bigchris

I obviously, But I would like to hear from others? SInce we are constantly striving to be taken seriously, it is key that we are viewed as professional and businesslike.... Speak up peaople!!!! bigchris

When you back date the information, you arse is on the line. Your boss, should be ashamed to even suggest that!!!! Did he, or did you do it on your own???? If you did, we can talk. But as a consultant and an AD, I would rather see an honest mistake, than a cover up. If I was a surveyor, my first question would be " WHat else is falsified?" Sorry, but it is the truth. Bigchris

One of my slam dunk gifts are fleece throws that we get from Wal Mart or Garden Ridge (craft store) I think that they retail for about 10.00 but we talk them down to 3.00 or less. BC

Christmas is fun at the facility, not at home. I love doing it for them. But no work at home for me!!!!!

When restorative was first brought to our state (GA) I developed a team approach in which the activities program, developed the actual program activities. Since we do all of the ROM and ADL stuff anyway, we developed a book that any CNA could pick up and use for the restorative program each day. Then we expanded on that with CNA's becoming leaders and training others (Volunteers, CNA, Dietary, ETC.) As long as the team leader was present then each restorative aid could participate with 4 residents a piece. bc

One of the basic things that I like to do is read and gather as much information as I can on the subject of proffesionalsim and the different types of information that might help. For me: Communication, Office Politics, HOw to get along with difficult people, leadership, how to be a gentleman, appearance, etc. Are the types pf books that I enjoy. I read each night, so I spend at least an hour reading growth type books. bigchris

In Ga, your scenario is acceptable. If there is a certified activity proffesional that is in the building, then being in the position of "administration" of activities is fine. That is my role in addition to consulting at my facility. I can't tell you if you are right or wrong, but to the best of my knowledge, it is not against the fed, so check your state. BC

Any comments or questions are welcome. BC

The short term rehab residents are the ones I have the hardest time care planning as well. We have a 60 bed rehab unit and it is always such a struggle for me to get their care plans done. Any suggestions any one has would be appreciated. The short term rehab resident is difficult to plan for. I have heard many different opinions on what should be done in regard to the care plan. I have to admit (especially having residents that have been at the facility for 2 days) that I do get lazy when it comes to the rehab care plan. Sorry, but unless the resident is there more than 2 weeks I don't even bother with the careplan. I do a progress note and the usual MDS stuff. This is not to say that I do not have activities with them and for them. We do. I just don't put the time into a formal care plan for someone who we cannot implement the care plan for! With that said, after 2 or three weeks I evaluate the resident and thier potential for discharge. If they have issues with activities I will care plan for them. Sometimes NOT!!! Any comments? BC

For those of you interested, Wal Mart has announced an initiative in which they are required to be involved in the community around thier stored. This is regardless of non profit status. Talk to the manager of your local walmart and see if you can get on board!! BC

Hello to all, I have a question and answer set for September, but I wanted to ask you all if anyone had a particular issue that they are grappling with. Let me know, Chris

I told you all, that I am doing research on this and I would not give up.....if anyone has anyquestions please let me know. Bigchris

I know that I am beating a dead horse.... But the Annual Conference for the Georgia Society of Nursing Home Activity Directors will be held in Norcross, GA on Sept. 31st- Oct. 2nd. e mail- bigchris1974@hotmail.com for further info!!!!!

Here are a few options for you. In regard to therapy, the first thing I do on Mondays is talk with the rehab lead on potential groups for the week, This is something that is usually a combo with therapy that we could potentially both get credit for in our docs. For example: each week we have a cookie social with all of the residents, but in truth...there are 5 or 6 activities going on at the same time. We may have a errand activity such as folding napkins or arranging flowers, there is a service activity , in which my high function residents will take care of 3 or 4 others, and there will be a work activity, where I will have envelope stuffing etc. All while they are getting cookies and coffee. Therapy will get credit and I will have stuffed envelopes, but here is the rub. I am the boss and I make sure that they know it. THe therapist is the good guy but they are doing OT, PT, whatever. What happens is then, I will take pictures or call the family, or make sure that they see me during the week, then I hear..."Oh watch out, here is the big boss, he will put you to work!" THen the family and I will talk about the one activity....but I get credit for it none the less. On room visits you have many options. I have a sign up sheet or notebook with a simple note on the front that says, all visitors please let us know you were here. My preachers/priests use it as well. In a pinch you could always put your card on the bed side table. Let me know what you think.... Chris

In reading the posts, I was a little confused as well. I think Miguel is on the right track and we could also add that we have adapted the activity in relation to his ability level. If he is giving instruction to someone, he is participating and the goal should reflect that he does enjoy it and we would provide the activity to his wishes.

