Upon a new admission, if a Residents does not have a community physician that has attending practices and agreements with the home, the home will obtain a physician for you. Each Attending Physician is required to sign an annual contract with the facility, and attending Physicians must meet the standards of criteria established by the government. Physicians have the right to accept or decline a Residents application. The home has created a pamphlet in the event you wish to obtain a new physician.
Medication and Treatment Management
Medications/treatments are prescribed by the doctor only and are administrated by a Registered Nurse or Registered Practical Nurse. No medication of any kind may be left in the Resident’s room. Not all medications/treatments are covered by the Ontario Drug Benefit Program (ODB) or the Government Pharmacy. There may be a charge for these medications that are not covered.
Each unit in the Home has a dedicated Registered Practical Nurse (RPN) who is responsible for the care and management of the residents on that unit. Some of their primary duties include:
- Administering prescribed medications
- Completing prescribed treatments
- Supervising and monitoring nursing staff
- Coordinating daily administrative duties, including nursing assignments and Resident care
- Overseeing Resident admissions, transfers and discharges
- Mentoring and training new staff and providing support and guidance to all staff members
- Monitoring medical charts and providing compassionate care and assistance to Residents and families
- Liaising with doctors and Administrator/Director and communicating any protocol changes to staff
- Ensuring compliance with all health and safety regulations
- Recording and maintaining accurate reports
- Identifying issues or emergencies and responding efficiently
Activities of Daily Living (ADLs)
Activities of Daily Living (ADL) are everyday functions and activities that individuals usually do without help. ADL functions include bathing, dressing, toileting, transferring, mobility, eating, personal hygiene, oral care and bed mobility. Care plans are developed to maximize the Resident’s independence in each of these tasks and all ADLs are identified in the plan of care. Below are the levels of independence/dependence.
- Independent – Resident can complete a task independent of staff or others.
- Supervision required – Resident requires oversight or prompting/cuing to complete a task
- Limited assistance required – Resident is very involved in a task, but staff help providing non-weight bearing assistance, such as guiding limbs through a piece of clothing
- Extensive assistance required – Resident is involved in a task, but staff provide assistance and weight-bearing support, such as lifting legs to put into clothing
- Dependent – Resident is not involved in the task and staff perform the entire activity daily
All Residents will receive x2 whirlpools in a 7 day period. Alternate bathing tasks can include a shower or a complete bath at bedside. Resident’s preferences will be noted in their care plan. This is in addition to AM and PM care being provided (if needed).
The ability to select appropriate clothes and outerwear, using the appropriate sequence and steps and to dress self independently, or with the appropriate level of assistance. Residents should be dressed in the AM for daytime and change into sleepwear in the PM for bedtime. This will be modeled around personal preference.
How the Resident uses the toilet, commode, bedpan, or urinal; transfers on/off toilet; cleanses self after elimination; changes pad; manages ostomy or catheter; and adjusts clothes. Continence is having complete control of bowels and/or bladder. Incontinence is having lost some or all control of bowel and/or bowel. Products are available for Residents use if their continence level changes. Incontinent products can be used for protection to absorb and lock away urine and feces so that leakage does not occur and the Resident’s skin is kept dry and healthy. Some Residents may request incontinent products for peace of mind and dignity. All Residents are assessed on admission, quarterly and as needed to ensure the appropriate products and level of care is provided.
The ability to move from one place to another, specifically in and out of a bed or chair. All Residents are assessed on admission, quarterly and as needed to ensure the appropriate amount of assistance is provided. Physiotherapy will assess for potential gait aides/mobility aides if required to maintain safety. A picture logo is placed in each Resident’s room to identify their transfer status to ensure continuity with assistance provided. All Residents are assessed on admission, quarterly and as needed to ensure the appropriate level of care is provided for this task.
The ability to move freely in one’s environment without restriction. This includes being able to walk or transfer with minimal assistance, and/or mobilize in a wheelchair around the home. All Residents are assessed on admission, quarterly and as needed to ensure the appropriate level of care is provided for this task.
The ability to get food from plate to mouth (reaching for, picking up and grasping a utensil or cup) and to chew and swallow. This also includes intake of nourishment by other means (e.g., tube feeding, IV fluids administered for nutrition or hydration). Upon admission, quarterly and as needed, a Registered Dietician reviews each Resident to ensure proper food and fluid texture and assess for any assistive devices that may be required to maintain independence. Dining tasks also include cleaning both face and hands after each meal. All Residents are assessed on admission, quarterly and as needed to ensure the appropriate level of care is provided for this task.
How the Resident maintains personal hygiene, including combing hair, brushing teeth, shaving, applying makeup, washing/drying face and hands. This also includes cleaning the body using a shower, tub, or sponge bath. All Residents are assessed on admission, quarterly and as needed to ensure the appropriate level of care is provided for this task.
The process of keeping one’s mouth clean and free from disease and other problems (bad breath) by performing regular oral practices such as brushing teeth and cleaning dentures. This includes oral health assessments, preferences and daily oral hygiene tasks completed by staff. All Residents are assessed on admission, quarterly and as needed to ensure the appropriate level of care is provided for this task.
How a Resident can move to and from a lying position, turns side to side, and positions body while in bed or alternate sleep furniture. Staff assess assistance required to complete the task, which include the use of an assistive device to aid in turning and repositioning (bed rail) and positioning head on pillow, positioning legs or arms on pillow and positioning and repositioning side to side. All Residents are assessed on admission, quarterly and as needed to ensure the appropriate level of care is provided for this task.
A carefully prepared outline of nursing care showing all of the Resident’s needs and the ways of meeting them; a dynamic document initiated at admission and subject to continuous reassessment and change by the nursing staff caring for your loved one. Wherever possible, the care plan is developed with the Resident.
