Clinical Update - Changing the Face of Caregiving

The Mobile Learning Era

2011-06-21T19:01:00.000-07:00

Did you know that the fastest growing group of technology learning is in the 50+ age group.

Did you know that we are in the era of 7 minute learning revolution? That time is limited for 2 day workshops? That people want to learn bight size chunks of learning when they need and want it not spend a whole day in a classroom?

Did you know that many learning institutions are 5 years behind google learners? That mobile learning is on the increase dramatically and that if you want to reach you staff you need to provide them with the opportunity to learn in multiple ways using technology?

This very interesting YouTube video is very iteresting. http://www.youtube.com/watch?v=yswtL_3cb_g

Congratulations to Rosedale Village

2011-06-19T19:59:00.000-07:00

Debbie Tunui has been working with Netsoft Technology on a new Instant Point of Care data collecting technology.

Congratulations for your forward thinking Debbie.

Really intersting Press Release. Why dont you check this out http://www.scoop.co.nz/stories/BU1106/S00593/new-hand-held-technology-provides-instant-point-of-care.htm

Apple peel helps prevent muscle wasting?

2011-06-19T19:48:00.000-07:00

Well maybe our grandmothers were right. An apple a day keeps the doctor away. Well this was something that I learned anyway.

Now I don't have a problem eating apples, I love them but I know of others who don't mainly because they are gas producing. However it now appears that there may be a compound in the skin of apples that actually prevents muscle wasting but many older people find the skin very difficlut to eat sowhat do we do? Yes thats right, we peel off ths skin which may turn out to be the best part of the apple.

While more research does need to be done, as always, it appears from a study done on mice that the mice who were fed this compound, ursolic acid became leaner and had lower blood levels of glucose, cholesterol and triglycerides. Very intersting.

No doubt there will be drug manufactured sometime in the future with these compounds. So maybe if we keep eating an apple a day (with the skin on) then we may be a much healther group of people who will have strong, healthy, well functioning muscles well into our old age.

Care Training Online Update

2011-06-19T16:26:00.000-07:00

I am amazed how well this is going. More and more people are joining and experiencing the benefits of have training at their fingertips 24 hours a day.

I am continually working to get more topics up on line so caregivers have access to comprehensive training. The topics that are now up online are
Infection Control
Aging Process - Skin
Challenging Behaviours
Reatraint Minimisations & Safe Practice
Stoma Care
Continence
Pain Identification and Management
Nutrition
Hydration
and this week will go up Aginig Process Muscles, Ligaments, Tendons and bones. Soon to follow will be Abuse and Neglect. Want to know more give me call.

Still, Lovely

2011-06-15T13:27:00.000-07:00

This movie is well worth seeing. It gives an insite of how it might be for a person with dementia. It is slow moving but profoundly frank. It left me with a strong sense of sadness.

I have worked with people with dementia for very many years, but I have never had such an emotional response to a movie for years. It certainly isnt a movie that you jump up from and walk out of the theatre.

I beleive it would be a great movie for caregivers, registered nurses, managers and owners to see. For those who don't understand what it might be like having dementia, this should have a profound affect and cant help but change attitudes

On-Line Training Update

2011-06-06T16:01:00.000-07:00

I have been going around visiting facilities in a variety of locations to talk to them about the online training. I am excited at the uptake and people are seeing www.caretrainingonline.com as a valuable tool to help train their staff.

I know what it is like to be a nurse and manager trying to get the education to all the staff and do everthing else as well.

My next move is to itemise what is in each segment of the topics and how long each segment is so that you know how much time you need to do the training. I am making changes all the time to not only add new material but also to help you in both time and training.

The next topics to go up is likely to be Aging Process - Muscles, Tendons Ligament and bones.

I am still looking at how to best do a topic as an Introduction to Caregiving that covers Customer Service and looks at the Social Model of Care but with a heading that will excite people and entice them to want to use it.

Like many of you, I am concerned at the lack of personal care. It is not that the carers don't want to do it, it is just they think their role is clinical rather than predominantly social with clinical when needed.

If anyone who thinks like me, can send me a topic heading that would entice them to open a link on it can they please email me at leigh@clinicalupdate.co.nz Caregiving has to start at the beginning and to build on skills.

The Vitamin D debate

2011-05-30T14:27:00.000-07:00

It seems we are caught between a rock and a hard place here. We are told to slip, slop, slap in the summer to prevent skin damage from sun yet we need the Vitamin D for healthy and strong bones!

What do we do?

For sometime I have been aware of this and have not used sunblock unless I am going to be out in the sun for extended periods. I never use and SPF factor in my moisturisers either. You see I already have osteoprosis and am on Vitamin D so why would I compromise my health even further?

Most of my day, like many others, is spent inside working. Why would I want an SPF factor in my moisturiser to protect me from the suns rays that I don't get? It doesn't make any sense to me.

While I may have sparked a debate on this, I hope a healthy one, just don't get caught up in all the hyp of generalised research that may not affect you. Research is now linking Seasonal Affective Disorder and other conditions like internal cancers, heart disease, immunity, diabetes, strokes to lack of Vitamin D.

Question? The more we find out, the more we complicate our lives and health.

Now I am not against research. It think it is very valuable and a great way for us humans to understand our bodies and how they work. But lets get a bit of balance here and some common sense.

