Effective care planning and communication are key to the fundamentals of elderly care

Assistant Health and Disability Commissioner Rose Wall today released a report finding that a care home breached the Code of Health and Disability Consumer Rights (the Code) for failing to provide basic care to a ninety-year-old elderly man with dementia.

The report is about the level of care a resident of a CHT Healthcare Trust nursing home received in the last ten months of their life. It highlights the importance for aged care facilities to provide the fundamentals of care for vulnerable consumers – in this case, managing the man’s weight loss, his nutritional care planning, monitoring his intake food and water and communication with the man’s daughter. , who held his continuing power of attorney (EPOA). Failure to provide these fundamentals meant staff failed to recognize that his condition was deteriorating and, sadly, he passed away.

In her report, Deputy Commissioner Rose Wall said effective care planning for older residents is essential to meet residents’ needs and ensure appropriate person-centred services are provided.

Despite two years of training, the nurses involved in the man’s care failed to think critically and did not follow the internal policies in place at the nursing home.

“In my view, it is the nursing home’s responsibility to ensure that its staff are aware of their obligations and provide services in accordance with accepted practices.

“While I am concerned about the lack of oversight of the man’s care plans, I am also of the view that it is the responsibility of all staff involved in the day-to-day care of a resident to be alert and attentive to the subtleties or not-so-subtle, signs of deterioration in the general condition of the resident, and be prepared to escalate areas of concern,” Ms. Wall said.

Ms. Wall also stressed the importance of communication with the EPOA of the man at critical decision-making points. The man’s lack of cooperation with the EPOA meant that the EPOA, as his legal representative, was not made aware of his father’s impaired medical condition, including the results of his blood tests, and had no opportunity to participate in decisions about his father’s health. care.

Ms Wall recommended that the care home undertake an audit to confirm ‘weight loss procedure’ is being followed; provide education to all nursing staff on care planning, weight loss monitoring, and food and fluid intake. She recommended that the nursing home share an anonymous summary of this case with all CHT Health Care Trust care staff (health care assistants and registered nurses) and consider whether its mandatory two-year training for registered nurses on the procedures of the nursing council should take place more frequently. She also recommended that the rest home issue a written apology to the man’s family.

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