EDUCATION STATION

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OBJECTIVES: At the conclusion of this series, the
participant will be able to:

1. Describe the regulatory expectations for addressing Trauma and Behavioral Health Services;
2. Explain the importance of understanding the symptoms and challenges associated with a diagnosis PTSD, Dementia, Mental Disorder, or Substance Use Disorder; and
3. Develop improved methods for the assessment and person-centered care planning for residents with behavioral health needs.

AUDIENCE: Appropriate to all clinical disciplines/positions

METHOD: Interactive Lecture 

DURATION: Two (2) 60-minute sessions

SUMMARY:

Phase Three of the revised Federal regulations for Trauma-Informed Care and Behavioral Health Services challenge long-term care facilities to ensure that they are fully prepared to care for residents with complex psychosocial needs. This two-part series offers an overview of the revised regulatory expectations and insight into policy development and staff education.

Part One will review the revised CMS regulations for Trauma-informed Care, with a focus on understanding and integrating the principles of trauma-informed care into daily practice. In the wake of the pandemic, the facility staff must have the ability to recognize and understand the nature of trauma and how post-traumatic stress impacts behavioral health and quality of life.

Part Two explores the concept of quality of life and the individual nature of satisfaction. The introduction of the Psychosocial Outcome Severity Guide requires long-term care communities look more deeply at the assessment and care planning process. This discussion will highlight strategies for policy development, staff education, and achieving and sustaining a culturally competent, trauma-informed environment of care. 

FOCUSED CONTENT:

Part One

• Trauma-Informed Care/Behavioral Health: Overview of Phase 3 Regulatory Compliance Requirements (30 minutes)
• The impact of the COVID-19 Pandemic on psychosocial well-being in long-term care (30 minutes)

Part Two

• Mental Health: Recognizing and Addressing Post Traumatic Stress Disorder (PTSD), Dementia, Mental Disorders, Traumatic Brain Injury, and Intellectual/Developmental disability (30 minutes)
• Communication and Coordination of Care: Assessment and care planning strategies; program development. (30 minutes)

OBJECTIVES: At the conclusion of this course, participants will be able to:

1.Describe the importance of a comprehensive, holistic assessment:

• a. Impact of disease process, chronic illness and comorbidities on quality of life, mood and behavior;
• b. History of lifelong psychosocial issues and coping skills; and
• c. Utilizing the MDS assessment tool to its full potential.

2. Develop team approaches to non-pharmacological interventions for mood and behavior:

• a. Integral role of the Physician as head of the clinical team;
• b. Coordination of medical, psychiatric, psychological and social interventions; and
• c. Creation of individualized, person-centered meaningful activity as the first- response to challenges of mood and behavior

3. Create a satisfying, livable environment:

• a. Assessment of the personality of the living and working environment;
• b. Understanding the impact of human nature on care relationships, mood and behavior; and
• c. Develop proactive education and quality monitoring systems to maintain a quality, satisfying environment of care.

SESSION ONE: The Dementia Epidemic

The intent and objectives of this course are reviewed in tandem with the revised Federal regulations for trauma-informed care and behavioral health. The numbers of long-term care residents with dementia grows every day, resulting in new challenges to achieving quality-of- life and psychosocial well-being. This conversation offers a fresh perspective on developing a person-centered assessment and care plan process.

SESSION TWO: Do You Know Me?

Dementia affects every victim differently. This conversation explores the most effective methods to capture a truly person-centered view of the individual. Addressing the needs of each resident requires a holistic approach to understanding the pre-dementia personality and lifestyle. Comorbid conditions, such as depression or anxiety, require careful consideration in the development of the care plan. This session revisits some of the tools introduced during the dementia focused survey project and their value in today’s assessment process.

SESSION THREE: Creating a Livable Environment

How do you measure the quality of life of an individual? How do you describe the culture of your long-term care community? In this session, we will explore the elements and circumstances that resulted in an environment that is truly livable. The COVID-19 Pandemic has had a devastating effect on long-term-care as an industry and as individual communities. This session offers a blueprint for rebuilding your community and achieving the cultural confidence and trauma informed perspective required to promote healing and recovery.

SESSION FOUR: Compliance and Quality

The revised regulations for residents’ rights require that we establish clear criteria for establishing capacity, particularly as it relates to the admission to and discharge from a secure memory care unit. In this final conversation, we will review the elements required for a compliant memory care environment. Additionally, we will review the intent and value of utilizing the Quality Assurance Performance Improvement process to ensure that your hard work is sustained over time.

