Table of Contents
At HealthyLovedOnes good caregiving is more about your credentials or even experience. We believe it begins with understanding and believing in the value of Tender Loving Care. So what is TLC? Are they just some words or American acronym or does it really have caregiving value?
If you love someone, you will automatically give TLC service. All you want is to make sure your loved one gets well as quickly as possible. You are attentive and forever anticipating their needs and requirements. You want them to feel comfortable and stress free. This is the foundation of TLC service and spirit. This service comes from the heart, from caring more about someone other than yourself, being unselfish, it’s a very special kind of caregiving.
1. Tend to yourself before tending others
2. Love yourself before loving others
3. Care for yourself before caring for others
Treat others the way you want people to treat you, be kind and considerate. Be nice and friendly, smile, smile and smile.
Loving means you are always genuine and sincere.
Care starts from your heart. Remember, people will always appreciate a caring attitude.
• Take Ownership of Yourself
• Caregiving Best Practices
• What You Don’t Have To Do
Take Ownership of Yourself?
Always remember – customer reviews can make or break your business. If you give good service you will get more happy customers, they are your best source of repeat and referral business. If you want to succeed in this business, you must take pride in your work, you must try and do the best job you can. The more the customer likes you the more they will recommend you. Good service sells itself.
Caregiving Best Practices:
• Anticipate needs and wants, ask clients if they want water, food, errands, TV, etc.
• Be pro-active, initiate conversation, and make a friend.
• Communication is the key to good understanding and building relationships.
• Keep daily journal, takes notes (likes and dislikes, activities, anything relevant), important for compliance and differentiation.
• Be a professional, be punctual, look tidy, and don’t forget to smile.
• Check in often, and develop a daily routine.
• Never forget TLC service and spirit.
What You Don’t Have To Do:
• Move furniture or other heavy objects.
• Heavy housework like loads of laundry and ironing, heavy cleaning, etc.
• You are not a domestic or slave, you have rights.
• Dangerous or high-risk activities.
• If not safe or you are not sure, don’t do it, call HLO support.
Arrival on Time: Always arrive on time or a few minutes early for your caregiver job. Call the HLO caregiver job supervisor immediately if you are running late.
Always Call the Client by Their Last Name: such as Mrs. Smith, unless the client tells you it is acceptable to call them by their first name.
Get Acquainted: Make the client feel comfortable and relaxed. Thank them for allowing you to work with them and let them know you are glad to have the opportunity to be their caregiver. Ask them to tell you about their preferences.
Review the Care Plan: this is your reference tool and where you will document the care in a Care Plan documentation log. Make sure you discuss with the client where to keep it and be sure to refer to it each day and to record care plan notes.
Never Touch Pills or Medication: including non-prescription drugs.
Do Not Give Your Friends or Family the Client’s Phone Number. If your family has an emergency or needs to reach you at work, have them call the care company (HLO) office and we will contact you.
Do Not receive or make calls from your cell phone while at work. You cellular mobile phone should be turned off and out of sight.
Do Not Solicit Money at Any Time, for Any Reason: from clients or family members. Any shopping needs will be managed by a Care Manager or Supervisor.
Never Come to Work Under the Influence of Alcohol or Drugs.
Follow the outlined Job Description in order to deliver quality caregiving. However, your daily care plan for each client will be customized.
Some chores may include the following:
• Assist with walking and light exercise.
• Prepare meals, followed by clean-up.
• Run errands (pickup prescriptions, dry cleaning, grocery shopping).
• Engage in physical and mental exercises.
• Provide medication reminders (monitor medication, Never Touch Pills or Medication).
• Escort on appointments with necessary updates (physical therapy, hair salon etc.).
• Escort to religious services or events.
• Engage in activities (games, memory books).
• Record daily care notes.
• Report any significant client changes to HLO office.
Keeping a Care plan Notes and Activities – Good documentation:
This section present to you - Observation, reporting and documentation of client status and the service furnished, including changes in functional ability and mental status demonstrated by the client.
Documenting Client Care - Maintaining accurate client care notes assists families, medical doctors, care managers and other caregivers to stay current with the client’s status and enables higher quality care.
Caregivers are responsible for reporting and documenting information about the client receiving care.
Client Care Documentation Components:
• Care Plan Outlining Care Routine.
• Care Plan Daily Note Sheet or Chart for Recording Daily Activities.
• Confidentiality of Information.
• Caregiver Duties and Performance Review.
Names for Care Reporting and Documentation Include:
• Care Plan Notes
• Clinical Record
• Patient Chart
• Medical Record
Quality care plan notes for each client care shift assist with the following legal protections:
1. Protects the caregiver by confirming the duties that took place.
2. Protects the care company (HLO) by confirming the care duties were performed.
3. Confirms specific care items were performed at specific times, such as turning the client receiving care to prevent bed sores every 2 hours or monitoring medication, fluids or bathroom visits. By confirming the care services took place as instructed, the caregiver is protected should anything out of the ordinary occur.