If our major source of vitamin D comes from the sun, why do we spend so much money on blocking it out when we are not in the sun?

While there are small amounts of vitamin D in some foods like oily fish (especially fish liver oils), salmon, sardines, mackerel, tuna, egg yolks, butter, some cheeses and oysters we cant possiblby eat enough of these to give us our required daily dose of Vitamin D.

So choose for yourself what you want to do.

For me I will continue to do what I am doing and get the maximum amount of Vitamin D from the sun whenever I can.

What about you? What about your residents who never go out in the sun? Think how you can help them naturally as well as through diet and supplements.

Customer Service in health care

2011-05-29T14:21:00.000-07:00

I have talked about this often but not using the words customer service. I talk about understanding and listening to the person and their needs and responding appropriately to what the person wants, not what you want to give them. You will also often have heard me talking about "who is paying your wages". It is the same thing.

This came up again when i was out of Auckland recently. It is particularly apparent in nurses from overseas although not exclusively. It includes both registered nurses and caregivers.

So what can we do to address this?

Well my next topic I am going to put on line is "Introduction to Caregiving". This is Customer Service. It will outline what is expected of a caregiver and will come with worksheets. It is not a required topic for District Health Boards but it is an essential topic for care - at all levels.

If you want to give your residents the best care available then your staff need to understand customer servicer, customer relations and social interaction. All of these come together to provide a place where people want to come and live, not fear; where people tell others it is a great place to live so so it sells itself; where staff retention is high and people are clambering to come and work for you; where you can pick and choose your caregivers.

All in all this is a good model of care and should be the industry standard. Who knows, it could do auditors out of a job!!!

And while were talking about the bowels!

2011-05-28T21:39:00.000-07:00

When is the appropriate time to give aperients?

In my experience, mostly it is given at meal times in conjunction with other medications often mixed up with food ( and yes I have been guilty of this too).

Did you know that this could affect the efficacy of other medications? Why?

Because aperients are designed to stimulate the bowel thus could influence the efficacy of other medications and speed up the absorption of them.

So when should aperients be given? At least 30 mins either side of medications being given.

Are aperients designed to be given every day?

Well of course not! So why do we give them every day to some people. Do they actually need them every day or do we, as nurses and caregivers, think they do?

Food for thought isn't it?

What is normal bowel habits?

2011-05-17T14:36:00.000-07:00

I know this is not something we sit and talk about over a cuppa but how different are your bowel habits to some one else? Do you know? Have you thought about it?

Therefore what is normal bowel habits for people in your care? Are you trying to regulate someone to what you consider normal bowel habits for you which may be abnormal for the person.

Maybe this should be a question that is asked in more depth when a person enters your facility so that you don't give them laxatives when they don't need them.

Next I will talk about when laxatives should be given.

Educating Caregivers on who is paying them

2011-05-15T20:21:00.000-07:00

I am working towards helping caregivers have a wider perspective on the care they are giving and how where the money comes from. I am doing this by frequently mentioning through my inservice workshops that the client/resident is actually the person who is employing them because they are paying for their care.

Payment can be directly through their own bank account or indirectly through the taxes they have paid over the years. I explain that the company they work for are only the filter or the bank if you like that collects the money and pays caregivers wages.

I also try to get them to understand that wastage of products like continence pads, are actually paid for by them through their taxes as the overnment subsidises the products.

I do this in the hopes that they will look carefully at the way they not only look after people but also in the way they use products and equipment. If caregivers have a wider understanding of how the money comes in to pay their wages and that they are paying for wastage may help them think a little about the care they give.

I hope to get them away from the government being a bottomless pit and that business have access to unlimited finance. This is not true. The money has to come from somewhere.

Repetition is the mother of skill

2011-05-09T19:18:00.000-07:00

I always become really heartened when something positive happens in my day. Last week I got an email from Fiji from people interested in my online training. As this training for caregivers is relevant in all countries, it has inspired me and excited me at the future of online training.

Being able to repeat the training over and over again is a benefit as I know that when ever I attend any training session I only pick up on a small amount of content, I then have to put it into practice and go back for another session to gradually build on my knowledge.

When I learnt to speak in front of a group of people I attended 6 full weekends training. I paid for the first one then I went along and helped in my own time, for another 5 weekends. This is what has given me confidence to speak in front of a group.

I have sat through countless sessions that Gigi Lim has presented on Medications for Clinical Update in the last 5 years and I am still learning things and I know they have been in presentations before.

So the beauty of the online training is that your staff can listen to the same training session several times till they understand the topic. That wouldn't that save you time in not having to repeat yourself.

Did you know the colour you wear influences the impact you have on others?

2011-04-24T16:53:00.000-07:00

Yes this is for real. I know that the colours I wear reflect how I'm feeling. I first became aware of this when my marriage broke up. I would not see or visualise myself in anything but black, white or grey. Every other colour, I thought, looked terrible on me.

I also know that the more colourful my clothes are the more joyful I am and my personality and behaviour reflects this.

