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Are We Inadvertently Killing Our Elderly?

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are-we-inadvertently-killing-our-elderly

While I don’t want to be an alarmist, this series that came out in 2002, albeit a while ago, it is still relevant today I believe: http://www.ccfj.net/NHSTLseries.html

So why should I bring this up now?

You will all be experiencing the heat wave we are going through at the moment and probably finding you are drinking more fluids than you would perhaps normally.

However it is good to remember that the older one gets the less likely they are to reach for or call for a glass of water. From the age of 60 thirst becomes blunted which quite simply means they don’t feel thirsty.

Therefore it is up to us as caregivers to think for our patients and offer fluids very frequently – at least 50 mls an hour, to enable them to remain hydrated.

Signs And Symptoms

To remind you of the signs and symptoms of dehydration check out this video:

However there are two early signs left off this list: falls and headaches.

Just think about how you feel when you are out in the hot sun and haven’t had a drink.

Now I know you get very busy and it is not easy to remember all the little things that need to be done.

But if a person does not ask for a drink, then it is likely to be forgotten or overlooked.

Failing to give a person adequate fluids is abuse though, as you will see in this blog article: http://www.nursinghomesabuseblog.com/dehydration/

Take Extra Care

On top of this, if a person dies as a result of dehydration, then you are likely to be culpable or blameworthy as the death could have been prevented as you can see in this article: http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11317558

Admittedly the nurse here appears to have had inadequate supervision.

But at the end of the day, two basics in the care of the elderly need to be understood by all your staff…

  • As people age their thirst becomes blunted
  • They are unlikely to ask for a drink

So if you don’t ensure they have enough fluid they may quietly slip away from you and die.

This can be labeled as abuse, and the neglect and death from dehydration is preventable.

Learn more here:

Get Creative In Providing Fluids

So how can you very simply provide fluid for those in your care?

  • Have fluid rounds in addition to the normal morning, afternoon tea and supper
  • Offer ice blocks sometimes as a variety
  • Watermelons are very inexpensive at certain times of year and it a very enjoyable way to help with hydration
  • Jelly is another easy way to get people to take fluids

Have a discussion among your colleagues and see what other enjoyable ways you can get fluid into people. You may be surprised at what you come up with.

More Resources

At a recent workshop I was at on fluid and electrolyte balance the presenter talked about an excellent book you may be interested in.  “Fluid & Electrolyte Balance – Nursing Considerations” by Norma Metheny which can be purchased here: http://www.jblearning.com/catalog/9780763781644/

And of course for Care Training Online members it may be timely for you to review, do or redo the Hydration topic online.

Have a parent that’s a little hard to handle? Download our free Challenging Behaviors Guide to discover how you can figure out what’s going on and maintain the relationship with your parent.

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Is Your Training Actually Effective (Or Just Wasting Time)?

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I want to take time to talk a little about evaluating your training. There are actually 5 levels of training that need to be evaluated.

Level 1
This is done immediately after a training session. In fact, you have probably all done these from time to time.

Emma Weber, the author of Turning Learning Into Action, calls these the “happy sheets”. They are the reaction type based evaluation.

Level 2
What do participants know? What has the person learned from the training or retained from other learning?

Core competencies could come into this level. By which I mean you send out an annual sheet for the staff to complete about what they know on a particular topic.

Or if you don’t already have one in the training session you could set a questionnaire at the end of an inservice.

Level 3
What are people doing differently as a result of the training?

This is behavior based. IT IS GLUE THAT CEMENTS THE LEARNING. This should be the aim of learning – to change or improve behavior.

Level 4
What are the results of the training? What effect has the training had on the business or environment?

Level 5
ROI – what impact has it had on the bottom line?

Now I want to focus a little on Level 3 because I think this is what can make the biggest difference to levels 4 and 5.

How can you measure this? What can you do to find out what they have learned, and not just from a competency assessment or worksheet that they do at the time of training or before or after?

My suggestion is to set a group case study.

Divide the staff into groups of 4 or 5 and set them a task to explore from the learning they have just done or a real life experience that has happened in your facility/organization.

Example 1:  Complaints topic:
Use a complaint you have received and get them to analyse the complaint (like you the manager or RN have had to do), go through the process of communicating with the complainant, write a letter to the person, examine how it could have been avoided and so forth. This will make them more aware of complaints and enhance the learning.

Example 2: Sensory System – Vision:
A client may have macular degeneration. As a Case Study, get them to define clearly what it is and how they could make life easier for a person with the disease.  Include getting them to sit and talk to the client about the disease, how it affects them and what they need to do to help them. This gives a better appreciation of what it is like to have this condition.