Subjective Notes vs. Objective Notes
Remember that everyone involved in the client’s care will be reviewing the Care Plan Notes.
Care Plan Notes MUST BE OBJECTIVE. Objective Notes are Facts. Subjective Notes are Opinions
• Use EXACT Quotes from the Client when they are communicating pain or discomfort.
• Only use Abbreviations which are Standard.
• Use Correct Spelling.
• Be Specific.
• Record Important Telephone Calls.
• Note Activities Throughout the Day as They Occur.
• Note Meals Eaten.
• Confirm Medications Taken (Never Touch Pills or Medication: including non-prescription drugs).
• Write Neatly and Legibly.
• Proof Your Written Documentation Notes.
• Share Your Opinions.
• Wait Until Later to Make Notes About Care Events.
• Share Notes About Your Own Personal Incidents.
• Wait Until the End of Your Shift to Record all Activities.
• Hydration (Fluids Drank)
• Bathroom Visits
• Changes in Mental Awareness
• Changes in Physical Condition and Abilities
Care Companies (HLO) will have a Daily Care Notes form which you can fill out each day and will include these types of items:
Health & Hygiene
• Transfer from bed to chair
• Bathroom Visit
• Catheter Care/Diaper Change
• Shower/Bed Bath
• Dressing Assistance
• Skin Care/Lotion
• Nail Care
• Dental Care
• Medication Reminder
• Exercise Routine
• Grocery Shopping/Meal Plan
• Set-Up Meal
• Assisted with Feeding
• Fluid Monitoring: Drank Glasses of Water
• Physical Therapy AM/Walk
• Physical Therapy PM/Walk
• Read Newspaper or Book
• Mental Exercise Game
• Other Activities:
• Wake-up Time:
• Nap A.M.
• Nap P.M.
• Bed Time:
• Bathroom Visits:
• Weighed Client lbs.
• Blood Pressure [email protected] AM
• Blood Pressure [email protected] PM
• Doctor Appointments:
• Indicate Client Status:Good, Fair, Poor
Poor Care Plan documentation could make it look like a caregiver is giving poor care or indicate neglect. Caregivers must be sure to provide solid care notes each day.
Long-term Care Insurance Companies: Care Plan Notes may be required in order for the insurance to pay the claim. This is why it is extra important to maintain professional notes daily and correctly document daily care activities.
Medication Reminder Charts: Medication monitoring is not the same as medication administration. Caregivers only “monitor” the medications to be sure the person receiving care took the medications as authorized in their medication chart.
Incident Reports: If a work injury occurs, such as a fall or damage of property (you dropped a vase and it breaks), this is separate from the Plan of Care. Call your supervisor and follow your company system for incident reports.
Care Plan Safety: Protect Yourself as the Caregiver and the Care Client by IMMEDIATELY REPORTING Any Significant Changes in Health Conditions, Safety Concerns or New Developments.
Observe: We have 2 ears and 1 mouth so we can listen twice as much as we talk. Observe with all of your senses - listen, smell and touch to observe changes in condition.
Quality of Care Plan Information: Remember that a long-term care insurance company, family members, doctors, nurses and in some cases an attorney acting as a legal guardian may be reading the care plan notes. Keep them professional and be sure to proof them at the end of your work shift.
Make Objective Observations
Document Care Services Daily
Understand Objective Notes vs. Subjective
Medication Monitoring is Just That - a Reminder to Take a Medicine as Scheduled
Protect Yourself and Your Care Company (HLO) and Document Care Provided
Good hygiene for both the caregiver and the care client are essential for maintaining good health. Watch this video to learn how to control infection in a home care environment.
Handwashing is the caregiver’s best friend. Handwashing is the single best way to avoid infection with contagious diseases and prevents germs from spreading.
Handwashing Tips: Sing “Happy Birthday to Me”: Singing “Happy Birthday” to yourself while washing your hands helps you remember the length of time necessary to properly wash your hands with soap and water for 20 seconds.
Professional Caregivers should wash their hands for 15 seconds for EACH HAND Wash Hands
BEFORE Direct Contact
with the Care Client and AFTER each contact.
1. Wet each hand thoroughly and apply antibacterial soap.
2. Rub your hands together making sure you scrub the entire hand, including in-between the fingers.
3. Scrub each hand for 20 seconds.
4. Be sure to clean under the fingernails as most germs hide under and around your fingernails.
5. Artificial nails should be avoided as they are difficult to clean.
6. Jewelry can serve as a nest for germs so remove when washing your hands.
7. Rinse both hands in warm water. Avoid very hot water as it can harm the skin and add to infections.
8. Be sure to rinse ALL the soap off of your hands.
9. Dry hands completely. Paper towels are suggested although motion-activated dryers are the best but obviously not usually present in a senior’s home…but just remember when in a public bathroom the motion-activated dryers are the best option.