Well apparently this is true. You can see more on this website http://www.colourcomfort.com/

Here are some examples of colour and impact.
If you want show determination, activity and motivation then wear red.
If you want to show authority, wisdom or intelligence, then wear navy blue
If you want to show calmness, inspriation or fantasising, then wear purple
If you are an innovative thinker, ready for change then magenta or fuschsia is your colout. (this is a colour I wear a lot and feel really good wearing)
Now if you want create harmony, decision making and team work then wear green. Give it a try at a staff meeting and see the results.
Interesting if you are reserved, mysterious or want to blend in, wear black. How many people wear black!!! Lighten it up with a colour and see the results.

Now you don't have to be decked out totally in the colour to create impact. It can be as simple as an accessory like a cardigan, tie or scarf.

There are many more colours that influence people so go and have a look at the website and see what you come up with and use colour to your advantage.

More people paying for private home care

2011-04-17T15:46:00.000-07:00

We are more and more becoming a user pay society.

While I am not altogether against this as I think people have more control over who they employ. If they are not happy with the care or service, they can terminate the contract and shop around for someone more suitable. It is not as easy if you have been referred to a service provider.

What my concern is the level of training the caregivers receive and the supervision. There is no one checking on the care being given on a day to day basis and is right for the person. Nor do we have a "watch dog" to see if the person is being treated fairly and respectfully.

Vulnerable people, whether they are elderly or not, are not known to speak out if they are receiving respectful or indeed the correct care. They take what is being dished out to them by the caregiver and don't want to risk being victimised or being left to fend for themselves if they do speak out.

So how do you address these issues? It is a difficult one but training is one way. It is not a panacea to fix all but it does deliver some understanding for those who are willing to learn. It does work for those who generally care and want to deliver what is right for the person or what the person wants.

What does need to happen is the caregiver has to understand they are employed by the person they are delivering care to regardless to who is paying the account. When this happens there should be a change in attitude towards their work and the important job they do. Training is part of this process.

In 20 years time 1-4 New Zealanders will be over 85

2011-03-30T14:42:00.000-07:00

That is the estimation. So just how are these people going to be accommodated?

Social isolation is going to be a much bigger problem in 20 years time if it is not addressed not. People who cannot get out and mix with people through illness, disability or depression are causing concern now so just imagine what it will be like in 2031!

Nutrition is also a major problem. How are people going to be nutritionally balanced? This is what helps their survival, motivation and ward off disease and illness.

Anyone who has lived on their own will know there is not quite so much joy in cooking for yourself as there is in sharing a meal with another person.

Many older people are under nourished not so much from lack of food, though it is a contributer, it is the lack of company. Dr Carol Wham from Massey University has just completed a study on the effects of nutrition on the elderly. It was conducted on 1000 people living at home. It was discovered that sharing a meal has a bigger impact on whether a person eats there meal or not.

Meals on Wheels does a great job, but it is empty if you have no one to share it with. What people enjoy most is the visit from the person who delivers the meal.

Not everyone gets involved in the community or in organisations. While when you are young and busy this is not a problem but when you live on your own, the skills to mix with people have not been developed. This leads to a person being more at risk of social isolation and are more likely to suffer from depression and disease and undernutrtion is also a contributer.

This is why when people enter a residential facility their depression abates, their weight increases and their nutritional status improves. Don't have to be a rocket scientist to understand this.

In 1987 when home care was first introduced with the aim of keeping people at home and out of the then Stage 1 rest homes, I predicted that the biggest disease we will see is social isolation. It has come true.

Social isolation costs the health care system far more than residential care does. The number of people who have repeated public hospital stays, increased homecare to keep them at home costs much more than residential care.

While I agree people have the right to stay home with support if they choose. I do not believe that ALL of the people who are receiving home care are there by choice. They are encouraged to stay home, even if they do not want to and know they need to have people around them. It is considered fiscally beneficial to keep them at home.

Wrong. It cost more when you take into consideration of all the different services that are involved in keeping them at home -home care, meals on wheels, public hospital care.

I am going to be one of the 1-4 over 85 in 20 years time. While I pray that I will remain active and able and have family around who are willing to support me, I am also prepared for the fact that I may need some help or residential care.

This means I have 20 years to ensure the caregivers who are going to help me live at home or in residential care know how to care for me as an individual and understand any medical conditions I have. Hence my mission to get on-line training throughout the country so consistent individualized care is the norm and everyone gets the care they want and what they deserve.

Positive emotions - what makes some people more resilient than others?

2011-03-28T15:22:00.000-07:00

I have long held the belief that how we think and feel has a huge effect on our health and wellness. In fact in my first book I wrote about the significant effect I beleive emotions have on people with dementia.

When dementia strikes, as they progress through the disease process where the mind is not longer in control, they are finally free to express what they are feeling, who they want to be with and what they want to say. They shoot straight from the hip which creates a lot of problems with carers who take what they say literally rather than seeing how it is for the person. I found it easy to work with people with dementia because I understood them and I didnt take offence at anything they said.

Understanding your emotions is hugely important and it is estimated that 80% of people have difficulties in this area. The 20% of people who freely express who they are as a person are those who are more successful in all areas of their life and have much less sickness and disease.

Now this can be learnt.

I was listening to Radio New Zealand interview with Barbara Fredrickson, a researher into understanding happiness who has developed a test for you to see where you fit on the happiness scale. This gives you guide to the areas you can change in your life.

She suggestes you do this test everyday in the evening for a period of 2 weeks to see how your day went and ratio of happiness you have in your life. To do this test go to http://www.positivityratio.com/single.php .

