Communication is Key

Communication is Key

Why might CMS require mandatory communication training for topics such as dementia management and reporting abuse?

For a few minutes, I’d like you to step outside of your role at work and instead step into my family this holiday season.  My grandmother is 96 years old, has dementia and lives in an assisted living.  She thinks I’m her younger sister Julia.  In my opinion, this is an honor as she was quite fond of this particular sister.  While it’s a habit to call her “mommom,” I do my best to call her Eva now.  Eva thinks my mother (her daughter) is her “mom.”  This of course is a much easier adjustment for me when I say, “How was your visit with mom yesterday?”

Why We Need to Embrace Person-Centeredness and Practice Our Customer Service Skills

Earlier this month I was sent a special invitation to attend Eva’s holiday party.  I happily RSVP’d YES! and counted down the days.  I was especially excited for two reasons:  One, my sister is pregnant with her first baby who is due on Christmas day so I knew there was a possibility I might not see my grandmother this year on Christmas.  The second reason, since I live more than 90 minutes away I usually only see her on weekends when activities are sparse.  Attending a special event during the week meant a lot to me and I wore my best Christmas sweater.

The party was scheduled to last from 6-7:30pm.  Knowing my grandmother likes to go to bed early I decided I better get there by 5:30 since I knew she’d never make it to the end of the party.  When I arrived, I went to find her amongst her usual crowd.  She was not there.  I asked a team member, have you seen Eva?  “I’m sorry I don’t know who that is – I don’t usually work on this side” – meaning with the memory care residents.  Since I was not offered any further help I decided to go to her room thinking maybe she wanted to change into her best holiday sweater too.

When I arrived at her room I found both her and her roommate sound asleep.  I immediately thought, “I must have the wrong night.  I’m currently 6 months pregnant and I have mush brain.  This is my fault – I have the wrong date.”

I stopped at the desk and asked, is tonight the holiday party?  “Oh yes, it starts at 6:00pm.”

Disappointed I explained that I live 90 minutes away and had RSVP’d for the event but my grandmother was already asleep.  The response, “I’m not sure why her aid would put her to sleep so early if you were attending the party.” 

Her aid.  I thought to myself, her aid knows she likes to go to bed early.  Her aid was doing her job by honoring my grandmother’s preferences to rise early and go to sleep early.  Her aid very well may have asked her, Eva do you want to stay awake for tonight’s party?  I wasn’t upset with her aid.  Far from it.  I was upset because there was a lack of communication.  The next day I received an apology via email saying that I was included in the headcount for the party but no one took into consideration that Eva usually goes to sleep before 6pm and to tell her aid I was coming.  I simply replied, “thank you, please tell Eva that her sister Julia came to visit but she was asleep.”

Dementia Management and Reporting Abuse

Earlier this year this same community did not update my grandmother’s paperwork to note that my mother was going on a cruise and would have poor cellular service.  The community was asked to notify Eva’s granddaughters in case of emergency. Of course, there ended up being emergency the very day after my mother left and my grandmother was hospitalized.  Since the community had failed to properly document my mother’s request to contact my sister and I, Eva was in the hospital for 5 days without us knowing.  For 5 days no one from her family visited her.  For 5 days, her dementia became exacerbated and the hospital placed her on antipsychotics because she was “exhibiting behaviors.” For an additional 2 days we had to work through red-tape to even get any medical information about Eva because she was admitted by the assisted living stating my mother was her next of kin with no mention of my sister or I.  After 7 days in the hospital, and 2 days watching Eva, a usually happy person, scream out in medicated hallucinations, we finally found out she had a simple UTI and could be released. Don’t let poor communication hurt your community like it did Eva and our family.

3 Easy Communication Tips:

  • Conduct formal communication training for all staff. Communication is perhaps the most important training because in the absence of strong communication systems, or when there is a breakdown of standard communication there are substantial consequences. Communication training benefits everyone – not “just” your front-line staff. Ask about our workshops.
  • Avoid siloed or top down communication. “They don’t tell us anything” – One of the most frequently heard pieces of feedback we hear from front line employees.  Host town hall meetings, incorporate key messages into shift to shift report, post news in key traffic areas, and promote to all team members to share information with others.
  • Incorporate team huddles at each shift. Huddles sometimes meet resistance from staff, but successfully implementing huddles can greatly improve communication. One client survey showed an increase to 90% in communication by implementing huddles! Learn more.

This article was written by staff member Allison Duda.

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