Outings

[yunakitty 2]

I just want to know what everybody else does in terms of outings. My healthcare admin and DON are constantly nagging me about outings and wanting me to take EVERYONE. I should tell you now that I have only 8 residents (we are a new facility.) I work on the healthcare side, that is, Assisted Living, Clinical, and Memory Care. We have 3 AL and 5 clinical. Our 3 AL people can get around pretty well, one walks unaided, one uses a power scooter/walker, and one uses a walker very slowly. In our clinical, all but one are wheelchair bound. The one that is not is totally confused all the time. Two of our clinical people can''t feed themselves, and another regurgitates randomly. So, as you can imagine, I can't take these residents out to restaurants. It would be embarrassing for them, plus our DON is always stressing that only nurses/CNA's are allowed to feed. So even if we were to take them to the restaurant and feed them, I'd have to have a nurse go with me. There are typically 2 CNA's and 1 nurse in Clinical, and 1 nurse/CNA in AL. I have put in requests at the beginning of the month that I need to have a nurse go with me. My DON always calls and tries to convince me I don't need a nurse, that she can't spare anyone, and when I insist that I do, she decides that that resident is not appropriate for an outing after all. But I still get nagging about not taking everyone.... I mostly take only the AL residents places where you have to get out and do something. I take Clinical people on Scenic Drives (like yesterday, and I had two Clinical people actually go.) We live on a resort island so there is a lot to see. We go out about 4 times a month. Usually it's one scenic drive/tour, one movie at the theater, and one or two restaurants. I have also gone for ice cream and once we ate a snack in the park.

 

I just can't have 5 people in wheelchairs when there is just me and the chauffeur to push people. My second week on the job, we did take EVERYONE to a restaurant (my boss, the IL AD also went) and it was a nightmare. You just can't get everyone inside at the same time, and when you have confused people, they get really upset at all the hassle. One resident at that time had to be on a pureed diet and the place claimed they didn't have a blender for the soup to make it smoother, plus this resident is a very proud woman and gets agitated easily, so she was embarrassed and angry and was chanting "God help us" over and over again. Other residents that are "with it" enough to tell what's going on are very uncomfortable by her and seeing her being spoonfed by her personal aide (who thank god showed up and fed her, then took her home separately.) That was the first and only day that I ever went home and cried.

 

I'm sorry to ramble and rant. I'm just wondering how you guys, with 100+ people, handle this? What do you do? Do you have criteria of who can go? Do you get volunteers or staff to help? How many people can you take at a time? Would you take someone who had to be spoonfed to a restaurant (fancy restaurant - I should tell you now that we are "upscale" and cater to an affluent population, so they don't want McDonald's - and I know that the HA would have a fit if "Lunch at McDonald's" was on the calendar she gave out to potential residents with marketing materials.) Or do you mostly only take people who can move around by themselves (even if very slowly), feed themselves, and basically know what's going on enough to enjoy it?

 

ETA: Plus, what is your typical percentage of participation? I try to explain this concept to the HA and DON... yes it seems pathetic that I only took two residents to lunch, but that's 25% of the population. So it's like taking 25 if we had 100. I don't think the state is going to shut us down because of this, but they act like I'm just making tags with everything I do. They think since we only have 8, why can't all 8 go? Oh, and the residents say they DON'T want to go. I respect their wishes. But then the DON goes in behind me and needles and needles them "But it'll be sooooo fun! Come on, let's get up!" and practically start dragging them out of their room. It's not like I'm leaving behind people who WANT to go. They don't want to go.

Edited January 8, 2008 by yunakitty

[BartMan 0]

Yes , an outing can be a nightmare if you do not have adequate staffing to go with you. I try and recruit volunteers to help. Not can it only be a nightmare without the proper staffing but it can be very unsafe for the Residents. Surely your Upper Management people realize this ???? If not, you can always do an in-service with the staff about how an outing is suppose to work and also invite your Administrator.... BartMan

 

