Community Based Care
Community Based Care, how new rules and regulations are changing the face of assisted living, residential care, memory care and long-term care.
At Elite Care’s homes in Tigard and Milwaukie, Oregon we are dealing with keeping love, relationships and autonomy in tack while dealing with a much more exacting audit process. The system imposed by the state regulations and license requirement is evolving into a focus approach where audit trail is necessary to pass survey process regardless of anything else. This evolution is necessary to assure that all facilities live up to high standard of medical care but sometimes hinders the love that is so necessary for elders to thrive.
Elite Care’s basic belief is that everybody has the right to life liberty and the pursuit of happiness regardless of age, physical or mental conditions. When residents have dementia, Alzheimer, memory loss or physical conditions that limit their abilities and increases their stress, making sure they are in a safe, loving environment is crucial to their wellbeing. The big question, is heavy documentation and the skill set it requires compatible with relationship based care and love? Traditionally care givers have been at the lower end of the wage scale and less likely to have a good education foundation that facilitates easy compliance with confusing and exacting rules. This is then made more complicated by the fact a lot of really good loving care givers do not have a good skill set in documentation and their energy that would be devoted to love and care is focused on documentation.
The biggest change is in the RNs role and how they are shifting from care givers with day to day care responsibility to educators and evaluators.
This is a major shift in their license from working at the bottom of their license to the top where they are expected to be focus on making sure that there is no change of condition and all the staff is properly trained to give care. Their time is devoted to training staff and making sure all of documentation required is done correctly, timely and auditable. This is a big change for most RNs who have the training to do all that is needed but often have not had the opportunity to take on a much greater leadership role.
At Oatfield Estates and Fanno Creek we are working hard at implementing a new technology: BIP tech. (Belonging, Influence and Purpose) that will facilitate the paperwork necessary in community based care. Community base care requires a good audit trail that show when care was given and what care was necessary. This is important to have it as easy and natural as possible otherwise it disrupts the flow of the caregivers and harms the culture. To have the residents thrive in Assisted living, memory care and long term care the culture becomes critical. Culture is based around rhythm and common language when that rhythm is disrupted, and the language is not reinforced there is a deterioration of the culture.
So what seems as contradictory in community based care directions that the state is desiring can be accommodated only with a new paradigm in how the RNs view their job, how documentation is integrated into the daily routine. Creating an environment that facilitates the growth of the care givers that have a natural propensity for love and empathy is primary and the responsibility of everybody in the organization. At Elite Care, in Portland Oregon our focus has been creating this environment and culture that both delivers auditable care giving trails with love and relationships.