Event ID:2988059
Event Started:7/6/2016 2:44:03 PM ET


[Please stand by for real time captions]

Hi, everyone. It is a little bit before 2:00 and we will give people a few more minutes to get signed on before we start.

We will get started. This is Emily. I will be your chat pane monitor and will give you housekeeping before I turn it over to our Speaker. First, all of your phone lines are on mute at this point for a better listening experience. If you have a question or comment, please use the chat pane on the right-hand side of your screen. Just a reminder that state and federal regulation require that you record attendance. Someone at your facility should be recording your attendance for this webinar today. If you need attendance tracking sheet, we have a template on our website under the toolkit page. Also I ask you to be patient today as we will show you a video clip. It has been a file since I have worked the Speaker system and what not in our conference room. Please be patient with us. At this point, I will talk a bit about our Speaker. Today we have Dr. Linda Beuscher with us. She is system professor at the school of nursing at Vanderbilt. She is also a geriatric Nurse Practitioner. She has a good bit of experience and long-term care and dementia care and also is where her research interests are. I will turn it over to her now.

Welcome, everyone. As we get started, I want to add a little bit. Thank you, Emily, for the lovely introduction. I worked for 15 years in long-term care with experience with residents and staff. I started out as a nursing assistants in a long-term care facility before I went to nursing school. I have had first-hand experience and have a great appreciation for you, your work and your new role as a feeding assistant. Today we are going to cover the third session of our Feeding Assistant Training. In this session we will review what the import aspects are making positive dining experience for the residence and your cell. We will demonstrate proper resident and staff positioning for feeding assistance. We will also illustrate the various types of feeding assistance you will provide for the residence. Will explain specific techniques for feeding and then discuss the required performance evaluation that must be completed to receive your certification. Before we get started, let's revisit the activity you had from Session number one. Close your eyes. Now, imagine the last good meal that you had. What made that meal memorable? Now that you have that meal in your mind, focus specifically on what was going on in that environment. We'll kind of noise was there are around the about me? What are you comfortable? Could you talk to each other? What was the lighting like? Was it dark or did you have it will lit so that you can see things. What about aromas? Could you smell the food -- third. When you walk in the kitchen, could you smell the food or the dining room. Cleanliness, was the table or counter clutter? Did you have to clear stuff off to be able to sit down? Now you can open your eyes. I'm guessing most of you thought of a positive -- positive experience where you could easily talk to your family or friend without much distraction. And also with a place that smelled really good and very inviting. Let's now compare that experience of that memorable meal with what you might see in long-term care setting. How often are there distractions to the residence? Who are they seating and eating with? What does the table looked like? What does it smell like in that area. You could probably sit and discuss that a bit. If you are wanting to chat you can do that. Average long-term facility has less than ideal eating environments. We will start our discussion first by describing what could be removed to make the environment more positive. These are simple things to eliminate an approved the residents experience. Firstly, most important and simply reduce noise and distractions. Some of that can be easy such as turning down or off the TV or radio. Some may not be as easy as limiting staff to staff conversations. It's incredibly common for us to observe a meal periods and see staff talking to one another and never speak to the resident they are assisting. Typically, those staff conversations are not work-related. This is a problem for many reasons. Number one it is rude. It's not respectful to the residents. It also increases the noise in the dining room. 'S Stasi to far away from one another, you can imagine trying to talk to one another over the dinner with the usual noise, silverware on the table, classes and people trying to talk. He becomes distracting. The person that becomes easily distracted will not be focused on eating and concentrating on the third. It's important you be watchful of distractions. Also, limit how many times you get up and down from the table. If you think about a person eating and forgot to put the glass down and have to get up going back-and-forth which distracts the residents as well. You can do these things to make it more positive. If you are in the dining room are likely to face these challenges. You can set the example and politely limit staff-to-staff conversations are redirecting the worker to say, hey, we will talk about it later. Or shift conversations back to the resident, which you should be doing. Also, as a reminder, very inappropriate when discussing with a resident to discuss any personal problems with a resident or negative work-related issues. That should not be in the conversation with the resident. On the second point, removing excess clutter. I bet you would not sit down to eat-in the midst of a bunch of trash. By removing the trash makes it feel more homelike and keep residents from eating and edible objects. May seem silly but truly a person with dementia may not recognize that is something that is not edible. It's important. As far as table decorations, you want to make sure there not impeding residents ability to reach food or impeding them to see other people at the dining table. Also to see them when they are able -- to see them when they are talking. Now lets switch to a positive dining environment and it what you can do to make it a more positive environment. First of all, good aromas. They help activate the appetite. Think about Thanksgiving dinner or, for me, was Sunday dinner going to my grandparents house. It was inviting. You could smell the delicious food as soon as you walked into the door. That's important for our residents as well. The couple of things we see a different facilities is keeping a pot of soup, cooking in the dining area or baking cookies and activities in the dining area. That helps increase a person's appetite. It increases their anticipation. It increases there and the patient that it's going to be a good meal. You want to be able to see what is going on around you. Soft music. I know the last point may be intuitive -- counterintuitive after talking about reducing noise but sometimes soft general music in the background can be relaxing without a person focus on their meal. You need to be conscientious of the volume and, please, select music the residents and joint rather than the staff preference. We see that happen as well and facilities. Just as you would prepare the environment for mealtime, you also need to make sure that the resident is ready to eat. There is several considerations. First, had the resident had the care there -- Benny. For instance, the person that they have a problem controlling their bladder/bowels. You do not want to be sitting at the dining room table someone who is in wet close. It would be unpleasant them for the resident and would also be unpleasant for the person sitting nearby. Also, if you take them into the dining room before having opportunity for bathroom care, it makes it harder for them to find the nurse aide too come get them, take resident back to the bathroom and bring them back to the dining room. They lose interest in the food. The food will be called. You will have to repeat the food and it disrupts the meal. Best to make sure to check with the nurse's aide that the resident has been to the restroom and can go through the rest of the meal. Medications, it takes a strong work for the Nurse two try to tech -- tracked the residents down. Some medications are given with males, some right before meals and some right after meals. Check with the Nurse two be sure they have had their medicines before going to the dining room. It's important to check with the nurse's aide also if the resident uses any of these items before coming to the dining room. For instance, do they need glasses? It's important for them to be able to see what they are reading, see who they are sitting next to and even the environment. Does the resident where hearing aids? Be sure they are wearing hearing aids to make sure they can hear what is being talked about around them. As [Indiscernible] mention, important for mealtime to be socialization. Thirdly, does resident wear dentures? Gingers are important to properly chew your food. If they do not properly chew their food -- Jen -- dentures are important to properly chew their food. If they don't have their dentures they cannot properly food -- to their food. If their dentures are being repaired, let the nurse know. That the cafeteria and dietary folks know so that they can provide an alternate meal cost something soft for the resident to chew. Other considerations: Be sure resident is comfortable in the dining room. Sometimes they get very cold. Asked the resident if they need a sweater. You can also bring a sweater or jacket to the dining room in case the resident wants to wear it later. This will be helpful also if they want to stay for music or activities as well. Be sure their hands are clean. Make sure they are clean before bringing them to the dining room. Would you want to eat your food with dirty hands Lex some residents use a clothing protector. Check with the nurses A. the word bid should not be used. This is a resident dignity issue. This is worth repeating. The word bid should not be used as for resident dignity. Asked if they have a favorite place to sit. People enjoy their meal better if they are seated in a preferred place. They can enjoy conversations with other residents or may even enjoy a certain view. We had one resident that loved sitting by the window because she loved to see all of the cars coming and going. It did not distract her from her meal. It was pleasant for her meal experience. This is a resource. If we have time later in the series we will show you part of the. It's the Alzheimer Resource Center of Connecticut. It's called dining with friends Burkitt's not necessarily typical long. -- lawncare tears -- well-care -- Long Term Care Setting. It's for Alzheimer's care. It creates a warm environment such as staff sitting at the table with the residents, even those needing very little feeding assistant. As well as creative, unique ways too meet dietary needs which was talked about during the last session. You can see the link on the screen and I will put it in the chat box for you. It will be on our website as well. If we have time during the series we will show it to you.