Pennie answered the question well. I alwys tell folks that you divide the day between a few things. When they wake up plus when they sleep plus care hours (PT, OT, CNA, etc) plus time spent eating, sleeping, B&B minus a normal wide awake day. That will equal thier "potential" activity day. Then I subtract how much time is spent in activities both passive, active and independent and run a "percentage" of activity time spent. This impromptu "formula" has made explaining to surveyors how much time a resident is "active" it also gives them a hard number to look at. I know it may be crazy, but it has gotten me out of some jams. And after you do it 700 or so times, it gets easier. bigchris

Was there a reply?

I have read all of the replies and I like the action that it is getting. I want to remind you all that there is a CarePlan section in the forum area of this site and I serve as moderator. I am glad to help if needed. Also, I wanted to give you all a warning on some of the replies that I have seen regarding forms. In some of the facilities that I have consulted for, the strict guidelines for each individual corporate policy, could...repeat could, make any and all of your documentation useless in the eyes of the surveyors. Due to the new regs and the subjectivity of each individual surveyor....some of these facilities have been sited because they used a "cookie cutter" form instead of making each resident an individualized Care plan/progress note/interview/etc. Since I have not seen the forms that you speak of...I just wanted to throw that out for you. I have seen a ton of Nursing Home staff, become overly reliant on checklists instead of making a unique assesment. There are many products that rely on this way of charting, and if you get the right surveyor, you could get burned. Just a tip... Come see me at the CP forum. bigchris

Mel , I believe that I sent an e mail to you, if not let me know. If so, please tell me if my response was helpful to you. If anyone else wants my answer, let me know. bighchris

My calendar changes daily due to my residents, I have a variety of programming for all levels so I will usually run my low function in the morning and move to educational or arty stuff near lunch. I then add food related around lunch or dinner and do fun stuff around 2:00. Then I will have a passive activity later in the afternoon. That is the basic structure, then add in volunteers, trips, entertainment. Sorry, I can't be more specific, but we even through in what I can "Spontaneous" activities throughout the day. These are usually, resident volunteer based in which they help me do a project. Basically, the calendar is my minimum schedule that gets added to each week or month. bigchris

I have found that publisher is the easiest for me to use, basically due to the cut and paste and the interaction with other microsoft products that I use anyway. It also has a ton of images that can be used and manipulated. bigchris

As always, comments are welcome.

Recently, I had a twist on the care Planning process in that a family member decided that her mother needed to go to every activity offered. Even though the resident did not want to attend all activities offered and it was contra indicated medically. In this case I actually care planned for the family member. This person did not have realistic expectations for her family member for amny reasons that were pointed out, not only in the CP conference but also in the CP and in charting. 1) First and foremost, the resident did not want to attend everything! ( the family member told us not to listen to her) 2) the activities are offered for all mental and physical capabilities. So she was not appropriate for all. 3) High participation is contra indicated with her medical diagnosis. Among other things, the Dr. wrote an order for 4 hours of elevated bed rest per day. Remember that we are here for the residents. Some families have the need to impose thier beliefs on your programs and the resident. Protect yourself with the state and others and document the behaviors of all involved. bigchris

I have done the Culture Change thing twice now. Once at my old facility and trying to implement it at my new. When I first started I thought it was the greatest thing on earth, and still do. However, it is a long and frustrating process at times. get ready to hear a lot of "That's not my job" I can give you more info if you like, it might take some time to go through all of my files. However, you can Google the "Culture Change" and I know that AASHA and many other organizations are getting it running. We actually went out to Missouri to see one of the first facilities that started it and that was cool. Let me know what you find out and I will start looking. bigChris

Thanks to Trixie, who wanted to know about Highly active residents. I gave her a few options, go see in the CP forum..... bigCHRIS