Also note that this test will probably not return the same results each day so do it honestly and it will give you a guide on how or what to change in your life. Most people in the US who take this test have a ratio of 2-1, depressed people have ratio of 1-1 but the successful people consistently have a ratio of 3-1.

Her website http://www.positivityratio.com/index.php is a very intersting read and also see where you fit on the happiness ratio scale.

Why do people still have a negative attitude to residential care

2011-03-27T16:14:00.000-07:00

I was out at lunch yesterday with a group of family and friends when I got talking about OnlineTraining I am currently developing. Out came all the negative things we hear from the media like:

No 1: Well they don't get paid enough so of course the care is going to be substandard.
My reply "It is not about money. While I agree caregivers are underpaid. Paying them more will not necessarily improve the care. It is a myth. Training is what improves and uplifts care and higher pay should be linked to training."

No2: It is terrible the way people get treated. The cases reported in the media are horrendous.
My reply: Yes they are but have you heard about the wonderful things that do happen in long term care every day. Like the staff who come in on their off duty time to help get a person ready to go out, or attend a picnic or outing to help make up the numbers or the caregivers who have been doing this work for 20 years or more and just love it and won't do anything else.

The public are too quick to criticise the industry without the facts. Yes there are some bad caregivers but there are bad employees in every job. I myself have seen far more committed, caring, sensitive, loving caregivers in my 38 years of working in aged care than I have seen uncommitted, uncaring, insensitive and unloving caregivers.

We must never loose our good sense of prespective.

Have you looked at your Gratitude Journal Lately?

2011-03-20T15:32:00.000-07:00

It doesnt do us any harm in the world of Me Me Me, to go through a crisis from time to time to make us realise just how lucky we are.

It is so easy to focus more on what we don't have but when the chips are down we really get a lesson on how lucky we are and what is really important. What am i talking about?

Last week I became unwell and ended up spending a couple of days in bed and another in Emergency Dept for tests. It is at these times one feels most grateful. So today I am going to tell you what I am grateful for in my life.

I am grateful for my wonderful children. My daughter stayed in Emergency Department for 11 hours with me. She was constantly in contact with my sons all through the day - one local and one in UK. They even kept their father up to date (we have been divorced for 24 years)

I am grateful for my sisters who were in constant contact with my daughter so see how I was and when I came home they called.

I am grateful for my friends who kept in contact with me and who did the work that needed to be done.

And you know at the end of the day, this is all what we need. To be loved and cared for. How powerful is that.

So what are you grateful for today? It never does any harm to reflect on the truly wonderful things in your life and how much they mean to you. take a moment to reflect. It may be the best investment in your time you spend today.

Technology

2011-03-13T19:56:00.000-07:00

I really feel for older people (not that I am a spring chicken myself) getting used to settling into to new environments, trying to make sense of this ever changing world where every thing happens so quickly and the young say "It's so cool" or "It's so easy". So what am I rabbiting on about,

Well my computer was so slow I spent untold time waiting for it to chug along (and it is only 4 years old) so I got myself a new one. Yes a modern, up to the minute laptop with all the bells and whistles - Window 2010. Designed to make life easier and quicker. Yeah Right.

Admitted I have only been working on it a few hours but I reckon I have wasted more time on this today than if I had done a full days work on my old one. My trusty old friend and companion is sitting beside me beckoning me "Use me please" but I am resisting. I am just plugging along with the new one waiting for it to do all the things it's suppose to do the way I want it to.

My daughter, who is so patient with me, just does everything so easily and quickly. Oh I am so grateful to have her around to help me. I would be completely lost by now and crying into my pillow or threatening to throw it out the window.

Yes it is much harder for us older people to keep up with this newer and faster technology. I can understand those who don't want to know anything about it. However on a final note, I wouldn't be without my computer. Would you? How did we manage without them?

The stories keep coming

2011-03-06T17:18:00.000-08:00

Now that the dust has settled, so to speak, and Christchurch people are picking up their fragmented lives the rest of the world goes on. It is hard once the initial tragedy occured for people to go about their everyday lives just as before.

However now life it starting to get back to some normality the post-mortums begin. This is the normal path of grief.

I feel for everyone who has suffered a loss. I personally don't know anyone who has suffered tragically in the earthquake but I am sure I would too come up with some regrets. It is very difficult to be philosophical at this time.

So lets send some love to everyone and wish them comfort and solice that they can find some peace within to see them through this time. The rest of us do feel for you. We can't forget you, not that we would want to, as you come to us each day, several times a day through the media.

I know they get some criticism but it is pleasing to know that NZ journalists showed humility, more so than our cousins across the ditch and from other countries according to a Radio New Zealand Spot on the media yesterday. It appears how they get the story doesnt matter.

This is what makes New Zealand and their people so great. It is what has made us so sought after in other countries. It is our humanness, our humility. Yes we are a very humble race and may we remain so.

I feel for everyone in Christchurch

2011-02-27T14:45:00.000-08:00

I just feel so helpless as I am sure everyone else ist feeling.

Just to think of all those who have nowhere to live now and all of those people living in Rest Homes, Continuing Care Facilities and Retirement villages who have had to leave their homes.

Residential Care people develop a very narrow spectrum on the world. It is only themself. The rest of the world, apart from their family is has little importance to them.

