Wednesday, December 15, 2010

Hearing Loss

For those of you who know me, you will know I have a significant hearing loss and wear hearing aids. Hearing aids are just that an aid. They don't fix the problem.

I find accents, and people who speak very softly incredibly difficult to hear orunderstand and in large groups I often don't hear anything - it is just a whole lot of noise that doesnt make any sense.

The purpose in me writing this on the blog is I don't think people who have good hearing understand how debilitating and disabling hearing loss is. Many people just retreat into their shell and don't speak out about it.

I am not one of those people. I do speak out and I do ask questions. I havr never felt happy how I was handled by audiologists either. The reason for this is I know they understand hearing loss but I don't think they understand the people who have hearing loss.

When you go to see them or have hearing aids adjusted it is in a totally false situations - a sound proof room with audiologists who have very clear speaking voices with good clear tone and timbre.

What happens when you leave this false environment, the general noise hits you - you have suddenly faced with so much noise it can be very unsettling and make you cringe.

Do we take any of these things into considerations for people in our care who have hearing loss? I don't think so. If you don't know what it is like to be hearing impaired it is impossible to identify with a person who is.

So give a little thought when people look at you blankley, retreat to their room or misinterpret what you say. If they have hearing aids, take good care of them, make sure they are free of wax are clean and the battery is working.

Believe me, it is no fun not being able to hear. And for you, if you have good hearing, protect it and look after it. It cannot be repaired or replaced and it worthwhile treasuring.

Monday, December 13, 2010

Christmas is upon us

I don't know about you but the years just seem to be getting shorter and shorter.

Now I know that is not true for some people. It is only those who are very busy that have this problem.

I am not complaining about having this problem. It is far better than being bored.

However being busy does have it's down falls. So to overcome this, I have joined a gym. Yes this time I have CHOSEN to join a gym.

So what has this done for me?

It has relieved my back pain, helped me sleep better at night, increased my energy and overall wellbeing and encouraged me to eat less and better.

My diet is usually pretty good but what I have found is I dont have the desire to eat sweet things to the same extent. There is also and added bonus. In the first 6 weeks I have shed 2" off my hips, 1" off my waist and 1/2" off my thighs.

My weight has not been an issue for me. I have been stable for years and for me it is a healthy weight but my energy levels have increased and that is important to me.

With my overall wellbeing improved I have the energy to enjoy another new grand-daughter due next week. I already have one 3 year old grand-daughter who keeps me busy so with 2 I am going to need all the energy I can muster.

So if you too have been considering joining a gym I would recommend it. I have set my target at 3 days a week. So my recommendation is you set the number of times you want to go and get into a routine. It is then just like going to work each day - part of the day.

Tuesday, November 30, 2010

Attachment theory

I received a new magazine in my letter box yesterday - a free one. It is called Natural Parenting. One of the articles has caught my eye and it is on "Attachment Parenting".

Over the years there has been all sorts of theories on what you should or shouldn't do with babies and bringing up children. This one makes incredible sense to me and I am wondering how this applies to the elderly in our care and the diseases that inhabit their body's.

Reaseach states that children who are emotionally secure are "more enthusiastic, persistent and cooperative and tend to be less fearful, oppositional, angry and are more joyous" They are also more likely to be "more popular with peers, more soically competent and more capable of empathy" and "they are less likely to be targetted by bullies".

On the other hand insecure children "seek attention in oblique or irritating ways and are more likely to grow up clingy and hypersensitive or aggressive and disruptive"

Now the article has a lot more in this of course but I have long believed that what happens to us in our childhood and how we learnt to react or respond to these issues has a major impact on who were are as adults in health and wellness.

My question has been, what actually makes us sick? Why is that some people fly through life with little or no illness and others are continually unwell? Why is it that some people are more resilient than others? Why is it that some people get dementia in a family and others don't?"

Because I am unable to answer these questions, I have listened to people's stories - their life story. This is where the clues lie. This is the clue to their behaviour.

In my first book I talked more about this but essentially it is not what happens to us that causes disease, it is the way we react and respond the the things that happen to us. If a person does not have the skills, confidence or tools to cope, manage or rise above each challenge that is set them they will become sick - either mentally or physically.

Now I know it is a lot more complex than that but I worry for all these young children who are put into day care at such a young age. Are we indeed setting them up to emotionally and physically unwell adults? Food for thought dont you think.

Monday, November 29, 2010

Compassion Fatigue in Nursing

I have come across this article on Medscape Nurses Viewpoint. It is really worth a read and can be found at.

Some interesting facts have come out of the survey carried out by Marily W Edmunds.

Nurses working 8 hour shifts are more likely to suffer compassion fatigue than those who work 12 hours shifts.

Intensive care nurses had higher satisfaction than emergency nurses

Nurses with the least experience reported higher rates of compassion satisfaction than more experienced nurses.

Nurses who had higher compassion satisfaction scores were more interpersonally "fullfilled" which is defined as being happy, being me, being connected to to others. They were happy in what they were doing, didnt feel trapped, were less likely to be bogged down or feel exhausted.

So what is the message here?

Nurses can suffer compassion fatigue which affects their coping mechanisms. They are the people who are more likely to ignor bells ringing, take days off sick, leave the organisation, reduce shifts etc.

So what is the message here?

Working as a nurse can desensitise some people. Nurses don't appear to be good at looking after themselves or their co-workers. Compassion fatigue is closely related to burn out. Compassionate nurses are a dwindling resource.

However I guess there is once bright star on the horizon. Psychiatrists have higher rates of suicide, sever depression and general compassion fatigue.

If we don't take care of ourselves how can we take care of others? This is what is lacking and why it is so important to bring the care back into caregiving.

Sunday, November 28, 2010

Excitement ahead for 2011

It is coming to the end of the year. I am feeling tired. Are you feeling the same?

But I am inspired for 2011. About this time of the year I am really looking foward to the next year. New growth, new development, new exciting things happening - but this time it is different.

2011 means business expansion but not so much in financial, although that no doubt will be a spin off, but expansion and the realisation of my mission to bring the care back into caregiving through training.

I have been working towards this for a long time. How to do it has now become a reality. How can I make training instantly applicable to more people. How can I make training easily accessible and affordable that reduce obstacles to learning?

Well I have found it. My goal to provide mini classrooms for training is being realised at this very minute.

You see there is only me. I am it in my business. If Ii want to get my message accross, how can I get training out to more people and not burn myself out.

So for now, watch this space. I am excited and inspired. Now I can get this information out to one person or a classroom which is facilitated by an educator.

Have I got you interested? Well keep reading and watching this space.

Thursday, November 18, 2010

I think many people are over Treaty Workshops

I think that this happens because many New Zealanders, especially Pakeha's, see these workshops as pro-Maori. In actual fact the Treaty was written for all Newlanders. Until Pakeha's understand this there will still be a them and us.

There is no them and us. There is only US. Yes us is all New Zealanders. This is what the Treaty of Waitangi is all about.

So why all this hoohaa?

It only comes from those who want to promote separatism not collectism.

We can all claim our space in our little world here at the bottom of the Pacific. We all have rights, the same rights.

So if you want to really understand the Treaty of Waitangi look at it in it's entirety not just the sections you want to claim for yourself. When everyone looks at it in this context we will see that New Zealanders comes in many forms and are all given protection under the treaty.

Arent we just a lucky country?

Tuesday, November 16, 2010

Cultural Sensitivity goes both ways

I know I am on a bit of a tangent here but it is time us Pakeha New Zealanders stood up for ourselves.

It may have sounded in my last blog that I am against other ethnicities coming to New Zealand. I am not. I feel they add a real richness to the diversity of our country.

What I am concerned about is that as a Pakeha New Zealander we are expected to accomodate everyone else with little regard to ourselves. We have needs and desires that are culturally appropriate for us too and I don't feel these are being met.

Frequently us Kiwi's have care dished out to us in the form of what others think we need. We are suppose to promoting Person Centre Care but it frequently does not happen. We are not understood by those who look after us.

Now I am not saying other ethnicities are not caring - they are but are they giving the care that the person needs to their cultural identity or is it the caregivers cultural identity.

If anyone if offended by what I am saying I am not apolgising. What I want is for those people careing for the elderly, disabled and infirm are giving the care that is appropriate to the clients needs, culture and indeed they want.

If you are having a reaction to this - great? I commend you. You are on the road to recognizing the needs and desires of a Pakeha New Zealander.

Monday, November 15, 2010

I am sick of being so PC!

As a Pakeha New Zealander I am fed up with having to bend to all other ethnic groups in this country.

We have a culture too. We are generally a fairly passive group of people. We have been told to recognise other ethnic groups and be culturally sensitve.

But what about us!!! Who is being sensitive to our needs? Who is making sure people understand US.

Get real Pakeha New Zealanders. Speak up for your needs and your rights. Stop being so passive about it.

A message to all caregivers, including RN's and Managers, Pakeha New Zealanders have rights and needs. Many of us have been living here for 4 or 5 generations. We don't have to take what you give to us.

