Efficiently cleaning an aged care environment
 
Cleaning is an essential part of the prevention of healthcare-associated infections.

Contact with contaminated surfaces or objects in aged care environments can cause infections.  So how do you keep an aged care facility clean?
 
Preparing the cleaners’ trolley
 
Upon arrival, cleaners consult the table of products and the protocol for alternating between detergents and disinfectants.  Some rules are immutable.  Gloves are mandatory for all contact with products as part of the cleaning standards.
 
Never mix cleaning products because this can create dangerous chemical reactions.  When using dilution equipment, ensure that it is well-maintained and kept in good condition.
 
Always refer to the manufacturer’s instructions and renew cleaning solutions accordingly.  Observe the temperature and contact time indicated.
 
Cleaners and in aged care facilities prepare their trolley by selecting the equipment that they need to perform all the care services scheduled tasks.  Staff use equipment that is in good condition, clean, and in compliance with safety regulations.  Organising the trolley is as follows:

​Put the cleaning equipment at the top.  This includes cleaning chemicals, disinfectants, sprays and wipes.

• Cleaning reserves are stored in the middle.  This includes toilet paper, gloves and hand sanitisers.
• Put the brush and shovel on the dirty shelf or bottom shelf.  This includes the bucket for dirty swabs, wipes and mops.
• Support for brooms and mop handles are located at the side of the trolley.
• The lid of the rubbish container can be removed via foot to avoid using the hand in handling the rubbish.
• One of the best cleaning practices is not to use sponges, coconut broom and wooden handles for cleaning an aged care facility.

Standard method in bedroom maintenance in aged care facilities
 
Hand hygiene is essential before cleaning, after cleaning, and whenever it is required, especially in changing gloves.  The care environment for the aged care setting is crucial.
 

• Ventilate the room once the resident steps out. Offer the option when they are around while the cleaning takes place.  Cover the patient if necessary.
• Dispose of the waste first.
• Staff begin by applying disinfectant to give it time to work.  Follow a logical sequence in cleaning the aged care facilities. It needs to be from a clean area to a dirty area and from top to bottom.
• Wet sweeping high surfaces.
• Use a combined disinfectant and detergent to wet wipe higher surfaces.
• Wipe in a single pass.
• Spray the cleaning wipe and not the surfaces to limit and reduce aerosol dispersion and penetration to moisture sensitive materials such as telephones.
• Turn and change the wipes between each area and between each room across the facility.
• Allow drying.
• For daily maintenance of the facility, areas commonly touched are wiped to reduce the risk of spreading germs by hands.
• After changing cleaning cloths, care facilities staff will wet wipe higher surfaces in the bathroom using the same pattern.
• Aged care cleaners change wipes according to a pre-established colour code.  They wipe and rinse according to the manufacturer’s instructions.
• Pre-treated gauze is sometimes needed in wet sweeping in aged care. Since it is moist, it needs to remain in the facility to use it.  Aged care cleaner needs to place a single gauze under the sole of the broom.  Wet sweeping should start at the farthest point away from the entrance of the room.  In a small space with not so much furniture, wet sweeping is done in a semi-circular fashion.  This method retrieves 90 per cent of loose dirt on dry and smooth floors – wet sweeping limits the take-off of dirt into the atmosphere.
• In cleaning aged care environments, never lift the broom.  Remove the used gauze from the brush on the threshold.  Lock the dirt in by folding the gauze.  Dispose of the gauze in the rubbish bin.

Flat mopping
 
Like any washing procedures in a cleaning aged care facility, flat mopping is preceded by wet sweeping.  The flat mop relies on a chemical and mechanical action to remove the dirt adhering to the floor and microorganisms they carry.
 
When using a detergent disinfectant, there is also a specific disinfectant action.  This gives visual and microbiological cleanliness.  The technique is the same as for wet sweeping.  The cleaner began with the most distant part of the room and performed semi-circular movements.  The mop is removed at the door.
 
Cleaning in aged care facilities is effectively done in the progressive method.  It is by verifying the correct operation of equipment to be left and be placed in aged care facilities.
 
