Disaster Plan

We've all been shaken by the events in Japan. Our hearts and prayers go out to those who have been affected by the tsunami and to those who are risking their lives to help.

Natural disasters like this should remind us to evaluate our own emergency and disaster preparedness. CCLD has a great self evaluation resource for this purpose. Compliance should not be the only reason for good planning. We have committed ourselves to providing excellent care to our residents. Their safety is our first priority.  Please take the time to review the self evaluation and make sure you meet or exceed every item on the checklist.

You can print the CCLD Emergency and Disaster Preparedness Self Evaluation here.
http://www.ccld.ca.gov/res/pdf/DisasterGuide.pdf

You can review and print the FEMA guide here.
http://www.fema.gov/areyouready/

The American Red Cross and CalEMA offer a Preparedness Training and other resources here.
http://www.prepare.org/home/

Overtime for Caregivers

Q - Tom, According to some websites we’ve researched, caregivers who work in a facility get overtime after working: 10 hours a day OR 40 hours a week.  Another website said that caregivers will only get O.T. after they work 80 hours in TWO weeks (so they can work 60hours 1 week, then 40 the next).

Can you clarify the O.T. law for caregivers working in RCFE's (care facilities)?

A - Both are wrong.  They start getting overtime if they work more than 8 hours in a day and also more than 40 hours in a week (unless they have voted and agreed to work 4-ten hour days).

Care facilities are governed under the Industrial Welfare Commission Order #5 (IWC 5).  Please go to the attached link for the full order and get the answers to other related questions like how much you can deduct for meal and lodging AND should you be paying for uniforms, etc.

 http://www.dir.ca.gov/IWC/IWCArticle5.pdf

Cold Weather Prep

The entire state of California has been experiencing cold weather this past week.  While I am sure you are all aware of the dangers of cold weather and the elderly, it is still a good idea to re-evaluate your current practices.  On the CCLD website you can find some information or guides to cold weather preparedness.  Some of the information will refer to your garden, pets, and even your home.  Please download these guides at the following links and share them with your staff?

• OES Cold Weather Safety Tips  
• Winter Weather health Tips CDPH 2007  
• Extreme Cold CDC Pamphlet 

Medications - Shadowing

We are still getting calls from facilities that have been cited from licensing for lack of Medication Training.  If you have completed the live medication class or the medications training on line then the problem usually is that the shadowing part has not been completed.

Shadowing has to happen in the facility and should be individualized training.  You can not complete this part of the training in a class.  Be sure to have documentation that this training is completed for yourself and all of your staff. 

The other items that you may have overlooked are that every employee needs to pass the medication test and have the documentation in the files.  The test also has to be completed in the facility.  You should have in each employees file, documentation that they have completed the classroom training (four hours for 15 beds or less and eight hours for more than 15 beds), completed the shadowing (2 hours for 15 beds or less and eight hours for more than 15 beds), and then a copy of the completed test.

The employees do not have to repeat the shadowing or take another test each year but they do need to have four hours of annual training on medications.  This applies to all employees who currently do or might pass medications.

Residents Refusing Meds

Q - I have a resident who refuses to take their medications, now what?

A - There are many reasons why a resident might refuse medications.  By the time an elderly individual enters into residential care they have already released control of many portions of their lives.  Controlling their medications is something they still have.  Take the pill or not.  Only they can decide.  Unfortunately, it may be a risky choice.  Here are a few things to consider if you or your staff encounters this problem.

1. Start by finding out whether they really need to take the medication.  If the medication is not needed to sustain life then you may want to check with the doctor and ask about stopping the medication.

2. If stopping the medication is not an option, consult the doctor about changing the time of day, or changing to before or after meals.  You will need to check the order and see if the medication is to be taken with or without food.  You should also get an order from the doctor for changing the time of day.

3. If swallowing is a problem, see if you can get permission to crush the meds or cut them in half.  You may want to consider asking about different delivery option s.  Ask the doctor & the pharmacist if there are other forms of the medication such as a patch, lotion or liquid.

4. It may also be the color of the pill.  Bright colored pills like red or orange can appear threatening.  There may be another generic or brand that is a different color.

5. Trust can play a part.  You may want to try having a different staff member present the resident with the medication.  It may not be about persuading the resident to take the medication.  It may be about the resident’s feelings toward a caregiver.

6. Other considerations:

·         The medication may affect the flavor of food.

·         The resident may be embarrassed to swallow pills in front of other people.

·         The medication may make the resident feel ill, make keep them awake, or constipate.

·         The resident may not like the texture or aftertaste.

·         Changing the resident’s routine may have positive or negative results.

Remember you need to notify the doctor every time the resident refuses to take a medication. 

If you have a question that you would like to have answered on Tuesdays with Tom send him an email.  Use the subject line Questions for Tom in your email. 

Email Tom at communitycareoptions@usa.net