Equitable Access to Aged Care Under Threat
Demand for aged residential care is forecast to increase by an estimated 15,000 beds by 2030
Demand for aged residential care is forecast to increase by an estimated 15,000 beds by 2030, but an unsustainable funding model is threatening equitable access to care for older New Zealanders, according to new research by the NZ Aged Care Association (NZACA).
The biennial Aged Residential Care (ARC) Industry Profile 2021-2022* is the most comprehensive report on the state of the industry, a source of credible data and insight used to inform the Association's policy and advocacy work.
NZACA Chief Executive Simon Wallace says the report shows trends underpinning the impact of chronic underfunding with an increasing number of providers charging accommodation supplements for additional revenue or by the sale of Occupational Rights Agreements, a license to occupy common in the Retirement Village sector and growing in popularity in ARC.
“As a direct result of chronic government underfunding providers are being forced to find additional income streams offering people premium room services, over and above standard rooms.
“At the same time, standard subsidy-only rooms are rapidly disappearing as they are unviable for owners trying to operate on needle thin budgets, providing care for an increasingly high needs population of older New Zealanders.
“The net effect of this is increasingly inequitable access to care for older New Zealanders.’”
As of 30 September 2021, NZACA member care facilities provided 93 per cent of the total 40,941 beds. As a whole, the sector cares for over 35,000 residents – nearly two thirds of whom (57%) are at one of the higher care levels (hospital, dementia, or psychogeriatric) and require highly specialised care by registered nurses (RN’s and caregivers. Health care assistants (ARCC)
Mr Wallace says underfunding has also driven a high turnover of RNs over the year at 48 per cent compared to 33 per cent in December 2019, with nurses being actively recruited by District Health Boards offering remuneration that providers are not funded to match.
"The effects of the pay disparity between DHB and aged care nurses are clear in this report. Never before have we seen nurse departures of this scale and with a critically limited pool to recruit from, the sector really is at crisis point.”
The sector’s high reliance on a migrant workforce remains high with 43 per cent of nurses on visas, while around one-third of the caregiver workforce is on a visa. Once again, the main countries of origin for the workforce on visas are the Philippines (39 per cent of RNs, 35 per cent of caregivers) and India (37 per cent of RNs and 40 per cent of caregivers).
“COVID-19 border exceptions and visa extensions, including the 2021 Resident Visa, have allowed ARC to maintain access, albeit reduced, to the migrant workforce it relies heavily on. While we welcome initiatives to recruit New Zealanders, it is apparent that there is a limited number of Kiwis willing to take these jobs. Working with Government to ensure clear pathways to a career in ARC for both Kiwi and migrant workers is a priority.”
The make-up of the sector has remained stable with 49 per cent of all New Zealand ARC facilities operated as part of a major group of care facilities, 50 per cent individual/minor group facilities and 1 per cent owned by DHBs.
The ARC sector is a broad-church, with a wide range of ownership models including religious institutions, charitable trusts, family-owned, not-for-profits, publicly listed, and privately owned facilities and groups of varying sizes. Publicly listed providers operate 34 per cent of the sector’s bed supply.
The report also shows that the median number of beds in rest home facilities is continuing to steadily increase and now stands at 60 beds, reflective of the fact that almost all new care homes are being built as part of large-scale retirement village operations.
*The Industry Profile 2021-22 for the aged residential care (ARC) sector is provided by NZACA and BERL. It includes information from the detailed NZACA Member Profiling Survey, the TAS Quarterly Bed Surveys as well as publicly available data from the Ministry of Health and the NZ Companies and Charities Registers. Responses to the NZACA Member Profiling Survey covered 77 per cent of the NZACA membership bed supply and 71 per cent of the total ARC bed supply. nzca.org.nz/advocacy-and-policy/are-industry-profile-2021-22
The New Zealand Aged Care Association (NZACA) is a not-for-profit, national membership organisation representing approximately 93 per cent, or more than 37,000 beds, from New Zealand’s aged residential care sector. The services our members provide include rest home, hospital, dementia, and psychogeriatric care, as well as short-term care.
Reference; Aged Care New Zealand Issue 02 2022
Electric bikes can boost older people’s mental performance and their well-being
Reminding you of your childhood cycle rides and the joy of being young
Getting on your bicycle can give you an enormous sense of freedom and enjoyment. It can increase your independence and knowledge of the local area and improve your access to the natural (or urban) environment. It can also be highly nostalgic – reminding you of your childhood cycle rides and the joy of being young.
