ADLS - Should they be in our job descriptions?

[ILoveMyLVN 0]

 

Hi everyone,

 

When I think of ADL's in relation to activities, personal care is limited to self esteem and pleasurable activities like facials, hairstyling, and some limited grooming like nail care.

 

Please let me know, what ADL's are you responsible for, if any.

 

I am concerned because my work is now saying that I must be able/willing to perform beyond this if need arises. We are in CA..This is not what I thought of when looking for an AD position. I have no skilled traning/clinical background in regards to nsg. or rehab.

 

Thank you in advance!

Edited October 28, 2008 by ILoveMyLVN

[Mance 0]

Hi, I have been an AD for 5 years now and we do have beauty shop days for the ladies and barber shop for the men. We set a time each week to have maicures for our residents each week. I'm not sure what CA. regulations are for nursing homes but ours have been getting more and more added to them here in GA. I mainly started doing it just because it does make a huge difference in how the residents feel about themselves. Most were used to having their hair done on certain days when they were at home and we try to keep that up for them. If it's not to much you might want to try and see about taking a Certified Nursing Assistant class and get certified in that. I did it so that I could help a little more than just my regular tasks if they need me. I hope that this info was helpfull.

 

Mance

 

]Hi everyone,

 

When I think of ADL's in relation to activities, personal care is limited to self esteem and pleasurable activities like facials, hairstyling, and some limited grooming like nail care.

 

Please let me know, what ADL's are you responsible for, if any.

 

I am concerned because my work is now saying that I must be able/willing to perform beyond this if need arises. We are in CA..This is not what I thought of when looking for an AD position. I have no skilled traning/clinical background in regards to nsg. or rehab.

 

Thank you in advance!

[ILoveMyLVN 0]

Thank you Mance.

 

Did your company recognize the efforts you made --ie pay raise?

 

I'm feeling underappreciated as it is, and especially so now since they are saying we're "expected" to be avialable to help with toileting if a need arises. Not like I don't have enough to do already. I did not expect it from an AD job. Thanks, all, for listening.

 

Any more input would be GREATLY appreciated.

Edited October 30, 2008 by ILoveMyLVN

[penkay 1]

Hi

Probably this will vary from state to state as well as facilitiy to facility -- I have always done as the other AD from GA said that we did Pretty Nails, we were lucky enough to have a Beauty Shop in the facility so res., got their hair done there. The Men had a chance to get theirs done there or once a month when the barb came in. -- As far as ADL's & taking to restroom this should be the CNA's job. You are not trained to lift residents nor to do their ADL's, if you dropped a res or hurt them this could turn out to be nasty law suit! I have hired assistance who were CNA's this has always back fired on me. Because when they (nursing) were short handed (which is usually always) they would pull her/him from activities to work the floor. You have a salary budget for your dept for you & your assistance(s). Nursing has theirs so let them get their own help (hire more CNA's) using their budget. Stand up for your dept if possible, activities is just as important as nursing & we don't want residents or other staff to start seeing us as nursing. Ok off of this ban wagon it just gripes me when they think we do so little or less important thatn other depts. Of course we must help each other (team work) out but with in reason.

[ILoveMyLVN 0]

Thank you for the input! I share your sentiments entirely, just a matter of how to stand up for my department without looking uncooperative to management. Keep in mind that I'm quite a petite lady too & not skilled with total assist.

In my case, the question involves a job description I signed nearly a year ago which states "Assist patiets with non-skilled Activities of Daily Living (ADL) as needed". We now have a new supervisor who is saying I have to be willing to fulfill this in any way that a need arises. Mind you, when I signed that I was under a different boss and we agreed that the ADLs were standard ones like grooming and nail care. Now, even if I agreed, I have no idea how I would be expected to simultaneously lead programs and do restroom assistance at the same time. On the other hand, I love my job and do not want them to have a reason to fire me if I refuse. Any suggestions how to gracefully or diplomatically refuse when they are acting like it's standard practice? I have an amazing consultant friend who said she's never heard of an AD doing this, and she is a CTRS who has worked with acts. for 25 years in our area.

 

Thanks all!!!! HAPPY HALLOWEEN!!

 

Hi

Probably this will vary from state to state as well as facilitiy to facility -- I have always done as the other AD from GA said that we did Pretty Nails, we were lucky enough to have a Beauty Shop in the facility so res., got their hair done there. The Men had a chance to get theirs done there or once a month when the barb came in. -- As far as ADL's & taking to restroom this should be the CNA's job. You are not trained to lift residents nor to do their ADL's, if you dropped a res or hurt them this could turn out to be nasty law suit! I have hired assistance who were CNA's this has always back fired on me. Because when they (nursing) were short handed (which is usually always) they would pull her/him from activities to work the floor. You have a salary budget for your dept for you & your assistance(s). Nursing has theirs so let them get their own help (hire more CNA's) using their budget. Stand up for your dept if possible, activities is just as important as nursing & we don't want residents or other staff to start seeing us as nursing. Ok off of this ban wagon it just gripes me when they think we do so little or less important thatn other depts. Of course we must help each other (team work) out but with in reason.

