Resident assessments

I wanted to talk about resident assessments. Identifying resident needs also should include an assessment of the skill set of the care staff that will be providing the care and services. Traumatic Brain Injury clients have a different set of needs than dementia or mental health clients. Staff need to receive training specific to the needs of residents with Traumatic Brain Injury. When care staff tell supervisors something is wrong they need to be listened to and the resident assessed. Nurses who complete assessments for residents need to access their resources to gather the necessary information they need. The internet is loaded with various resources from credible sources.

Blood pressure alerts

Monitoring a patient's or a resident's blood pressure is more than just taking the blood pressure recording the result and giving a pill. A facility should have parameters for when a resident's blood pressure reaches a specific parameter and the physician should be notified, including when a standard fax is adequate or when a phone call should be made to alert the doctor.

A person's blood pressure must be evaluated along with any other symptoms that are exhibited. A blood pressure of 77/36 is of grave concern because it the individual's vital organs such as kidneys, brain and lungs may not be getting adequate oxygen. If the resident is responding appropriately, the blood pressure should immediately be rechecked to determine if it is an accurate reading or if it is operator error or mechanical malfunction. If it is indeed an accurate result, the resident maybe exhibiting other symptoms such as non-responsiveness, confusion, dizziness, inability to speak. Medical intervention is necessary, the sooner the better. The resident needs to be evaluated/assessed.

Like wise if the blood pressure is high, the blood pressure needs to be evaluated. If the resident is responding appropriately, the blood pressure should immediately be rechecked to determine if it is an accurate reading. If is is indeed an accurate result, the resident maybe exhibiting other symptoms such as headache, dizziness, nausea, vomiting, slurred speech, inability to raise both arms, smile or other symptoms of stroke. The resident should immediately be transported to the hospital and the physician notified.

It is more helpful if the resident's physician determines the parameters for which he wishes to be notified.

New nurses

I did a visit at a facility today. I shared my concerns with the facility nurse and she responded as if her responsibility was to only send a fax to the doctor and failed to alert him to why he was receiving the fax. I could not determine if she did not have the scope of knowledge to realized that a blood pressure of 77/36 and/or a blood pressure of 211/114 was a serious medical problem. I would like to give her the benefit of the doubt I just don't think she gets it.

Lots of changes happening at the state level. Our state government expanded the definition of financial exploitation of the elderly which was a good start. Training for individuals in the financial institutions, family members and facilities is paramount to preventing the exploitation of our senior citizens. It is very unfortunate when exploitation occurs and the ramifications for the senior involved is wide spread. This past week a news paper had a story where a gentleman was robbed of over 2 million dollars by a woman who promised marriage and companionship. Although the courts said she will pay the money back the reality is that probably will not happen as scamming elderly men was how she made her living. Keeping in contact and having frank discussions about financial matters with loved ones is the most effective means of protection against financial exploitation from crooks.

emergency preparedness

Every facility needs to have an emergency plan because disaster does not schedule their events. We had a facility with a fire in which residents were evacuated. The facility staff were prompt in responding and the facility nurse developed a care plan to address resident needs related to being moved. Some of the issues she addressed included watching the residents for respiratory stress due to potential exposure to smoke, stress of moving from familiar surrounding to a different location, how to provide a calm safe environment and respond to potential behaviors. This professional nurse also included directives on how to deal with questions from family members and the media. Resident were found to be calm and dealing with the changes.

My a year goes by pretty fast. There have been multiple changes to state resources and staff reassignments. We continue to have the 1-800 number for the complaint resolution hot line and for individuals to report abuse. This year appears to be gearing up to spotlight financial exploitation of seniors and what it looks like. Please return to this blog for additional information. Changes have settled down for the time being so hopefully posts will be more regular and timely.

Elder Abuse Prevention Conference review

This is the third Elder Abuse Prevention Conference I have attended. Each year it improves dramatically. The Keynote speaker Paul Greenwood, San Diego County Deputy District Attorney delivered an educated, dynamic heartfelt presentation. He was engaging, humorous and passionate about his topic. He spoke about the myths and misconceptions surrounding the investigation and prosecution of criminal elder abuse cases. He also addressed financial exploitation and how to best recognize, investigate and prosecute allegations of elder abuse. Dr. Mindy Schaffner addressed the unique considerations of mental health and aging. The audience was very diverse and Dr. Schaffner answered questions and took comments providing a lively interactive session. I believe the group could have continued on for another hour we were sad to have to call a halt so conference participants and attendees could have lunch. After lunch, Therese Murphy, Yakima County Prosecuting Attorney, discussed what we are doing locally to combat elder abuse and discussed locally prosecuted cases. She identified specific pieces of information that are needed to conduct a successful prosecution of an abuse case. Ms. Murphy stated financial institutions are now able to report suspicious activity on a clients account to Adult protective services. Another breakout session included a presentation by a secret service agent, John Lowry. He spoke about scams and fraud targeted to vulnerable adults and how to avoid identity theft. Mr. Lowry was very knowledgeable, interesting and invited questions from the audience. The conference ended with the panel of experts answering questions from the attendees. The conference was time well spent.