Remember, always wash your hands:
• After contact with the senior client
• Before and after situations in which your hands are going to be contaminated
• After bathroom breaks
• After lunch breaks
• Before preparing food
• After preparing food
• After sneezing
• After coughing
• Before putting on gloves
• After taking off gloves
Strict hand-washing routines are the “gold standard” for reducing infections associated with health care. Infections communicated in nursing homes, hospitals and doctor’s offices are linked to nearly 100,000 deaths a year affect more than 1 million patients. When accompanying as client to any of these facilities, always ask the medical professionals: “Have you washed your hands?” Take hand-washing seriously: for your health and for the client’s health.
1. Plain Soap: removes surface residue but does not kill micro-organisms that are on the skin, instead it suspends the micro-organisms.
2. Anti-Microbial Soap: removes dirt and residue from your skin and uses an agent that will kill most micro- organisms. Some agents in this type of soap will continue to kill microorganisms after your hands are dry.
3. Anti-Septic Handrubs: These gel-type of disinfectants will decrease the micro-organisms on your skin but soap and water are always best.
1. Disposable Gloves - required when you may come into contact with blood or body fluids. Discard after use.
2. Disposable Aprons - wear when there is a risk of clothing being contaminated with blood or body fluids or when a care recipient has a known infection.
3. Face Masks - where if concerned the nose or mouth will be splashed when caring for someone with a contagious infection.
About Gloves: Gloves may protect the person wearing the gloves but micro-organisms can be passed from the outside of the glove to the client.
Be Sure the Gloves are Clean on the Outside and DISCARD AFTER USE Gloves do NOT take the place of proper hygiene.
Key situations where hand hygiene should be performed include:
1. Before touching a patient, even if gloves will be worn.
2. Before exiting the patient’s care area after touching the patient or the patient’s immediate environment.
3. After contact with blood, body fluids or excretions, or wound dressings.
4. If hands will be moving from a contaminated-body site to a clean-body site during patient care.
5. After glove removal.
How Infections Spread:
Micro-organisms are also called germs and are tiny living things seen only with a microscope. This is why thoroughly washing your hands is important. Pathogenic organisms can produce diseases referred to as infections. Avoid infections by avoiding micro-organisms.
Putting on Gloves:
1. Remove any sharp jewelry.
2. Remove glove from box. Gloves come in small, medium and large. Most are rubber latex and are pre- powdered. Those who are allergic to latex should use vinyl gloves.
3. Hold glove with your thumb and forefinger and insert hand into gloves
4. Work fingers into proper places
Removing Gloves without contaminating your hands:
1. Pinch the palm of one glove and pull away from the palm.
2. Push the fingers of the pinching hand up inside the other glove, stretching the material of the glove towards the cuff of the other glove until it emerges by the wrist.
3. Pull the fold down until the glove is almost off (you will be pulling the glove inside-out).
4. DO NOT take the glove completely off.
5. Hook the ungloved thumb between the wrist and the skin of the other gloved hand and pull down, pulling both gloves off (both gloves will now be inside out).
6. Dispose of the gloves properly.
• Put on clean gloves.
• Wipe up immediately by cleaning from the outside (cleanest) to the inside (dirtiest).
• Use the appropriate cleaning agent (use 1:49 household bleach to wipe up surfaces contaminated by body fluids such as blood and vomitus).
• Never pick up glass, even with gloved hands.
• Dispose of gloves and cleaning equipment and supplies.
Gloves Do Not Take the Place of Good Hygiene
Fingernails Harbor Germs
Wash Hands Before and After Patient Contact
Environmental cleanliness enhances the lifestyle and creates a pleasant and safe environment for both the caregiver and the client receiving care services. A tidy home environment creates a happy home and eliminates the chaos caused by disorganization.
Cleanliness is contagious. If you keep yourself and the care environment neat and clean, everyone who visits will also want to keep the area neat and tidy which will make the caregiver’s job much easier.
Standards of cleanliness indicate a sign of overall care provided. Concern will be present if the care premises are not kept clean and in order.
• Wash soiled clothing, sheets and towels immediately
• Disposable gloves, and wipes should be tossed into trash
• Use 1:49 household bleach to clean areas that are contaminated by body fluids, e.g. vomitus
• Remember to wear gloves to protect yourself and wash your hands properly afterwards.
Note: Kitchens and Bathrooms are Used the Most and Require Daily Cleaning Maintenance Integrate Daily Cleaning Into Your Daily Care Plan Duties
Stay Organized: create a space for all of the care tools you will be using so that everything has a place for you to find it and return it after use.
Create a Cleaning Schedule, Tidy Up Kitchens and Bathrooms after Each Use, Use the Right Cleaning Products, Organize Your Environment.
Personal Protective Equipment is also called PPE. This will include special clothing, such as a scrub outfit and clogs, along with gloves, face masks, eyewear goggles and aprons.
Remember to always wash your hands before and after wearing gloves as gloves do not take the place of hand washing.
