Person Directed Care Answers

Change Ideas:

Consistent Assignment

Activities

Bathing

Consistent Assignment Q&A

1. How do familiarity and routine help increase comfort and competence?

When staff members care for the same people each day, they become familiar with those residents' needs and desires in an entirely different way — and their work is easier because they are not spending extra time getting to know what the residents want. They know from their own experience with the residents.

2.  How important are relationships to residents?  To caregivers?  To co-workers?

When staff and residents know each other well, their relationships make it possible for care and services to be directed by the residents' routines, preferences and needs.

When staff routinely work together, they can problem-solve and find creative ways to reorganize daily living in their care area.

3.  How important are relationships to quality care?

Relationships form over time — we do not form relationships with people we see infrequently.  To encourage and support relationships, consistent assignment of both primary staff and ancillary staff is recommended.

4.  Could consistent assignment positively affect workforce retention?

Call-ins and turnover are reduced when meaningful relationships develop. Workers know they are being counted on and respond by becoming more dependable.

Activities Q&A

1. How do you determine residents’ interests?

Ask residents or those closest to them (families, caregivers, friends, etc.). Consider past life roles and look at systems to honor personal preferences for scheduled activities or those occurring at any time, such as in the evenings or weekends.

2. Can a resident assist with food preparation as part of an activity?

Absolutely! For individuals participating in a food activity, the facility should plan with the resident based on his or her preference, while also ensuring safety and hygiene. For example, if a resident chooses cookie making, that resident could help with mixing ingredients at his or her level of preference and capability. Some facilities have kitchens, cooking areas or equipment for residents.

3. Do all activities have to be planned?

No. Spontaneous activities should occur at any time and not be limited to the schedule of activities. Others should be encouraged to participate, such as non-activity staff, volunteers, families and other residents.

Bathing Q&A

1. How could this change idea promote a resident’s willingness to bathe?

If bathing practices are forced, residents feel attacked, demoralized and fearful, and will be upset for hours; bathing will become an exhausting process. To help understand this concept, view the video “Bathing Without a Battle.” For more information and to order online, go to www.bathingwithoutabattle.unc.edu.

2. What is meant by “institutional bathing"?

Bathing environments that lack personal touches appear sterile. Better bathing environments should have personal touches that are pleasant, such as soft, fluffy warm towels and robes, plants, music, murals or pictures, warm and soothing décor, and other decorations the residents prefer. Residents and staff should be part of the decision-making process prior to bath re-design.

3. How will this impact the facility bath schedule?

The residents’ personal preference will become the bath schedule. Bathing should be as close as possible to the process that was used in the residents' homes, including the approach, method, day and time of day.