Pakeha New Zealanders, it is time for a revolution.

Stop apologising for who you are.

Stop being afraid to say what is not happening for you.

Stop receiving care or being dressed in clothes you dont want to wear or are culturally inappropiate for you.

Stop allowing other people saying we are cultrally insenstive. We are not. We are very accommodating to all cultures so how about other cultures thinking about us and our needs.

A message to other ethnicities - Start thinking about what is culturally appropriate for your clients and be culturally sensitive towards them.

Sunday, November 14, 2010

Steeling people's belongings is Theft!

I don’t know if caregivers are aware of the importance of people belongings? It always grieved me when I had to face relatives who complained that clothing or belongings were missing or I had to advise relatives that their precious belongings had been mistreated or lost. I now find myself on the receiving end of and it does not sit well with me at all. Yes, my mother’s clothing has gone missing from a residential facility.

I am not criticizing the facility she is in. Far from it. It was them that brought it too our attention.

What I am criticizing are the people who look after my mother who who have complete disregard for her belongings.

I know that some cultures view clothing as something that covers the body – nothing more. I know that some people believe first up best dressed. I know that some people just don’t care and some people don’t know how to look after a person’s clothing.

This is not so for me or my culture – Pakeha New Zealander.

Our upbringing is we care for what belongs to us. What we own is very important to us and is to be treasured. If we choose to give it away, as many of us do give clothes and belongings away, we willingly do so.

But when we feel we have our belongs stolen we feel betrayed and hurt. To take what does not belong to you is theft and theft is a crime.

My mother is on a subsidy. She doesn’t get very much money but she likes to look nice and we do our best to do this. The cost of doing this falls on our shoulders which we gladly do.

But we don’t appreciate people stealing her clothes. We don’t appreciate going in to see her dressed in well worn, tatty clothes because that is all that is left for her to wear. I consider this abuse!

On top of this my mother has macular degeneration so her vision is very poor. This does not mean that she does not like to look nice. She does.

It also means that she would not know who took her clothes either. They could be whisked out from under her nose and she wouldn’t know.

This whole thing really distresses me. I am not blaming the management but
I am distressed, and yes angry, that people have so little regard for my mother that they want what meager belongings she has left.

I do my best to get the message out how important it is to respect a person and their possessions. I will not give up.

While I can’t get it to everyone, and yes probably I am getting to the converted. The people who do care. At least I hope I am promoting some debate so we can get a better deal for those in care.

Tuesday, November 9, 2010

This is your day! Your on your way!

What a great mantra to start your day.

With feet in your shoes and brains in your head ...

The power of advertising.

I am with the National Bank. I also have to say there is not much I remember about advertising, that is if someone asked me to relate sayings to ads. However I have to say "This is your day! Your on your way!" has really got me.

Now I don't have much trouble getting out of bed in the morning. I love what I do. I am inspired and excited by each day and what it is going to bring forth for me. It is my purpose for being alive.

So what is your purpose? What gets you up every morning? Mine is clear.

My purpose is the bring the care back into caregiving. To help caregivers understand what a privileged role they have and how their very being can influence a person's day. They are the light that shines for the person - the cheer germ.

If you cannot get up everyday knowing you are going to make a difference in someone's life each day then I feel really sorry for you.

If you only get out of bed every morning just to get your pay cheque? Then I feel very sorry for you?

Find something that inspires your day. Inspires you as a person. Makes a difference in someone else's life. Then this IS YOUR DAY! YOUR ON YOUR WAY.

Have a great day.

Monday, November 8, 2010

Keeping Stress Free

I am not a gym junkie. I find it difficult to get myself motivated. I take the dog for a walk. That was me.

However recently I decided I needed to do something about my energy levels. I was getting tired and lethargic and of course headachy. So I made a decision.

I will join a gym.

So I went on the recommendations of a friend and I must say I haven't been disappointed. I joined a ladies only gym and it is very different to a mixed gym.

So what have been the benefits for me?

I have more energy. I sleep better. I have time for me in a different space. I meet new people. I meet up with my friend. I am relaxed. I can go on and on.

So if you are finding your energy levels dropping getting close to Christmas why not consider doing something for yourself. You may just be amazed at the results.

Sunday, November 7, 2010

In the news again!

Saturdays Herald devoted a two page spread on yet another complaint about an aged care facility. I feel for the grieving family.

However it is clear that Geoff Harper has a real gripe about Aged Care as this is not the first artilce he has written or been involved in about Aged care. He is against multi-nationals coming in to New Zealand.

To a certain extent I understand his gripe but at the end of the day because I am care focused, it comes from the calibre of staff employed. The employer is superflouous. It is a training issue.

However talking about scabies. Once it gets into a facility it is extremely hard to irradicate. The itch keeps coming back and flare ups are common. I have been involved in a facility that had a scabies outbreat and it kept coming back for 3 years.

What surprises me is that scabies wasn't treated in the first instance. Whenever there is a person with a rash dermatolgy say - Treat for scabies first. Early detection and treatment is what controls such outbreaks.

Scabies is rife now in New Zealand and not only in Aged Care facilities. It is also resistant to a lot of treatment available. It, like many other infection and infestation, have mutated to ensure the survival of the species. It seems the harder humans get to eradicate bugs the smarter the bugs or mites become.

So what is the answer?

1. Infection control principles. The most important is Hand Washing.
2. Observation skills of staff - early reporting will help to control these infestations.
3. Training

In the end this is what it comes down too. Increasing knowledge improves care. This is what it boils down too.

Thursday, November 4, 2010

Time for a funny

This is a true story. It was told to me last night by one of the Rotary members of the club I belong to. It actually happened to him.

This man was fishing in his little boat off the shores of Omaha. He lowered the fishing line over the side of the boat and very shortly he got a bite - an boy was it a big bite.

He reeled in this mighty catch getting very excited. OOOOOO I've got a big one here. Fish Killer strikes again.

He struggled and pulled on his rod and reeled in his catch. He was so excited but his excitement changed to amazmene whe he got it to the surface and up popped a head. He had caught a DIVER!

Yes that is right. He snagged a human and dragged it to the surface. Now I don't know about you but at this point I get some very vivid pictues in my head. I just wish I was a cartoonist!

According to the diver he wondered whatever was happening. He was minding his own business swimming along under water when suddenly he feels this tug and he cant get away from it. He had no idea what was happening.

Guess this is a novel way to make friends!

This is certainly a tall story, but it is true. One I think that will keep grandchildren amused for years. The one that didn't get away.

Tuesday, November 2, 2010

Knowing right from wrong

It turns out the person who stole the money off a lady with dementia was the wife of a detective. Surely she would know right from wrong. There is no grey area in this case - taking from someone else is wrong!

While I know we do not know the circumstances behind this case the mere fact of taking something from someone else without their permission is wrong.

How often do caregivers in their daily care inadvertently take from those in their care. I am talking about taking away their independence their right to choice the freedom to speak for themselves.

A person I know who is in care told me the other day that one caregiver wouldnt listen to her when she said what she wanted to wear. She told her NO something else that the caregiver chose was better. So this person had to wear something she didn't like.

This is disempowerment. A caregiver's role is to encourage a person to make decisions for themselves and accept what they choose. Not take the power of choice away from them.

Monday, November 1, 2010

Still we see people taking advantage of those less fortunate

I note in the NZ Herald that a Tauranga woman stole $10,000 from an elderly lady who had dementia. What made this worse she was actually living with this woman. To her defense she felt guilty and told a family member. Her sentence 5 months home detention

This is not an isolated case. Too often we hear of people taking advantage of the vulnerable elderly. What goes on in these people's minds?

I guess it is more of what I discussed Monday. It is the ME society. What can I get rather than what I can give.

Sunday, October 31, 2010

What has the world come to?

Reading this morning’s NZ Herald where children as young as 10 or less were threatening people who did not give them sweets for Trick or Treating last night. On top of that there were families transporting children to the more affluent areas for Trick or Treating hoping for better pickings.

What has the world come to? Where are the instillation of values in these families? It beats me!

I personally am not a fan of Halloween. It is a very American thing that has come in over the last few years. I certainly wasn’t brought up with it but then life was a lot simpler back then. The big event of the year was Guy Fawkes. Yes we celebrated a person who wanted to blow up the English Parliament!!

Having said all this, I am not against progress or change. What bothers me most is the behaviour of society. If children are not given sound boundaries and values, where is this society heading to?

Now I am not saying it was all wonderful when I grew up but I sure as hell learnt about the values of gratitude, and respect among others. I learnt that when I was given a gift (even a sweet is a gift) I said thank you, even it if I didn’t really like the sweet I had received.

I learnt that being respectful (courteous and polite) actually received many more rewards than being nasty and disrespectful. Pretty simple logic isn’t it. Why are so many of our children not instilled with these very basic principles these days?

What I also find somewhat disturbing is some of the children causing these problems come from God faring homes. Families who go to church on a regular basis yet somehow these values are escaping being of importance. Is this not part of the religious teaching these days?