Personal Safety Precautions Include the Following:
Protect Your Face and Hands: Wash Your Hands, Wear Gloves
Protect Your Lungs (if Client has Contagious Infection) - wear a Face Mask. Avoid Falls: Wear non-slip shoes or clogs.
Avoid Back Injuries: Practice Safe Lifting Techniques.
Report Sexual Harassment: From a Client or Co-worker or Manager.
Emotional Abuse: Ask for assistance if a client exhibits aggressive behavior.
Chemical Hazards: Be aware of ingredients in cleaning products, detergents and medications which you will be coming into contact with while performing caregiver duties. Remember that even cleaning products contain chemicals, use with care.
Community Safety: Be aware of safety precautions in the client’s neighborhood. Be sure to follow basic safety guidelines when arriving or leaving at nighttime. If you feel the client lives in a neighborhood which has safety issues, discuss ways to plan around this with your Care Manager.
Pet Safety: Clients may have a pet such as a dog or cat. Understand any special personality needs of the pet and be sure you feel comfortable working as a caregiver in a home with a pet. If you have any issues at all, discuss them with your Care Manager. If you experience an incident with a pet, such as a dog bite, immediately report it to your Care Manager and go to the Emergency Room for treatment.
Fire: Follow Emergency Procedures in Care Plan. Know where the fire extinguisher is located.
CALL 999: for medical emergencies, fires or other life threatening emergencies.
Call 999 for medical and all life threatening emergencies, Personal Protective Equipment is also called PPE, Infections can be avoided by Washing Hands and Wearing Gloves, Cleaning Products can be Chemical Hazards.
Recognizing emergencies and knowledge of emergency procedures, including basic first aid and implementation of a client’s emergency preparedness plan.
Follow these steps when you begin care for a client in their home:
1. Home Assessment: Know the layout of the entire home to be prepared for an emergency. You will need to know where smoke and water can go in the home.
2. Smoke and Fire Alarms: where are they located in the house? Check batteries each month.
3. Where would you go if evacuation were necessary for a fire?
4. Always call the office of the home care agency first and know the evacuation plan and for immediate emergencies call 999.
Fires: Fires in the house are usually preventable. Preventing household fires and how to respond safely should be part of emergency planning.
Prepare Ahead of Time for fire emergencies: Think through what you would do if the home experienced a fire. If you are providing caregiving services at a facility such as a nursing home, learn their emergency procedures. They will have instructions available and notices on doors and exits for evacuation procedures. Know where the flashlight and matches and candles are at a client’s home.
As most fires can be prevented it is important to review fire safety tips:
1. Do not smoke while working.
2. Do not allow a senior client to smoke in the home, if possible. If they must smoke in the home, make sure they only smoke while using an ashtray. Do not allow them to smoke in the bed or to smoke when oxygen is in use.
3. Check electrical cords to be sure they are not cracked or frayed.
4. Notice if light bulbs blink or seem to burn-out quickly. This could be a sign of an electrical issue which should be reported.
5. Turn off and unplug electrical appliances when you are not using them.
6. Be cautious to turn off ovens and stoves when not in use - always check everything twice.
7. Keep flammable items away from the stove, radiators and reading lamps.
8. Do not use candles. If a candle must be used for a dinner celebration or birthday, be very aware of the importance to extinguish them when you leave your work assignment. Candles are one of the most popular causes of fires. Be mindful to keep candles away from flammable objects and burn them only for short time periods.
1. Know where fire extinguishers are located and understand how to use them.
2. Fire Extinguisher Directions: Be sure you understand how to use a fire extinguisher. Read the directions.
3. Blankets: Know where extra blankets and sheets are kept in the home as a back-up fire extinguisher. A blanket can be thrown over the fire to extinguish it.
Should a Fire Start:
1. Call 999.
2. Extinguish the fire if possible (small kitchen fires on the stove-top).
3. Escort the client out of the home if safe to do so.
4. Confine the fire by closing doors of empty rooms to slow the spread of smoke and flames.
Note: If the household has a Fire Extinguishers. Make sure the location of the fire extinguisher is known to you and make sure it works.
Being PREPARED is Your Best Defense for Emergencies.
• How to Evacuate.
• Where to Evacuate to (where to go).
• How to Help Clients during the Emergency (what items to take while remaining calm and keeping them calm).
• Who does what (will your Care Manager call the family and relieve the caregiver? Will a back-up caregiver arrive?).
Make a list of these items so you will be prepared if an emergency occurs:
1. Know the “Emergency Plan” for your client care company (HLO) and know the steps you are to take when it is implemented.
2. Review the Emergency Plan for your company (HLO) each year so you are familiar with the steps.
3. Exercise safety throughout your work day. If equipment isn’t working properly, notify your manager.
4. Know your game plan for your must-have items (create a natural disaster kit if necessary).
5. Check your weather forecast each day before you go to work.
Basic First Aid: First aid means the initial help you will offer to treat an emergency injury such as a cut finger with bleeding or a person with sudden illness such as heart attack, asthma etc.
