All posts by aoadmin

Risk of Falling for Elderly Nursing Care Plan

Elderly Falls and Trips

In the United Kingdom, the number of patients readmitted to hospital after treatment for a fracture had risen significantly since 2008/9.

Click here for the comprehensive falls risk assessment

Trips and falls can be a major hazard for any elderly person.  A fall can have serious and life changing implications for a patient, and the fear of falling can impact negatively on their lifestyle and the activities they enjoy.

It is vitally important that a comprehensive falls risk assessment is completed for all patients and any issues associated with, or increasing, the risks of falls are identified.

This risk assessment must be reviewed at least monthly or more regularly  if the patient’s condition changes, because any deterioration or slight changes in the patient’s condition can increase their risk of falling.

The objective of any person centred Care Plan is to ensure the patient’s issues and needs are set out in great detail and are very much at the core of the Care Plan.

The starting point is a detailed consultation with the patient and their relatives. Any issues which might increase a patient’s risk of falling are discussed and a plan to address the issues is formulated and agreed.

Many factors can increase a patient’s risk of falling, such as their mental state and the impact that may have on memory and poor or impaired eyesight.

Hearing difficulties can sometimes cause balance problems also increasing the risk.

A patient’s mobility, steadiness and gait and any issues they have with that, or an inability to ask for  help, can increase the risk of falls.

Any medication which causes drowsiness including sleeping tablets may result in  falls.

A patient’s room and day rooms must be kept clear of potential trip hazards and where possible the patient should wear well fitting shoes, and not slippers, even though they may be more comfortable.

You should consider any of these issues which are causing an increase in the risk of falling and where possible suggest or agree a plan which will address or improve the issues and record this.

Anything, however simple, that can be done to help should be recorded and implemented, such as ensuring the environment is free of clutter and ensuring a call buzzer or alarm is given to the patient.

Safety of the patient is of course paramount, and a key consideration when preparing this Care Plan.

You need to look at ways of ensuring the patient’s safety, which may involve the use of a pressure mat next to the bed to alert staff when the patient gets up, bed rails to prevent a patient falling out of bed or a lap strap in a wheelchair.

Any form of restraint must be assessed as a benefit to the patient and agreed with the patient and relative. You need to record your assessment in detail.

You need to look at any equipment which the patient will be using, such as a zimmer frame or walking aid and assess what risks they might have by using them.

When considering the issues central to a falls Care Plan, you need to strike the right balance, and look at what risks prevail in promoting and encouraging the patient’s independence, but at the same time minimise as far as possible the risks of falling.

4813-stressed-nurse

Nurses in Britain are Buried by Paperwork

Nurses in Britain are Buried by Paperwork

Nurses in Britain buried in paperwork planningforcare.co.ukNurses in Britain spend an estimated 2.5 million hours a week on “non-essential” paperwork that’s where Planning for Care can help

The Royal College of Nursing believes nurses are burdened with too much paperwork and too many targets.

I think every nurse would support that belief.

The view adopted by the inspectors and auditors appears to be ‘if it’s not written down, it’s not happening.’

In reality, there can be a well written Care Plan but the quality of care might bear no resemblance to what is set out within the Care Plan.

Nurses would much rather spend their time caring for patients or residents than completing paperwork such as care plans.

Unless nurses are producing excellent Care Plans, Care Home grades will suffer.

30 years ago written Care Plans did not exist, but the care delivered was, in the main, very good or excellent.

Perhaps this was because nurses did not have to spend much of their time producing the volume of paperwork that is necessary today.

I do very much believe in the benefit of care plans today.

It is the way forward and if written well, can really have the capacity to have a substantial effect and improve the quality of care.

Documentation is a crucial aspect of care, which facilitates the continuity of care and it forms an accurate record of care provided. It is now vitally important that the quality of resident’s care and nursing documentation is of the highest standard.

How Our Care Plans Can Help

A good system of Care Planning undoubtedly can help the nurses and carers complete the paperwork far quicker and more comprehensively.

A system of personalising care planning for the elderly, which Planning for Care provides, can vastly improve the delivery of care and help Care Homes improve the grading they are awarded by the Care Inspectorate by helping them meet their regulatory requirements.