So what are we going to do about it? Well I am sorry I don’t have the answers.
All I can say is that I feel proud and comfortable that I have instilled these values in my own children and they will instill them in their children. That is the best I can come up with.

I am not going to put another load on to our school teachers either. I think they do a wonderful job. However they could use a tool such as the virtues in their teaching. It may make things much easier for them in the long run.

I am going to lay the blame firmly back on the parents or parent of the childre. I don’t care if it a one or two parent family, these values start in the home. They come from parents being respectful towards each other and their children and the parents appreciating everyone. You don’t need a two parent family for this to occur.

I was a single parent for many years yet I still managed to set these very basic values into my children. These are learned behaviours and they can be learned. If we go back to the basics of teaching values and the art of giving and receiving we will start to see some changes.

It is time for us to teach our children to think about not what they can get from others but rather what can I give to others. This is a basic law -the art of giving and receiving and it has served society for centuries. For what you give out will return a ten fold dividend – be it time, money, respect, appreciation, love, joy. Pretty simple really don’t you think?

Thursday, October 28, 2010

The power of clarity

I have been having a few problems with my dog not coming to me when I call him, running off doing his own thing and almost saying "I am going to do as Ii like".

Well I decided this was going to stop. Serious behaviour training was called for. (I sound like the Nanny programmes dont I)

An interesting thing happened as a result. The moment I committed to it and decided to take action everything changed. He suddenly became very obedient and no longer runs away from me plus he is more content and happy.

So why did this happen?

It is the power of two words - Commitment and Clarity. Once I got clear and I became committed to taking action things changed.

The same thing happens in our everyday life. If things are not working for you as well as you would like take a look at how clear you are on what you are wanting to achieve and how committed you are to achievign it. Once you identify these two areas be prepared to be amazed by rapid results.

Tuesday, October 26, 2010


Talking about happiness what is happiness? Is it a state of wellbeing? A state of inner peace? A sense of wholeness?

I guess it is something very individual however I think it is a state that many people have lost or forgotten what it feels like.

When did you last have a belly laugh? Something that rocks and shakes your whole insides. When did you last burst into peels of laughter?

For me it has been quite a long time. The art of laughter seems to have passed me by. Are you in the same boat?

To examine this a little more for myself living on my own there is not a lot of opportunities to break out into a belly laugh. Sure when I go out I enjoy myself and I smile and laugh but it is not a belly laugh that often.

Recently I went to a friends place for dinner. I didnt acutally know it was her birthday nor did i know any of the people there apart from her. There was a just a small gathering.

Before I left home I would have given anything to stay home. I was tired. I had a headache but I said i would go to dinner so I went.

After dinner my friends brother devised a quiz on how much did we know about his sister. Well I have to say we didnt know a lot but what did happen we had a lot of laughs. It has to be one of the best nights out I have had for a long time.

The final note here was I found my laughter germ again and my headache went. I come home relaxed and had a wonderful nights sleep. Stark reminder of how easy it is to lose the art of laughter. Have your lost your laughter germ too?

Sunday, October 24, 2010

What is Reverence

On uesday night last week (19th October) I was on Improv Radio with Pat Armitstead. In Pat's show, she uses the Virtues Cards.

The Virtues Club was founded 25 years ago in Canada. They researched all the religions in the world and took from each the common words used by each and brought them together as a tool to help parents rear their children with these values.

I was to draw the card for the show and I drew Reverence.

The word Reverence is quite a difficult word to explain. I think it is something that is inate in us but in European society we lose quite early on in life because we are taught to live so much in our heads.

Reverence to me is a state of being. It is a soul connection where a person allows thenself to just be themselves. A state where a person is not striving for or too something just being at one with nature and themselves.

I would be interested to hear what others say about reverence. You can either add to this blog or email me at

If you want to listent to the show it is well worth a read.

Monday, October 11, 2010

Are we too PC for our own good?

As I mentioned yesterday, have we lost the ability to laugh at ourselves?

While I don't support riducule or put downs of anyone, because I dont like to be the recipient of them comments and jokes about other cultures have gone on for years.

The Irish have been the but of jokes being purported as stupid (which they are not) the Scots as being miserly (and they are not) to name a few. Yet I don't see these people getting up in arms about it. They just laugh at it along with everyone else.

This whole issue with Paul Henry has got totally out of hand and I personally think laughing at someones name or questioning where a person was born will continue to be asked. Sacking Police because a joke was sent on email with a comment to is a bit over the top. How many of us have been guilty of making a flippent remark?

The issue here really is the forum these comments, remarks or jokes are made in. Everyone is so careful to save face.

Perhaps Paul Henry just says what others are thinking but too afraid to speak out? I don't know but it has all got totally out of hand in my book.

Sunday, October 10, 2010

My 4 leged mate is on the mend

I am pleased to say the my mate's eye is healing well. He is back to his old self.

Now I don't know if this is a male thing, but he hasn't learned. He still harrasses the cat!! What is the matter with him?

Is it name thing? His name is Henry. Do Henry's not learn?

As far as the other Henry is concerned (Paul) the sad thing is we have lost an excellent interviewer. Sure he get a bit too sure of himself from time to time but hey haven't we all said and done things we regret.

Are we becoming a bit to PC. Why can we not laugh at ourselves? Has the world lost its capacity to turning the other cheek?

I was told as a youngster "Sticks and stones will break my bones but names will never hurt me". I think it is things like this that make us stronger.

Tuesday, October 5, 2010

The joy of animals

A few weeks back I posted an article about animals and how important they are. Many women claim animals are better listeners than men. Well there are many comparisons we could make if we want to.

My 4 legged mate Henry (my dog) I reckon causes me as much grief as any 2 legged male could. Her has allergies that cause his ears to flare up which requires treatment. When ever I go to treat his ears, he runs away (is there an analogy here for me).

Now he has scaped his cornea and has to go to an eye specialist. It seems like it is never ending.

However, all that a side, I wouldnt be without my mate. He keeps me company in my home and in the car. I talk to him and he NEVER answers me back, he just listens. His pleasures are simple like an early morning walk. He sits under my desk while I am working and he cuddles up to me at night and keeps me warm. AND the cat hates him.

I guess it is telling me that life isnt always perfect and how we want it to be. All the challengers and upheavels help us to be compassionate, careing and above all tolerant. We are truely blessed aren't we.

Wednesday, September 22, 2010

Personal Grievances are avoidable

On my walk this morning I was thinking about personal grievances or PG's for short. PG's come about through not knowing the law and though quick unthoughtout actions.

The emotional cost to a business owner or manager is huge and adds to an already stressed person. On top of this is the lost time and the $$$$$.

A single personal grievance is likely to cost you a minimum of $2500!(if you are lucky) On top of this there is the time to prove your case - written and verbal recall. Then there is the lack of sleep which increases stress levels.

The thing is PG's are avoidable. They don't need to happen if you know how to deal with employees.

Just look at what is happening in the ACT party now. We have a tit for tat war. You hurt my feelings now I am going to hurt yours. This is Parent/Child behaviour.

Adult/Adult behaviour is the only way. It is about knowing what to do and not allowing emotions to get in the way.

Want to know more? Then come and find out about Employment Law and how you can protect yourself. Go to for more information.

Tuesday, September 21, 2010

About the Treaty of Waitangi

I know a lot of people are confused about the Treaty and think it is for just Maori. In fact the Treaty is for all New Zealanders. This takes all the fear away from it.

The principles of Participation, Protection and Partnership are really good principles in which to give good care. There is no mystery about this at all.

So if you are one of those who were skeptical, then just think when you are providing any service for any person in New Zealand are you including them in the discussion and seeking their input (participation), is it what the person wants (partnership) and how does this mimimze risk or harm to a person (Protection) then you will have no trouble understanding the Treaty of Waitangi.

Sunday, September 19, 2010

All it takes is a phone call

Currently I have someone who keeps sending me faxes that I cannot answer. I don't know the motive behind this but have a suspicion that someone is trying to tell me something.

I send out faxes to people on my data base to remind them of upcoming courses. Some people have a phone fax so a fax is not automatically received. Others appear to turn their fax off at night.

Recently I received a letter from my phone company stating they had received a complaint because a fax from my phone had woken up a person 4 times during the night. I have not been told who this person is, and there is no way for me to find out who it is as the Privacy Act prevents this information being devulged.

Now the issue for me here is, all it takes is a phone call to tell me to remove them from the list. With out this information I can do nothing.

Another point is it is a business fax. There is currently no law in New Zealand that requires me to get permission from a business to receive a fax unlike emails.

I am now getting someone who has set a fax to come back to me that i cannot answer. A nuisence fax - and yes it is a nuisence.

The thing is, if it is an impostion to receive a fax all that has happen is ring or email me to take them off the fax list. It is not hard. I will not be offended or upset. I will not take any reprisals either. All I will do is take them off the fax list.

This sort of retaliatory behaviour is so unnecessay. I am not in the business of upsetting people. If I have done this, then I apologise.

