What senior care providers should report back to their clients
Senior care involves a complicated set of relationships between several parties: the senior receiving care, the client or family member who’s often organizing and/or paying for the care and one or more senior care providers. Communication among these parties is the key to ensuring seniors receive the physical and emotional support they need when dealing with a loss of independence.
Family members might feel guilty when they’re not providing the care themselves, says Elizabeth Wright, MSN, ANP-BC, ACHPN and geriatric nurse practitioner at Oasis Hospice in Lancaster, California. Being provided with information about their day-to-day care and activities helps assuage some of that guilt, she says.
But reports aren’t only for the benefit of clients. Patty Calderon, a hospice caregiver in South San Francisco for the past 10 years, says she often shares caregiving duties with another provider, so reports are crucial. Come time for a shift change, providers need to be able to give a detailed update to the other caregiver so everyone’s on the same page.
Finally, detailed reports can also protect providers, particularly when the senior’s cognitive capabilities have diminished. Calderon gives the example of dementia patients who become frustrated when they can no longer communicate their needs.
“It could be that the client has been combative or aggressive,” she says. “They can hit their arm on their bed railing … and [the report] is a protection for you, too, because at least there’s something to show that you’ve been making the client’s family aware or the agency aware.”
Here are the basics on how and what to share with your senior care client.
Figure out the best form and frequency of communication
Beyond empathy, one of the most important things you can do to keep family members, as well as medical providers, in the loop is to provide regular reports. Nora O’Brien, DPT and executive director at United Hebrew’s Willow Towers Assisted Living and Willow Gardens Memory Care in New Rochelle, New York, recommends senior care providers “find out how often and via which channels clients/family members would like to receive feedback on their loved one.”
Communication methods include:
Shared notebooks kept in the home.
“I have seen very detailed notes left by these caregivers to family members on a daily basis,” Wright says. “Sometimes the notes are done weekly or notes are simply jotted down on a desk calendar highlighting changes or concerns. On one occasion, I have seen notes made on an iPad at the patient’s bedside.”
What to report to clients and/or other providers
Dr. Seema Sangwan, internist at San Mateo Primary Care in San Mateo, California, outlines three different types of functions related to the senior’s health that you should report back on: physical/functional, cognitive and social.
Physical functions/status and ADLs
The first category includes anything related to nutrition, grooming, toileting, physical activity and sleep patterns.
Did the senior finish their meals or did they have any difficulty chewing or swallowing?
Is the senior maintaining their weight?
How many bowel movements did they have that day and what was their liquid intake and outtake?
Did they have a shower, sponge bath or perineal care?
Did they develop any new bed sores or bruises?
Were they able to go for a walk or did they have a fall?
Did they go to bed and/or wake up at the usual time?
Wright adds that it’s important to provide clients with information about “how much [seniors] can do for themselves (called activities of daily living [or ADLs] in the medical world).”
ADLs are a crucial indicator of how seniors are doing overall and include, for example:
Can the senior get in and out of bed or a chair by themselves?
Can they feed themselves, bathe and dress themselves and/or can they do toileting activities independently?
Calderon says the information provided by caregivers should be tailored to the specific conditions a senior might have. If they have diabetes, for example, note any new sores or cuts they might have, as diabetics are at higher risk for infection. Or, if the senior is on new medication, be sure to observe the effects carefully and report back to the client and/or medical provider. Sometimes the dose is too high and/or the senior might be feeling too sedated.
Sangwan lists cognitive aspects to look for and report on like:
Did the senior read the newspaper or listen to or watch the news or any other TV shows that are usual for them?
Did they play any games?
Did they ever seem confused, overly sleepy or act in an aggressive manner?
In addition, Calderon suggests that if the senior has dementia, they may be experiencing sundowning moments or mood changes that should be noted.
We all know that isolation is a major problem for seniors, especially those who live alone, so you’ll do well to report back to your clients on their social activity. For example:
Do they show any interest in connecting with friends?
Are they interested in their regular neighborhood walks?
Jerome Bagaporo, head of clinical services at United Hebrew’s Skilled Nursing Facility in New Rochelle, says clients want a holistic picture of their family member’s health. In other words, in addition to food and water intake, dressing and hygiene activities, “they want to know if they are participating in the many social and recreational activities we offer and what their level of engagement was,” he says.
How reporting benefits everyone involved
Experts’ experiences prove that thorough reporting can make a world of a difference. Calderon recounts an instance in which she was working with a senior who was complaining of intermittent leg pain, so she was treated according to that symptom with Tylenol. However, Calderon noticed the leg pain would get worse when the senior was constipated, even though the pain presented in her leg and groin area instead of her stomach. Because the care provider was keeping track of the senior’s bowel movements, the doctor decided to take a closer look at the connection between the symptoms and was eventually able to figure out that there was a blockage in the senior’s large intestine, and she needed surgery.
Clearly, regular and specific communication about a senior’s condition is essential to providing them with quality care and alerting family and medical providers to new health conditions. It’s certainly a case for perfecting your reporting process.