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Care Plans are a Necessity

When I worked on the Nursing Care floor of a CCRC (Continuing Care Retirement Community), I learned very quickly the importance of documentation and Care Plans.

Of course my first care plan meeting was quite the learning experience, so let me enlighten you prior to your first meeting as a caregiver/partner.

First, what are Care Plans and why are they necessary?

The care plan is a formal process that begins at admission to a community and is continuously updated throughout in response to changes in condition and evaluation of goal achievement.

Planning, delivering, and maintaining individualized or patient-centered care plan is done by meeting quarterly with the departments/specialties to discuss current status of a person’s health, abilities, and risks, as well as their future goals.

If you are caring for some one living in an Assisted Living or Nursing Home, these departments/specialties may include:

  • Dietary
  • Therapy (Occupational, Physical, Speech)
  • Nursing or Assisted Living Director
  • Activities
  • Social Work
  • Resident
  • Power of Attorney/Family Caregiver
  • Physician (sometimes)
  • Hospice (if person is receiving care)

Care Plans are a necessity!

They are documented goals focused on the expectations to maintain or enhance quality of life, and eventually, end of life.

With that in mind, be sure to understand the wishes and needs of the older adult that is being cared for, from the holistic point of view.

  • Physical
  • Mental
  • Occupational
  • Environmental
  • Spiritual
  • Social
  • Financial
  • Emotional

Having this information in writing and understanding it can make a big difference for many, especially those with cognitive impairments, or loss of conscience.

For example:

  • Does someone want to attend group activities?
  • Do they want to be visited by religious volunteers or attend services?
  • Do they want any type of artificial health assistance (feeding tube, Tracheotomy, etc.)?

Improve goal achievement and the needs of the person.

Whether it is proper weight gain, socialization, maintaining ability to walk, assisting anxious behavior, and so on.

Furthermore, take your time in meeting, taking notes, and following up with the care team. Emphasis on following up! (Things get busy and sometimes forgotten, hindering goals from being reached.)

Family meeting

For those aging at home, a care plan is a necessity too!

Therefore, getting together with the one you are caring for, or with, and discussing current challenges and goals along with questions to ask physicians, therapists, lawyers, dieticians, etc. is essential and can truly impact their life.

Caregiver Consultant or Care Managers can help

Although an added expense, their job is to guide you through goal setting, which will save you time, stress, and make sure all gaps are filled. A consultant can direct you to the right professions, tasks, paperwork, and questions to ask.

However, if hiring a professional is not feasible at the moment, The Caregiver Toolbox is a great point of reference.

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