“The challenges facing everyone in the care sector are growing exponentially with constant changes in law, increased regulation and the potential threat of litigation.”

The focus on nursing appears to have changed and, instead of it being a wonderful, satisfying and fulfilling occupation, it is now very much a race against time.

It is in everyone’s interest that the standards of care improve.

The National Health Service, and nurses in Britain are wonderful institutions which have to survive and flourish.

Progress is a great thing, but there needs to be a balance to ensure there is no deterioration in the very core standards and values of nursing. We need to rethink the path we are taking.

The days of placing massive importance on positioning each pillow case with the closed end facing the entrance door of the ward have gone!

But was it really such a pointless exercise?

In those days every nurse knew every detail about every patient, and every aspect of patient care was delivered with precision and thought.

Patient care may have been delivered in a task orientated way, but attention to detail was everything.

The pride nurses had in their job was tangible.

A mixture of the nursing cultures of yesteryear and today is, I think, needed to help elevate nursing to the high standard of profession it should be.

View our free sample Care Plan or our full range of Care Plans here. 

Music can be an Amazing Therapy for Dementia

Dementia and Music

In my experience music can reach many individuals who suffer from dementia in a very special way.

We asked families to tell us the resident’s favourite music which we recorded onto an ipod, the music was specifically chosen for them.

For some residents it had a remarkable effect.

For one gentleman who had very little interaction with his wife or carers, and very little interest in anything it has given him a real interest in something. He is much more expressive and animated, he now communicates with everyone.

His wife admitted that when we first asked her about trying this, she was really sceptical.

She said recently she cannot believe the difference in her husband, he is much more happy, he is showing a real interest in something and his quality of life has improved dramatically due to the music.

An improved or good quality of life for any elderly person should be every nurses or carer’s goal.

Music has dramatically improved many resident’s quality of life, It has been wonderful for the person and very special for their families.

Music has power especially for individuals with Alzheimer’s disease and related dementias.

It can spark compelling outcomes even in the very late stages of the disease.

When used appropriately, music has the power to change mood, manage stress-induced agitation, stimulate positive interactions, facilitate cognitive function, and coordinate motor movements.

This happens because rhythmic and other well-rehearsed responses require little to no cognitive or mental processing.

A person’s ability to engage in music, particularly rhythm playing and singing, remains intact late into the disease process because, again, these activities do not mandate cognitive functioning for success.

Most people associate music with important events and a wide array of emotions.

The connection can be so strong that hearing a tune can evoke a memory of the event and take the person back to that time and place.

Prior experience with the piece is the greatest indicator of an individual’s likely response.

Music that is soothing for one person may remind another of the loss of a loved one and be tragically sad.

If the links with the music are unknown, it is difficult to predict an individual’s response.

Therefore, observe a person’s reaction to a particular arrangement and discontinue it if it evokes distress, such as agitation, facial grimaces or increasing muscular tension.

It is such a simple idea but is really worth trying as it can make a difference.

Click here for a person centred Nursing Care Plan for dementia.

Nurses in Britain spend an estimated 2.5 million hours a week on “non-essential” paperwork – Planning for Care Can Help

Britain’s nurses spend an estimated 2.5 million hours a week on ‘non-essential’ paperwork and clerical tasks, according to research.

The Royal College of Nursing believes nurses are burdened with too much paperwork and too many targets.

I think every nurse would support that belief.

The view adopted by the inspectors and auditors appears to be ‘if it’s not written down, it’s not happening.’

In reality, there can be a well written Care Plan but the quality of care might bear no resemblance to what is set out within the Care Plan.

Nurses would much rather spend their time caring for patients or residents than completing paperwork such as care plans.

Unless nurses are producing excellent Care Plans, Care Home grades will suffer.

30 years ago written Care Plans did not exist, but the care delivered was, in the main, excellent.

Perhaps this was because nurses did not have to spend much of their time producing the volume of paperwork that is necessary today.

I do very much believe in the benefit of care plans today.

It is the way forward and if written well, can really have the capacity to have a substantial effect and improve the quality of care.