But beyond the feel-good factor, can cycling actually make any difference in mental abilities and well-being? This was something our new study aimed to investigate specifically looking at cycling among older adults.
While most studies incorporate exercise in a gym situation, our study wanted to examine the impact of cycling in the real world – outside a controlled environment. So older adults, aged 50 and above, were asked to cycle for at least an hour and a half each week for an eight-week period.
Participants either cycled on a conventional pedal bike, on an electrically assisted ‘e-bike’ or were instructed to maintain their regular non cycling exercise routine as a comparison group. Mental abilities, mental health and well-being were measured before and after the eight-week cycling period.
Participants either cycled on a conventional pedal bike, on an electrically assisted ‘e-bike’ or were instructed to maintain their regular non cycling exercise routine as a comparison group. Mental abilities, mental health and well-being were measured before and after the eight-week cycling period.
Exercise is thought to improve mental functioning through increased blood flow to the brain – as well as an encouraging regrowth of cells, specifically in the hippocampus. This is known to be an area associated with memory. So it was expected that the greater physical exertion required for pedal cycling, compared to cycling an e-bike with a motor would result in greater benefits to mental functioning.
One of the tasks we used to measure mental ability is the ‘Stroop test’. The task involves participants being shown the name of a colour printed on a card in a different colour script – imagine the word ‘blue’ printed in red ink. Participants are asked to say the colour of the ink that the word is printed in, rather than reading the name of the colour. The Stroop test measures how accurately someone is able to minimise distraction from the written word when reporting the ink colour.
We found that after eight weeks of cycling, both pedal and e-bike cycling groups were better at ignoring the written word, indicating that their mental function had improved. This was not the case for non-cycling control participants.
Aside from the benefits found to some mental abilities, we also saw a trend for mental health improving for the e-bike cyclists, but pedal cyclists did not change on this measure. This could be because e-bikes may be more enjoyable to ride than normal pedal bikes – helping to improve mental well-being.
We also found e-bike cyclists spent more time cycling on average each week than the pedal cyclists. Many of the participants commented that they felt they could go further on the e-bike as they could rely on the motor to get them home if they could not manage it by themselves. This research, to some extent, provides support for many bike-related motivation quotes, including the following from Sir Arthur Conan Doyle:
“When the spirits are low, when the day appears dark, when work becomes monotonous, when hope hardly seems worth having, just mount a bicycle and go out for a spin down the road, without thought on anything but the ride you are taking.”
It seems then that e-bikes have the potential to re-engage older adults with cycling and provide a great opportunity to increase physical activity and engagement with the outdoor environment. So given that more than three million older people in the UK live alone, of whom more than two million are older than 75, it might just be that the use of an electric bicycle could help to improve older people’s lives by increasing independence and mobility – all of which can have a significant impact on their well-being.
Reference; Aged Care New Zealand Issue No 2 2022
Research Associate in the Faculty of Brain Sciences, UCL
Research fellow, Oxford Brookes University
Carien van Reekum
Professor of Psychology and Neuroscience, University of Reading
Reader in Urban Mobility, Oxford Brookes University
This article is republished from The Conversation under a Creative Commons license. Read the original article here: the conversation.com/electric-bikes-can-boost-older peoples mental performance and their well-being 11264
If you are wanting to keep your bones strong remember cycling doesn’t put any stress on your bones to keep them strong. It’s important to ensure you have regular variety in the exercise you do.
If you need advice on what exercise will be good for you just contact Therapy Professionals Ltd Ph: 03 3775280. Email: email@example.com our friendly physiotherapists can help.
Use it or lose it
Did you know the use-by date on food isn’t valid once you’ve opened the packet? Belinda Allan takes a look at the food dating game and offers advice on how to keep your family safe from food-bourne illness.
According to a survey funded by the New Zealand Food Safety Authority (NZFSA), people are more worried about food poisoning than any other food related issue, and not without reason. Every year, there are an estimated 119,000 cases of food-bourne illness. Up to 40 percent of those are believed to be caused by unsafe food handling practices in the home.
Taking notice of ‘use-by’ and ‘best-before’ dates is one way you can reduce your risk.