Tuesday, September 14, 2010

Did you know that WHO predict that by 2020 COPD will be the 3rd leading cause of death in the world!!

I am stunned by the stats on COPD. That it has increase so significantly in woman that it may be the leading cause of death & disability in NZ. and there is more
4th major cause of avoidable hospitalisation in NZ for over 45's
6th most common reason for admission to hospital
Estimated to cost $80.6 million per year and
Maori are 4 times more likely to be hospitalised than non- maori
Mortality rates in Maori are 3 times higher than non-maori
Risk is greatest in Maori females and are hospitalised 5 times more than non-maori

What is worse, this is all preventable.

The Study Day by Gwendolyn Graty was excellent. The stats were mind boggling ( will put more in over the next day or so).

It was an extremely practical and useful session. I came away wondering just how many RN's are providing inadequate treatment for people through lack of knowledge.

On top of this we came away with our personalised kit for us to teach others on how to use inhalers - AWESOME DAY

Sunday, September 12, 2010

A personal gripe!

My mother is in care. She loves the place she is in and the caregivers are fantastic but this weekend she did not have a wonderful experience.

The caregiver taking care of her was rough and hurt her while drying her after a shower. Put her on the toilet and then walked out and left her for a long time. Didn't tidy up her room and on top of all of this, Mum couldn't understand her accent. In essence the caregiver didn't care!

Now I am not angry at the place she is in as they really take good care of her. I am angry at the Agency who provided this caregiver for a weekend shift and caregiver abused and neglected my mother.

Facilities have no way of checking out staff they hire from an agency. They have a reasonable expectation that the agency will provide trained compassionate cargivers to deliver the care the facility expectes. Clearly this was not the case yesterday.

Needless to say I laid a compalint with the facility that they can pass on to the agency. I am also prepared to go to the agency myself but will let the facility deal with it initially.

Wednesday, September 8, 2010

I am gb smacked!!

Yesterday at a Cultural Safety workshop I was running, one person wrote on her evaluations sheet "I didn't know Pakeha's have a culture?"

This stunned me. Is this how we see ourselves? Do Pakeha's really see themselves without having a culture?

Fact is, we definately have a culture and it is time we started claiming it. This is why people complain about care. Their needs are not being met.

Tuesday, September 7, 2010

Co-operation, collaboration & support

This is what is needed in an emergency. Christchurch is now doing this but why wait for a disaster to occur?

Knowing your neighbours (or business colleagues). Working together should be ongoing.

How often to you meet with other rest home or continuing care facilities in your area? What resources could your share? What support could you offer each other?

Don't wait for something bad to happen to do this. If you met every month or six weeks, shared knowledge, or even just friendship if an emergency struck you would know who to call on.

So ring other facilities in your area today. Set up a breakfast, lunch or coffee afternoon. See how you can help each other now, not in a disaster.

Do it now. Do it today. It may just be the best decision you made - to know they neighbour (or facilty).

Monday, September 6, 2010

Cost effective training in house

If you are finding it difficult to get your training needs met or finding it too expensive for your budget, why not join a group in your area?

A 3 hour session could cost as little as $125.00+gst if sufficient people are interested. How does is work?

The normal fee for a 3 hour session is $750.00+gst DONT FREAK OUT
When you combine with 2 other facilities it becomes $250.00+gst ( 3 facilities total)or
3 homes it becomes $187.50+gst (4 facilities total)
4 homes it becomes $150.00+gst (5 facilities total)
5 homes it becomes $125.00+gst (6 facilities total)
You are never going to get a better offer than this for in-house training.

Not only will you get such good value training, you will also get handouts, presentation material and evaluations that meet audit requirments.

Interested? email

Sunday, September 5, 2010

As we reflect on how difficult it is for people in Christchurch .......

Our hearts go out to all of those in Canterbury whose lives have been thrown into disarray after the earth quake. It is difficult to comprehend how one would act or react in such a situation. Even with all the tragedy around them there are still some amazing stories that are coming out.

It is early days yet and as the reality of the situation sets in over time this the full impact of the devastation will sink in. Loss of family pets, income and for some jobs and business' will all have an affect.

I have only one meassage for anyone in this situation, endeavour to focus on the great things you have not what you don't have hard and all it may be. I was reminded of this when I went to my son's wedding in the UK and wrote the article below.

Remember this quote "What doesn't kill you will make you strong". Words people don't want to hear right now but on reflection will come to pass. It is times like this family become our life blood, our solace, joy and comfort.

Communities will become stronger, new friendships developed. All the things we require to live. Things can be replaced, but family and friendships are forever.

You may find this personal artilce of some help.

Wednesday, September 1, 2010

Dont worry if you talk to your dog, your not barking mad

As a dog lover I talk to my dog a lot. He is my mate. I also talk to my cat. I am delighted to know how normal it is when you look at the stats according to a Purina Pet Survey. This are the results
Animal instincts

* 61 per cent of women tell their dog about their problems.

* 31 per cent of women feel their dog is a better listener than their partner.

* 24 per cent of men used their dog to talk to a good-looking stranger in the park.

* 14 per cent of men said their dog showed them more affection than their loved ones.

- Source: Purina Pet Survey

Don't worry if you talk to your dog, you're not barking mad

Do you think you're mad when you start talking to your dog? Don't worry, at least half of animal owners spill their problems to their pets, according to a new study. And it gets worse - a third ... More

The restof the article can be read in NZ Herald Wednesday 25th August paper. Sorry the link wont come up but the title is "dont worry if yoiu talk to your dog, yournot barking mad"

Monday, August 30, 2010

Person Centre Care

For a long time I have felt guilty when I talk to people that the disease is not the most important thing to deal with, it is how we are going to help the person with the condition; whatever it is. The disease is secondary.

I am pleased to say now that others think along these lines too.

Yesterday I went to a talk given by Graham Stokes a renowned pyschologist from the UK on the care of people with dementia. Here he said that "Person Centred care is not about the dementia but about the person with dDementia".

If you are struggling with writing care plans that are relevant, just think of this. If you had dementia and were unable to take care of your every need, what would be the most important things for you to be able to live your life?

It is times like this an RN has to put their clinical knowledge behind them. Yes it is important as the reason care is required but it is of much less importance for the person who is requiring care and their familiy.

Focus on the care the person requires that keeps them healthy and maintains their dignity. That is delivered to their values and what is important to them. Understand the behaviour displayed always has a reason. ALWAYS! Without exception.

Understanding these simple principles will help you provide person centres care.

Sunday, August 29, 2010

Why do audits create so much anxiety?

I went to a very inspiring workshop on Saturday. It was about why we get unwell from a mystics point of view. Now I know you may think I am a bit off the wall here, but just bear with me on this.

Anxiety comes from fear. Fear of what may happen to us. However, this all has little foundation for the reality is WHAT WOULD REALLY HAPPEN IF YOU DIDNT GET A PERFECT AUDIT? An if we let this fear control us, we become unwell. Simple really but very difficult to put into practice. Fear of being wrong or doing things wrong are embedded in our history. This is what cripples us. When you look at the whole scenario what is the likely result?

Reality - Not very much. You would be given an opportunity to relook at areas that could be improved. You won't lose your job, the facility is unlikely to be closed down (unless it is really bad) and you have an opportunity to do better next time. Not that bad eh?

Yet so many people become extremely anxious when an audit is coming up. Some people don't sleep. Some people work extremely long hours in the hope they will get everything perfect and then are devastate when they don't. Some even crash after the audit.

Reality - unlikely you will not be perfect as each auditor will view the facility differently and have a different interpretation and expectations of you an your facility. Many don't even have a residential care back ground and only see it as an acute setting environment and not a person's home. Two different philosophies.

So how do you overcome anxiety prior to an audit?

1. Understand what is going to be required by the auditor
2. Be prepared to provide the auditor with sound argument as to why you provide care in a particular way and explain your reasoning
3. Learn ways to manage your stress so it doesn't control you (You may like to come to the Stress Management Workshop on 3rd November
4. EMPOWER yourself with knowledge through workshops, discussion from others and learn what to do to reduce your stress.

This Wednesday, 1st September, there is a workshop on this that will help EMPOWER you. You will get this from both the trainer, Jessica Buddendijk, and the other attendees.

The more you know, the more empowered you are, the more confident you are to see the audit as just another day in your life as a manager.

Dont miss out on this opportunity. go to

You won't regret it.

Wednesday, August 25, 2010

Inspiration of the day

If you woke up this morning with more health than illness, you are more blessed than the million who will not survive this week.

If you have never experienced the danger of battle, the loneliness of imprisonment, the agony of torture, the pangs of starvation, you are ahead of 500 MILLION people in the world!

If you have food in the fridge, clothes on your back, a roof overhead and a place to sleep, you are richer than 75% of this world!

If you have money in the bank, in your wallet and spare change in a dish some place, you are in fact among the top 8% of the worlds wealthy!