Documentation is a crucial aspect of care, which facilitates the continuity of care and it forms an accurate record of care provided. It is now vitally important that the quality of resident’s care and nursing documentation is of the highest standard.

A good system of Care Planning undoubtedly can help the nurses and carers complete the paperwork far quicker and more comprehensively.

A system of personalising care planning for the elderly, which Planning for Care provides, can vastly improve the delivery of care and help Care Homes improve the grading they are awarded by the Care Inspectorate by helping them meet their regulatory requirements.

“The challenges facing everyone in the care sector are growing exponentially with constant changes in law, increased regulation and the potential threat of litigation.”

The focus on nursing appears to have changed and, instead of it being a wonderful, satisfying and fulfilling occupation, it is now very much a race against time.

It is in everyone’s interest that the standards of care improve.

The National Health Service is such a wonderful institution and it has to survive and flourish.

Progress is a great thing, but there needs to be a balance to ensure there is no deterioration in the very core standards and values of nursing. We need to rethink the path we are taking.

The days of placing massive importance on positioning each pillow case with the closed end facing the entrance door of the ward have gone!

But was it really such a pointless exercise?

In those days every nurse knew every detail about every patient, and every aspect of patient care was delivered with precision and thought.

Patient care may have been delivered in a task orientated way, but attention to detail was everything.

The pride nurses had in their job was tangible.

A mixture of the nursing cultures of yesteryear and today is, I think, needed to help elevate nursing to the high standard of profession it should be.

Elderly ‘reluctant to complain’ over health care

Elderly people are reluctant to make complaints about poor health care or do not know how to, the Parliamentary and Health Service Ombudsman says.
A report suggested 56% of people aged over 65 who experienced a problem did not complain because of worries about how it might impact future treatment.
Nearly 20% did not know how to raise a complaint, it said, while a third felt complaining would make no difference.
Ombudsman Julie Mellor said it could mean some are “suffering in silence”.
That could “lead to missed opportunities to improve the service for others”, she added.
The research involved a national survey of almost 700 people over the age of 65, as well as focus groups and case studies.
‘Proactive approach’
One carer in Manchester told authors: “When people have a problem they don’t know where to go; they are referred to a computer which they don’t have; they are referred to a library which is too far away to get to… (and) they wouldn’t know what to do anyway.”
The report recommended a more proactive approach from NHS providers, saying they should make sure all users know how to complain and are reassured there will not be repercussions.
It said progress had been made, including through steps by the government to explore a new streamlined public ombudsman service to handle complaints.
But Age UK said the research was a cause for concern.
Charity director Caroline Abrahams said: “Seeking and responding to older people’s views and experiences is crucial if we are to prevent future care scandals like those that have too often blighted our hospitals and care homes in recent years.”
Healthwatch England said a universal, independent complaints advocacy service that was easy to find and simple to use would improve the situation.
A spokesman said: “We know the NHS is under pressure at this time of year, it is therefore vital that if things do go wrong patients are informed how to raise concerns and how to get help to do so if they need it.
“Without this support, thousands of incidents will continue to go under the radar every year and mistakes will never be learnt from.”
Source BBC News

NHS ‘TripAdvisor’ to let families check care home quality: Site will allow reviews from other families and show ratings that inspectors have given

