger, and things staff should never say but more importantly, what to say and do instead.

Health care staff are experiencing unprecedented levels of pressure in these unimaginable and frightening circumstances of a pandemic. Staffs are stressed not only at work but also at home and in their communities. When our stress response is on full alert at all times, we are at risk of mental, physical and emotional exhaustion, or even collapse. This session is uniquely crafted as a visual experience, not a lecture with slides full of bullet-points. Participants will learn to identify their individual stress responses and learn techniques to shift to a place of calm, and to strengthen their resilience. Woven throughout the session are principles of trauma-informed care that staff can immediately apply to themselves, residents and families. These are powerful principles in helping individuals in times of vulnerability and in challenging circumstances.

Attendees will hear the challenges faced by patients, families and the hospital when inappropriate transfers and/or involuntary discharges occur. Learn how to help your staff, residents, tenants, patients and families make better transfer decisions and how your organization can better prepare for often inevitable changes in conditions or emergencies that precipitate the need to be seen in emergency services. There will also be a discussion about the Iowa Physician Orders for Scope of Treatment (IPOST) law, including specific emphasis on what distinguishes it from advanced directives and surrogate decision-making. Attention will be paid to the “Comfort Only” designation, how it is distinguished from “DNR” and how this should direct care for patients.

More and more people who have dementia and their caregivers are discovering the many benefits technology can provide with stimulating activities, cognitive care and non-pharmacological behavior management. This enlightening session will review current innovations with the use of technology in the care of persons with dementia. Participants will gain a general understanding of available technology and how it can improve quality of life for residents, how to integrate technologies in the care of people living with dementia, and an overview of the impact and outcomes that technology can bring to those living with dementia.