Nursing

Nursing staff includes Registered Nurses, Registered Psychiatric Nurses, Licensed Practical Nurses, and Health Care Aides. Nurses and Health Care Aides are on duty 24 hours a day. The care is overseen by the Resident Care Manager. Each shift is monitored by a charge nurse who is responsible to direct the care of each resident. All Health Care Aides are certified and are expected to provide care in a kind and compassionate manner.

Nursing staff believe that each Resident deserves the very best care that can be provided in order to promote, maintain and/or restore as much independence as possible. We assess individual abilities and try to provide comfort, support and dignity for each person. Nursing staff are available to discuss care issues, either in person or over the phone.

Nursing staff will assist you, if necessary, in daily grooming, dressing and hygiene. You will be provided with a weekly tub bath and shampoo. Regular eye, mouth, foot and nail care is maintained by nursing staff.

Nursing staff are your link to services provided by other members of the health care team (i.e. Physician, Occupational Therapist, Spiritual Care, and Maintenance). Referrals for these services will be forwarded on your behalf.

The University of Manitoba Dental Program provides dental services to Residents in personal care homes. Arrangements for these appointments can be made through the Nurse. You may also make dental appointments with a dentist of your choice. You are responsible for the fee charged and for the transportation cost.

It is strongly recommended that Residents have their dentures marked for identification prior to admission. Dentures can be labeled by our nursing staff on admission.

A podiatrist visits Bethania Personal Care Home/Pembina Place Personal Care Home every two months. Arrangements can be made through your Nurse. The fee for this service is payable by you and is recoverable through extended health care coverage. All Residents with diabetes are referred to the podiatrist for their foot care.

A Foot Nurse visits Residents requiring specialized toenail cutting, treatment of calluses and foot massage every two months. Arrangements can be made through your Nurse. The fee for this service is payable by you and may also be covered by an extended health care plan. An authorization form must be completed for foot care services. One is included in your pre admission package or at the nursing unit.

Abuse is defined as any mistreatment, whether physical, sexual, mental, emotional, financial or a combination of any of them, that is reasonably likely to cause death or that causes or is reasonably likely to cause serious physical or psychological harm to a person, or significant loss to the person’s property. Abuse of Residents is not an acceptable or appropriate practice and will not be tolerated at Bethania Mennonite Personal Care Home and/or Pembina Place Mennonite Personal Care Home. All Residents will be treated with dignity and respect by all staff at all times.

WRHA Geriatric Mental Health Teams can be consulted regarding care planning and approaches for Residents with difficult-to-manage behaviors. Aggression, excessive calling out, wandering and other disruptive behaviors may be cause for referral. These specialized teams assess the Resident in-house and collaborate with staff and family in the development of approaches. As well, the team provides education about the causes of difficult behaviors, prevention and management techniques.

The spread of disease among a group of residents is always of concern. Bethania Group abides by standards and procedures outlined by Manitoba Health to prevent the spread of infection. Staff take great care to ensure that appropriate techniques are utilized to minimize the risk of infection. Residents and families can assist us by maintaining good hand-washing techniques. Visitors are requested to refrain from visiting during times when they are ill. Residents are encouraged to provide permission to receive a yearly flu vaccination. We strongly recommend that families and friends receive a flu shot which is available from either their physicians or the Infection Control nurse at Bethania in early fall.

Bethania Mennonite Personal Care Home and Pembina Place Mennonite Personal Care Home recognizes that any mechanism used to restrict the freedom of movement of any Resident should be avoided if possible. Restraints drastically impede the freedom and normal lifestyle of any person. Restraint free care is promoted in order to encourage each Resident to remain as independent as possible and not infringe on the Resident’s rights and dignity. All other options will be tried before restraints are initiated. Bethania’s Restraint Policy is included in the Admission Package.

Therapeutic massage aids in pain relief, improved circulation, better nutritional absorption, increased or decreased muscle tone, relaxation, and better mobility in the joints, as well as rehabilitation of muscles and damaged tissues.

Residents wishing to receive massage therapy are encouraged to seek out a private Massage Therapist to arrange for visits to the facility. Payment is the responsibility of the Resident. Please be certain to inform the nurse if a Massage Therapist will be providing therapeutic massage to you/your family member.

The Minimum Data Set (MDS) is a clinical assessment tool that is in use in many personal care homes across Canada . Throughout your stay, we will be asking the resident and/or the family several questions to help us to assess the resident’s care needs. In turn, the answers help us create a care plan that is specific to the resident, providing the right care, at the right time. We will be entering the information obtained during our interviews into a computer database. By using a laptop computer to enter the information directly into the computer database, the staff can then spend more time in direct care activities. The information on the wireless network is protected from unauthorized users. Our staff that is involved in providing care will be using the information to help plan the best care possible. The Winnipeg Regional Health Authority will also be using information from the MDS system to look at the quality of care that is given throughout Winnipeg. Only authorized persons will have access to the information on this database.

Bethania Group has an Occupational Therapist on staff who will meet with the Resident after admission to assess functional abilities and make recommendations for any aids or equipment, including wheelchairs and walkers. Appropriate treatment will be outlined and modified as needs change.

In order to ensure appropriate selection of equipment, the Occupational Therapist must be consulted prior to purchase. The Occupational Therapist will assist with selection and purchasing of equipment to ensure appropriate sizing and comfort. The designated responsible party will be contacted regarding assessed needs and consulted for approval of purchases.

Bethania manages the personal health information of Residents in compliance with the Personal Health Information Act (PHIA). Your personal health information will be entered in a health record. This record will include your name, address, date of birth, Manitoba Health number, Personal Health Information number (PHIN), next of kin, and past medical, social and medication information. It may also include reports and progress notes from health care professionals involved in your care.