It is based upon a template which defines the areas the care plan covers. These areas typically include nursing interventions, and outcomes; and ensures consistency of care. They also focus on essentials of care – nutrition, sleeping, positioning, oral care, personal hygiene and falls prevention (to name a few).
Wound & Skin Care
Wound prevention and management can be challenging, particularly when a Resident is living with complicating factors or diagnosis’s that may increase the risk of new wounds or prolong the healing of existing wounds. Our health-care professionals must recognize that personal health, the environment and the context in which Residents live all impact skin integrity and wound healing. Ultimately, the body must heal itself, so the purpose of the health-care team is to optimize the body’s ability to prevent or heal a wound. Assessments identify all relevant factors, while interventions must acknowledge and align with a Resident’s culture and values.
The pain management program goal is to promote comfort and quality of life to Residents. Assessments on pain are done on admission, quarterly and when there is a change in status. The pain management program works closely with nursing (RN, RPN, PSW), physicians, physiotherapy, pharmacy and other community service providers.
We discuss pain management with physicians to advocate for Resident comfort. We also work with physiotherapy to review equipment and transfer options that may be contributing to pain.
Continence care programs are in place to ensure that Residents have an appropriate toileting program in place and if needed, the appropriate continence product (ie. pullup, brief, pad). Assessments for continence are completed on admission, quarterly and when there is a change in status. This team works closely with Nursing Restorative when needed to promote continence through prompted voiding or appropriate assistive devices (i.e. raised toilet seats). Our vendor, Attends has a comprehensive selection of products and excels in customer service.
Resident Care Conferences
Resident Care Conferences are also referred to as Multidisciplinary Care Conferences. At the time of admission, a nursing and medical assessment is completed for each Resident, and a plan of care is formulated, with input from the Resident and family. Within the first four to six weeks after admission, a conference is held for each Resident. The Resident is encouraged to attend if he/she desires and if it is appropriate. Family members, physician, nursing staff, activity director, food service supervisor, and any other personnel who are involved with the Residents care (or who could provide appropriate input), are asked to attend. The plan of care will be re-assessed at the conference. This conference is then held at least annually and offers an opportunity for all parties to communicate and maintain a consistent approach to care and quality of life for the Resident. Concerns or questions can be addressed to nursing staff anytime. This conference is an excellent opportunity to share information in an informal setting, at a scheduled time, with all departments represented. The Director of Resident Care and Administrator are also available for family conferences at other times as the need arises. Staff continually evaluate the plan of care and update the approach based upon Resident status. The Resident and family are encouraged to be active participants in all components: assessment, planning of care and evaluation of outcomes. Also, the Resident and family members are encouraged to become involved in the provision of care to the extent that they are able and willing. The Resident and or family member (Resident/POA/SDM) may have access to the plan of care upon request. If they require assistance to read or understand its contents and intent, this will be willingly provided. A registered staff personnel will be present while these documents are being reviewed.
Personal Clothing and Personal Aides
The facility is the Resident’s home and we like to have each Resident dressed in appropriate clothing of their choice. An adequate supply of clothing is essential. The home requests at minimum 7 days’ worth of clothing on admission. Permanent press clothing is preferred for ease of laundering. Woolens (natural and phentex), silks, cashmere, 100% cotton, 100% acrylic or fine fabrics are not suitable for our laundering system as they will not withstand our laundry hygiene system. General laundry services are provided by the facility.
On admission, the home will attach permanent labels to the Residents clothing. This is to ensure that the clothing is delivered to the appropriate Resident once laundered. Due to the possibility of cross-contamination, it is the policy of the facility that Residents’ clothing not be taken out of the facility for washing, other than items that require dry cleaning.
Any new clothing is to be dropped off with the front secretary. They will initiate the request for labelling and arrange for pick up from the laundry team. Once the labelling is completed, the item(s) will be placed in the Residents room in the appropriate space. The home provides the Residents with hangers for their closets.
For Residents that require daily or occasional use of aides such as glasses, hearing aids and/or dentures, please ensure they are labelled prior to admission.
We understand that hearing aids, dentures and glasses and clothing can be quite costly. It is frustrating for all parties involved when these items go missing.
It is important to note that Fiddick’s Nursing Home and Retirement Home Ltd is not responsible when these items go missing or are damaged unless a staff member is responsible. (i.e staff accidentally drops dentures when cleaning)
Suggested Clothing List for New Admissions
(Please ensure that all clothing is machine washable)
- 7 days’ worth of clothing (socks, pants, undergarments, shirts, pyjamas etc.)
- Non-slip Slippers
- Glasses, hearing aid(s), denture(s)
- Outdoor clothing (i.e. hat, coat, gloves and boots)
- Special toiletries (outside of what the Home provides, no bar soap)
** Please avoid clothing with washing instructions such as: hang flat to dry, gentle cycle, cold water only, dry clean or hand wash only**
Residents are encouraged to bring in a favorite chair, lamp, plants, and pictures to make their room more homelike, personal and comfortable. For safety and appearance reasons, please consult with the maintenance/environmental services team before hanging pictures or rearranging furniture as we can complete this task for you. In addition, items must be able to be cleaned as per infection control policies.
Resident/families must consult with the maintenance/environmental services team before purchasing personal appliances or operating such appliances in the facility to ensure it is CSA approved.
Memory foam items are not permissible unless it is contained in a high grade protector that can withstand daily disinfection and sanitization.
At times, the Home receives requests to change the interior curtains. It is important to note that all curtains in the building must be fire resistant material, and we ask that you do not bring in your own curtains.