Thanks, Emily.

Proper positioning is very important when assisting for feeding with a resident. The resident needs to be sitting upright. If they are in a feature needs to be close enough to the table so that they can reach the utensils and the food. Also, if they are seated in a wheelchair which some will be, you want to make sure they are not slumped to one side. This is important to make sure they are in proper position to make sure that they can swallow correctly and the flu can pass down through the esophagus to their stomach. If you are assisting a resident while they are lying in bed or seated in a Geri-chair, make sure the resident's head is raced 60 degrees to 90-degree angle. As you can see in our figure, that's a 60-degree angle. If you want to [Indiscernible] again, important for them to have the food pass properly from the esophagus into the stomach. If a resident's head should be centered midline or if they are not straight in the bed or over to the one side, pillows are very helpful to prop the resident into proper position. If resident needs to be repositioned, please find the nurses and or the Nurse two help you. If in doubt, always ask about the position of the patient. Some patients may only be in that position because they have some type of skeletal condition. It's important to make sure that you check with the nurse. Let's shift are focus from the positioning of the resident to your positioning as feeding assistant. When assisting resident with mills, be conscientious of how you are seated yourself. You should always be at the resident's level. Seat yourself in consideration with the resident's impairment. Particularly, if you were watching this webinar with a co-worker, I encourage you to do quick role-playing with each other with one standing and at one sitting. For the person sitting, how does it feel to have someone towering over you? Is it intimidating? Do you feel nervous? We will give you a second to do that.

Feel free to share your answers with everyone on the chat pane or with me. We will read them out to you. How would you feel if someone stood over you while trying to provide you with assistance?

I encourage you to use the chat pane. If you do not, you will have to listen to me more. I will share how I have felt. Linda and I have led this activity many times. I have been the person being fed with someone standing over me. It intimidating as Linda said. It's also very uncomfortable because you are at an awkward angle. You cannot really make eye contact with the person helping you. You wouldn't want your family member to feel that way. You wouldn't want to make the resident feel that way. There is a strain on your neck, your whole upper body when someone stands over you rather than sitting next to you.

Someone also said it would make me feel less than. I think that's true.