Caregivers

Quarterly

A newsletter
for caregivers
from the
Iowa Health
Care Association

...
Fall
2016

aregivers can help

residents transition
from antipsychotic use by
using these communication
techniques and alternative
medicine approaches with
a healthcare professionals
approval.

Antipsychotic management
moving forward

ith the right tools and

information, caregivers can
assist in decreasing the
off-label use of antipsychotic drugs.
Antipsychotic use has become an
ongoing issue as the drugs have
been often prescribed to memory
care patients to treat behavioral
problems without a psychiatric
diagnosis. This is concerning due
to the serious side effects that can
deeply impact the persons quality
of life.

studies have shown that these are

normal behaviors in those with
dementia resulting from something
they find scary, upsetting or
uncomfortable. As a caregiver,
consider that the resident is trying
to tell you something, such as they
are hungry, thirsty, tired, bored or
need to use the restroom.

One Step Forward

The push to reduce

antipsychotic drug use began
The Facts
in 2012 after a report found 83
percent of antipsychotic drug
Not only are antipsychotic
drugs expensive; they increase the insurance claims were made
for nursing home residents
risk of death, falls with fractures,
without conditions approved for
hospitalizations and other
antipsychotic drug use.
complications resulting in poor
Long term care facilities,
health and high costs.
working
with doctors and family
These drugs can help some
members,
have made great
individuals with dementia who
progress
in
reducing antipsychotic
have psychosis; however, most
drug
use
since
then. As of May
often antipsychotics are prescribed
2016,
half
of
the
American Health
for use when a person acts in a
way that is challenging or disturbing Care Associations (AHCA)
skilled nursing center members
to othersthey dont necessarily
have psychosis. This could include have reached or surpassed the
hitting, yelling, crying, refusing care nationwide goal in reducing
antipsychotic usage by at least
or throwing things.
Some believe that antipsychotics 30 percent, months ahead of
may help with these behaviors, but the December 2016 deadline.

Communication techniques
Listen, talk slow and use a
calm tone
Ask yes or no questions and
use affirmations
Smile, laugh and use humor
Repeat, rehearse and repair
Watch your language and
dont argue

Alternative medicine
approaches
Tea or milk
Familiar or comfort foods
Essential oils, such as
lavender, rose or rosemary in
small amounts
Pets or small children
Acupressure
Light exercise
Bath or shoulder massage
Music
As a result, the overall decline
in antipsychotic use in AHCA
members is 30.4 percent. There
is a 25 percent decrease in nonmembers.
The Iowa Health Care
Association (IHCA), an AHCA state
affiliate, is part of the progress.
IHCA has been committed to
helping our members reduce
the use of antipsychotics in
their buildings, said Mary Jane
Carothers, IHCA VP, Quality
Improvement and Clinical Affairs.
Continued on page 4

Working Effectively

strategies for managing conflict

Its common for people, especially co-workers, to have

differing opinions, miscommunications and misunderstandings.
All these things can create conflict in our life and work;
however, the problem is not the conflict, but rather how we
handle it.
Most people prefer to avoid conflict rather than to simply
resolve the problem. This is almost never a good solution and
often leads to regret, guilt and increased stress. Effectively
managing issues will lead you to be much happier and
healthier. Here are six strategies for managing conflict.

1. Dont overthink it
Is it a big deal? Sometimes our feathers may be ruffled or our
feelings get hurt, but its probably not worth getting worked up
about or spending too much energy on.

2. Think it through
Before addressing someone, take time to think the issue over
to yourself. Think about what you want to say and then write it
down and rehearse it.

3. Talk it out
Set a time to talk it out, face-to-face. Meeting in person is
intimidating, but is usually the best choice. Face-to-face
communication allows for an active exchange and gives you
the opportunity to make use of important body language, such
as a handshake or smile.

4. Use a mediator
If a situation is particularly sour and other efforts did not work,
confiding in a neutral third party, such as a supervisor, could
be a good idea. A mediator can remain objective, listen to both
sides and assist in resolution and compromise.

5. Apologize when appropriate

Be aware of your own part in the conflict and acknowledge if
youve done something wrong or inappropriate. Sometimes
you have to meet people halfway, apologizing even if the
conflict wasnt entirely your fault.

6. Work on your communication skills

The greatest strength you can have is effective communication
skills. A problem well-stated is a problem half-solved!
Fall 2016

Serve as a mentor
Every experienced caregiver has a
responsibility to serve as a mentor for new
caregivers. Everyday actions and behaviors
contribute to a caregivers success. Gently
mentor new caregivers to show you care and
support them. Here are some ways you can
help make a new employee more comfortable
in his/her new job.
Dont expect the new caregiver to know
everything. Just because he/she may be
certified, doesnt mean they have a lot of
hands-on experience yet.
Be respectful of questions. Answer each
question as best as you can in a positive
manor. If youre unsure of the answer, find the
answer or direct the caregiver to someone
who does know.
Remember your first week on the job.
Demonstrate compassion and patience.
Ask for feedback. Ask a new employee
to honestly share their experiences, both
positive and negative. Ask what you can
do to ensure the new caregiver has a great
experience.
Demonstrate caring. Ask new caregivers
to share a meal with you, buy them a
coffee, make sure they get their break, and
frequently offer to help.
Page 2

Techniques for Caregivers

Kick resident loneliness to the curb
Even among a roomful of people,
its easy for residents to feel
lonely or miss their old, familiar
surroundings, family and friends
but there are steps caregivers
can take to help minimize these
feelings.