If you can read this message, you just received double the blessing in that someone is thinking of YOU, and furthermore you are more blessed than over two BILLION people in the world who cannot read at all!

Tuesday, August 24, 2010

Person Centred Care

There are many overseas model working in New Zealand. We have Spark of Life (Australia), Person Centred Care (USA) and Liverpoole Pathway (UK) yet we have our own model that was developed in 1840. Yes that is right, the Treaty of Waitangi.

What it stated, briefly, is that Maori health would have dominion over their own health in the form of Partnership, Participation & Protection.

Is this not what we all should be doing in health care? Is it not indeep what you want for yourself in health?

We are suppose to be in partnership with a person. That to me means discuss, inform, advise, recommend, listen, source help in fact anything that is needed to keep a person well through this partnership. It should not be power and control, "I" prescribe the care, you follow the instructions. It is to discuss what will work for them. It means to look at the person and take every aspect of the person into account. Their lifestyle, support network, finance, comprehension and cultural background into account.

For all of this to occur, a partnership has to be developed with the person or their family. Without a willing partner in health, a positve outcome will never occur. The most important ingredient in this partnership is trust. If a person does not trust the health professional and believe what is being discussed is best option for them then the partnership fails and illness prevails.

A health professional is an advocate for people in requiring care. We are there to protect them from harm or ill effects; to speak up for them if they are unable to speak for themselves; to fight their battles if they cannot do it themselves. None of this can be achieved unless there is a sound partnership and willing participants.

So why do we have to import all these systems and models when the simplicity of the Treaty of Waitangi principles of 1840 apply?

If you are not applying these principles and adhereing to them when dealing with a person then you are letting your clients down.

Monday, August 23, 2010

Registered Nurse Role

Increasingly I am having discussions with facilities who are experiencing difficulties with Registered Nurses understanding their role.

The problems they are finding are an inability to supervise, delegate and in interpersonal relationships. It appears RN's do not understand how important it is for them to supervise caregivers and not just leave them to do their work. There is little or no follow-up.

RN's have to realise that Caregivers do not have the body of knowledge registered nurses have. They require supervison. If an RN is delegating a task they have to make sure the caregiver is actually competent to do it. Delegation by Abdication never works. You will just get more unsatisfactory care and increase RN and Managment frustration.

On top of this there a variety of cultures working in the industy. They come from a variety of value systems that are vastly different to ours and our clients. This needs to be understood and taken into consideration. So to address this, I have put a workshop together to help RN's with these tasks.

What RN's don't realise that there Practicing Certificate is at risk here. All caregiver work under RN's supervision. Are you and your Practicing Certificate safe?

For more information on this contact

Sunday, August 22, 2010

How did the name Pakeha come about

The meaning of Pakeha appears to have changed over time. Prior to 1815 it meant "white person" who came from England to settle in New Zealand. Then was applied to any fair skinned person born in New Zealand. Later it was applied to all fair skinned people in New Zealand.

However Dr Michael King in 1985 defined Pakeha as any "non-Maori" person.

More recently Ross Himona says linguistically Pakeha means a New Zealander of non-Maori or non-Polynesian decent.

This to me make sense. I am happy to be called a Pakeha. It defines who I am. A non-Maori ihabitant of New Zealand.

So what have I learned? As we are all boat people i.e. we inhabitated New Zealand from another land, the Maori were the first to settle and the Pakeha the second to arrive, mainly from Great Brittan. We are a country that has relative harmony between the cultures, that live together to create what we have today. Everyone has contributed to New Zealands very existance.

I give thanks to Jodi Ranford who explored this topic and has written a wonderful artical titled Pakeha, Its origin and meaning. It can be read at
It is well worth a read.

Thursday, August 19, 2010

Did you know before European settlers Maori did not have a name for themselves

In the process of research for a new e-book I am compiling to help people understand people, and I am starting with Pakeha', the Maori did not have a name for themselves only a number of tribal names.

According to Dr Michael King, noted New Zealand Historian "Maori relates closely to 'tangata whenua': people of the land: but with connotations of 'those who were here first' and 'host people'.

However the Maori people themselves do not refer to themselves as Maori. They refer to their tribal membership say Maori kaumatua Ross Himona. They are Maori only in relation to Pakeha. Maori means "normal" i.e. in relation to Pakeha. quotes from Pakeha, Its origin and meaning by Jodi Ranford.

Interesting isnt it?

Wednesday, August 18, 2010

Health Benefits of Vitamin C

The use of supplements in a diet has been hotly debated for years. It is pleasing to note that now their is evidence to support the health benefits of Vitamin C.

According to a Dunedin based research people with tumours have "low levels of Vitamin C present and high levels of a protein which allows the tumour to thrive in conditions of stress". to read more go to

So is there a connection between stress and cancer? Maybe.

Where I sit on this is for years I have beleived that our body speaks our mind. Whatever our body is displaying there is a reason. If you find that reason, then you can fix the problem. Sounds simple. Well not really.

More and more scientists are linking disease to stress i.e. Heart Disease is well known for one. Could it just play a bigger part in our lives than we realise? Could managing stress levels be the key to good health?

Living a balanced life is certainly helpful. But do people know what a balanced life is? This creates more questions than answers doesnt it.

I personally believe we are responsible for our own health. If taking supplements is part of your daily health regime, then that is great. However it does not elimnate the need for a good diet, exercise, rest and relaxation. It also means managing your thoughts and emotions. The chatter box that is continually running inside our heads can be as big a cause of disease as anything else.

Stress is much more complex that we realise. It is a part of our everyday life. If it controls you rather than you controlling it, then disease will result in some form. If this is you, you may like to look at the Maintaining Resilience Workshop in November.

I believe the key to a long and healthy life is knowing and understanding yourself, living by your values and taking full responsibility for everything in your life. It is never too late to start.

Tuesday, August 17, 2010

How well is your team functioning

Yesterday I did a training session for an organisation where a senior staff member was struggling to get all the systems in place and get the team on board.

As is often the case when a new person comes into a position, they pick up all the anomalies. This can be very threatening to the rest of the team as it feels like more being added to their already heavy workload.

Another issues is it depends on what country the RN has done the training in or era the person trained in. These all add to an interesting mix in the team.

On top of this there are also caregivers from many cultures working in the facility. Oten they see time being an issue and do not fully understand what their role entails. it is not just to care for the resident it is to observe what is happening to the resident and report it to the RN but they need to know what to report and why. If they dont know what to look for, why would they report it. A resident is giving a whole heap of clues before they become unwell. It is the caregivers that see this. They now need to know the importance of these observations for a RN to make a clinical decision.

So the whole issue comes down to communication and training.

I know it is yet another issue to deal with in an already very heavy work schedule however if you want to reduce your work load and create more time in your day communication and education are essential.

If you are struggling with similar issues why not run a facilitated session with me. I have no history with your organisation that hinders my ability to see and seek clarity. We create a safe place for everyone to discuss the issues and create solutions. It may just be the way for you to create more time in your day. I could just be a great investment.

Monday, August 16, 2010

Rest Homes Caregivers under fire again

It beats me how the sick in mind manage to find their way to look after the frail and infirm. What is happening to our society? How is it that people go into a line of work with the expressed aim to abuse those in their care for their own gratification. They pray on those who can't fight back but the thing is they do fight back. They display behaviours that is saying something is wrong.

I know the number of people abused is small but it should never happen at all. Every person has a right to life and the right to be cared for with dignity and respect. When cases hit the news media, I become really angry. Many people are out promoting the good work that aged care facilities do and along comes some bad apples the spoil the whole crop!!

How can we prevent this from happening?

Fact is it is almost impossible. A Police check is done on each person (or should be done) but these take forever to come back. Meanwhile a person with a history of abuse has been employed. What else can an employer do? Often these people present very well. They are smart predators and know just what to say.

For me, I just feel really sad that people have so little regard for others that they can even think to cause harm to others.

Sunday, August 15, 2010

Did you know?

That laughter produces 167 chemicals! These are antioxidants that keep us healthy.

Laughter increases the number of antibody-producing cells and enhances the effectiveness of T cells i.e. creates a healthy immune system.

Promotes physical and emotional release

A good belly laughs gives is a great body workout

Acts as a distraction from stress - removes the focus away from the problem.

Is a great for socialisation. It connects us with others and elevates our mood.

How long do you spend laughing in your day.

All of this promotes healthy outlook on life, and is known to reduce heart disease and other stress related conditions.

Children do it effortlessly. They laugh at what appears to us to be nothing. Adults appear to have to have a reason.


Or is it something we have developed in our process of "growing up.

Or is this what is helping us to grow old?

How often have you laughed today?

Thursday, August 12, 2010

Training to care for a Pakeha

Yesterday I did a full days training for an Agency. Of those that attended there wasn't one Pakeha person there. This is not unusual nor is it a criticism. It is just a fact of life.

However, I asked them how much they new about Pakeha's and they looked at me blankley?

We can't blame them for not knowing about Pakeha's. We haven't told them who we are. It is impossible for them to know unless we tell them. Pakeha's, on the whole are not that good at saying what they want to a person's face. It is likely they will ask for very little then complain when they don't get what they want.

