Bathing without a Battle, the groundbreaking approach to delivering individualized care for people with dementia, is now in its second edition.

In addition to the original materials, the new book substantially updates the section on special concerns, including pain, skin care, transfers, the environment, and determining the appropriate level of assistance.

Elise Nakhnikian is PHI’s Senior Online Editor

UPDATE
The symposium has reached capacity.  Registration is currently for the waiting list only.

Registration is open for the 2008 Symposium on Strengthening the HCBS Direct Service Workforce on May 8 and 9 in Baltimore.

Presenters will highlight best practices, federal and state initiatives, and research findings aimed at developing the home- and community-based direct service workforce. That includes direct support professionals, personal care attendants, personal assistance providers, home care aides, home health aides, and others who assist people in their homes and other community-based settings.

The event is being hosted by the Centers for Medicare and Medicaid Services’ National Direct Service Workforce Resource Center, with the support of the U.S. Department of Health and Human Services and the U.S. Department of Labor.

Elise Nakhnikian is PHI’s Senior Online Editor

In yet another sign that the needle is moving in the right direction, two major trade publications for long-term care providers ran features last month on how to empower direct-care staff so residents and organizations can benefit more from their input.

In Provider magazine’s “Working on CNA Empowerment,” (pdf) author Joanne Kaldy advocates both classroom and on-the-job training to develop clinical and leadership skills. She also quotes experts on the importance of actively soliciting and acting on CNAs’ input – and then making sure they see how their ideas have been implemented.

“When DONs and other interdisciplinary team leaders encourage and empower CNAs to report their insights and to take an active role in care planning and quality assurance, patients benefit, nurses have more time to do their jobs, families are happier, and facilities function better,” she writes.

Meanwhile, in Nursing Homes Long Term Care Management, Susan Gilster and Jennifer Dalessandro write about transforming organizational culture. Workers need a shared vision to work toward, they say. They also need respect, information in the form of a thorough orientation and ongoing education, and recognition for a job well done.

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Providing health insurance makes consumer-directed home care workers more likely to stay, both on the job and in the field as a whole, according to a study from Washington state.

Evaluation of Interventions to Improve Recruitment and Retention (pdf) reports on a survey to evaluate a series of initiatives instituted by the Home Care Quality Authority (HCQA). The changes were aimed at improving recruitment and retention of the so-called individual providers (IPs) who participate in the state’s consumer-directed home care program, many of whom are related to the people they care for.

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If you need to know how many hours of training states require for nursing assistants, or you want to compare your state’s requirements to others, a new table in PHI’s Clearinghouse can help.

Federal regulations require nurse aides to get at least 75 hours of training, including at least 16 hours of supervised practical or clinical training. That’s a good start, but most consumer advocates and researchers who’ve studied direct-care work think more is needed. Most state governments appear to agree, since they require more than the federal minimum.

State Nurse Aide Training Requirements, 2007 (pdf) lists the minimum number of total hours and clinical hours required by each of the states and the District of Columbia. Twenty-eight of the 51 require more than training than the feds, with 12 states and DC requiring 120 hours or more. Thirty states require more than 16 hours of clinical training.

The greatest amount of training required is in Missouri, which mandates at least 175 total hours and 100 hours of clinical.

Elise Nakhnikian is PHI’s Senior Online Editor

“Most of us hear about abuse in long-term care and we assume some evil person out there tried to take advantage of somebody vulnerable. But the truth is, we all have the potential to be abusive. You can have the best intentions and still be abusive without even knowing it,” says Heather Picotte, administrative manager for the Adult Abuse and Neglect Prevention (AANP) project.

“For instance, if you’re stressed because you’re caring for a family member who’s ill, and you go in to work and you’re trying to bathe someone who doesn’t want a bath, you might get frustrated and react badly. Or if someone doesn’t make it to work, so you have to care for more people, and you’re doing everything in a rush, you could do something abusive without even realizing it. Consumers can be abusive too. If you’re dealing with a family member who’s sick and you’re stressed out, you can take it out on the caregivers, or even your family member. And elders can become combative.

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