Most packaged foods with a shelf life of less than two years must have one of these labels. There are some exceptions. Bread, for example, can have a ‘baked on’ date.
The ‘use-by’ date is about food safety. It is determined by the time required for pathogens in food to grow to levels above which illness might occur. Providing the food is stored correctly and isn’t opened, it should be safe to eat until its use-by date. After the use-by date, a food can’t legally be sold and shouldn’t be eaten. Use-by dates usually appear on perishable food like meat, poultry and deli products.
‘Best-before’ dates are about food quality. Foods can be sold after their best-before dates provided they are fit for consumption. However, they may have lost quality and some nutritional value. You’ll find best-before dates on less perishable foods, such as cereals, flour and canned goods.
It sounds simple but the reality can be confusing. Once you’ve opened the packaging, the shelf life is the same as if the product was unpackaged. For example, a packet of vaccuum-packed smoked salmon may have a use-by date that is one month away, but once you’ve opened it, you should keep the salmon in the fridge and eat it within two days.
Food manufacturers have to provide directions for use and storage on the packaging to ensure the food will keep until the date shown. This should include information about how quickly the food should be eaten after it is opened. We checked out the deli section of the supermarket and found that most manufacturers complied. But some provided no instructions on what to do once you’ve opened the pack.
How long should you keep it for?
According to Dr Greg Simmons, from the Foodsafe Partnership, how long it is safe to keep a particular food depends on many factors: its water and protein content, its freshness pathogens likely to grow on the food, and your immune status.
Also, use-by dates should be treated with caution if you are pregnant or have lowered immunity due to illness or medical treatment.
Always take note of the use-by date and storage instructions if there are any. As a general guide, here’s how long you can keep food in your fridge once the packaging is opened.
For safe food chill out!
Consumer 438 July 2004
Fun in the sun
Outdoor activities for aged care residents
From: Aged Care New Zealand Issue 02 2022
After the winter months cooped up inside, many aged care residents look forward to getting out into the fresh air.
As spring approaches, seniors living in aged care should be encouraged to enjoy the warmer weather and reap the health benefits of some time spent outdoors.
After the winter months cooped up inside, many aged care residents look forward to getting out into the fresh air. So as the warm weather slowly starts to return, the prospect of spring can create feelings of anticipation and joy for everyone.
Staying active and enjoying the outdoors is particularly important for the elderly so finding activities that are suitable to their abilities is essential.
Some favourite spring activities often enjoyed include walking, picnicking, and working in the garden. Of course, aged care residents range from the more adventurous who might enjoy swimming to those who just love the atmosphere outdoors and want to sit somewhere and simply drink in the fresh air.
It all gives joy and adds meaning to our lives.
The value of going outdoors
As warmer weather returns, it is important to realise how truly beneficial getting outdoors can be for the elderly. So spring is a great opportunity to add some new activities to their routine. Carers can tempt residents outside with interesting ideas to stay physically and mentally active.
Getting outside and into the sunshine exposes our bodies to the essential Vitamin D. This vitamin is crucial for strong bones, healthy muscles and improved mood. Daylight is also important for regulating our body’s clock, helping to promote a healthy sleeping schedule.
Research has shown that people with dementia who undertake between 10 and 15 minutes of activity outside a day improved their health significantly. For the elderly with mobility issues, simply sitting outside for a short period of time can have positive mental and physical health benefits. It is important to monitor the position and make sure the residents are wearing protective clothing, sunscreen and drinking plenty of water when exposed to the sun.
Planning outdoor activities
Elderly people with Alzheimer's and other forms of dementia may find outdoor tasks difficult or feel overwhelmed by a change in their preferred routine. However, with the help and reassurance from professional carers or family members, simple and enjoyable outdoor activities can still be incorporated into their care plan.
Activities can be planned to occur around the same time each day. They can be designed to coincide with the times when the person with dementia may be most often active. They can be encouraged to play a part of the activity or simply made comfortable in a spot where they can observe others.
Here are a few other things to consider when planning outdoor activities:
Keeping it local makes it easier
Aged care residents do not need to be overly active to enjoy the mental and physical health benefits of spending time outdoors.
The outdoor activities will need to be suitable for residents who have a wide range of limitations. So, for some residents, simply spending time sitting in the dappled shade or on the verandah can be enough. Other outings can be planned to meet the abilities of the more active seniors, from a walk around a park, or a visit to a swimming pool, the zoo or the botanical gardens.