For those who were transported in the middle of night to another city it must have been extremely traumatic but what was the option? None really.
Being shifted to a new location is bad enough but to have to get used to new caregivers, strangers all over again must be devastating.

While I can write about the trauma for these people, I do feel so helpless. What can I do apart from send some money. It feels such a little thing but I know that in the end it will be well received.

I am also amazed at the generosity of people. On Saturday I was involved in a Rotary fund rasing event for the earthquake and our local hospice. We do this every year and usually people just give coins. This year however the generosity was incredible. $5, $10, $20 and even $50 notes were given this time.

This is what heartens my spirit. The selflessness of those who realise just how well off we actually are.

It is with a heavy heart I write

2011-02-23T12:54:00.000-08:00

The sadness of what has happened in Christchurch is so over whelming particularly as I was in Christchurch this last weekend. While I am pleased that my friends are all okay, I, like many of you I am sure, feel so for the devastation they have suffered and the continued suffering they are going to experience.

I would like to do something but what? Sitting up here watching the whole disaster unfold on television I have found very distressing as I am helpless. Apart from giving money, there is little else anyone can do at this point.

There are so many people who are now displaced - taken away from their own homes or living spaces. Rest home residents transported out of Christchurch, mothers having babies early and having to leave their city to do so, injured people leaving their loved ones behind to be treated in other centres. All too much to bear.

But they are all alive. I guess that is some comfort.

For those who have lost loved ones, my heart goes out to you. There is little I can say apart from my prayers are with you as are the prayers of many New Zealanders and people from around the world.

I guess in the end, their is little protection for us when mother natures trackes her path.

A Very Exciting Day Today

2011-02-20T20:31:00.000-08:00

Today I have launched my new training website www.CareTrainingOnline.com It is exciting because now all of New Zealand can access the same training. Consistent, applicable, accessible and affordable training is now readily available for you to access.

My goal has always been to train as many people as I can in the Art of Caregiving. People who are unable to take care of themselves through sickness, disease or fraility deserve to have the best care available and be care for people who really understand what to do.

Now you can take advantage of all my wisdom - all the knowledge and expereince I have accumulated over my 46 years of nursing - 37 of them in aged and young physically disabled care.

On top of that I am available to answer any questions you may have and help you solve problems. I hope you will take advantage of this training and join in on the ride with me.

I know there are going to be some teething problems but if we all work on this together we will iron them out quickly so please tell me how it works for you. That is

Is it easy to access?
Is it instanly applicable?
Does it meet your needs?
I definately know it is affordable. So keep me informed on how it is working for you and NOTIFY me immediately is it isn't working. I am here to serve you.

Thank you for you support. The journey now begins.

Do bully's actually know they are bullies?

2011-02-14T14:20:00.000-08:00

Well actually no they don't. They are often shocked and horrified if you tell them they are a bully.

According to an article in Medscape written by Laura A Stokowski, the bully just sees themself as smarter, faster, or more skilled than anyone else. Unfortunatly this inflated ego is actually incorrect.

So what labels can we apply to these people to help you identify the serial bully? According to C Dellasega the author of "Girl Wars and "Mean Girls Grown Down: Adult Women Who are Still Queen Beeds, Middle Bees and Afraid-to-bees", they fall into these categories.

The super nurse - the one who does all the courses and conveys this knowledge continually so others think they are smart
The resentful nurse - the one who develops and holds grudges: pits others against others
The person who uses put downs, gossips and starts rumours - shares negativity and quick to take offense
The backstabber - cultivates friendships, then betrays them - the 2-faced person
The green with envy person - tends towards envy and bitterness
The cliquish person - the person who uses exclusion for aggression; shows favouritism and ignores others.

Do you have anyone on your staff like this? It could be you or one of your staff members or managers.

In an article I wrote for Kaitiaki some years ago, I believe the best way to manage a bully is to develop skills within yourself. If you identify them and stop playing into their hands, you will be able to manage them better.

You see the question you have to ask yourself is "why does this person affect me so" or "what do I need to do to develop the skills to stop them from making me feel powerless".

The key to managing a bully is to not let them to have power over you. However if this person is bullying residents then it does become your problem to handle.

People in care are very vulnerable. They often don't have the ability to fight back through fear of retribution and vitimisation so they don't fight back. You need to identify these people early and help them identify what they are doing.

So how will you do this? I will put this in the next blog.

What are the warning signs of a serial bully?

2011-02-07T12:33:00.000-08:00

Reference checks are mandatory and the best way you to get warning signs. Devise yourself a checklist that will give you warning signs.

However, these people are very clever and you may not pick up from a previous employer as they will only give you people they know will give them a good reference. This of course can make reference checks difficult.

However take into account their employment record. How many jobs have the had in the last 5 years. This is some indication there is a problem.

Remember the Serial Bully is an adept liar so it may also be difficult to pick up from their body language.

They will, however tell you all the things that were wrong with their previous employer and the people there. If this occurs don't let your ego get in the way. Just listen and take notes. Do not employ on the spot.

While you have to be careful with the questions you ask if you can engage them into a conversation where they do the talking and tell you about their background, what they like doing, what are their goals you may just find little pieces of information will surface. They may even contradict themselves.

It is a tricky one with questions to ask but if they willingly chat to you just listen. You may be surprised what yo find out.

