Now I know that perhaps the cynical among you will think that I’m sending this with a smirk. Actually I’m not. Actually I’m sharing it with the same sense of enthusiasm that I experienced when I read it. The letter came with a resource offered by CMS entitled “Hand in Hand” which is available FREE OF CHARGE to anyone who requests a copy. Information about how to request this excellent resource is included in the letter.
The letter that follows will be of great interest to anyone who works in a retirement setting, licensed or unlicensed, or for anyone who knows someone living in a retirement center, licensed or unlicensed. This is because in reading the letter one sees that the government agency that sets the minimum standards of care in nursing homes, in this letter, makes clear that it is the individual elder who comes first, not the task, not the paperwork, not staff convenience or efficiency. CMS refers to this aspect of standards of care as person – centered care. Note the entire paragraph in which person – centered care is described and defined.
CMS also makes clear that if person – centered care is adopted as a philosophy in a nursing home, organizational changes will be called for. We can’t keep doing the same things the same way and just say we have person – centered care. We can’t keep using the same words and say that we have person – centered care. One word that comes to mind is “compliant.”
The letter is from the Department of Health and Human Services, within the Center for Medicare and Medicaid services (CMS) and I quote it here in its entirety.
Dear Nursing Home Administrator:
Section 6121 of the Affordable Care Act requires the Centers for Medicare and Medicaid Services (CMS) to ensure that nurse aides receive regular training on caring for residents with dementia and on preventing abuse. CMS created Hand in Hand, the training you are receiving today, to address the annual requirement for nurse aide training on these important topics.
Our mission is to provide nursing homes with one option for a high – quality program that emphasizes person – centered care in the care of persons with dementia and the prevention of abuse. The Hand in Hand training materials consist of an orientation guide in six one – hour video – based modules, each of which has a DVD and an accompanying instructor guide.
Person – centered care is an approach to care that focuses on residents as individuals while also emphasizing the role of the caregivers working most closely with them. It involves a continual process of listening, trying new approaches, seeing how they work, and changing routines and organizational approaches in an effort to individualize and de – institutionalize the care environment. Person – centered care is at the heart of the Hand in Hand training.
Consistent staffing, empowering nurse aides, making person – centered care a team commitment, and building relationships, you and your staff will be able to better understand and respond to residents’ needs. These practices may also play a role in preventing abuse by helping caregivers put themselves in the shoes of residents, understand residents’ actions, look at their own actions, and know themselves and their limits.
Implementation
Though Hand in Hand is targeted to nurse aides, it has real value for all nursing home caregivers, administrative staff, and others. For this training to be most effective, it is important to choose a team approach to training. Hand in Hand asks nursing home administrators to educate, empower, and create an environment of person – centered care with an emphasis on a team approach and building relationships.
Person – centered care is about seeing the person first, not as a task to be accomplished or a condition to be managed. It is the fulfillment of the Nursing Home Reform Law (1987) to consider each resident’s individual preferences, needs, strengths, and lifestyle in order to provide the optimum quality of care and quality of life for each person.
While annual training for nurse aides on dementia care and abuse prevention is required in current nursing home regulations, we do not require nursing homes to choose Hand in Hand specifically as a training tool. Many other excellent tools and resources are also available.
Thank you for your commitment to utilizing available materials such as Hand in Hand for the required annual training for nurse aides. We anticipate that these enhanced training programs will enable you to continuously improve dementia care and abuse prevention, as well as resident and caregiver satisfaction in your community.
For information to download the training modules or inquire about replacement copies of the Hand in Hand Toolkit please visit http://www.cms-handinhandtoolkit.info/Index.aspx
Sincerely,
Patrick Conway, M.D., MSc
CMS chief medical officer
Director, CCSQ
http://www.cms-handinhandtoolkit.info/Order.aspx
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