When choosing an outdoor activity consider the hobbies and interests the residents used to enjoy. Often the pleasure and relaxation they felt doing these activities in the past will return.
A sporting event might be overwhelming for some seniors but attending a home-grown social game might be a great way to spend an afternoon. There is the same action and excitement, but with less noise and confusion.
Taking advantage of the local area by walking around the block or wandering around window shopping can be a great way for seniors to get some light exercise outdoors. For residents in wheelchair a trip around the aged care residence can be adventure enough.
Many times, simply deviating from the usual routine and getting a breath of fresh air outdoors will lift the mood of aged care residents. Creating a variety of activities that are realistic and enjoyable can generate a great deal of happiness.
Ref: Aged Care Issue 02 2022
Furniture and fittings for residents with dementia
For people with dementia the world can be a confusing and frightening place.
Dementia affects brain function and can impact a person’s thoughts, behaviour and ability to perform everyday tasks. Support for people with dementia is vital and their environment must help to minimise the difficulties they experience.
Living in an aged care facility with well-designed personalised spaces and suitable furniture and fittings can significantly improve the physical, psychological and social needs of residents with dementia.
When designing or preparing a living space for people with dementia practical and comforting elements need to be incorporated. It is essential to include equipment and fittings that assist residents with the practical day to day requirements, and it is equally important to facilitate the personalisation of private bedrooms and communal space with articles that have meaning to the residents.
Strategically placed familiar furniture, ornaments, art works, treasured keepsakes, photo albums, framed photographs or other items of significance to residents can help generate reassuring emotions.
In private bedrooms a display of personal items may serve to support the identity of a person with dementia by reminding them of family members and the things they have enjoyed and achieved in their lives.
In common areas a similar display of reminders from residents’ lives helps personalise the shared space and increase the residents' sense of belonging. It may also serve to foster exchanges with others in the communal areas and help staff to get to know the residents more personally.
Providing navigational cues
People with dementia can be confused by distances and directions which makes it difficult for them to find their way around. This can be very distressing for people with dementia and create difficulties for carers.
To assist their navigation the indoor environment can be designed with distinctly different rooms or zones that utilise helpful visual cues, such as wall, floor and furniture colour. This can alleviate the associated anxiety and confusion of residents when they don’t know what room they are in or how to find their way around.
Navigation is also assisted when a familiar item is hung on a resident’s bedroom door or located just outside it.
Thoughtful layout of fixtures, fittings and furniture can provide reminders that help people with dementia navigate the space and recognise the purpose of the space they are in.
Suitable fixtures and fittings
When choosing fixtures and fittings it’s important that their purpose is early recognised. They need to be safe and comfortable to use and suit people with reduced manual strength and dexterity.
Grab rails in bathrooms are especially important with the risk of slippery surfaces posing a serious hazard, especially for people with dementia.
Sturdy handrails for internal and external stairs can be very helpful to assist residents to safely use the stairs. An added safeguard is to make the handrail extend beyond the first and last steps with clearly defined ends. This makes it easier to determine the length of the staircase and may lessen the risk of elderly residents misjudging the top or bottom step.
Oval shaped handrails on stairs are particularly useful as they are more ergonomic than round or square handrails, With the soft curved edge of a round handrail and the broad flat surface of a square handrail, an oval shaped handrail is more comfortable for residents to support themselves with their forearms when moving up and down the stairs.
Colour also helps to encourage the use of the handrails and grab rails. If they are in a colour that contrasts with the wall, they will be easier to locate.
Handles and safety locks
Rather than conventional fitting, curved or C shaped handles are best for doors, drawers and cupboards that need to be operated by people with dementia. These are easier to use by people with reduced strength manual dexterity. Fixed handles set at a 45-degree angle are also easier to use for elderly residents.
Safe door locks are important to protect people with dementia as they often wander off and become lost. They need to be protected from accessing dangerous environments or from leaving the premises without assistance.
Locks must also be fitted to cabinets to safeguard residents with dementia from gaining access to toxic chemicals, medications or dangerous equipment.
There are many specialised fittings that can be installed in aged care facilities to prevent residents with dementia from gaining access to places that present a risk to them.