Before you start:
It is vital that you will perform a “Scene Survey” and Only act when it is safe to do so.
Remember scene safety is a dynamic situation that can change frequently.
Call for help and dial 999 if the victim is unresponsive.
Once you know it’s safe begin your care
Continue to care for the victim until qualified help arrives
Try and record the information you observe to pass onto the emergency services
If exposure to blood or body fluids occurs, seek medical advice
Always wash hands thoroughly after providing emergency care
Cuts and grazes: cleansed with normal saline/mild antiseptics, cover with dressing/band aids
• Small bruises will be healed without intervention within a few days
• Cold packs can ease the effect of swelling and reduced pain
• Deep cuts can caused severe lost of blood, should apply direct pressure immediately to stop the bleeding
• Control of severe bleeding is a life saving skill. Without intervention, the victim can die in a short period of time.
• A victim may have internal bleeding. Check for the common signs such as bruising, swelling, rigidity in any body parts. If in doubt, send the person to hospital for proper medical care.
• Sit up patient with head bending forward.
• Pinch the soft part of the nose for 10 to 15 minutes.
• Ask patient to breathe through their mouth.
Seek medical attention if:
• Bleeding can’t stop for more than 10 minutes.
• Suspected foreign bodies inside the nostrils.
• The bleeding is a result of a blow to the head or a fall.
Sprains and strains:
Sprain is a stretch or tear to a ligament
Strain is when the muscle/tendon is twisted torn or pulled – result of overstretching/over contracting of muscle
The RICE principal: Rest: rest, stop moving.
Ice: apply ice for the first 48 to 72 hours.
Compression: apply compression bandage to limit swelling and movement.
Elevation: keep the injured body part raised and supported.
• Burns – caused by dry heat (e.g. fire)
• Scalds – caused by wet heat (e.g. hot liquid, steam)
• Other causes: electrical, chemical, friction, electricity and radiation
Superficial burn (1st degree burn)
• Red, moist, swollen and painful
• Burned area becomes whiten when touched
• No blisters
Partial thickness burn (2nd degree burn)
• Red, swollen, moist, painful and becomes whiten when touched
• With blisters
Full thickness burn (3rd degree burn)
• Involve all layers of the skin
• Burned areas may be charred black or whitened.
• Not painful because the nerves have been destroyed
• No blisters formed
First aid care:
• Remove the victim from the source of heat.
• Remove any constricting items such as rings, necklaces or shoes – before the affected areas swell up.
• Remove any non-adhered clothing from the affected areas.
• Hold or immerse the burn in cold running water (tap/clean water) for at least 20 minutes or until the area is not painful.
• Cover the burn with clean, lint free dressing.
• Alternatives to lint free dressing is a clean, unused plastic bag/kitchen film (except for chemical burns).
• Burns of the face/chest may impair breathing - seek medical attention immediately.
• Do not immerse large burns in cold water – can bring on shock.
Remember most burns can be prevented
Do not use ICE, lotions, ointments or creams on burns
Do not break blisters
Serious burns may not be painful as there may be damage to the nerve ends
Burns that cover more than 10% of the body are treated as serious burn.
Call 999 for all serious burns.
• Choking happens when a foreign body such as food is obstructing the airway
• Most choking events happen when a person is eating
• The patient may clutch the neck, this is called the “universal sign” of choking
First aid care:
• If you suspect someone is choking, ask the patient, “Are you choking?”
• If the patient remains coughing, encourage the patient to cough to relieve the obstruction
• If the patient is responsive/conscious but not breathing normally, perform the following sequence:
• Use the heel of your hand to give 5 sharp Back Blows by supporting the patient’s chest
• If Back Blow fails, stand behind the patient, perform “Abdominal Thrusts” by placing your clenched fist between the navel and lower end of the breastbone
• Grasp your fist with the other hand and push inward and upward sharply up to 5 times
• Check after each thrust to see if the obstruction is relieved.
• If unsuccessful, continue alternating 5 back blows and 5 abdominal thrusts until the object is relieved or the patient becomes unresponsive
First aid care for unresponsive choking patient:
1. Lower the patient carefully to the floor
2. Call 999 immediately
3. Begin CPR with chest compressions until ambulance arrives or the patient wakes up
Never allow a suspected choking patient to leave your sight
For patients who have received back blows or abdominal thrusts must be send to see a doctor for follow care to rule out damage to internal organs.
CPR stands for Cardiopulmonary Resuscitation which is performed on people when he/she is not breathing and the heart stop pumping. It involves chest compressions (pressing) and exhalations into the person’s mouth (blowing). Training in CPR should be taken if you are a caregiver, especially if you are caring for someone with heart disease. Sometimes an automated external defibrillator (AED) machine is maintained in the home of clients with heart disease. Proper training should be provided for use of these devices.