My suggestion is if you have any doubt, dont employ.

I am going to follow this topic through on the next blog and will start to unravel the personality type that fits the serial bully. I just may help you identify any people you currently employ and prevent you from employing these people in future.

Do you have a bully in your midst?

2011-02-06T14:00:00.000-08:00

I haven't got round to writing any articles this year as I have been very busy with the on line training. However I believe this subject to be so important that I will do a series of short discussions on this blog.

Why do I believe it is important?

People in care are very vulnerable. It is up to us to protect them. To make sure that they are free from any harm.

The Serial bully is the one you need to look out for. They are so cunning and conniving and make others feel they are wrong; including managers.

I am sure that you either have or have had someone in your midst who you just don't trust. The person that has all the answers, says the right things at the right time. The one you just can't catch or couldn't catch out?

Don't despair I have been duped by these people.

Over the next while I will put up some of the signs to look for. Not too much at a time so you have time to digest and reflect. So here goes.

Do you have anyone on your staff who you know is lying to you? They are so convincing? They have all the answers and are quick to come up with them if asked? They may even get to you first? Watch this person very closely.

Is there someone who is just so charming when you speak to them? The argument is always very plausible but there is some alarms going up in your head? They are very willing and very empathetic - especially when they know you are in ear shot. In fact they are likely to go over the top if they know you are around.

Be very wary of these people. They could be a serial bully.

Remember the elderly or disabled in your care are unlikely to speak up. The mere fact they have had to give up their independence is enough to force them into submission.

Next time I will look at the signs before you employ a serial bully. There are some.

Personalities in Rest Homes

2011-02-01T13:05:00.000-08:00

I had a conversation the other day with a person from the industry who said there was a problem with caregivers not showing empathy to residents, similar to Psychopathic Personality. Is this your experience?

I believe we do have a lot of bully's working in our industry which makes me very sad but while some of it may be calculated and intentional, I believe most of it comes back to two things.

1. They have this warped understanding of their job being one that They are in charge and Tthey are there to get the person in their care to do what They tell them. After all They have to look after them!!!! They don't understand that their job does not include taking the power away from the person in their care. Does not mean they control them.

2. They don't know what empathy is. They have no conception of what it is to connect with a person, to listen, understand and be present with another person and help them get their needs met. No one ever did this for them! They had to do the best they could to SURVIVE. That is all they know. Survival means earning as much money as they can to feed themselves, send money home, buy "toys" and certainly not get emotionally involved in their work.

Do you understand what I am saying? Are there any other people who see it like I do or are there really a lot of bully's or psychopathic personality types working in Caregiving?

Are you a dabler, a hacker, copulsive or have Mastery in your life?

2011-01-31T14:39:00.000-08:00

I went to a very intersting educational session today run by NZ Training and Development (I would strongly recommend that educators and trainers belong to this organisation - want to know more, go to www.nzatd.org.nz. There are divisions in Auckland, Hamilton and BOP as well as Wellington and Christchurch.)

It was on Mastery. So to have Mastery you need to be passionate about what you do, practice the skills you want to develop and monitor your performance.

People who attain mastery in their life live on the edge, challenge the status quo, be committed to continually reset their script, is committed to learning and development of the self and is a life long learner.

Have you acheived mastery in your life?

To be a master you have to be patient, purposeful and persistent.

Mastery has been recognised by many and this quote by Albert Einstein describes it very well. "Anyone who devotes himself to a cause with his whole strength and soul can be a true master. Therefore for this reason, mastery demands the whole person"

Is this you? Do you have a cause you are devoted too?

I heard today they expect this year to be another bad year!!!

2011-01-23T14:01:00.000-08:00

Well you have a choice whether you buy into it or not. People have bad years all the time. Just look at what the weather has been doing - and this has nothing to do with the economic climate.

I know it is difficult for people who have and are suffering hardship. Many people are affected by floods,earthquake and disasters of many different types. I am sure even if you are not affected by nature at the moment all of you at sometime will have experienced loss, hardship, pain and suffering.

It is really hard while in the midst of these trauma's but one thing for certain is that the pain and suffering doesn't last forever.
While you never forget these times, life has a habit of showing us how to get through and that good times, fun and laughter can result.

So how does all this relate to my first sentence?

The way in which we make it through the tough times is dependent on your attitude. If you think you can't, then you are right. If you think you can, then you are also right.

So if you think it is going to be a hard financial year, then you are right if you choose to buy into it. On the other hand if your attitude is one that you will always get through, there will always be enough to go round and have some left over, that you can still provide great care on a limited buget then you will be able to do all of this and more.

On the other hand if you say that you can't manage on the budget and pay for the extras that are so important, like training, then you are also right. It is called a self perpetuated prophercy.

Try this year to change the way you think and believe it is going to be a great year, that you can afford training (even if you think your budget can't), believe you have full occupancy in your facility, believe that your staff are very trainable - the list goes on. You choose your destiny.

I have worked on this philosophy for years. Yes it can get hairy at times but when you truely believe in what you are doing then a way will be found. Your prayers, wishes and desires can and will be fullfilled.

I'm 63 and tired

2011-01-18T19:12:00.000-08:00

I received this today. I don't know if others are feeling like this but it sure did hit a cord with me. Maybe you are the same. If it offends anyone, then I apologise in advance.