[Jen 0]

In my state, AD's are prohibited from doing ANY of what is regarded as ADL's-toileting, transferring, feeding unless you've taken the State Feeding Class-and then only those without choking or swallowing risks. I assmued that this is a federal standard. I, too have never heard of AD's expected to do these things and I've been at this for 15+ years and have been at 3 facilities. Yes, we do hairand nails-those are considered activities and not ADL's. The survey guidelins are very clear about that. Most facilities I know don't want activity staff clipping nails and definately not when the resident is diabetic. Only nurses and not CNA's can do that in this state. Are you a licensed long term care or assisted living facility? I think this would be a liabiltiy issue for your facility and for you. Diplomatically, you could ask what it is in your state that you can legally do. No matter what your job description says, that's the most important issue.

[Jen 0]

In my state, AD's are prohibited from doing ANY of what is regarded as ADL's-toileting, transferring, feeding unless you've taken the State Feeding Class-and then only those without choking or swallowing risks. I assmued that this is a federal standard. I, too have never heard of AD's expected to do these things and I've been at this for 15+ years and have been at 3 facilities. Yes, we do hairand nails-those are considered activities and not ADL's. The survey guidelins are very clear about that. Most facilities I know don't want activity staff clipping nails and definately not when the resident is diabetic. Only nurses and not CNA's can do that in this state. Are you a licensed long term care or assisted living facility? I think this would be a liabiltiy issue for your facility and for you. Diplomatically, you could ask what it is in your state that you can legally do. No matter what your job description says, that's the more important issue, that and the safety of the residents.

[ILoveMyLVN 0]

Dear Jen your advice is so greatfully appreciated. We are in a new adult day health care type facility. It is surveyed by CMS and OLTC falling under long term care guidelines. Our admin. has assured us that as long as our rehab dept. has trained us on transferring then we should do it..And now that our rehab dept. has shown us, (40 min taining) I still do not feel confident that, like you said, it's in our "scope of practice". Would you please refer me to the survey guidelines referring to scope of practice under Federal Long Term Care survey guidelines? What state are you in? In our state the CNA training is about 4 months and I think these types of things are considered skilled, right? I do agree the patient's safety is our main priority and I don't want to do anything where they could get hurt, or I could hurt myself.

 

Have a spectacular weekend! Thanks again all.

 

 

In my state, AD's are prohibited from doing ANY of what is regarded as ADL's-toileting, transferring, feeding unless you've taken the State Feeding Class-and then only those without choking or swallowing risks. I assmued that this is a federal standard. I, too have never heard of AD's expected to do these things and I've been at this for 15+ years and have been at 3 facilities. Yes, we do hairand nails-those are considered activities and not ADL's. The survey guidelins are very clear about that. Most facilities I know don't want activity staff clipping nails and definately not when the resident is diabetic. Only nurses and not CNA's can do that in this state. Are you a licensed long term care or assisted living facility? I think this would be a liabiltiy issue for your facility and for you. Diplomatically, you could ask what it is in your state that you can legally do. No matter what your job description says, that's the more important issue, that and the safety of the residents.

[Philco 0]

In my facility I am only supposed to stop if a light is on and get the right person for the job- unless you are certified you personally can get in trouble if you acdiently hurt someone.

[Philco 0]

In my facility I am only supposed to stop if a light is on and get the right person for the job- unless you are certified you personally can get in trouble if you accidently hurt someone.

[mainemom06 0]

I am currently an Activity Assistant in a LTC facility in New Hampshire. We are a no-lift facility, so I cannot help the LNA's with ADL's because I have not had that training. However, what we (activity staff) must do is give a "snack pass" in the morning and afternoon. We have 45 residents, so each nutrition/hydration pass takes about an hour. We would prefer not to do this, because it takes time away from other activities that we could do with the residents. We are also responsible for knowing any special food restrictions of the residents when we do the snack pass (and I see this as a big responsibility). Since I have no choice in this duty, I use it as an opportunity to visit with residents, and chalk it up to 1-1 time!

I agree that the answers to this question are going to vary from state to state, but also more commonly from facility to facility depending on resident population, number of staff, and training of staff.

I agree with one of the other posts....the facility is taking a big risk when they ask staff to perform duties for which they are not qualified or trained. To me, that is the most important point.