Pakeha's need to stand up for themselves. Tell people who you are. Then they will get the care you want.

Wednesday, August 11, 2010

Psychoneuroimmunology - have your heard of this?

Psychoneuroimmunology is the science relating to the effects the brain has over the immune system.

Now I have long known this. It is not based on empiracle research. It is based on observations of people.

In 1986 I noticed the relationship between stress and colds/flu. It occured to me that people who looked after someone with dementia usually ended up sick in bed when they were given a rest i.e. the person with dementia was admitted for respite care. The first week was forced rest, the second week was recovery and then the person went home again and the cycle continued.

However I did notice that the carer was never able to continuing careing much after this. Their body could not reach the same level of functioning.

You see, for any disease or illness to occur there has to be a host. This host has to create the right environment for it to thrive.

Now scientists are validating this. Interesting mmmmmmmmm

Tuesday, August 10, 2010

How do we get the care we need?

It is a very different environment in New Zealand today. No longer a we a monoculure or a bi-cultural society for that matter. We are a multi-cultural society.

But let us not forget our own roots. Lets not forget that in this society there is such a thing as a Pakeha culture. We do have the right to be care for as a Pakeha. No matter how we look at it, Pakeha still make a the majority of New Zelanders and are being cared for by a multi-cultural workforce. Pakeha need to tell the carers what they want not let them give them what they think you want.

Now I am not intending to start a riot here. I think we are very blessed to have such rich diversity in NZ. What I am saying, let us not forget that Pakeha has a unique culture of its own and needs to be recognised to. While Pakeha now are good at recognising and embracing other cultures. Do the other cultures recognise and embrace us in the same way.

Monday, August 9, 2010

We must stop medicalising residents in residential care

It seems as though becoming frail and old is now no longer a natural process. We used to be able to have the comfort knowing that if we ever needed this care, we would be could go into a home like environment where we could live out our life in peace and tranquility.

This is no longer the case.

We have to have a medical condition and be medicalised rather than the fact we just need help with our daily living.

There is a huge push to keep people in their own homes where they are cared for in their own surroundings – their home. For some people this is not an option. They have to go into care for a variety of reasons i.e. increased falls, increased memory loss, inability to safely take care of themselves, absence of family members to fulfill the roll or some other very valid reason. Not all of these have a medical condition attached to them. It is as simple as that. The only thing that has changed is their living environment.

Why do we do this to our elderly or disabled people? Surely residential care is precisely that – a place to live where we get help with our daily needs.

We were not meant to live alone, we are after all social animals, and surely we have the right to a home not a “medicalised model of health”.

Think about it. If you get to a point where you are no longer able to take care of yourself, do you really want to live in a hospital? That is what we are in danger of creating if we don’t stand up and say what we want.

People in residential care rarely become sick in fact they are more likely to require less medical intervention once the stress and loneliness of isolation is removed. They are just not able to care for themselves.

A plea to auditors – please don’t make these facilities into hospitals. Think of them as a home where people live 24/7 and look at what is working well for the residents in a home not what you would expect to find in a hospital.

Sunday, August 8, 2010

Migrant workforce

Apparently 50% of the doctors looking after us in New Zealand are migrants. I would say it is as high if not higher across the whole health care industry.

My concern is not that they are migrants but how much training do they receive to understand the Kiwi Culture. I am sure they do Treaty Workshops but does that really equip them to look after the emotional needs of New Zealanders?

I have absolutely no doubt as to their technical/clinical skills. I do have concern about communication skills. People who are unwell often feel powerless. They do not have the knowledge or the energy to request information. Combine that with values & beliefs differentation you get people's needs not being met. This is where the focus now needs to be.

Thursday, August 5, 2010

Care Creed

Have you asked me today?
Have you acknowlededge me today?
Have you understood me today?
Have you loved me today?
Or am I just another TASK in your day?

Wednesday, August 4, 2010

How big a part in our everyday work does trust play?

I would say it is our job to creat a high trust environment. We may have all the clinical knowledge in the world if we don't have trust from the people we serve it means nothing.

If you look at the so called "difficult people" in your work and/or life how much is it a trust issue.

Trust is an integral part of our pyschi. Violate that and it becomes very difficult to restore the relationship.

Children do not have a conscious mind till the age of 6 according to Bruce Liptor a biologist. So if a childs trust is violated prior to this age is it fair to say they will go through life with this issue? I think it is a pretty good chance.

However remember trust can be violated at any stage in our lives.

While we cannot do anything to fix people and their trust issues we can at the very least do what we can to work in such a way that they feel safe.

Are you giving safe care?

Tuesday, August 3, 2010

Speed of Trust

Yesterday i talked about how important trust was in intimacey. Fact is Trust is necessary for any relationship. Check ou Steven Coveys new book "Speed of Trust" Yu can read a review at

Monday, August 2, 2010

Companionship and Intimacy in Residential Care

Being able to share your life with someone is really important. Being intimate with someone is also important but intimacy does not have to include sex.

I think this is where people get confused with intimacy.

A caregiver, be it RN or caregiver, is being intimate with people every day. Residents or clients allow you to get up close and really personal with their personal care. Whether a person is comfortable with you doing this care or not is directly proportionate to the level of trust a person has in you, the caregiver. You cannot be intimate with anyone without trust.

Don't get confused around intimacy and sex. While they are integral in some relationships, intimacy and companionship is quite different. This is what you see in residential care.

Think about the people in your life that you share you inner most feelings with? Does it always involve sex? No it doesn't.

The people you gravitate towards are those you feel comfortable with and you have a high degree of trust with. If the trust in this relationship is violated, then the relationship breaks down and being intimate is no longer possible i.e. you will no longer share your thoughts, feelings and ideas with. This is what being intimate is all about.

Think about the people in your care. How do they share their lives with others in the facility? It doesnt involve sex but it does entail a sense of joy, wholeness and welbeing. This is intimacy and companionship.

Sunday, August 1, 2010

Sunset Love

I dont like the title article in the NZ Herald on Sunday Supplement is actually quite good. On page 3 of the supplement I am quote as saying
We are meant to be iving with other people. We are not meant to be alone". I believe this to be true.

While many people do choose to live in their own home and want to till they die there are some people who know they cannot manage on their own any longer and would love some company.

If a person is frail and mobility a problem then living with other people can help. Living with only your own thoughts can make your unwell. What you focus on is what you get.

I have seen so many people who come in to a residential facility with multiple health and disability problems that often is a very short time don't meet the profile received. While the health problems still remain the happiness scale improves teir health outcomes and they become less of an issue.

If you want to find out how you rate on the happiness and health scale go to and do the simple test. I scored in the top 43% of people who will still be alive in 21 years. What is your score. Give it a go.

Thursday, July 29, 2010

What does living in a Bi-Cultural Society mean?

I have heard said by many, that we are multi-cultural society not a bi-cultural society. While that is correct our history has to be taken into account.

The Treaty of Waitangi was there for the preservation and protection of both parties where they could live in harmony. Well that is how understand it to be.

When a person understands what living in a bi-cultural society actually is living in a multi-cultural society becomes easy.

How is that so? Just think about it. When you understand people differences you also get to see their similarities.

Wednesday, July 28, 2010

$ value of nursing staff in residential care

On one hand there is a move to improve the care of the elderly thround specialist nurses yet on the other hand there is a devaluing of the those already working in Aged care?

I am talking about pay rates. For the life of me I do not understand why Rn's and Caregivers in both the public and private sector do not have parity.

The media is quick to jump on the aged care when a perceived wrong is noted yet the incentive to have well trained nurses in the private aged care sector appears to be discouraged.

I have to say it is time that this issue was addressed not from a union point of view but a moral point of view. Is this not he same as women getting parity with men? A continual battle for recognition of value?

Go to for discussion on Taihape nurses being expected to take a cut in pay.

My question on this is. The public sector nurses are looking to get yet another pay rise. I understand it is under negotiation. What about the Aged Care Sector? Will they get the same rise? Will the government top up the funding to cover this for the private sector?

Maybe it is time the way the private sector is funded? Two bundles of money. One for wages and one for business. Just a thought.

Tuesday, July 27, 2010

Rest Homes hit the media yet again

This time it more about business of Rest Homes. Unfortunately the writer, Geoff Harper does not understand the difference between Rest Homes and Continuing Care facilities which have a different staffing ratio due to the different needs of each group. However he does have some valid points about overseas ownership. ("Country's rest home industry leaves a lot to be desired" written by Geoff Harper NZ Herald 27th July Pg A9)

My concern is not so much the finances going off shore, but the values difference of some people who are purchasing aged care facilities. They are finance focused and more likely to cut corners in the areas that matter most to people in care. Where the owner comes from a country where money is god, the sole purpose for existance people have a much lesser value. This can make it very difficult for Kiwi'a to work in these facilities.