Moreover, some tasks constitute more in-depth maintenance which requires planning.  This includes the vents, tops of wardrobes, or the thorough cleaning of beddings.
 
Cleaning staff are needed to brush sanitary installations and wooden furniture.  Cleaning in aged care set up can be challenging but rewarding.  Imagine your contribution to the health and wellness of our seniors.

Author: Beau Sleeman, Clean Group
 
Aged Care New Zealand Issue 02 2022

​We investigated a group of middle-aged people who are part of the Dunedin study, a comprehensive longitudinal project that has continued for five decades.  We found people with thinner retinal nerve fiber layers (one of the cell layers in the retina) had slower mental processing speed.  This is one of the first cognitive processes to decline in Alzheimer’s disease.
 
The people in our study were 45 years old, which is young for investigating age-related neurological diseases like Alzheimer’s.  But treatments and interventions are most effective when administered during the earliest stages of Alzheimer’s and it is crucial to find ways of identifying people’s risk as early as possible.  Easy risk identification will also help with clinical trials for Alzheimer’s disease treatment.

Why the retina is a good biomarker for the brain
 
Many of the processes that happen in the brain also occur in retinal ganglion cells, another layer of cells that make up the retina.  This includes some of the abnormal processes common in Alzheimer’s disease, such as the abnormal deposition of amyloid beta protein and cell loss.

​Retinal imaging has many advantages over the other imaging technologies.  It’s fast, with each scan taking only a few seconds, non-invasive, painless and relatively cheap.
 
It’s also widely available.  In Aotearoa, every hospital eye department has an optical coherence tomography (OCT) device for imaging the retina, and these devices are increasingly available in primary care clinics and retail optometrists.
 
Retinal imaging also lends itself to being interpreted by artificial intelligence applications.  This means assessment of Alzheimer’s disease risk from the retina could be quick, easy, and widely available.
 
For these reasons, researchers are beginning to investigate how early the retina starts to thin in Alzheimer’s disease.  The disease has an insidious onset with a gradual decline in cognitive processes such as memory, but the underlying pathology tends to be fairly far along by the time people notice the symptoms and seek medical treatment.
 
If we can detect retinal thinning before the symptoms become apparent, it could be possible to identify people who are in the earliest stages of Alzheimer’s disease.

Why this matters

While there are a number of potential causes of cognitive decline, papers from our research group are building up a picture of the factors associated with this outcome.  We found people experiencing cognitive decline by 45 have older looking brains and more tiny bleeds and lesions, known as hyperintensities, in their white matter (measured using MRI).
 
Our research found people with thinner retina had older looking brains and other structural brain abnormalities.  This suggests cognitive decline, detected in its earliest stages, is associated with cell loss in the brain and retina.
 
To investigate this question even further, we are now focusing on measuring study members’ levels of a specific type of protein (phosphorylated tau pTau181) which is abundant in neurons and deposited in cells in several neurodegenerative diseases. This is thought to be one of the earliest indicators of Alzheimer’s disease and it will help us to understand whether the changes we are observing are specific to Alzheimer’s disease and how early they can be detected.

Developing treatments for advanced stages of Alzheimer’s disease has been ineffective so far, and it seems likely future pharmaceutical treatments will be most effective in the earliest stages of the disease.
 
Also lifestyle-based intervention may help to mitigate symptomatic cognitive decline. This makes early identification of people who would benefit from these interventions extremely important.

​
​Author:
Ashleigh Barrett-Young
Postdoctoral Fellow in Psychology, University of Otago
 
This article is republished from The Conversation under a Creative Commons license.  Read the original article here: theconversation.com/a-window-to-the-brain-the-retina-gives-away-signs-of-alzheimers-disease-and-could-help-with-early-detection-188655
 
Aged Care New Zealand Issue 02 2022

​Updating the flooring for aged care living communities makes an enormous difference to the safety, functionality and appearance of the interior spaces.
 