The concept of Chain of Survival:
• Early recognition
• Early CPR
• Early Defibrillation
• Post resuscitation care (hospital care)
Adult CPR 8+ years
• Not breathing or not breathing normally, place both hands on centre of chest.
• Compress 5-6cm depth
Child 1-8 years
• 5 rescue breaths before you start CPR
• Compressions use one hand in the centre of the chest. Compress 1/3rd depth
Infant 0-1 year
• 5 rescue breaths before starting CPR
• Compressions use 2 fingers in the centre of the chest. Compress 1/3rd depth
Note: All CPR should be performed on a hard flat surface. Pushing hard and pushing fast while maintaining the airway open is the key to effective CPR
Your own safety is paramount no matter what. Do not become a victim yourself.
Following the steps in the emergency management procedure will help ensure that you approach each incident with a structured plan this is beneficial to the rescuer and the victim.
Emergency Preparedness Plan provides an Action Plan for How to Evacuate, Where to Go, How to Help the client, Who to Call and Who Does What, Basic First Aid is mostly good common sense.
Personal Information: Maintain confidentiality of any information you hear or which the client may share with you. Just as when you work for any company, the company information remains confidential, so does your client’s personal information remain confidential.
Financial Information: Money matters of a client should remain confidential. Do not discuss your financial issues with a client and simply change the subject if a client you are caring for begins discussing finances with you.
• Do Not Share Client’s Information with Others
• Verify Identity of Doctors, Pharmacists or Any Other Providers Who May Call and Refer them to the Care Manager
• DO NOT Get Involved in Information Transfers to a Medical Professional in Order to Protect Yourself
• Never exchange money with a client in order to protect both yourself and the client
• Personal information about your client remains confidential to you
Steps for Following Client Confidentiality:
1. Maintain Confidentiality of all Caregiving Information.
2. Refer Anyone Requesting Information to a Care Manager.
3. “Keep It to Yourself”
PHI (Protected Health Information) is all individually identifiable health information in any form:
ASK YOUR SUPERVISOR if you are unsure of how to proceed in a situation involving sharing private health information.
NEVER DISCUSS PHI you see or hear while performing your job with anyone unless necessary!
Caregivers Must Keep Client Financial and Personal Information Private, Keep it to Yourself.
Effective Communication begins with active listening
When speaking to the client, say their name and speak clearly and give them time to answer. Remember that body language is part of the communication process. Meet your client with a smile.
• Speak clearly and face the client when talking.
• Use proper vocabulary, avoid using jargon.
• Speak Naturally: Speak at Normal Rate, Not Too Fast, Not Too Slow.
• Listen to the client more than you talk, listen fully and attentively, do not interrupt.
• Show empathy and understanding.
• Be enthusiastic.
Example of Active Listening
Client says: “My son always arrives 15 minutes late, never on time.”
Caregiver says: Since your son always arrives about 15 minutes late, why don’t we plan on waiting for him to arrive before we place the roast in the oven.
By understanding the age of the person you are caring for you can communicate about topics they are familiar with and learn how the events in their life impacted them.
Marketers have given labels to generations of people born between certain years, as a way to stereo-type their behavior based on the norms that were present when they were developing into adults.
• G.I. Generation (Traditionalists): born between 1900 and 1924
• Silent Generation: born between 1925 and 1942
• Baby Boomers: born between 1946 and 1964
• Generation X: born between 1965 and 1979
• Generation Y or Millennials: born between 1980 and 2000
• New Silent Generation or Generation Z: born between 2001 and the Present
The G.I. Generation or Traditionalists (also called the “Greatest Generation”) lived through the Great Depression and fought in World War II and the Korean War, went to college in record numbers as part of the G.I. Bill and experienced the Cold War. They are known to be patriotic, loyal and fiscally conservative.
The Baby Boomer Generation (the babies born to those who came back from fighting World War II). The Baby Boomers experienced the Vietnam War, Watergate, the Civil Rights Movement, the Kennedy Assassinations, the Moon Landing and the Cold War. Boomers are known to question authority and crusade for causes.
By understanding the generation of the client, you may start conversations around the events that occurred in their lifetime.
Realize that just as you have certain ways of communicating with your friends, clients also learned a certain communication style for the era when they were coming of age.
Wherever there are people, there always will be conflict. It’s a simple fact of life. Opinions vary, and miscommunications and misunderstandings occur. People have differing values and priorities, and most of us resist change. All of these things create conflict in our life and work. The problem is not conflict itself, but rather how we deal with it. Here are seven strategies for learning how to manage and avoid conflicts in your caregiving job:
1. Deal with it. Most people prefer to avoid conflict. There are some caregivers or nurses who quit their jobs rather than attempt to resolve an interpersonal conflict at work. This almost never is a good solution, and it usually leads to feelings of regret and guilt. Besides, if you quit every time you have a conflict on the job, you’ll be quitting every job you ever have in a short period of time.