I just want to know what everybody else does in terms of outings. My healthcare admin and DON are constantly nagging me about outings and wanting me to take EVERYONE. I should tell you now that I have only 8 residents (we are a new facility.) I work on the healthcare side, that is, Assisted Living, Clinical, and Memory Care. We have 3 AL and 5 clinical. Our 3 AL people can get around pretty well, one walks unaided, one uses a power scooter/walker, and one uses a walker very slowly. In our clinical, all but one are wheelchair bound. The one that is not is totally confused all the time. Two of our clinical people can''t feed themselves, and another regurgitates randomly. So, as you can imagine, I can't take these residents out to restaurants. It would be embarrassing for them, plus our DON is always stressing that only nurses/CNA's are allowed to feed. So even if we were to take them to the restaurant and feed them, I'd have to have a nurse go with me. There are typically 2 CNA's and 1 nurse in Clinical, and 1 nurse/CNA in AL. I have put in requests at the beginning of the month that I need to have a nurse go with me. My DON always calls and tries to convince me I don't need a nurse, that she can't spare anyone, and when I insist that I do, she decides that that resident is not appropriate for an outing after all. But I still get nagging about not taking everyone.... I mostly take only the AL residents places where you have to get out and do something. I take Clinical people on Scenic Drives (like yesterday, and I had two Clinical people actually go.) We live on a resort island so there is a lot to see. We go out about 4 times a month. Usually it's one scenic drive/tour, one movie at the theater, and one or two restaurants. I have also gone for ice cream and once we ate a snack in the park.

 

I just can't have 5 people in wheelchairs when there is just me and the chauffeur to push people. My second week on the job, we did take EVERYONE to a restaurant (my boss, the IL AD also went) and it was a nightmare. You just can't get everyone inside at the same time, and when you have confused people, they get really upset at all the hassle. One resident at that time had to be on a pureed diet and the place claimed they didn't have a blender for the soup to make it smoother, plus this resident is a very proud woman and gets agitated easily, so she was embarrassed and angry and was chanting "God help us" over and over again. Other residents that are "with it" enough to tell what's going on are very uncomfortable by her and seeing her being spoonfed by her personal aide (who thank god showed up and fed her, then took her home separately.) That was the first and only day that I ever went home and cried.

 

I'm sorry to ramble and rant. I'm just wondering how you guys, with 100+ people, handle this? What do you do? Do you have criteria of who can go? Do you get volunteers or staff to help? How many people can you take at a time? Would you take someone who had to be spoonfed to a restaurant (fancy restaurant - I should tell you now that we are "upscale" and cater to an affluent population, so they don't want McDonald's - and I know that the HA would have a fit if "Lunch at McDonald's" was on the calendar she gave out to potential residents with marketing materials.) Or do you mostly only take people who can move around by themselves (even if very slowly), feed themselves, and basically know what's going on enough to enjoy it?

 

ETA: Plus, what is your typical percentage of participation? I try to explain this concept to the HA and DON... yes it seems pathetic that I only took two residents to lunch, but that's 25% of the population. So it's like taking 25 if we had 100. I don't think the state is going to shut us down because of this, but they act like I'm just making tags with everything I do. They think since we only have 8, why can't all 8 go? Oh, and the residents say they DON'T want to go. I respect their wishes. But then the DON goes in behind me and needles and needles them "But it'll be sooooo fun! Come on, let's get up!" and practically start dragging them out of their room. It's not like I'm leaving behind people who WANT to go. They don't want to go.

[heavenstar 0]

"God Help Us" is right. Maybe your resident is not far off!

 

If I were you (and Thank God, I'm not!) I would forget eating out totally. That seems to be an impossible feat for both you and the residents. Besides, eating out is overrated. If your residents feel that they have to eat out, then maybe catering in from a favorite restaurant is an option for you, or if not, maybe getting a private room for your group so no one gets embarrassed. This is only if you have adequate staff to help feed.

 

Could you break your trips up into different categories every month? For instance, once a week, take everyone on a scenic trip. You could even hire a tour guide to show different things- historic homes, ghost tours, Churches, architecture, whatever. But make it to where you don't have to get off the bus.

 

Then, have different trips suitable for your different levels. Alzheimer Patients would take a trip down memory lane or something. Then the next day have a different group with a different itinerary.

 

It sounds like this is what you are already doing. If this is working for YOU (and not your DON) then maybe you should just present it to her a little differently by adding in goals and therapeutic objectives by splitting up the group in their care plans.

 

 

This sounds like a LOT of planning and very time consuming. I thank God that I do not have transportation except once a month and all of my residents are independent!

[smarteesue 0]

This is one of the best times to make sure your survey interests are current. All activity personel know that activites are based on a residents interests. They cannot be forced to go if they say they don't want to. When you have a current selection of surveys you can find out who wants to go and who doesn't. Then you will always have cases when residents say they want to go and then refuse to attend. This is for a number of reasons that not everyone will understand. When they refuse make sure to document the fact, word for word, be specific. In fact each time you take an outing take the time to write down exactly what happened and give copies to the Administrator and DON so they will better understand why you need the help. Communication is the key.Good Luck and God Bless.