Keep residents connected.

Changes to health can affect

residents social connections and it
can be difficult and intimidating to
build new relationships. Talk about
existing connections important
to residents, including how those
relationships can be strengthened.
Suggest alternative ways to keep
in touch, such as a telephone call,
skype or even a letter!

Provide things to do.

Become familiar with residents,

interests and hobbies, whether
old or new. Provide these types of
opportunities for residents to get
together and make new friends.
There is something satisfying and
enjoyable about being involved in
groups with a shared interest.

Recognize challenges.

Challenges range from losing

hearing, eyesight, mobility
or strength. These make
communication much harder,
especially in social situations. Find
out how its affecting residents and
ask how (and look for ways) you
can help to make things better.

Build confidence.

Cope with life events.

Residents dealing with loss or a

sick loved one may be at higher
risk for feelings of loneliness,
especially if its a life partner. Listen
to how residents are feeling and
think about their needs in staying
connected. Encourage them to
accept offers of support from
friends and family.

Building relationships is very

difficult without confidence. Have
a conversation with residents on
past achievements in their life and
personal strengths that could help
them cope with current challenges.
Discuss supports that might help
as well as what they can offer
others!

Be open to different
perspectives and trying
something new.

Adapt to change.

Work together.

Leaving familiar environments can

be isolating. For new residents,
discuss their wants and needs in
their new home. Talk about ways
residents can maintain friendships
as well as opportunities where they
can build new ones.

Provide activities that reflect the

interests of individual residents to
prevent social isolation. Listen to
what residents want, then discuss
and build ideas together from
there.
Work with residents. Explore
services and community resources
that could provide support and
develop networks to share
knowledge and ideas.
Source: http://www.iriss.org.uk/resources/preventingloneliness-and-social-isolation-older-people-prompt-cards

Cochlear implants reduce risk of depression

Seniors with cochlear implants have a reduced risk for depression due
to better hearing, one study found. A cochlear implant is an electronic
medical device that replaces the function of the damaged inner ear. In
other words, cochlear implants do the work of damaged parts of the inner
ear (cochlea) versus hearing aids, which make sounds louder.
The study included 113 participants age 50 and older who have received
either a hearing aid or cochlear implant. Participants completed a
geriatric depression scale questionnaire before receiving their device, as
well as 6 months and 12 months after.
Those with the hearing aid devices initially reported lower depression
scores, but ultimatey those with cochlear implants showed even lower
scores.
To learn more about this study, visit http://www.ltlmagazine.com/news-item/turn-sound-turn-down-depression.

Fall 2016

Page 3

Caregivers Corner
Continued from page 1

Antipsychotic management moving forward

Our Quality Committee goal is that at least 50 percent of our members
will reach the CMS 30 percent reduction goal by the end of 2016. We
are on target to meet this goal by the end of December and also to have
Iowas average reduction rate equal 30 percent.

The Caregivers Role

Caregivers are the secret weapon in effective reduction of
antipsychotic drug use. The CNAs or universal workers intimate
knowledge of each resident is the key to identifying what non-drug
approaches or interventions can help prevent the negative behaviors
for which these drugs are often prescribed, said Carothers. The well
trained caregiver understands that most dementia behaviors are either
unmet needs or are provoked by staff approaches or misunderstood
environmental cues.
Caregivers can reach out to family members to gain useful information
on a residents behavior. Family can provide how the resident typically
expresses themselves when hungry, angry, anxious or scared. They
can also let you know what comforts the resident and their typical daily
routine. Ask family for their perspective on the best ways to identify and
meet their loved ones needs.
Carothers encourages caregivers to have an active role in detecting
why the resident is acting as they are, including helping to develop care
plan approaches that will reduce drug use and improve quality of life for
the resident.
For information on how to manage different dementia behaviors, visit
https://www.caregiver.org/caregivers-guide-understanding-dementia-behaviors.

benefits of working
in long term care

1. You have the chance

to develop a lasting
relationship with your
residents.

2015 Quality and Excellence Awards

2. You can learn a lot from an

older generation.

3. Small favors are greatly

appreciated.

4.

You gain a new

perspective on aging.

5. Your co-workers tend to be

caring people.

Fall 2016

Save the Date

Health Care
Assistants Conference
December 14

(Add information in the Fall)

Caregivers Quarterly is a newsletter

published by the Iowa Health Care
Association (IHCA) for the staff of its
members and is intended to help them stay
informed on current techniques and issues
related to providing care in nursing homes,
assisted living, home health, residential
care and independent living facilities.
IHCA and their members are dedicated to
improving the quality of long term services
and supports in Iowa through educational
programs and proactive advocacy with
the Iowa and U.S. legislatures and
administrative agencies. The Iowa Health
Care Association (IHCA), Iowa Center for
Assisted Living (ICAL) and Iowa Center
for Home Care (ICHA) are affiliated
respectively with the American Health Care
Association (AHCA), the National Center
for Assisted Living (NCAL) and the National
Association for Home Care and Hospice
(NAHCH).
Managing Editor: Nicole Mergen,
Communications Intern
Editor: Claire Seely, Director of
Communications
Iowa Health Care Association
1775 90th St.
West Des Moines, IA 50266-7726

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