The importance of furniture
Furniture can make a huge difference to create an environment that feels more like home. The right furnishings can transfer even a cold, harsh place into a welcoming, familiar ambience.
Choosing the right furniture is important for physical and psychological well-being.
Moving is highly stressful to people with dementia but if their surroundings are kept as consistent as possible, the transition is less difficult. Whenever possible, personally owned furniture, such as a favourite armchair, should be installed in the resident’s room. If the resident is relocated, the old armchair goes too, and if possible, placed in a simitar position in its new location.
The shape of furniture and its material can contribute to a soothing ambience. Timber furniture can be a good choice as the lustre of wood tends to make a room look cosier than some contemporary finishes.
The shape of a table can be important too. A square or oblong dining table has more defined spaces for people to sit while eating and this can be less disconcerting to a person with dementia.
Carefully selected furniture with distinct colours or tones can help to clearly distinguish it from the background and reduce trips and collisions. Smaller lounge room furniture, such as coffee tables or lamp tables, are safest when in a contrasting colour for visibility. It is best to minimise clutter or rugs, as these can be trip hazards. Shelving can be mounted on the walls to display books and other items out of harm’s way.
Placing a chair near a window provides a tranquil space to support times of contemplation. People with dementia may sit for extended periods of time, so choosing the right chair for comfort is important and this might well be the favourite old armchair.
There are many design elements that can help to promote independence for people with dementia. When the environment is familiar, easy to access and navigate, it helps to support everyday task and promote safety, security and comfort. Following these tips may help to improve the quality of care that an aged care facility can provide its residents with dementia.
Ref: Aged Care NZ Issue 02 2022
Ability, not age should be the only factor determining what exercise you do
Research has repeatedly shown that exercise in older adults is linked with lower
disease risk, reduced risk of falls and better overall health.
It is a common assumption that exercise in older people is difficult and dangerous, so it’s perhaps best avoided. But this is often not the case – even if these ideas are ingrained in society. Research has repeatedly shown that exercise in older adults is linked with lower disease risk, reduced risk of falls and better overall health.
But misconceptions about age and exercise still exist – and it’s not difficult to see why. Exercise recommendations, even from health authorities, are often based on age. But if you look closer, you notice that these recommendations are often identical to those for younger people, with the difference being in assumptions of ability.
Indeed, it’s true as you age you lose muscle strength, bone density, and your body composition shifts from muscle to fat. However research shows exercise training at any age results in positive gains to muscle mass, muscle strength, bone density, and improvements to overall health – even to people as old as 97.
Safety is also a commonly perceived barrier when exercising at an older age. However it appears that the benefits of exercise, both aerobic and resistance, outweigh the risks of injury or cardiovascular events.
When choosing what type of exercise to do, it’s your ability – not your age – that should be your primary consideration. Older people are more likely to suffer from one or more age related diseases or health conditions (such as type 2 diabetes, osteoarthritis, heart disease and stroke) that may affect their ability to take exercise. But risk of and recovery from these conditions are all positively influenced by daily exercise. Even arthritis symptoms can be reduced by low impact movements.
So what type of exercise should you be doing? Prescribing training based on a person’s age is too simplistic, as people can be very different from one another. For example, I’ve met both frail 65-year-olds and others that can outpace me on the track. Exercise prescription should be done by ability. And, whichever mode you choose, remember it should always challenge you.
Maintaining a high level of low intensity activity (such as walking, jogging, or cycling) is a lifestyle choice correlated with longevity. Given that almost 50% of UK adults don’t meet minimum activity guidelines, this is an immediate positive impact that people can have on their fitness and health, both through the benefits of being active and by off-setting the negative health effects of being sedentary.
Simply moving around more is a general way of maintaining fitness and general health. For example, standing up every ad break when watching TV, walking to the shops instead of driving, or taking the stairs are all great ways of increasing activity.
However, other types of workouts may also have similar benefits for older people. High intensity interval training (HIIT) exercise, which involves exercising at (or near) 100% effort for short bouts followed by rest, is a popular form of aerobic training. While HIIT training is often assumed to be only for those who are athletic or young, our research shows that HIIT training in both older men and pre-diabetic older men and women, is beneficial to overall health. It’s worth noting that we need stationary bikes of safety, as an intense bout of HIIT exercise may make people of all ages feel a bit faint.