Suitable flooring for aged care living communities must be hardwearing, easy to clean, safe and cost effective.  The flooring’s manufacture and installation could also have a minimal impact on the environment.  Another consideration to take into account is the longevity of the flooring in aged care because its frequent replacement increases financial and environmental costs.
 
Flooring that meets these demands will help protect people and the planet and ensure that for many years residents’ floors remain attractive, safe and comfortable.
 
The right flooring will ensure that residents, staff and visitors feel comfortable and welcome.
 
Safety

It is important that the type of flooring in aged care meets the necessary safety precautions to reduce trip and slip hazards. A uniform finish with anti-slip surface properties is vital.
 
Some of the best flooring products for wet areas provide a non-slip surface with embossed and particle enhanced surface that are slip resistant and reduce aquaplaning.
 
Ceramic and porcelain tile should also be avoided because wide grout joints or uneven tiles can create a tripping risk.
 
Vinyl flooring is easy to walk on without slipping.  Vinyl is generally a harder flooring surface than cork and rubber which makes it less forgiving when it comes to falls.
 
While some carpet is more difficult to manoeuvre wheelchairs on, when installed correctly, wall to wall carpeting is smooth, soft and comfortable with a minimal slip hazard.  Carpet is especially ideal in colder regions because it provides warmth underfoot and adds a cosy ambiance.
 
When considering flooring safety, understanding how it affects indoor air quality is essential.  The underlay and adhesives used in installation of some flooring can emit volatile organic compounds (VOC’s) and can cause respiratory irritation, allergies, headaches and asthma.

Easy to clean
 
A most important requirement for aged care flooring in almost every room is that it is hygienic and easy to clean.  To ensure that no dirt or fluids can get trapped in the surface of the flooring it is best to choose flooring solutions with little or no texture.
 
Linoleum is naturally antibacterial and antistatic, as well as durable, flexible, and sound absorptive.  Linoleum is very easy to clean, maintain and disinfect although it is not quite as stain resistant as vinyl.
 
Vinyl is also comfortable to walk on, it is easy to clean and maintain and is often manufactured with antimicrobial additives.
 
Resin is another popular choice in aged care environments for its ability to deliver on each functionality, durability and safety demands.
 
Epoxy coatings are fast curing and have tremendous advantages for keeping it clean compared to conventional flooring solutions.
 
Hardwearing
 
In aged care facilities, the flooring needs to be sturdy enough to withstand foot traffic as well as wheelchairs, laundry and other trolley traffic.
 
The right flooring can make an essential contribution to the quality of the facility where it can endure these activities that would normally result in unappealing, unserviceable and unsafe damage. 
 
The durability of resin systems is a distinct advantage in environments such as aged care, as it can    withstand the inevitable scuffs, scrapes, scratches, and spillages that it will be subjected to and maintain its aesthetic and functional properties for the long term.  Seams or joins in flooring is one factor that contributes to flooring deterioration.  Sheet vinyl with the least joins possible is a good choice for durability.

Aesthetics
 
 A plain white floor finish may help to make an interior appear larger, but it can look severe, cold and characterless.  The addition of colour in the surface or with safety mats can help the interior to look less clinical and more friendly.  
 
Creating the right atmosphere is important, but no matter how colourful or decorative the floor is, with cracks and dirt it rapidly becomes hazardous and creates a negative impact on the site.
 
Resin can provide a colourful and cheerful environment and yet it is seamless and is robust enough to cope with the demands of aged care residential communities.

​Acoustics

Carpet remains a popular choice in some areas of aged care residence for comfort and acoustic reasons.  Carpet softens harsh sounds and create a quieter more peaceful indoor environment.
 
Carpet can be a cost-effective option for administrative areas where replacement and heavy traffic is not such a major concern.  The soft nature of carpet immediately minimises sound from footsteps, chairs scraping and objects falling on the floor.
 
Specialised carpet with open yarn structures is designed to trap sound and the intelligent backings are engineered to hold the sound instead of reflecting it.  These ‘acoustic carpets’ act as strong absorbers for medium and high frequencies, achieving maximum sound absorption in the frequency range of speech.
 