Families will be able to check the safety and quality of every care home in the country on a new TripAdvisor-style website run by the NHS.
They will be able to see if homes have been rated good or inadequate by inspectors and read critical reviews from other relatives.
The site is being launched by the Government amid concern that as many as a third of care homes in England fail to meet basic standards.
At the worst, inspectors have found patients calling for help, left severely dehydrated or with ‘worrying’ bruises.
From today, the details of all 17,000 care homes in England will be published on a section of the NHS Choices website.
Each will have an overall rating of outstanding down to inadequate, based on the most recent inspection by the Care Quality Commission.
But relatives will also be able to award their own scores out of five and write reviews, similar to those on the TripAdvisor website for hotels and restaurants.
There will be nothing to stop care home managers giving themselves glowing reviews under the guise of members of the public. Staff or relatives with a grudge against a home could also post bad reviews unfairly.
However, officials at the Department of Health say comments will be checked before they go online to ensure they are not offensive and the website will be constantly monitored.
Ministers hope the site will drive up standards by encouraging the worst-rated homes to improve, or relatives will be unlikely to choose them.
 The Mail has repeatedly exposed failings in residential care as part of our Dignity for the Elderly campaign.
Health minister Alistair Burt said: ‘This is a victory for those who are worried about care. With a click of a button, the public will be able to make an informed choice about care.
‘This data will show clearly the difference in quality across care homes and will help drive up standards by highlighting poor performers, which will mean they have to shape up their services or lose out.’
The Government claims the website will make England the first country in the world to provide families with so much information about care homes.
Figures from the CQC show 36 per cent of residential care homes inspected so far have been graded as inadequate or requiring improvement.
The situation is even worse for nursing homes caring for frailer patients, with 55 per cent deemed inadequate or requiring improvement based on recent inspections.
The CQC’s chief inspector of adult social care, Andrea Sutcliffe, has admitted that ‘week in, week out, our inspectors discover some truly awful care’. At the worst homes, they have found residents with ‘worrying bruises’ or dementia sufferers with ‘malnutrition or life-threatening dehydration’.
In an interview earlier this year, she said there was a ‘shocking lack of respect for people’s dignity’ in the worst homes.
‘Sometimes it is abuse – older people treated roughly, worrying bruises that have no explanation,’ she said. ‘Sometimes it is neglect …It can all add up to a thoroughly miserable and frightening experience for people often in the most vulnerable of circumstances.’
At one, the Old Village School Nursing Home in Bedfordshire, inspectors uncovered such appalling neglect they sought a court order to close it immediately. But this was granted only at 5pm and some frail residents were still being moved out on to the street in wheelchairs at midnight before being transferred.
The new website will also state the hygiene rating of homes, based on inspections by the Food Standards Agency, and the number of beds.
It will give the staff turnover, as a percentage of those who left in the last year, and whether there is a registered manager.
Beth Britton, a campaigner whose father spent nine years in care homes after being diagnosed with dementia, said: ‘Anything that helps families to be more informed when making these decisions is to be welcomed.
‘I very much hope this new resource will provide more transparency about quality of care and give families increased insight at what is a hugely challenging time.’
Source Mail Online

Alzheimer’s charities expect 60 per cent rise in calls after Christmas

Alzheimer’s charities are expecting a 60 per cent rise in calls after Christmas as families who rarely see elderly relatives finally notice signs of dementia.
Figures from the Alzheimer’s Society show that January is the busiest month for enquiries, with a surge in calls after the festive season.
The charity said families often contacted them in January after spending time with elderly relatives over Christmas, and noticing worrying symptoms which could signal dementia.
The statistics show that last year there was a 60 per cent leap in call numbers between December and January.
The month is the busiest month by far for calls, with 5,600 enquiries received last January, plus a significant rise in online research.
Experts said families often feared dementia when in fact the changes they noticed – such as occasionally forgetting names, or why they had entered a room, could be put down to old age.
Other possible signs of dementia – such as losing interest in things, or repetitive and obsessive behaviour, were often missed, the charity said.
Jeremy Hughes, the charity’s chief executive, said: “We know dementia is the most feared illness for many, and there’s no question that it can have a devastating impact on people, their family and friends.
“It’s important we tackle confusion around what are and aren’t signs of dementia, and help give people confidence in approaching loved ones about their concerns so people don’t delay getting help.”
A survey of 4,000 people found 72 per cent did recognise that repeatedly forgetting names of family members and everyday objects could be a sign of dementia.
But nearly two thirds also thought putting everyday objects in the wrong place, such as a mug of tea in the cupboard could mean someone has dementia.
The charity said such absent- minded mistakes are relatively common.
Confusion about the order in which day to day tasks are carried out – such as the order in which to make a cup of tea – was more likely to indicate dementia, experts said.
Four in 10 people thought that forgetting why they have walked into a room might be a sign, which the charity said could happen to anyone.
Experts said a more worrying symptom would be if the room itself seemed unfamiliar. Only four in ten people felt compulsive or repetitive behaviour could be a sign of dementia.
However, a change in behaviour showing repetitive, compulsive or ritualised behaviours, which can include repeated use of phrases or gestures, or repeatedly asking the same question, can be a sign of dementia.
The charity said occasionally forgetting the name of a person, thing or place was unlikely to mean dementia and more likely to be a product of an ageing memory.
Signs of dementia which are not well-known include mispronouncing words or stuttering, and losing an interest in things you once enjoyed.
A smaller survey of people affected by dementia showed that over half waited at least six to twelve months after noticing dementia symptoms before seeking help.
Source The Telegraph