[ILoveMyLVN 0]

Thank you Mainemom,

 

We has a training but it was brief, and not what I consider something that made me feel completely comfortable doing the ADL assist they are looking for. I don't know why it sppears places are simply trying to do more with less and seeming to want to maximize what staff they do have to do as much as possible (if not more!).

 

Do you see this as a trend in our industry? I hope not!

 

Well I'd also think that with all the regs we are under that they'd want to cover themselves as much as possible from a potential lawsuit or other dispute if something bad happened.

 

Thanks again for the input. It means so much. I love this board you guys are a HUGE asset. Hugs to you all.

 

I am currently an Activity Assistant in a LTC facility in New Hampshire. We are a no-lift facility, so I cannot help the LNA's with ADL's because I have not had that training. However, what we (activity staff) must do is give a "snack pass" in the morning and afternoon. We have 45 residents, so each nutrition/hydration pass takes about an hour. We would prefer not to do this, because it takes time away from other activities that we could do with the residents. We are also responsible for knowing any special food restrictions of the residents when we do the snack pass (and I see this as a big responsibility). Since I have no choice in this duty, I use it as an opportunity to visit with residents, and chalk it up to 1-1 time!

I agree that the answers to this question are going to vary from state to state, but also more commonly from facility to facility depending on resident population, number of staff, and training of staff.

I agree with one of the other posts....the facility is taking a big risk when they ask staff to perform duties for which they are not qualified or trained. To me, that is the most important point.

[ramzy 0]

Hi

Probably this will vary from state to state as well as facilitiy to facility -- I have always done as the other AD from GA said that we did Pretty Nails, we were lucky enough to have a Beauty Shop in the facility so res., got their hair done there. The Men had a chance to get theirs done there or once a month when the barb came in. -- As far as ADL's & taking to restroom this should be the CNA's job. You are not trained to lift residents nor to do their ADL's, if you dropped a res or hurt them this could turn out to be nasty law suit! I have hired assistance who were CNA's this has always back fired on me. Because when they (nursing) were short handed (which is usually always) they would pull her/him from activities to work the floor. You have a salary budget for your dept for you & your assistance(s). Nursing has theirs so let them get their own help (hire more CNA's) using their budget. Stand up for your dept if possible, activities is just as important as nursing & we don't want residents or other staff to start seeing us as nursing. Ok off of this ban wagon it just gripes me when they think we do so little or less important thatn other depts. Of course we must help each other (team work) out but with in reason.

We also have a beauty shop for hair cut and the activity deppartment provides manicures. I think it would be great if we had some CNA training so we could help out. I find if I want a resident that is a 2 assist in walking I have to wait for the CNA's to be available to help or if someone is sliding in their chair I CAN NOT help them. But, My AD is afraid they (nusring and CNA's will take advanage of this.

[ramzy 0]

Hi

Probably this will vary from state to state as well as facilitiy to facility -- I have always done as the other AD from GA said that we did Pretty Nails, we were lucky enough to have a Beauty Shop in the facility so res., got their hair done there. The Men had a chance to get theirs done there or once a month when the barb came in. -- As far as ADL's & taking to restroom this should be the CNA's job. You are not trained to lift residents nor to do their ADL's, if you dropped a res or hurt them this could turn out to be nasty law suit! I have hired assistance who were CNA's this has always back fired on me. Because when they (nursing) were short handed (which is usually always) they would pull her/him from activities to work the floor. You have a salary budget for your dept for you & your assistance(s). Nursing has theirs so let them get their own help (hire more CNA's) using their budget. Stand up for your dept if possible, activities is just as important as nursing & we don't want residents or other staff to start seeing us as nursing. Ok off of this ban wagon it just gripes me when they think we do so little or less important thatn other depts. Of course we must help each other (team work) out but with in reason.

We also have a beauty shop for hair cut and the activity deppartment provides manicures. I think it would be great if we had some CNA training so we could help out. I find if I want a resident that is a 2 assist in walking I have to wait for the CNA's to be available to help or if someone is sliding in their chair I CAN NOT help them. But, My AD is afraid they (nusring and CNA's will take advanage of this.

[turtle 0]

We also have a beauty shop and the activity department does the nails. Our CNAs are responsible for cleaning, clipping and filing the nails, we just paint them. Most of my staff, including myself, are certified as CNAs and we do jump in and help out when needed, especially when a resident wants to attend an activity and is waiting to be assisted with tolieting, etc. I have never had a problem with the CNA's taking advantage of this and have actually found that they are more helpful with getting the residents to activities when they see that we are willing to help them out when needed. We are all overwhelmed with paperwork and planning but, to me, the bottom line is the residents. This is their home and it is our responsibility, no matter our position, to see that their needs are met.