"I'm 63 and I'm Tired"
By Robert A. Hall

I'm 63. Except for one semester in college when jobs were scarce and a six-month period when I was between jobs, but job-hunting every day, I've worked, hard, since I was 18. Despite some health challenges, I still put in 50-hour weeks, and haven't called in sick in seven or eight years. I make a good salary, but I didn't inherit my job or my income, and I worked to get where I am. Given the economy, there's no retirement in sight, and I'm tired. Very tired.

I'm tired of being told that I have to "spread the wealth" to people who don't have my work ethic. I'm tired of being told the government will take the money I earned, by force if necessary, and give it to people too lazy to earn it.

I'm tired of being told that Islam is a "Religion of Peace," when every day I can read dozens of stories of Muslim men killing their sisters, wives and daughters for their family "honor"; of Muslims rioting over some slight offense; of Muslims murdering Christian and Jews because they aren't "believers"; of Muslims burning schools for girls; of Muslims stoning teenage rape victims to death for "adultery"; of Muslims mutilating the genitals of little girls; all in the name of Allah, because the Qur'an and Shari'a law tells them to.

I'm tired of being told that out of "tolerance for other cultures" we must let Saudi Arabia use our oil money to fund mosques and mandrassa Islamic schools to preach hate in America and Canada , while no American nor Canadian group nor Australian is allowed to fund a church, synagogue or religious school in Saudi Arabia to teach love and tolerance.

I'm tired of being told I must lower my living standard to fight global warming, which no one is allowed to debate.

I'm tired of being told that drug addicts have a disease, and I must help support and treat them, and pay for the damage they do. Did a giant germ rush out of a dark alley, grab them, and stuff white powder up their noses while they tried to fight it off?

I'm tired of hearing wealthy athletes, entertainers and politicians of both parties talking about innocent mistakes, stupid mistakes or youthful mistakes, when we all know they think their only mistake was getting caught. I'm tired of people with a sense of entitlement, rich or poor, brown or white.

I'm real tired of people who don't take responsibility for their lives and actions. I'm tired of hearing them blame the government, or discrimination or big-whatever for their problems. I’m tired of them not believing it could be their own fault.

Yes, I'm damn tired. But I'm also glad to be 63. Because, mostly, I'm not going to have to see the world these people are making. I'm just sorry for my granddaughter.

Robert A. Hall is a Marine Vietnam veteran who served five terms in the Massachusetts State Senate.

There is no way this will be widely publicized, unless each of us sends it on!
This is your chance to make a difference.
" I'm 63 and I'm tired”. If you don't forward this you are part of the problem.

Happy New Year

2011-01-11T15:00:00.000-08:00

Well I don't think this will be so for many who live in Queensland. I am beginning to think that I live in the lucky counntry. While we here in NZ have had our share of disasters nothing of the magnitude Queesnland is experiencing could anywhere match this. I really feel for them.

2011 is really here now and I am sure before we know it, 2012 will be here. I dont want to appear the eternal pessimist as I really am an optomist, this is the fact. Busy people notice the years flying by while pessimsts see them dragging.

This year is going to see many changes in clinical update. For one all my caregiver training programmes are going on line. It is a lot of work but all worthwhile. I promise you that you will not be disappointed with the programmes that go on line.

I will keep you updated as to what, when and how of the programmes and when I go live so to speak. Watch this space.

Hearing Loss

2010-12-15T14:57:00.000-08:00

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.

Christmas is upon us

2010-12-13T13:09:00.000-08:00

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.

Attachment theory

2010-11-30T12:56:00.000-08:00

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.

Compassion Fatigue in Nursing

2010-11-29T13:16:00.000-08:00

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

http://www.medscape.com/viewarticle/732211?src=mp&spon=24&uac=130724MJ

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.

Excitement ahead for 2011

2010-11-28T16:05:00.000-08:00

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.

I think many people are over Treaty Workshops

2010-11-18T14:39:00.000-08:00

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?

Cultural Sensitivity goes both ways

2010-11-16T14:07:00.000-08:00

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.

I am sick of being so PC!

2010-11-15T12:28:00.000-08:00

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.

Steeling people's belongings is Theft!

2010-11-14T14:19:00.001-08:00

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.

This is your day! Your on your way!

2010-11-09T15:42:00.000-08:00

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.

Keeping Stress Free

2010-11-08T12:41:00.000-08:00

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.

In the news again!

2010-11-07T11:51:00.000-08:00

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.

Time for a funny

2010-11-04T15:35:00.000-07:00

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.

Knowing right from wrong

2010-11-02T12:58:00.000-07:00

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.

Still we see people taking advantage of those less fortunate

2010-11-01T01:30:00.000-07:00

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.

What has the world come to?

2010-10-31T15:37:00.001-07:00

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?

The power of clarity

2010-10-28T14:25:00.000-07:00

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.

Happiness

2010-10-26T12:17:00.000-07:00

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?

What is Reverence

2010-10-24T17:50:00.000-07:00

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 leigh@clinicalupdate.co.nz

If you want to listent to the show http://www.planetaudio.org.nz/player/player1.php?id=73382 it is well worth a read.

Are we too PC for our own good?

2010-10-11T13:05:00.000-07:00

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.

My 4 leged mate is on the mend

2010-10-10T14:14:00.000-07:00

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.