Staff are required to maintain the confidentiality of your health care record and are required to sign a Pledge of Confidentiality. You may request information from your health record. Bethania Group cannot release your health information to another person without your permission.

Requests for information from a health record should be made to your nurse who will contact Bethania’s Privacy Officer for involvement.

Also, prior to admission, you or your designated responsible party will be asked to sign a release form for permission to use your name or a picture of you in posters or the newsletter publication which are open to public viewing. You are not obligated to provide permission.

Prescription drugs covered by the daily Residential rate are ordered from the pharmacist on physician’s prescription and are dispensed by professional nursing staff. Payment for non-insured drugs is the responsibility of the Resident.

To prevent the harmful effects of some drug interactions, we request that after admission you do not use any medications or preparations without the knowledge and approval of your physician at Bethania and Pembina Place. If you are planning to be away from the facility, you will be provided with sufficient medication to cover the length of time you are away. Prescription medications generally should not be kept in your room.

Medications are reviewed quarterly by the physician, nurse and pharmacist and will be adjust if indicated. Medications are reviewed with the Resident and family members at the Post-Admission Conference and then yearly at the Annual Care Conference. Nurses will notify family members of medication changes prior to care conferences at their discretion. However, Residents and family members may ask the nurses about current medication regimes at any time.

Enacted in May 2001, the Protection for Persons in Care Act enforces the protection of persons in personal care homes and hospitals from mistreatment – physical, sexual, mental, emotional or financial. This legislation creates a formal process for reporting, investigating and resolving allegations and suspicions of abuse in health care settings.

Operators of personal care homes and hospitals must maintain a reasonable level of safety and protect patients from abuse. Under the legislation, concerned citizens and staff working in health facilities have a duty to report suspected abuse or the likelihood of abuse by anyone to the Minister of Health or his designate at the Protection for Persons in Care Office.

All Manitobans, particularly the most vulnerable, deserve to live in an environment free from fear of harm. This Act provides an extra safeguard, adding to the high quality of health care Manitobans have come to expect in this province.

Residents and/or their family members may contact the Protection for Persons in Care Office as follows:

Access Line: 204-786-7132 (or toll free 1-800-855-0511)

Fax: 204-775-8055

E-mail: protection@health.gov.mb.ca

Web site: Protection for Persons in Care

The physician may determine that a psychogeriatric consult is appropriate for Residents having psychiatric difficulties (e.g. changes in behavior, difficulty coping, depression). The Psychogeriatrician visits Residents at Bethania on physician’s order, at no charge to the Resident. The recommendations for care and medication management are reviewed by the primary physician and implemented when necessary.

Residents of Bethania and Pembina Place are assessed on an ongoing basis for the safest and most comfortable means of transferring to and from bed, wheelchair, and other surfaces. In accordance with criteria outlined in Bethania/Pembina Place’s Resident Transfer policy, some Residents require the use of an electronic lifting device for their daily transfers. One type of electronic lift, which completely lifts the Resident, requires the use of a sling in which the Resident sits. A Resident who uses an electronic lift on a regular basis is assessed by the Occupational Therapist for the most suitable size and type of sling for that Resident’s individual needs.

We advise that if Residents require use of an electronic lift, they are responsible for the cost of their own sling. With very few exceptions, one sling per Resident is adequate. The sling may need to be replaced due to wear and tear (e.g. every 2-3 years and/or as the Resident’s needs change). The Occupational Therapist will communicate with the Resident and/or family to discuss the need to purchase and the cost of the sling.

Residents requesting an internal transfer should discuss their request with the unit nurse or Social Worker.

We support an “aging in place” philosophy which seeks to minimize internal transfers. Internal transfers will be permitted when the health care team, in consultation with family, assesses another unit or room as better suited to meet a Resident’s identified nursing care, behavioral, and/or social care needs. The health care team is not obliged to comply with a request for a transfer within the facility if they do not assess that the benefit outweighs the cost of disrupting the Resident’s stability.

While it is regrettable, at times the health care team may need to weigh the costs and benefits of transferring one Resident to meet the needs of another. Transferring a Resident to benefit another shall only be done when a Resident transfer is considered urgent and no other options are available. Residents and family members will be consulted prior to any move.

To Another Facility: Residents and/or the designated responsible party wishing a Resident transfer to another facility are to refer their request to the Social Worker who will initiate the application to the personal care home requested.

To The Community: Residents and/or the designated responsible party wishing a Resident discharge to the community must first refer their request to the Social Worker who will arrange for a home care assessment to determine whether the necessary supports may be provided in a community setting.

Before leaving the facility, Residents and/or their families must inform the nursing staff on the unit regarding time of departure and expected time of return. The daily Residential charge continues to be payable to the Home for any period of social leave absence. Generally, these should be for no more than a total of 21 days in any year.

When Residents leave the facility for an outing they or their loved ones must advise the nurse and sign the outing book at the nursing station.

Social Workers function in a variety of roles, all of which are aimed at promoting the Resident's optimum adaptation and psycho-social functioning within their environment. Also may initiate interventions that aim to retain, strengthen and broaden the Resident's social support system and promote interventions that maintain or enhance Resident dignity, coping, and self-fulfillment. As well, the Social Worker acts as a Resident and family advocate in relation to interactions with the health care team, facility administration, and external service providers/agencies.

The Social Worker facilitates admissions, transfers, and discharges from the facility. Before and after admission, the Social Worker assists families and significant others with managing caregiver stress, coping with their loved one's health issues, provides advice in negotiating the health care system, and offers suggestions to manage stressful family dynamics which impact the Resident's and family's well-being.

Residents and/or their families may meet with the Social Worker at any time (appointments preferred). Interventions may include counseling, providing education, or providing practical advice/assistance.