OBJECTIVES: At the conclusion of this session, the participant will be able to:

1. Describe the regulatory expectations for trauma-informed care;
2. Explain the regulatory requirements for admission, transfer and discharge of residents;
3. Recognize the impact of relocation stress on residents with dementia; and
4. Develop improved methods for the assessment and person-centered care planning for residents with behavioral health needs.

AUDIENCE: Appropriate to all clinical disciplines/positions

METHOD: Interactive Lecture 

DURATION:  60-90 minutes

SUMMARY:

Easing the transition from home to a long-term care community remains a challenge for many organizations. For most, the move is a last resort. A diagnosis of dementia heightens the individual’s emotions and increases the risks of untoward events, such as falls, altercations and elopements. This session offers an overview of the revised Federal regulations for admission, transfer and discharge and guidance in policy development. Insight into understanding and addressing relocation stress for people impacted by dementia is a focus of this conversation.

CONTENT:

1. Overview of the regulatory expectations for person-centered, trauma-informed care planning; (15 minutes)
2. Review of the federal regulations for admission, transfer and discharge; (10 minutes)
3. Discussion on assessment and evaluation of impact of relocation stress on new admissions diagnosed with dementia; (25 minutes) and
4. Discussion on developing coordinated team strategies for minimizing the potential for re-traumatization. (25 minutes)

OBJECTIVES: At the conclusion of the presentation, the participant will be able to:

1. Explain the regulatory expectations relative to resident quality of life and psychosocial well-being;
2. Describe the reasonable person concept and the influence of the community culture in matters of advocacy; and
3. Develop a culturally competent community that recognizes and values the rights and responsibilities of every individual.

AUDIENCE: Appropriate to all disciplines and positions

METHOD: Interactive lecture 

DURATION: 90 minutes

Summary:

The October 2022 revisions to Phase 3 of the RoP introduce several new and important considerations in achieving compliance in areas relative to residents’ rights, quality of life, and psychosocial well-being. Cultural competence requires the community to consider how you define what is “reasonable” in various scenarios of potential psychosocial harm. This session is intended to offer a framework for integrating the revised standards into daily practice. In a community where a majority of residents are challenged by cognitive decline, advocacy becomes vital to the quality of life and support of each resident. 

CONTENT:

• Overview of the revised regulatory expectations relative to resident quality of life and psychosocial well-being; (30 minutes)
• Discussion on the reasonable person concept and how the influence of the community culture affects matters of advocacy (30 minutes) and
• Keys to developing a holistic approach to improved quality of life. (30 minutes)

OBJECTIVES: At the conclusion of the presentation the participant will be able to:

1. Understand the revised Federal regulations on Activities and Behavioral Health and how they apply to therapeutic activity services.
2. Define the elements of “meaningful” as they apply to the changing demographic in long term care.
3. Achieve true “culture change” through the creation of environments in which meaningful activity is central to the well-being and daily routine of each resident.

AUDIENCE: Activity Professionals, Licensed Nurses, CNAs, SWs, Rehab

METHOD: Interactive Lecture

DURATION: 2 hours

SUMMARY:

Part I

This interactive program is designed to provide caregivers involved in facilitating therapeutic activity and behavioral interventions with ideas and strategies for satisfying the needs of a rapidly changing population. Discussion is focused on developing a team approach to the provision of meaningful activity and the benefits of a well-coordinated, interdisciplinary program of activity designed to engage and divert, particularly in cases where challenging behaviors are being addressed. 

Part II

This section of the presentation provides professional caregivers a framework for developing an assessment process that results in a deeper understanding of what motivates someone to do what they do. With greater understanding comes a more focused, personalized care plan to accommodate the complicated needs of every individual. Transitioning to new program structures to align with the focus on psychosocial well-being and trauma-informed care will also be discussed.

OBJECTIVES: At the conclusion of this program, the participant will be able to:

1. Describe the impact of the COVID-19 Pandemic on the culture of long-term care relative to behavioral health, psychosocial well-being, and quality of life;
2. Explain the path long-term leaders need to take to re-define what is homelike for increasingly diverse communities; and
3. Achieve and sustain an environment of care that fosters a satisfying, holistic, person-centered approach to healing and recovery.