The joy of animals

2010-10-05T16:53:00.000-07:00

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.

Personal Grievances are avoidable

2010-09-22T12:02:00.000-07:00

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 clinicalupdate.co.nz for more information.

About the Treaty of Waitangi

2010-09-21T14:33:00.000-07:00

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.

All it takes is a phone call

2010-09-19T16:35:00.000-07:00

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.

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

2010-09-14T22:02:00.000-07:00

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

A personal gripe!

2010-09-12T13:05:00.000-07:00

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.

I am gb smacked!!

2010-09-08T13:22:00.000-07:00

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.

Co-operation, collaboration & support

2010-09-07T13:33:00.000-07:00

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).

Cost effective training in house

2010-09-06T19:55:00.000-07:00

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 leigh@clinicalupdate.co.nz

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

2010-09-05T14:24:00.000-07:00

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. http://www.careadvisoryservices.co.nz/articles/play.htm

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

2010-09-01T13:48:00.000-07:00

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"

Person Centre Care

2010-08-30T14:12:00.000-07:00

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.

Why do audits create so much anxiety?

2010-08-29T14:47:00.000-07:00

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 http://www.careadvisoryservices.co.nz/clinicalupdates/resilience-performance.htm)
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 http://www.careadvisoryservices.co.nz/clinicalupdates/audit-anxiety%20.htm

You won't regret it.

Inspiration of the day

2010-08-25T14:03:00.000-07:00

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!

Person Centred Care

2010-08-24T13:54:00.000-07:00

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.

Registered Nurse Role

2010-08-23T13:51:00.000-07:00

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 leigh@clinicalupdate.co.nz

How did the name Pakeha come about

2010-08-22T15:54:00.000-07:00

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 http://maorinews.com/writings/papers/other/pakeha.htm
It is well worth a read.

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

2010-08-19T14:19:00.000-07:00

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?

Health Benefits of Vitamin C

2010-08-18T14:53:00.000-07:00

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 http://tvnz.co.nz/health-news/vitamin-c-may-have-benefits-in-cancer-treatment-3654381

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.

How well is your team functioning

2010-08-17T15:24:00.000-07:00

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.

Rest Homes Caregivers under fire again

2010-08-16T14:23:00.000-07:00

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.

Did you know?

2010-08-15T14:12:00.000-07:00

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 DO WE?

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?

Training to care for a Pakeha

2010-08-12T14:12:00.000-07:00

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.

Psychoneuroimmunology - have your heard of this?

2010-08-11T11:39:00.000-07:00

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

How do we get the care we need?

2010-08-10T11:48:00.000-07:00

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.

We must stop medicalising residents in residential care

2010-08-09T14:55:00.001-07:00

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.

Migrant workforce

2010-08-08T13:55:00.000-07:00

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.

Care Creed

2010-08-05T14:33:00.000-07:00

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?

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

2010-08-04T12:30:00.000-07:00

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?

Speed of Trust

2010-08-03T12:03:00.000-07:00

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 http://www.bcwinstitute.com/Learningcenter/Press/speedoftrust.pdf

Companionship and Intimacy in Residential Care

2010-08-02T15:43:00.000-07:00

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.

Sunset Love

2010-08-01T15:20:00.000-07:00

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 http://www.attitudefactor.com/ 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.

What does living in a Bi-Cultural Society mean?

2010-07-29T16:26:00.000-07:00

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.

$ value of nursing staff in residential care

2010-07-28T14:59:00.000-07:00

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 http://www.insitenewspaper.co.nz/pages/section/article.php?s=Breaking+News&idArticle=17108 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.

Rest Homes hit the media yet again

2010-07-27T15:49:00.000-07:00

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.

Trial by Media - again

2010-07-26T15:03:00.000-07:00

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.

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

2010-07-25T14:28:00.000-07:00

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.

Pharmacokinetics
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 http://www.medsafe.govt.nz/profs/datasheet/f/Frusidtabinj.htm

How well do you understand the medications you are administering?

2010-07-22T16:23:00.001-07:00

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 http://www.careadvisoryservices.co.nz/clinicalupdates/medication.htm

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

2010-07-21T16:41:00.000-07:00

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.

The integration and transition of home to residential care

2010-07-20T16:29:00.000-07:00

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
http://www.insitenewspaper.co.nz/pages/section/article.php?s=Management&idArticle=16289

Did you know??

2010-07-19T11:46:00.000-07:00

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 http://culturalsafety.massey.ac.nz/

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.

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

2010-07-18T21:38:00.000-07:00

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 http://www.insitenewspaper.co.nz/pages/section/article.php?s=Education+%26+Training&idArticle=16284

What are the benefits of training staff

2010-07-18T15:22:00.000-07:00

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 http://www.insitenewspaper.co.nz/pages/section/article.php?s=Education+%26+Training&idArticle=16284 .

Where do you come from

2010-07-07T15:27:00.000-07:00

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?

Who is a Kiwi?

2010-07-04T21:03:00.000-07:00

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..

Who's Challenging who in Challenging Behaviours

2010-06-27T22:34:00.001-07:00

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?

What is Kiwi Culture

2010-06-16T21:53:00.000-07:00

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/

Cultural Sensitivity

2010-06-03T19:56:00.000-07:00

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.