There are numerous real life situations that occur in your facility or organization that you can use as a fun and practical exercise.

Give groups time to complete the project and present to you or even at a staff meeting.  What better way to enhance the learning of your staff?

While I could put scenario examples in Care Training Online that you could use, what more effective way than using your organization’s own real life examples with people you already know.

Ready to start effectively training your team?
Get these printable Infection Control Protocols to share with your team and learn how to deal with 19 different infections & communicable diseases in your care facility.

A Quick Trick To Keep Learners Interested

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A Quick Trick To Keep Learners InterestedHave you ever wondered why training may be ineffective in your organization? The answer lies in the one you are teaching.

At What Point In A Training
Does A Learner Stops
Paying Attention?  

Neurologists all give slightly different answers but the average appears to be around 7-20 minutes.

So with an hour long training session, unless you keep learners interested or do something different in that hour to bring their back to the session, you can expect the learner will miss out on a lot of information.

Unless you create smaller sections of time and facilitate the training, you have probably done nothing more than tick the box that you have trained staff (or some of them) on a topic required for your contracts.

But there will be few benefits to the care being given or to saving you time by caregivers knowing what to do and doing it right.

How And When Should You Stimulate Interest?

Every 10 minutes you should have an exercise, stimulate discussion or provide a quiz.

Do something that is going to help your staff sit up and take notice again or bring their attention back.

With Care Training Online, you can pause the video and discuss a real situation or stimulate with some form of question.

Why Is Group Learning Better Able To Stimulate The Learner?

“Every time something changes in the training room, you reboot the learner’s attention AND increase their retention of information and decrease difficult learner behaviours” says Derek Rowe a Melbourne based training consultant.

This is where you come in. How can you reboot your learners to retain what they have learned? What do you need to do to stimulate the learner?

For me the most logical way is to discuss a person in your care that maybe be causing a problem or may have had a problem solved.

It could also be a complaint that was received: retrace the steps in the restraint process to see at what point it went wrong and became a problem.

When people relate training to personal experiences or stories, the retention is greater.

REMEMBER: All stage plays and films have a director. Running a training session is just the same. YOU are the director.

So when teaching your caregivers, the best way to get a person to learn and retain information is to “Provide them with real life experiences that become indexed in their memory. Comprehension comes when the learner draws inferences that are relevant and correct,” say Jenny Swain, Educator and Learning Designer.

For all of you who are struggling with caregivers doing things wrong or you are continually fighting fires, the only solution is to invest in learning and development for you staff.

As I said earlier, abdication of this responsibility and ticking the box to satisfy auditors will not save you time; it will compound your problem.

Take a look at this video to help understand how people learn. It really puts it into perspective..

Start training effectively with these printable Infection Control Protocols.
Share them with your team and learn how to deal with 19 different infections & communicable diseases in your care facility.

Why Students Forget 70% Of What They Learned Within 24 Hours

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Have you heard of the forgetting curve? Have you perhaps experienced it?

You know what I mean. You attend a fantastic training session or workshop, leave all fired up with what you want to do with the new information…

And then BINGO you hit the reality of work and suddenly you have forgotten everything you wanted to implement.

Research tells us that on average students forget 70% of what they learned within 24 hours of the course.

This article is extremely interesting and got me thinking about what we can do to help people remember rather than forget what they have learned.

There will be things that may not necessarily be important to you or the student but as a manager or educator you want to make sure you get the best bang for the buck you’ve spent.

Well don’t you? I know I do. So how can this work or what can we do at Clinical Update and Care Training Online?

For those of you who are using Care Training Online, why don’t you give your students a retest of the worksheet after they have done the topic or segment to see what they have learned?

Another option may be for you to devise a quick quiz for them to do 24 hours after the topic. Or give them their certificate to write down what they have learned.

In the future we are going to be devising brief online quizzes to go with each Care Training Online topic but until this happens, use what resources that are currently available to you.

I have been thinking about how we can help retention learning with Clinical Updates as well. What can we do to stem the forgetting curve?

I will be discussing it with our trainers but in the meantime, before we go to each break, I will get you to write down the main points you got from each 2 hour (approx.) session.

Now it may be that I can get the trainers to put together a quick quiz at the end of each 2 hour block.

However, my goal is that every caregiver (including registered and enrolled nurses as well as caregivers) will be the best you can be.

This also means helping you use the knowledge you receive in a constructive way that provides the best care you can give and to feel empowered personally with your new or revisited knowledge.

If you want to read more on the Benefits of Testing the Memory go here.

OR  Click here to learn more about The Power of Testing Memory.

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