2. Conflict needs to be dealt with. If you ignore or avoid it, it can lead to increased stress and unresolved feelings of anger, hostility and resentment. When you learn to manage conflict effectively, you’ll be happier and healthier, physically and emotionally. You’ll have better relationships. You’ll be a better leader, a better team member and a better person. You’ll gain respect, improve your self-esteem and build courage. You’ll get more of what you want.
3. Think it through. Before addressing the person with whom you have a conflict, consider discussing the situation with an objective friend or family member. This can help to clarify issues and needs. Seek feedback and advice in dealing with the situation. But be careful not to rely on the opinion of an involved third party who may have his or her own agenda. Plan your strategy, including what you want to say, and then write it down and rehearse it. Create a note card, if necessary, with your main talking points. This will help you to feel more in control and stay on target.
4. Talk it out, face to face. Meeting in person can be intimidating, but it is often the best way to go. Face-to-face communication is more effective than other forms because it allows for an active exchange of information. It gives you the opportunity to make use of the handshake, a smile, eye contact, hand gestures and other important body language. It also allows you to observe important nonverbal cues from the other party. Set aside time to meet with the person face-to-face at a mutually convenient time and place. When possible, meet on ‘neutral turf’ rather than one of your offices so no one has the ‘home court’ advantage.
E-mail and letter writing should be avoided, if possible, to resolve conflict or to discuss sensitive topics, problems or hurt feelings. It is too impersonal and indirect and increases the risk of miscommunication and misunderstanding. A phone call is the next best thing when in-person meetings aren’t possible.
5. Use a mediator if necessary. If a situation is particularly volatile or troublesome and other efforts have not worked, you might invite a neutral third party, such as a supervisor, to act as a mediator if this is agreeable to all concerned. A mediator can remain objective, listen to both sides, and facilitate resolution and compromise. Be firm on your objectives; you’re there to resolve a conflict, not defeat an opponent.
6. Apologize when appropriate. Be aware of your own part in creating the conflict. If you’ve done something wrong or inappropriate, be willing to acknowledge it and say you’re sorry, even if the conflict is not entirely a result of your actions. Sometimes you have to meet people halfway to get to where you want to go.
7. Choose your battles. There always will be differing opinions and ways of doing things. Decide which issues you can live with and which need addressing. If you bring up only the most important issues, you will develop credibility. On the other hand, if you make an issue about everything, you’ll be labeled a complainer. Then, when you have a legitimate beef, you likely will be ignored like the fabled boy who cried wolf.
8. Work to minimize conflict. Take steps to minimize conflict at work before it happens. Work at developing good relationships with your client. Get to know people. Be friendly and sociable. Everyone has different needs and priorities and comes from different cultural backgrounds. Contrary to what you’ve heard, familiarity breeds respect.
9. Work on your own communication skills. The ability to express yourself clearly will allow you to say what’s on your mind, ask for what you want and need and get your point across. There is an expression that a problem well-stated is a problem half-solved.
10. Avoid troublemakers as much as possible. They will suck you in and drag you down. Don’t engage in gossip or backstabbing. Get the facts before jumping to conclusions about something you’re heard through the grapevine. Know when it’s appropriate to walk away from a confrontation, and always consider the source in the face of criticism or hurtful comments.
Conflict can’t be avoided, but it can be minimized and resolved. Although avoidance sometimes seems like the easy way out, facing conflict head-on in an appropriate and professional manner will lead to better relationships, a more productive work environment and empowerment.
If you care for others, it is also imperative to make your own health a priority. Consider these suggestions:
• Create lists and establish a daily routine. Keep track of tasks, then balance, prioritize and delegate responsibilities. Most importantly, modify your schedule to avoid anxiety and exhaustion.
• Take care of your body and mind. Besides fitting exercise into your schedule and maintaining a balanced diet, it's crucial to find time to relax, pursue a hobby and connect with friends. Neglecting your own physical and emotional health leaves you vulnerable to disease and exhaustion.
• If you feel depressed, get help. Caregivers are at tremendous risk for depression, yet many do not realize that they are depressed. These feelings can develop over time and will become progressively worse if not treated. Instead of hoping this condition will just go away, seek medical help; it'll make all the difference.
• Regularly talk with a counselor, support group or close friend. Even though you may not want to discuss your feelings and frustrations, it's beneficial to find an outlet. A sympathetic listener could provide the support, comfort and perspective you need to get through the day.
• Giving proper care and attention to yourself and your loved ones will create a healthier, happier environment sure to improve everybody's quality of life.
Use Active Listening to Better Communicate with clients.
Bend Knees and Use Wide Stance for Safe Lifting.
The caregiver/patient relationship can often be tenuous and difficult. Home care is a stressful setting that typically involves great sickness or disability and within that, it is easy for tempers to flare and patience to run thin. This is unfortunate, however, because in addition to being a difficult relationship, the caregiver/patient relationship is also an immensely important one.