AUDIENCE:  Leadership

METHOD: Interactive Lecture 

DURATION: 90-Minutes

SUMMARY:

The COVID-19 Pandemic has changed the long-term care industry forever. Declining consumer confidence, inadequate human resources, and a shifting demographic require that we offer the type of community that will satisfy both the legal and human expectations for a quality existence.

This session is designed to inspire a new leadership perspective, moving all leaders to be creative and tenacious in meeting the challenges of the emerging culture of long-term care.

CONTENT:

1. Review of the impact of the COVID-19 Pandemic on the current and emerging culture of long-term care; (30 minutes)
2. Discussion on the steps necessary to creating an environment that meets the expectations of today’s regulators and consumers; (30 minutes) and
3. Strategies for achieving and sustaining an environment of care that fosters a satisfying, holistic, person-centered approach to healing and recovery. (30 minutes)

OBJECTIVES: At the conclusion of this session participants will:

1. Explain the importance of Sensitivity and Cultural Competence in achieving workplace harmony;
2. Describe the ways in which the organization can support everyone’s right to dignified treatment, in full recognition of their ethnic, religious, sexual, and cultural needs and preferences; and
3. Develop systems and approaches that meet the organization’s goals for quality of work-life and cultural competence.

AUDIENCE: Appropriate to all disciplines and positions

DURATION: 90 minutes

METHOD: Interactive Lecture

SUMMARY:

As the long-term care community becomes more diverse, representing a variety of ethnic and cultural considerations, long-term care communities need to ensure that staff understand and embrace the value of sensitivity and cultural competence in the workplace. This session explores the regulatory and employee expectations for dignified, fair and equitable treatment in matters of communication and responsiveness to the potential barriers to equity and harmony. This discussion will focus on developing a set of standards and practices that support effective and sustainable pathways to achieving the organization’s goals for inclusion, cultural competence, and quality of life.

CONTENT:

1. Discussion on the importance of Sensitivity and Cultural Competence in achieving workplace harmony; (30 minutes)
2. Evaluation of the ways in which the organization can support everyone’s right to dignified treatment, in full recognition of their ethnic, religious, sexual, and cultural needs and preference; (30 minutes) and
3. Strategies for the development of systems and approaches that meet the organization’s goals for quality of life and cultural competence. (30 minutes)

OBJECTIVES: At the conclusion of the presentation the participant will be able to:

1. Define lateral violence;
2. Identify methods to create a safe environment;
3. Discuss coping and stress reduction interventions; and
4. Create a safe, comfortable, and satisfying environment for everyone living and working in the community.

AUDIENCE: Appropriate to all long-term care disciplines and positions.

METHOD: Interactive lecture

DURATION: 75-minutes

SUMMARY:

The trauma associated with the COVID-19 Pandemic has been identified as the primary contributor to the deterioration in social behavior. Studies suggest that the isolation imposed by the pandemic has caused us to be less sensitive to others. In an industry challenged by insufficient resources, the resulting frustration and tension create the ideal environment for violence to occur. This session will define lateral workplace violence and identify trauma-informed approaches to minimize the potential for violence to occur.

CONTENT:

• Review of the impact of the COVID-19 Pandemic on LTC community culture: (20 minutes)
• Overview of lateral workplace violence: what it is and how it impacts relationships: (30 minutes) and
• Developing a trauma-informed community culture of safety, comfort, and satisfaction: (25 minutes)

OBJECTIVES: At the conclusion of this training, participants will be able to:

1. Explain the intent of the Federal regulations relative to trauma-informed care and behavioral health;
2. Recognize and appropriately respond to the signs and symptoms of mental health and substance use disorders;
3. Develop appropriate policies and procedures to address legal marijuana; and
4. Access effective programs and services to support healing and recovery across a broad demographic.

AUDIENCE:  Appropriate to all disciplines and positions

DURATION:  1-2 hours (adjusted to host’s timeframe)

SUMMARY:

The Federal regulations on Trauma-informed care introduced a new focus on ensuring long-term care staff is prepared to address a broader variety of behavioral health needs. Included are requirements for staff skill and competency in providing care to individuals diagnosed with post-traumatic stress disorder (PTSD), substance and alcohol use disorders, and related conditions like depression and anxiety. The COVID-19 Pandemic has added additional urgency to this need for staff education and training. National studies reveal a significant increase in adverse behavioral health conditions, including symptoms of anxiety and depression, or increased substance use to cope with stress or emotions related to the pandemic in many communities.