And when HIIT training incorporates leg balance and strength exercises there’s both perceived and actual deceases in fall risks to older people, as well as cardiovascular improvements.
Resistance training, or exercises that require your maximal strength, is also a great option for people of every age. Not only will many older people be capable of performing resistance training, they will also benefit greatly from it – with studies showing strength and resistance training improves bone density, muscle mass, and physical ability.
Resistance training also doesn’t need to involve heavy weights in a gym, but as a general guide the movement should be challenging and near the limit of your strength if repeated about ten times. For example performing a chair squat (getting up from a seated position repeatedly) can be made harder by holding weights, cans or even a bottle of milk. It can be made harder still by balancing on one leg as you stand up.
While older people are likely to gain muscle mass and strength from exercise, it does get harder to build muscle tissue as you age. Even elite athletes, who maintain lifelong high levels of training see decreases in performance as they age.
But fitness isn’t the only positive change from exercise. Exercise is also shown to improve mental health, wellbeing and cognitive function, alongside improved bone density and longer life. Improved bone density from weight lifting may also minimise injury if an older person does have a fall.
Balance is also an important skill at any age – and this skill can be trained. Improved balance may prevent falls or injuries from falls in older people. Activities such as yoga or tai chi may improve balance. But even as simple as standing on one leg while putting your socks on can challenge your balance.
A great combination of strength and balance exercises are ‘asymmetrical exercises’ which involve moving only one side of the body at a time. This can be as simple as balancing on one foot whilst moving the other leg back and forth, or using one arm at a time to perform a lifting or throwing movement to challenge and improve balance.
In short, the best type of exercise – regardless of your age – has already been outlined by the NHS. Aim to be physically active daily, do activities that improve strength, flexibility, and balance at least two days a week, get at least 150 minutes of moderate intensity activity, or 75 minutes of vigorous intensity activity a week, and reduce time spent sitting or lying down. And no matter your age or ability, do exercises that continue to challenge you
Author: Bradley Elliott, Lecturer in Physiology, University of Westminster.
Ref: Aged Care NZ Issue 02 2022
If you need help to get started with an exercise programme our friendly physiotherapists can help. Just contact Therapy Professionals Ltd Phone 377 5280 email: firstname.lastname@example.org
How flooring design contributes to healthy supportive aged-care environments
‘Safety isn’t expensive, it’s priceless” - Anon
Aged Care NZ Issue 01 2022
Slips and falls lead to thousands of injuries in New Zealand every year, with flooring surfaces playing a major part in many of these incidents. Assessing the risks and choosing flooring products that are slip-resistant and suitable for each application is therefore paramount for the designer and management team as it ensures the safety of users and a reduction to the risk level and likelihood of litigation.
When it comes to choosing products to be part of an aged care facility, the right products ensure a better, safer and cleaner environment for all who utilise the facility.
Flooring contributes to the design of healthcare facilities in a multitude of ways, contributing aesthetically to the overall look and feel of a facility, providing comfort for patients and staff, and working as a way-finding tool to designate areas.
At the same time, the flooring palette has to take into account the demands of each space.
The best way to approach these design areas is to decide on a style, such as a clinical or relaxed environment, and research colour trends and how colours affect emotion especially within mental health.
Designers need to consider the lifestyle, the overall feel required in the project, research products that are fit for purpose and that will provide sustainable slip resistance where required, the abrasion level of the flooring and wear layers, the ease of cleaning and ongoing cleaning and maintenance costs.
Ultimately a product is usually selected based on whether it is ‘fit for purpose’ or not.
Surfaces with a raised profile or heavy texturing, for example, should not be used in areas where wheeled traffic is expected, but it is recommended for floor safety in areas such as central kitchens and wet areas.
From floors that stand up to frequent spills, to an option that is adhesive-free, flooring products should be thoroughly tested to ensure that they meet the needs of different spaces in a healthcare or aged care project.
Slips and trips
Slips occur when a person’s foot lose traction with the ground surface due to wearing inappropriate footwear or when walking on slippery floor surfaces such as those that are highly polished, wet or greasy.
Trips occur when a person unexpectedly catches their foot on an object or surface. In most cases people trip on low obstacles that are not easily noticed such as uneven edges in flooring, loose mats, opened drawers, untidy tools or cables from electrical equipment.