In order for quality care and healing to take place, the caregiver and the patient must foster a good relationship, no matter how difficult that may be at times. Here are seven steps caregivers and patients can take to improve their relationship and form a genuine bond:
1. Get to know them: To build a relationship, it is important to know more about your patients than just their disease process. Relating to hobbies, children, or other interests might help the patient feel comfortable, and it might lessen the overall anxiety of the visit.
2. Educate: Patients trust us, along with their physicians, to be their educators. They want to understand their treatment options and disease consequences. It is important for them to have an understanding of the healing process so that they can then make educated choices. Also, when educating, be sensitive to visual or auditory limitations and to language barriers. These are some ways to educate:
• Offer them reading material - this means including appropriate literature in the waiting room and/or office.
• Provide them with appropriate website links.
• Set them up with community resources.
• Provide video resources.
• Allow the opportunity for questions.
3. Anticipate their needs: Whether in the acute care or primary care setting, learn to anticipate your patients’ needs. This will show them that you do care and that you want to provide them with the best plan of care possible.
4. Learn to Ask for Help: The caregiver/patient relationship is very intimate and it often involves difficult, confusing or emotionally challenging scenarios. One of the first steps toward high-quality communication and a safe, healing relationship is transparency and the ability to ask for help. This is true for both the patient and the caregiver. In order to build trust, the patient needs to be able to request help when it is needed and, in order to provide quality care, the caregiver needs to be able to ask the patient for help in understanding something new or clarifying a preference or concern. Asking for help is central to communication and communication, in turn, is central to the rest of the caregiver/patient relationship.
5. Exercise Compassion: A home care environment often entails a severely disabled or wounded person who may not have full command of brain function and capacities such as motor skills, memory and speech. These types of disabilities are difficult and can easily create frustration within both the client and the patient. Frustration, however, leads to a strained and fractured relationship, which is not appropriate for the home care setting. Instead of allowing frustration to take hold, caregivers and patients alike should seek to exercise compassion. Compassion for self and others allows people to soften their hearts toward another person and get to a place of honest communication.
6. Be Patient: Patients who have suffered a traumatic brain injury often have difficulty with skills like speech and memory. Additionally, since traumatic brain injuries often affect the part of the brain that deals with response to stimuli, risk-taking and adherence to rules, injured people may exhibit less concern for rules and an increased level of risky or downright dangerous behavior. Patience is the most important virtue a caregiver can have in situations like these. It is important for a caregiver to understand that injured people are not always in complete control of their actions and, with that in mind, to give the person extra time to calm down and make different decisions. This often requires reasoning, positivity and empathy.
7. Use Encouragement: Encouragement is an underrated soft skill. In addition to motivating patients to behave differently when needed, encouragement also goes a long ways toward boosting a patient’s self-esteem and making him or her feel capable and in charge once more. Additionally, since being encouraging with patients benefits both the caregiver and the individual, it can rapidly increase the fullness of the relationship.
8. Be an Active Listener: Each client has a story to tell and learning to truly listen to that story will quickly foster a bond and encourage increased communication and understanding. Additionally, active listening with clients encourages increased rapport and allows the caregiver to better pick up on potential warning signs. When having a conversation with a client, make eye contact and turn your body toward the person speaking. Be careful not to interrupt and ask plenty of good questions to ensure that the client feels heard and respected.
9. Do What the Patient Loves: Do you have a patient who loves to read but cannot anymore due to poor vision or impaired brain function? Maybe you have a patient who loves puzzles, scrapbooking or board games. Whatever the case may be, make a concerted and honest effort to engage the patient in these pastimes. In addition to helping a client feel more involved, whole and capable, these activities can go a long way toward decreasing feelings of distress in a patient and encouraging positive changes in behavior.
10. Practice Respect: Caregivers must have a deep respect for the patient and his or her family. The patient’s home is a workplace and must be treated like one. When a caregiver is respectful of a patient’s home, belongings and preferences, the patient feels respected in turn, which leads to less distress and an increased feeling of relaxation and comfort. Additionally, practicing constant respect serves to place the patient and the caregiver on the same plane, encouraging increased communication and a deeper relationship. When practices like empathy, active listening, respect, transparency and patience are exercised, both a patient and a client can find themselves in a deep, caring and safe relationship. In a home care setting, these types of relationships are integral in creating healing and comfort. Although home care relationships can be challenging, at times, both patient and caregiver can take a variety of simple steps toward improving the relationship and creating a lasting bond.
11. Offer follow-up calls or surveys: Another way of saying “I care” is to provide a follow up phone call after a visit. This just says, “I know that our visit is over, but I want to be sure that you are ok.” Patient satisfaction surveys are another way of saying, “I want to do everything I can to be sure that your visit or hospital stay was pleasurable-you are that important to me.” - See more at: http://www.nursetogether.com/how-build-better- rapport-patients#sthash.G1PoIxiC.dpuf