I would like to think we are a "people first" country. Survival tactics are different here. We can get a financial hand up from the government even if it is a meagre one, it does help. Owners who come from a value system where survival is up to them have a totally different focus.

So please let the government consider these factors when assessing overseas ownership. Does this person fit in with the values of this country? Are the people of New Zealand going to disadvantaged by this business owner?

For example how can the onwner of a shipping company know how to look after older people! Zilch in my book. I think you can see where I am coming from.

Monday, July 26, 2010

Trial by Media - again

It is sad that yet again the media want to have a "go" at rest homes. While residential care will never be perfect for many families I know that in most cases you all do a wonderful job.

This recent front page headline proves to me how important it is to have staff well trained. While the facility admits there were some errors in documentation it appears the gentleman was well cared for.

What you will never be able to predict or account for is family guilt and a society that wants to apportion blame. The reality is that older people are more at risk of falling and dare I say it - dying.

As a carer you can only rely on the information a resident gives you. If they say they are not in pain or are fine there is little you can do. Indeed you should empower the person to make their own decision. However you will always come up against people who think a residential facility can wave a magic wand and do the impossible - like stopping a person from dying.

All I can say is the importance of training yet rears it head again. When I am teaching observing, recording and reporting I instill in the Caregivers that this is all about ensuring they write everything down and they cover their butt.

However you will never be able to do the impossible. Sometimes it is just time for a person to die. Can they at the very least do this with some dignity without being plastered across the media. I know at the very least, that is what I would want for my family.

Sunday, July 25, 2010

Do you have people with fluid retention who are not responding as well as they could to Frusid?

At a recent Medication Adminstration Training Session for Caregivers, Gigi Lim, Senior Lecturer at Auckland University was saying that if Frusid is given after food, the medication action may be delayed (See below Pharmcokinetics for Frusid from Medsafe Website)

So if you have people who are not responding as well as expected to Frusid Medication administration time may the problem. Discuss with your doctor and Pharmacist and see if shifting the administration time could make a difference.

Approximately 60 to 70% of an oral dose of frusemide is absorbed. Peak plasma concentrations occur 60 minutes after oral administration and 30 minutes after intramuscular injection. They increase with increasing dose. Administration after food apparently delays absorption producing lower but more persistent blood concentrations.

Full Fact Data Sheet can be viewed at

Thursday, July 22, 2010

How well do you understand the medications you are administering?

Registered Nurses and Managers of care facilities, have very high expectations of caregivers. While there is no legal provision made for who may or may not administer medicines are the caregivers actually receiving sufficient information on how the medications they are giving, actually work? Do they understand what happens if the medications is not given in accordance with the manufacturers instructions?

Medications are chemicals. Like all chemicals they are designed to work under certain conditions. If the conditions are not correct, then the efficacy of the chemical will be altered.

So what are some basic actions for medication efficacy?
1. Swallowed with a at least ½ glass of water – not a sip of tea or coffee or put in their food or crushed especially with certain formulations if they are Enteric Coated, Controlled Release or Slow Release
2. Put directly into the mouth on a spoon – not in the hands, or picked up with the fingers
3. Given at specific time – on an empty stomach, with food, after food or morning, noon, afternoon or evening

Every time a medication is given outside of the manufacturers instructions, it reduces the efficacy of the medication.

Yet if we are honest a lot of medications are administered outside these “warranties” if you like.

Caregivers are trained in the 5 point pre-administration check before any medications are given. This we do well.

So what else should any person administering medications know?

What happens to the medication in the body? Not in fine detail but have some understanding how drugs are absorbed and distributed around the body. This enhances the understanding of the importance of their role.

Is this done well? No it isn’t.

We make it as safe as we can with the limited knowledge that is given to the caregivers. On the whole I believe we do a good job but we could do a better job by enhancing their understanding.

Clinical Update (NZ) Ltd is very fortunate to have been able to contract the services of an expert in the field of medications in Gigi Lim, Senior Lecturer at University of Auckland. Not only is she a Registered Nurse, she is also a Pharmacologist. She decided that she did not understand how the medications she was giving worked, so she did something about it. Now with her clinical nursing knowledge and her Pharmacology knowledge, she can teach in a way nurses understand.

I have been working with her for the last 5 years helping Registered Nurses, Enrolled Nurses and Caregivers understand how medications work in the body. I am fortunate to to be present at all her training. It is part of my business. I have never left any session without taking away some new information.

The bottom line here is we cannot expect caregivers to know everything but we can empower them with knowledge. We can help them understand the importance of their role. Medication administrations errors can be prevenable and many errors are caused by lack of knowledge and understanding of the drug's efficacy. Give them the tools to do their job. Understanding Medication action is but one of them. After all if they don’t understand what they are doing, the how and the why are superfluous. Take the next step. Give your caregivers the knowledge to do their job well. You will reap the benefits of good care.

For the next Medication for Caregiver course in Auckland go to

Wednesday, July 21, 2010

Caregivers have a thirst for knowledge that we don't often recognise

Having run two caregiver training courses this week it just never ceases to amaze me of the knowledge they have and the new knowledge they seek.

Firstly Observing Recording and Reporting. Having gained some understanding of the importance of reporting what they see, hear, feel, and writing in a factual way using what where when and how empowered left them buzzing.

At Medications for caregivers with Gigi Lim I was astounded at the questions they asked. They are more highly skilled than we sometimes give them credit for. Some of those who attended had been to 3 of Gigi's classes. That shows a real thirst for knowledge.

Next year there will be more information on specific medications for them to empower them further.

Lets not underestimate the abilities of these caregivers and thank you to the facilities/organisations that supported them in their endeavours.
You and your residents/clients are the winners here.

Tuesday, July 20, 2010

The integration and transition of home to residential care

It is pleasing to see there is now a move to look more closely at this. A conference coming up in September is taking a good look at this. If you want to find out more about it go to

Monday, July 19, 2010

Did you know??

That cultural safety has been in place in New Zealand for over 20 years and Irihapeti Merenia Ramsden one of the instigators of this. If you are interested in finding out more about the history of Cultural Safety in New Zealand, which has a strong bias for indiginous people then take a look at this article

If you think you alone cant make a difference, just look at what Irihapeti did. She has moved mountains. Now it is time for us continue her good work but to include all cultures, including pakeha New Zealanders. We have our own culture too that needs to be recognised.

Sunday, July 18, 2010

The value of training - is it an expense or an investment

With budgets being squeezed, training seems to be the poor relation. Yet some people still find the value in training. This article in Insite outlies the Oceania Living experience on training and how targeted training has save $$$ in ACC levies and reduced attrition.

Well worth a read. Go to

What are the benefits of training staff

According to Oceania Group National Training Manager, Mike Knowles, they have reduced the accident rate through a targeted Occupational Health and Safety training strategy. They used to face $20,000 per months in ACC claims and it has now dropped to $5000 per month. So if you think training is a cost, it is actually a saving when looking at figures like this.
This article in Insite is well worth a read.
Go to .

Wednesday, July 7, 2010

Where do you come from

The Maori people define themselves by there iwi. Where they have come from. This is not where they live. I fell into this trap when I was asked where I came from, and I said West Auckland but the person wasnt asking me that. They were asking me what my heritage was. While I have a strong Irish ancestory from both sides of my parents, i do not identify myself with being Irish. I am a New Zealander and being a Pakeha New Zealander, I have a unique identity. How do you defien your uniqueness?

Sunday, July 4, 2010

Who is a Kiwi?

Pakeha New Zealanders have done such a wonderful job of learning to understand other cultures that we are at risk of loosing ourselves. We have apolgised to the Maori for what we our forefathers have done, and so we should. It wasn't right. The Maori people have done a great job of getting back their heritage and claiming who they are. We have welcomed all other cultures to our shores to make us a rich and diverse culture. It is now up to us to claim back who we are and start telling people who we are as a people. If we don't invest time in explaining who and what is a Pakeha New Zealander, then we will be come embittered and unhappy, forever winging about the bad care we get. Lets stand up for ourselves and claim our space and tell our carers just how to care for us or we are going to continue to get more of what we dont want..

Sunday, June 27, 2010

Who's Challenging who in Challenging Behaviours

Talking to a colleague the other night about a residents "challenging behaviour" got me to thinking that maybe it is time we addressed this topic again.

For those of you who know me, or have had me in to do training on Challenging Behaviours in-house, will know my philosophy on this topic. Firstly, a caregiver has to ask, "Why is the behaviour Challenging Me, because I can guarantee the behaviour discussed doesn't challenge every caregiver in the facility, including RN's. In fact, often when I go in to do training we focus on a particular behaviour that is challenging and problem solve to get answers as well as the understanding behvaiours. It becomes a very enlightening and rewarding experience for everyone.

While I understand repeatative behaviour can be very distracting and annoying, the fact is, the person is trying to tell you something. We don't have to always answer them in words either. Our actions and our love can often be sufficient to distract them even momentarily.

