Have you ever realized that the MDS boxes us in? The care plan is driven by the MDS. Hopefully you go way beyond the MDS but just in case you don’t, let this be some encouragement. Think outside the MDS box. The Section F Preferences indicated on the MDS are very good actually if you think of most interests most people have, which is precisely how a national form needs to be. However, we all know there is much more to a person than those eight interests indicated.
Also, a good reminder is that the M in MDS means minimal. Just this word, a word even in the title, infers we should be learning more about a person. Hopefully you already do this. I once conducted an audit of all resident activity profiles and social histories for the 80-90 people who lived in a certain nursing home. It was depressing. All that was discovered was the minimal eight MDS Section F Activity Preferences questions and not much more. I realized how sad it is for our lives to be minimized down to where we are born, go to school, whether we married and had kids and what our career was. This particular company did ask one question many do not however. It was, What do you wish you would have done more of? Perhaps not surprising was that the most common answer was travel. Let that inform you, by the way. Travel a lot with those who live where you work. Don’t plan all alone though. Use one month to plan with people who both live and work there. Then spread a travel theme out over a whole month. No need to hurry.
What matters to people? Dig deeper. Some falls take place because the person had a preference or routine of sitting or kneeling on the floor. We often don’t find this out until finding the person on the floor numerous times, talking about it maybe during care conference with the family and then finding out about the person’s habit of doing this. Would most assessment forms discover this? Probably not and yet a part of a person and definitely something we’d want to know. I recommend purposefully going outside the MDS. Ask for specifics, preferences, habits and routines.
And then simultaneously get these details in the care plan and don’t be afraid to tailor the care plan to the person – we’re supposed to. Imagine yourself the new team member needing to know the details of a person in order to take really good care of them.
I also suggest asking questions that matter.
What do you love?
What do you hate?
What are your pet peeves?
What are you passionate about/causes you care about?
A man living in a household nursing home was a comedian. A paid traveling comedian well known in his area. The caring team realized they could learn his jokes. They very intentionally learned them and set each joke up always giving him the opportunity to say the punchline which made everyone laugh. What a beautiful example of learning the details and then helping the person to continue at his highest practicable level of wellbeing!
An activity director discovered the few details of a resident’s life from the activity assessment including she was a classical pianist. One day when the woman was upset and almost hurting others to the degree the team didn’t know what to do and at their “wit’s end,” the wise activity director offered to play some classical piano music for her. This brought the person “twelve notches down” AND she even stated to the activity director, “You are good at your job.” This is proof there is power in the details of going deeper! Deep knowing. To be well known. Know the person. These are all principles of the culture change movement. Join us in changing institutional culture. One way to do it is to delve into the details of people’s lives.
Carmen Bowman, MHS, of Edu-Catering: Catering Education for Compliance and Culture Change is an activities/engagement/culture change consultant. As a regulator turned educator, she provides “be your own surveyor” training, also new or not-yet-qualified activity director consultation, and psychosocial wellbeing consulting for the whole team. Training videos now available on https://www.patreon.com/educatering