Dine with Dignity – Fantastic New Product

Dine with Dignity has created an adult bib which can make dining stress free, for people who have difficulty eating, or people with a disability and where spillages can be a problem.

Eating, and the enjoyment of food and drink, is and always should be one of life’s pleasures.

However, for some elderly people, or people with a disability, it can become a daily challenge.

Dine with Dignity has been created to meet a real need in the care sector.
To purchase a Dine with Dignity Apron click here to visit the Buy Now page.

Many medical conditions can cause difficulty with the physical act of eating, cutting food into bite-sized pieces, holding cutlery, and successfully getting food from a plate into the mouth.

Drinking can be equally as challenging. It is so important to ensure that the experience of eating and drinking is a pleasurable one and that all issues are addressed in as dignified way as possible.

Take the stress from dining

  • Protect clothing from spillages
  • Save carers time
  • The adult bibs are made of 6oz double layer polycotton
  • Absorbent
  • Washable

‘Almost too late’: fears of global superbug crisis in wake of antibiotic misuse

It is “almost too late” to stop a global superbug crisis caused by the misuse of antibiotics, a leading expert has warned.

Scientists have a “50-50” chance of salvaging existing antibiotics from bacteria which has become resistant to its effects, according to Dr David Brown.

The director at Antibiotic Research UK, whose discoveries helped make more than £20bn ($30bn) in pharmaceutical sales, said efforts to find new antibiotics are “totally failing” despite significant investment and research.

It comes after a gene was discovered which makes infectious bacteria resistant to the last line of antibiotic defence, colistin (polymyxins).

The resistance to the colistin antibiotic is considered to be a “major step” towards completely untreatable infections and has been found in pigs and humans in England and Wales.

Public Health England said the risk posed to humans by the mcr-1 gene was “low” but was being monitored closely.

Performing surgery, treating infections and even travelling abroad safely all rely to some extent on access to effective antibiotics.

It is feared the crisis could further penetrate Europe as displaced migrants enter from a war-torn Middle East, where countries such as Syria have increasing levels of antibiotic resistance.

Dr Brown told said: “It is almost too late. We needed to start research 10 years ago and we still have no global monitoring system in place.

“The issue is people have tried to find new antibiotics but it is totally failing – there has been no new chemical class of drug to treat gram-negative infections for more than 40 years.

“I think we have got a 50-50 chance of salvaging the most important antibiotics but we need to stop agriculture from ruining it again.”

Resistance is thought to have grown due to colistin being heavily used in pockets of the agricultural industries, particularly in China, often to increase the physical size of livestock.

Worldwide, the demand for colistin in agriculture was expected to reach almost 12,000 tonnes per year by the end of this year, rising to 16,500 tonnes by 2021.

In the UK, nearly half of all antibiotics used are in farming, according to reports, although the use of it as a growth agent has been banned in the EU since 2006.

The unnecessary prescription and use of antibiotics as a form of treatment is also believed to be an aggravating factor.

Although the imminent threat of the resistant bacteria spreading throughout the UK remains small, it could worsen in Europe next year, Dr Brown added.

He said: “In 2016, a number of factors are going to come together – including the effects of the migration crisis.

“I think, for the time being, northern Europe will be okay. Southern Europe, places such as Italy and Greece, and the Middle East are more under threat because of weaker health systems and weaker monitoring systems. India, especially, could be in real trouble.