Carpet tiling is also used to great effect in non-critical care spaces.  It is popular for its ease of installation and replacement and for the variety of patterns and colours available.
 
A drawback with carpet is that completely removing harmful air contaminants from carpets can be difficult even with regular cleaning and vacuuming.
 
Cork floors have been popular for decades for its sound softening properties as well as its natural rich deep undertones.  However a disadvantage is that while its natural surface repels moisture, standing water an permeate the joints which can cause damage on cork floor in bathrooms or laundry areas.
 
Natural rubber tiles or rolled rubber flooring are also sound absorbing options for aged care living communities.  Rubber is a rapidly renewable resource, making it very durable and a good shock and sound absorber. It is available in many colours and has a natural finish that gets better over time.  It is also naturally antibacterial and requires very low maintenance.
 
Sustainable
 
Suitable flooring in aged care settings should also be considered in terms of  its sustainability.  The key environmental impact of flooring comes from the energy required to manufacture it, the kinds of raw materials used in its manufacture, and the products required for the surface treatment and glue.
 
Various sustainable flooring options suitable for aged care settings are produced from recycled and recyclable materials that do not compromise on safety, design or durability.
 
Sustainable carpet and carpet tiles made from regenerated and renewable yarn is one such choice.
 
However, carpet backing or underlay is one of the main sources of Volatile Organic Compounds (VOC’s).  So it is important to make sure that the product under the chosen sustainable flooring is also non-toxic and comes from a sustainable and renewable source.
 
Recycled plastic bottles are some of the materials that can be converted into a soft, and durable felt carpet underlay that benefits acoustics, comfort levels and the environment.
 
Cork is an all-natural, biodegradable and renewable product with a long lifespan when it is maintained properly. Cork is harvested from the bark of cork trees, so the same tree can be periodically harvested over and over for up to 250 years.
 
Cork is flexible, holds warmth and softens sound, and with a shock absorbent structure it all adds up to comfort underfoot.
 
Linoleum is made from natural resources, so it is easily recycled and biodegradable.  At the end of its life, linoleum can be turned into an energy recycling incineration plan or garden compost.
 
Hygienic
 
Hygiene, infection prevention and antimicrobial resistance is also a major consideration when selecting, flooring particularly in an aged care setting.
 
Epoxy solutions are a hygienic flooring option in areas where hygiene is particularly important such as bathrooms and kitchens.  Over the years resin floors have become renowned as the strong, durable and safe option for commercial and residential floors.
 
In these areas the floor is best when it is seamless, waterproof, and easy to clean.  It must also withstand the wear and tear if excessive foot traffic and thermal shock from hot ovens, heavy equipment and spillages of corrosive foodstuffs for the long term.
 
Robust polyurethane systems with an antimicrobial additive are highly recommended for these areas.
 
There are many flooring options appropriate for aged care residential communities that transform the overall appearance of the interior, minimise the impact on the environment, keep maintenance and replacement costs low and, most importantly, support the safety needs of the residents.
 
 
Aged care NZ Issue 02 2022
 

Advantages to you are, we:

• come to you
• adapt the physiotherapy programme to your environment and needs
• identify things in your environment that may inhibit your recovery and suggest solutions 
• teach you and your support people your physiotherapy programme.

How it works!!
 
Simply do one of the following:
 

• Ring Therapy Professionals Ltd, phone: 377 5280
• Ask to be referred to Therapy Professionals by a Doctor or Health Professional.  It is important that they include your ACC45 number, Date of Accident, Date of Birth and the letter from ACC accepting the claim and advising of claim number.

A physiotherapist will then contact you and arrange a convenient time 

Charges:
 
ACC only partially contributes to the cost of your assessment and treatment.  To cover the costs a co payment is required.
 
A Co-payment will be invoiced to you for:

•  each visit 
• work related to your treatment, eg phone consultation, applications for equipment, extending ACC treatment cover (ACC35).

​Contact Details:
 
Phone:           (03) 377 5280             
Fax:                 (03) 377 5281
Email:              [email protected]
Website:        www.therapyprofessionals.co.nz
 
Charges reviewed on 1 April each year.