STAY ACTIVE STAY INDEPENDENT STAY ON YOUR FEET

Module 4: Additional areas of concern

Learning objectives Increased knowledge on the definition of a restraint as well as alternatives to using them More understanding on communicating with residents with dementia and how to decrease their fall risks Increased knowledge related to safe toileting practices

restraints Using the least amount of restraints is the best practice Address behaviors before considering the use of restraints Some alternatives to restraints: bed and chair alarm systems low beds moving the resident closer to the nursing station increased monitoring regular toileting assistance from family Retrieved from: Ref: Safer Healthcare Now! (http://www.saferhealthcarenow.ca/EN/Interventions/Falls/Documents/Falls%20Getting%20Started%20Kit.pdf

restraints Restraints that limit movement or decrease physical activity can: Cause Confusion Decrease mobility and muscle strength Cause physical agitation Address Behaviours - if the individual is restless/agitated, find out if they are cold, need to use the washroom, dehydrated, lonely, in pain, frightened, have an infection, started on new medication etc. Alternatives– employees need to use an interdisciplinary (multiple professionals) approach in order to keep work loads reasonable Retrieved from: Ref: Safer Healthcare Now! (http://www.saferhealthcarenow.ca/EN/Interventions/Falls/Documents/Falls%20Getting%20Started%20Kit.pdf

Communication tips for residents with dementia Use your knowledge of what the resident likes and dislikes, and their daily routine to discover the meaning behind their behaviors Pay attention to the resident’s non-verbal communication when they are speaking to you Reassure residents who are agitated and be positive. Remember there is a reason for the behavior Accept the resident’s reality and do not challenge it. Instead, redirect resident toward a positive thought or activity Reference: Alzheimer Society. (2010). Day to day series: Communications.

Communication tips for residents with dementia Be aware of your own non-verbal communication Use clear, plain language but avoid talking down to the resident Use non-verbal communication with residents who do not understand verbal communication Use touch when appropriate to show reassurance Use a positive photograph or video with calming scenes Speak softly, read to the resident or play music that they enjoy ***CHANGES*** Removed second point for non verbal – we have a no sent policy Reference: Alzheimer Society. (2010). Day to day series: Communications.

SAFE TOILETING Using safe toileting practices can help reduce the risk of falls The bathroom should be well lit, especially at night. A night light is a good option to guide residents in the dark Remind residents not to hold onto the sink, door frame, or any other unstable support when walking to the bathroom. Encourage the use of mobility devices if needed Residents should be encouraged to use the grab bars on either side of the toilet to help in sitting and/or standing from the toilet. This will provide stability and help maintain balance Retrieved from: Ref: Safer Healthcare Now! (http://www.saferhealthcarenow.ca/EN/Interventions/Falls/Documents/Falls%20Getting%20Started%20Kit.pdf

SAFE TOILETING Toilet seats need to be at an appropriate height for each resident Low toilet seats can cause problems for residents when transferring to and from the toilet because they may have difficulty bending down and have less lower body strength High toilet seats can cause unsteadiness when sitting if the resident cannot place their feet on the bathroom floor Toilet safety frames, commodes, or raised toilet seats can be used to increase the height of the seat Always make sure the clamp or locking mechanism on the toilet seat, frame, or commode is secure and stable for use Retrieved from: Ref: Safer Healthcare Now! (http://www.saferhealthcarenow.ca/EN/Interventions/Falls/Documents/Falls%20Getting%20Started%20Kit.pdf

SAFE TOILETING Applying a toileting schedule can prevent residents with poor mobility and balance from trying to go to the bathroom unsupervised A call bell should be within easy reach for the residents in case they need assistance Retrieved from: Ref: Safer Healthcare Now! (http://www.saferhealthcarenow.ca/EN/Interventions/Falls/Documents/Falls%20Getting%20Started%20Kit.pdf

Module 4 Quiz

Which of these recommendations is NOT an alternative to using restraints? Monitoring the resident more closely Moving the residents room closer to the nursing station Using bed rails when the patient is in bed Bed and chair alarm systems

ANSWER Which of these recommendations is NOT an alternative to using restraints? c) Using bed rails when the patient is in bed

Choose the most correct answer: Restraints that limit movement or decrease physical activity can…. ? Help a person sleep Decrease muscle strength Cause dehydration Be a positive reinforcement

ANSWER Choose the most correct answer: Restraints that limit movement or decrease physical activity can…. ? b) Decrease muscle strength

Which of the following is NOT a tip for communicating with residents with dementia? Provide reality teaching Provide reassurance when the resident is agitated Pay attention to non-verbal communication Look for meaning behind the resident’s behaviour

ANSWER Which of the following is NOT a tip for communicating with residents with dementia? Provide reality teaching

Which of The following are important communication strategies when interacting with residents with dementia? Use clear, plain language being careful to not talk down to the resident Use appropriate touch to provide reassurance Speak softly, read to the resident or play music All of the above

ANSWER The following are important communication strategies when interacting with residents with dementia ? d) All of the above

Modules created by: North Bay Parry Sound District Health Unit Please fill out the evaluation form here

References Safer Healthcare Now! (http://www.saferhealthcarenow.ca/EN/Interventions/Falls/Documents/F alls%20Getting%20Started%20Kit.pdf Alzheimer Society. (2010). Day to day series: Communications.