I am vehmently against the use of medication to try and modify behaviour. It really just doesn't work. I came to realise this when I was a Charge Nurse at Greenlane Hospital, but I battled with a Geriatritian who would not listen the what we said and saw and insisted we give the anti-psychoitcs she charted. It wasn't till I had my own rest home I was in a position to offer more respect for clients in my care. I was fortunate to have a GP who had a similar philosophy saying he could only prescirbe on the information we gave him. I suggested we have a trial on taking everyone off sedation and anti-psychotic drugs and he agreed. With his support we were able to offer a better quality of life for the residents. I replaced this with Reike, Holistic Pulsing, Aromatherapy & flower essence and I spent my time on educating the caregivers. I probably was one of the first Rest Homes to have a policy of this nature, and that was in the early 1990's! For 5 years, before I sold the Rest Home, not one sedative or anti-psychotic drug was used at all.

What happened when the caregivers changed their attitude, behaviour and reaction to a person was the residents behaviour became much less of a problem. We were solution based. We talked to the families to find out their background and gleamed some possible answers to their behaviour. Don't underestimate the information families give you and it's relevance in understanding the person and don't ignore what the person is saying either. The result we got , was a group of residents who were more responsive and staff that were solution based.

While it is a help to understand the condition the person has, at the end of the day it is the behaviour that has to be addressed. This can usually be managed well with love and understanding. One thing that people know and respond to is how safe, or unsafe, they feel around the caregiver.

With the introduction of so many different ethnic groups looking after our people, if is more difficult for them to understand the Kiwi culture. Many of these ethnic groups do not provide residential care for the elderly or disabled in their own country. Nor do they do not understand who a Kiwi is. What our culture is. Who we are as a "people" or the lifestyle the residents have lived.

For example, It is only of recent years there has been a wide variety of ethnicities living in NZ. It used to be Maori and Pakeha. That was it. With the failing brain, spare a thought to how the person may feel when they wake up to a person from India, Philippines, China, Korea, Africa or where ever coming into their room in the morning. Is it just possible they may feel they are living in another country rather than their country of birth?

Now I am not saying any of this is wrong, what I am saying is, UNDERSTAND THE WAY THE PERSON YOU ARE GIVING CARE TO MAY FEEL when faced with these situations or challenges. Find out about the person and see how they would like to be cared for. Don't assume they want to be treated as the culture you were brought up in. They won't. Like you, they only know what they know, and, after all, they are paying your wages. They are your client. At the end of the day it boils down to a training issue. HOW SKILLED ARE YOUR STAFF IN WORKING WITH PEOPLE AND THEIR BEHAVIOURS?

Wednesday, June 16, 2010

What is Kiwi Culture

Talking to friend today about Kiwi's, I was saying that we are not very good at saying what we want or don't want. However if we don't get what we want or expect, rather than confront the issue, we will skirt around it and tell 25 other people about how bad we were treated or whatever the complaint it.

Contrasting this with European people, for example people from Germany, who will tell you exactly what they want or don't want. If they dont want to talk to you, they will say "I don't want to talk to you now".

As Kiwi's we are most offended by such comments where as it is normal practice for other nationalities to express themselves honestly.

Something we all need to understand about each other, especially other cultures coming in to care for New Zealanders/

Thursday, June 3, 2010

Cultural Sensitivity

There is little doubt that in New Zealand now we have a blend of cultures. This is very evident in health care and here lies the challenge. The way of life for many people from these countries, especially the eastern cultures, if frequently one of survivial. That is quite foreign to us Kiwi's. We have been privileged to receive a handup to help us through the tough times. We are essentially a fairly laid back culture. Rarely have we had to fight for anything in our lives. So fundementally those giving care have a totally different focus on care to those receiving care i.e. task verses understanding the person. This makes person centred care very challenging for some cultures who have a very analytical based learning system. Are you more focused on the task or the person? They both have equal value. Doing task only is very disrespectful to those in your care.

Monday, May 24, 2010

When dealing with people who have challenging behaviours, the first thing to ask is "Why is it so challenging?" At a training session yesterday, the people were having problems with a lady kicking and hitting. When i asked what time of day, I was told 8.30 in the morning. How come i wasnt surprised? She didnt want to get out of bed at that time of the morning! They then told me she wasnt a morning person. How hard is that to fix?

Always remember. Treat everyone living in residential care as if they are living in their own home and work to their preferences. Then some of this behaviour will stop.

Sunday, May 23, 2010

The Nursing Council of NZ says that any person who diminished, demeans or disempowers someone in their care, is culturally unsafe.

How often in your day do you diminish, demean or disempower someone without even realising you are doing it.

Think about your practice and ask yourself, do I do this? Do I not respect the culture of the person I am looking after. Do I not think about the weather when I am putting clothes on them? Do I do things for a person that they can do for themselves, because it is quicker? Do I put them in a wheelchair, rather than get them to walk because it is easier for me? Do I rush past a room because I am too busy to pass the time of day with a person or listen to their concerns? Do I forget to pass on a message I have received for a person and told them a relative has called?

Think about your day and if you have answered yes to any of the above, or something else, then maybe you are culturally unsafe.

Sunday, March 28, 2010

Back to my hobby horse. When are caregivers (and that includes Managers & RN's) going to get the fact that a residential facility is the residents home!!

At a recent workshop one of the participants talked about a potential resident who had come in for short stay care where they met all her requirements like breakfast in bed and meals in her room. The lady was really happy so she decided to come in permanently. At this point, the rules changed. She could no longer have breakfast in bed and other meals as she had when she was in for a short stay.

What a let down for the lady? It is a big enough decision to come into care in the first place, to suddenly the rules have changed must have really thrown the lady.

My question was, why did the rules have to be different for a permanent resident to a short stay? Was it to get a bed full? If so, how unethical!

I was told "she needed to socialise". Well, who says she needs to socialise? She had probably lived on her own for some years and didn't socialise at home. Why suddenly does she have to now? She would socialise when, and if, she was ready.

Think about how you are treating your residents. They are, after all, paying your wages. What does it matter if they have their meals in their room. We have to stop running these places like institutions and really think about the people who live there full time - and it isn't management.

Sunday, March 21, 2010

Back to the Asian countries. I was speaking to a business man from Singapore on my way back from the Philippines, and talked to him about my observations on the long school day for children in Asian countries. He was telling me that in Singapore they are now realsing it is not good for children to do all study and they are looking at ways for children to have a more integrated learning experience. So perhaps we dont do too badly here in good old Godszone. Especially when we are 3rd in OECD for English and 5th for Maths. We must be doing something right.

Another thing to consider too is, it has been discovered that children under 2 years of age, who do not have a single constant caregiver in their life e.g. just one of many in a Day Care Centre where the caregiver changes regularly, have high cortisole levels. While cortisole has other functions, prolonged high levels of this hormone are known to be a factor in Diabetes and heart Disease. Cortisole is essential for blood glucose metabolism, blood pressure regulation, insulin release for blood sugar maintanence plus immune function and inflammatory responses. Could these factors just be the reason there is an increase in Diabetes and Heart Disease world wide?

To me, no-one has to be a rocket scientist to understand that prolonged exposure to stress, producing high cortisole levels, must have an affect on a person through out there life.

Worth considering isnt it.

Monday, March 15, 2010

Have you ever stopped to think why people from Asian countries seem to be able to work longer hours than we do? Well it has become very apparent to me.

I am currently in the Philippines and coming in to work you see all these little children going off to school at 7am in the morning. The same was in India when I was there 3 years ago. Their school day starts at 7-7.30 am and finishes at 5pm!! In New Zealand, and other countries as well, our school day starts at 9am and finishes around 3pm. We are not conditioned to work long hours.

I have long wondered at the capacity for people from other countries to work long hours and seemingly not get tired. If we had had from the age of 5, had a school day that was 9 hours long minimum, our bodies too would be conditioned to withstand such long days.

On top of this, their class size is around 50 student yet we grumble if we have 30 students claiming it is not conducive to good learning. Who is right? I dont know but what I do know is that they value and prize education as a way forward.

Worth pondering on isnt it?

Are we brought up to be too soft? I dont know, but they certainly seem to cope better with longer hours than we do.

Sunday, February 21, 2010

Cross Cultural Communication

We all know how difficult it can be communicating with our own culture, so how must it be for those from a completely different culture? Mis-communication happens all the time. It is especially difficult for our older people and those with hearing loss - I know, I have hearing aids. So if you are going to give the best care you can to the vulnerable in our care, you need to look very carefully as to how you talk to people. Are you sure they understand what you are saying or are they just being polite and nodding their head in agreement just to please you? This goes for everyone.

Now because I am used to having to get people to repeat themselves due to my hearing loss, it is not that way for everyone. So as nurses and managers, you need to coach people who have English as a second language to make sure they know what is being asked and to have the confidence to ask for it to be repeated if they don't. It is no good to complain about the work not being done the way you want it to be done, if you dont invest the time in orientating people to how you want it done - and this includes the way the culture of the people being cared for want to be communicated with. My saying for this month is
"If the team do not know the why behind the what, then the how is superfluous"