Falls can result from a slip or trip but many also occur during falls from low heights such as steps, stairs and curbs or from an uneven surface in the flooring.
Selecting control measures – design of facilities
The best way to eliminate slips and trips is to build and design facilities with safety in mind.
The following should be considered during the floor design stage:
The role of PCBUs
PCBUs must manage the health and safety risks associated with slips and trips by eliminating the risk so far as is reasonably practicable, and if that is not reasonably practicable, minimising the risk so far as is reasonably practicable.
This involves a systematic approach to:
There are various ways to control the risk of slips and trips, listed below in order of their effectiveness (known as the hierarchy of control).
More than one control measure may be needed to provide the best protection.
Identifying slip and trip hazards
Common slip hazards include:
Common trip hazards include:
Controlling the risks of slipping
Floor treatments that improve slip resistance are those that increase the surface roughness of the flooring. The main floor treatments are sand blasting or grinding, chemical etching, coating with resins and using floor mats or adhesive anti-slip strips.
Examples of different floor types that may be suitable in an aged care setting include:
In addition to ensuring the best flooring options, when selecting and purchasing footwear – both for residents and staff – consider whether it has good slip resistant properties, in addition to any other required safety features. For example:
Carers and staff in aged care environments, both at aged care facilities and in homecare situations, owe a duty of care to the individuals under their care. This means that choosing a safe flooring solution is an important consideration when designing a building in aged care environments.
When it comes to choosing products to be part of a hospital facility or an aged care facility, the right products are going to ensure a better, safer and cleaner environment for all who utilise the facility.
10 Ways to Love your Brain
Start now. It’s never too late or too early to incorporate healthy habits
Growing evidence indicates that people can reduce their risk of cognitive decline by adopting key lifestyle habits. When possible, combine these habits to achieve maximum benefit for the brain and body.
Break a sweat
Engage in regular cardiovascular exercise that elevates heart rate and increases blood flow to the brain and body.
Hit the books
Formal education will help reduce risk of cognitive decline and dementia. Take a class at a local college, community centre or online.
Evidence shows smoking increases risk of cognitive decline. Quitting smoking can reduce risk to levels comparable to those who have not smoked.
Follow your heart
Risk factors for cardiovascular disease and stroke – obesity, high blood pressure and diabetes – negatively impact your cognitive health.
Brain injury can cause risk of cognitive decline and dementia. Wear a safety belt and use a helmet when playing contact sports or riding a bike.
Fuel up right
Eat a balanced diet that is higher in vegetables and fruit to help reduce the risk of cognitive decline.
Catch some Zzz’s
Not getting enough sleep due to conditions like insomnia or sleep apnoea may result in problems with memory and thinking.
Take care of your mental health
Some studies link depression with cognitive decline, so seek treatment if. You have depression, anxiety or stress.
Staying socially engaged may support brain health. Find ways to be part of your local community.
Challenge your mind. Build a piece of furniture. Play games of strategy, like bridge.
10 Ways to love your brain
Start now. It's never too late or too early to incorporate healthy habits
Ref: Alzheimer’s Association NZ
Aged care providers share COVID lessons
The Aged Care Quality and Safety Commission has published a report of the key takeaways and lessons learned from 34 aged care providers who experienced an outbreak in at least one of their residential services in Victoria, Australia.
The 42-page report is based on interviews with CEO’s, senior managers and board chairs that aimed to understand what providers learned before, during and after the outbreaks, what they are doing differently as a result of their experience and the roles other parties played in responding to the outbreaks.
The report covers planning, governance, human resources, care and service delivery, infection control and communications. The sections on human resources and infection control have the most learnings.
Among them is the need to better know staff including their domestic arrangements and ability and willingness to work onsite during an outbreak.
‘Many providers felt they did not have a good understanding of their staff’s individual circumstances or their capacity to work during an outbreak and described having a better understanding of their workforce since experiencing an outbreak,’ the Aged Care Quality and Safety Commission found.
Providers also faced challenges with staff who were furloughed, which means stood down because they were potentially exposed to a person with COVID 19.
To help overcome these challenges, providers said they worked with staff to suit their needs. This included identifying what was needed to enable staff to work during an outbreak, facilitating staff to work remotely if possible and accommodating staff who were covid positive or working with covid positive residents in hotels to mitigate concerns of transmitting the virus.