“The migration crisis will probably not be helping anything as a lot of people coming over from Syria could be bringing bugs.

“People are getting a sick a lot more often there because of sanitation. Once one bug has got resistance, it can pass it to another.”

Despite European Union regulations aiming to cut back on the unnecessary use of antibiotics, Dr Brown believes it will take more than just legislation to tackle the superbug crisis.

Market forces will need to be compelled to cut usage, perhaps when prompted by a shift in public opinion, he said.

“Those with a vested interest find ways around legislation. So, in addition to public policy we will need also the power of market forces,” he added.

“When the public start demanding meat that has not seen antibiotics – because they understand that the meat may contain antibiotic resistant bacteria – only then will real progress be made. We need education about the threat.”

Government scientists re-examined 24,000 samples of bacteria from food and humans in the UK following the discovery of mcr-1 in China in November and found the gene in just 15 samples.

The Soil Association said the mcr-1 was found in E. coli from two pig farms, in stored E. coli from a pig and in three E. coli samples from two human patients, which were also found to be resistant to other antibiotics.

It was also found in 10 human salmonella infections and in salmonella from a single imported sample of poultry meat. The earliest British positive sample was a salmonella from 2012.

Source The Guardian

NHS nursing levels: Nine in 10 hospitals missing targets

The vast majority of hospitals in England are struggling to recruit enough nurses, figures show.

Some 92% of the 225 acute hospital trusts in England did not manage to run wards with their planned number of nurses during the day in August.

The figures, published by the NHS, show that hospitals in England are falling short of their own targets for levels of safe staffing.

The Department of Health said staffing was a priority.

A spokesman added that 50,000 nurses were currently in training.

Analysis by the Health Service Journal shows average staffing levels across the 225 acute hospital sites in August was worse compared with data for January, when 85% of hospitals missed their staffing targets for nurses working during the day.

The figures also showed 81% of hospitals failed to have enough registered nurses working at night.

Some 79% of hospitals missed their target for registered nurse staffing across both day and night.

‘Long way to go’

Royal College of Nursing chief executive Janet Davies said hospitals were trying to catch up on their staffing levels.

She told BBC Radio 4’s Today programme: “We went through a period of time where we were trying to save money. We cut posts, we didn’t train enough nurses and we’re still feeling the effect of that.

“We’ve a long way to go. We’ve got to catch up on this for some time. But equally, we have to keep the nurses we’ve already got. It’s great to train people, it’s great to bring people in, but our experienced nurses are leaving.

“They’re leaving because they’re overtired – it’s a bit of a vicious circle.”

She said nurses were “exhausted” at the end of their shifts and often having to stay late to provide extra care.

“They do get very concerned because they know what they should be doing for patients and if they can’t, it’s really upsetting,” she added.

Hospitals have been required to publish monthly data on whether they have enough nurses on wards since April 2014.

It followed a report into the Mid Staffordshire NHS Trust, which was heavily criticised for failings of care that may have contributed to unnecessary deaths.

Many hospitals have had to boost their nurse numbers by recruiting overseas, and spending on agency staff has contributed to NHS deficits.

A Department of Health spokesman said: “Staffing is a priority – we’ve put more than 7,600 additional nurses on our wards since May 2010 and there are 50,000 nurses currently in training.

“We know that there are big challenges for hospitals, so we are helping the NHS to employ the staff it needs at a fair price by clamping down on rip-off staffing agencies and identifying billions of pounds of back-office savings so that as much money as possible goes to the front line.”

It comes after a study published in the British Journal of Anaesthesia suggested that fewer patients die after emergency surgery in hospitals that have more doctors and nurses.

The research, looking at data involving nearly 295,000 patients, also found death was more likely following a weekend admission, saying this showed staffing was a factor in the so-called weekend effect.

And a separate Nursing Times survey last week suggested nurses are under so much pressure that they cannot guarantee safe care for their patients.

The survey of nearly 1,000 nurses found eight out of 10 are under more stress at work than they were a year ago, with more than half saying they “rarely” or “never” had either sufficient time or staff to ensure safe care for patients. A third said their ward or team was “always” short-staffed.

Source BBC News