Alzheimer’s and Dementia Workforce Assessment Task Force Chad Helton, LNHA Executive Director of Post-Acute Care Facilities Service
Bluegrass Care Navigators • 40 years of providing end-of-life care • Serving over 1,000 Kentuckians, in 32 counties across northern, central, and eastern Kentucky • We have a long history of expanding our services and programs to meet the needs of our community • We serve individuals living with Alzheimer's and other forms of dementia across our service lines • We are committed to developing the work force to provide the best possible care to all we serve • We value the opportunity contribute our voice to conversations like these • We are committed to working with our community partners to improve the quality of care provided to all patients and caregivers
Why This Conversation is Important To Us • In 2018 we served 1,438 individuals living with the diagnosis of Alzheimer's or some type of dementia • Bluegrass Care Navigators serves over 150 Senior Living Communities across our 5 regions • Bluegrass Care Navigators employees over 500 Kentuckians across the Commonwealth • Bluegrass Care Navigators just received a $1 million grant from the Administration for Community Living/Administration on Aging to address gaps in services for those living with Alzheimer’s and age -related dementia and their caregivers
Outline of Focus • Hiring with a purpose- this isn’t for everyone • Train with a purpose- not for accumulated hours at a training kiosk • Learn from experience- Involve ALL of the staff- the best ideas aren’t coming from Administrators, Executive Directors, DONs, or Taskforces • Reimbursement- We can’t ask for more without giving more • Wonderful training already available- make attainable • Let’s not make this harder than it already on providers • Make care attainable early on • Carve out regulations for dementia care
Hire with a Purpose • The goal of this taskforce starts from the moment an individual applies to work in a memory care setting • Not everyone is cut out for this • Things we need to know: 1. The “why” – why is the person we are interviewing drawn to this line of work 2. How they respond the scenario based questions- specific to dementia care 3. Review of where they have worked before- are they ready for this 4. Don’t sugarcoat the job in the interview - they are going to find out
Train with a Purpose • Could less be more? – YES! • We feel really good about ourselves as leaders sitting someone down for 8 hours of computer based training • Training needs to be scenario based and interactive • Training needs to be tailored to each community and they population they serve • Training needs to be tailored by position i.e. Nurse, CNA, Dietary, Activities, Maintenance, Housekeeping, Administration, Social Workers- this is an “all in” thing if we are going to make it work • Use what we know works- Teepa Snow and The Virtual Dementia Training
Learn from Experiences – Involve Everyone • Every day, every shift there will be an opportunity to learn from an experience – teach that it is ok to admit we could have done something differently so that we can learn • Review occurrences as an IDT: 1.Did we respond or react- what could have been done differently 2.What was going on in the environment around the occurrence? 3.What could we have done to prevent the occurrence? 4.What were the redirection option available? 5.Were there warning signs that we can see now but missed 6.How do we go forward • Involve the entire team in these reviews: daily, weekly, and monthly
We Will Not See the Change We Desire Unless Reimbursement Changes • Many recommendations include: pay the staff more, provide better training, require certifications, improve the environment, etc. • Great ideas! But how… many of our Kentucky facilities are barely making payroll or maintaining their building due to low reimbursement • Solutions cost money- Facilities operating with a high Medicaid utilization do not have the resources to make the changes we want to see • Low Medicaid reimbursement and high liability costs- neither are being addressed
Wonderful Training Programs that Already Exist- Teepa Snow • • 30 years of experience as an OT has Challenging behaviors become one of the world’s leading • Meaningful Activities educators on dementia and dementia • Music care. Founder of Positive Approach to • Care (PAC) Communication • • Dementia 101 Teepasnow.com • Teepa’s GEMS • Brain changes
“Dementia doesn’t rob someone of their dignity, it’s our reaction to them that does.” -Teepa Snow
Virtual Dementia Tour – a Glimpse Inside • All about perspective • Training that allows us to briefly walk in the shoes of those we are caring for every day • Redefines what person-centered care really means • Highlights impact of environment • A must for anyone work with dementia patients • Secondwind.org
Let’s Not Make This Harder Than It Already Is • It is often easy to say, “we will require them to do this.” That isn’t the answer if we can’t afford to do so • Subsidize trainings like we spoke of a moment ago • Provide incentives for training and processes • Encourage and enable • Let’s get a taskforce of the folks doing the work together • Avoid a one size fits all strategy- every place is different from Pikeville to Paducah and everything in-between
Make Care Attainable • Today in Kentucky, the fact is you either have to be poor or wealthy to receive memory care • Allow all people not matter of income to get the appropriate care setting at the appropriate time • Kentuckians are living in SNFs when not appropriate because Medicaid won’t pay for AL/PC • People are staying at home in dangerous conditions because they cant afford the high costs of AL/PC communities
Carve Out Regulations for Memory Care • Our memory care patients are not the same as the other patients we are serving in the community • We need regulations that would encourage more providers to provide memory care without fear of punitive regulations when dealing with patients with behaviors • Listen to the OIG recommendations from the earlier presentation
Next Steps… That’s Up To You • Hire with purpose • Train with purpose • Learn from real experiences • Invest and protect • Take advantage and help pay for/incentivize the incredible training tools already available • Let’s not make this harder • Make care more attainable, available, and affordable • Regulations that make sense for memory care
Chad Helton,LNHA | Executive Director of Post-Acute Care Facilities Service chelton@bgcarenav.org Follo ollow Blue luegrass ass Car are e Na Navi viga gator tors: s: @bg bgca caren enav
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