‘Providers also said they would make emotional and mental health support available to staff early, noting that they were working under conditions of extreme stress and were susceptible to burnout,’ the report said.
Infection control procedures
Aged care providers identified effective infection prevention and control planning as important, but many said they felt unprepared for the intensity and complexity of the reality despite being familiar with infection prevention and control procedures.
‘Many providers described that, in hindsight, they would have provided more infection control training earlier for staff across the services,’ the report said.
It was also necessary to frequently provide ongoing infection control training to reinforce messages and minimise complacency.
Having staff demonstrate infection control measures such as hand hygiene before working on the floor, a train-the-trainer approach to distribute knowledge, checklists and instruction videos to support staff with limited English are among strategies identified to address the challenges.
‘Since experiencing outbreaks providers continue to focus on infection control by prompting infection prevention champions, employing infection control leads, providing ongoing training and communications to all staff on site, undertaking hygiene spot checks and increasing the amount of hand hygiene stations, PPE stations and clinical waste bins,’ the report said.
Delivery of care
Providers faced several challenges delivering care during an outbreak that were escalated when staff were furloughed, and other workers were brought in.
As a result, providers recognised the importance of being able to quickly identify residents and their care needs. For some providers this involved using wristbands, photos and laminated printouts of key documents, such as resident profiles and care plans, placed inside residents’ rooms or on walls or doors, according to the report.
‘Having simplified documents, checklists and charts available at the point of care made staff and residents alike feel more confident in the delivery of care and services,’ it said.
Some providers had not thought about how essential services such as food would be managed in an outbreak and some had underestimated the additional time these tasks would take, the report said.
To overcome these challenges, providers said they needed more than one back up contractor to ensure food services were maintained during the outbreak.
'Providers also highlighted the importance of ensuring contracts had systems in place to maintain a high standard of infection control, and that contractors should be included in all infection control communications and training to ensure a consistent approach across the services,’ the report said.
It is also important to provide clear step-by-step instructions to all staff involved in preparing and delivering food to ensure appropriate infection control is maintained, providers said.
‘Providers found they had to plan every detail of how food would be moved throughout the service to prevent potential contamination across different residents and areas of the service.’
It was also important to ensure kitchen staff were trained and educated. For one aged care provider, they made their infection control nurse available to contactors to advise on safe food handling procedures and answer questions.
Other key learnings
It is critical to:
From: Aged Care NZ Issue 02 2021
Osteoporosis – not just a woman’s disease
‘Only women get osteoporosis, right?’ Not quite.
At least one in five Kiwi men will break a bone because of osteoporosis and when men get a hip fracture, they’re more likely to require care in a long-term facility. Even worse, 37% of men who get a hip fracture will die within a year after the accident. It shouldn’t be this way.
One of the biggest issues is that people simply don’t know that men are also at risk of this disease. In fact, men are less likely to be assessed or receive treatment for osteoporosis after they’ve broken a bone. It’s incredibly important that men know they’re at risk of this disease.
The good news is, it’s never too late to start taking action for your bones Here are three ways men (and women) can help minimise the risk of osteoporosis.
1. Maintain a healthy body weight
If you have lower body weight, you’re more likely to have less bone issues.
Also, if you’re older, having low body weight will mean you have less fat padding around the hips, taking away a nice cushion to minimize the impact of all fall. So, make sure you eat a balanced nutritional diet, and maintain a healthy body weight.
2. Quit smoking
Smoking slows down the cells in your body that build bone health. If you’re a smoker, try to decrease how much you smoke, or quit entirely so that your bones can stay healthy.
3. Don’t drink as much alcohol
This is also a tough habit to break. But alcohol affects the cells that build and break down bone. Too much alcohol can also make you unsteady on your feet, making you more likely to trip, fall and break a bone. Try to decrease your alcohol intake. Seriously your bones will love it.
Most importantly if you or the men in your life have broken a bone following a simple trip or fall since you turned 50, you are twice as likely to break another bone in the future.
And, if you would like to learn more about how to improve your bone health, please visit the website www.knowyourbones.org.nz
If you need help to gain weight or want an exercise programme that is right for you, just contact Therapy Professionals Ltd
phone: 03 377 5280 or email: email@example.com. Our friendly therapists can help.
From: Keeping on August 2023