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									 PERSONAL CARE HOMES




   INFORMATION FOR
RESIDENTS AND FAMILIES
                                   TABLE OF CONTENTS
    INDEX
    PART 1 Application and Admission Process ............................... 4
    What does a personal care home (PCH) provide
    What does Supportive Housing provide
    How does one apply for a PCH/Supportive Housing
    Is there a waiting period
    Can an individual’s application to a PCH be refused
    What is Advance Care Planning
    PART 2 Personal Care Homes in the Region ............................... 7
    Choosing a Personal Care Home
    Personal Care Home Tour Sheet
    Bethesda Place
    Menno Home
    Repos Jolys
    Rest Haven Nursing Home
    St. Adolphe Personal Care Home
    Villa Youville
    Vita Personal Care Home
    PART 3 General Information About Personal Care Homes ... 23
    INTRODUCTION .................................................................................... 23
    Welcome
        Vision - Mission - Values
        Resident’s Rights and Responsibilities
        Abuse Policy / Protection for Persons In Care
        Ethical Framework for Decision Making
        Confidentiality
        Service Concerns
        Personal Care Home Standards
    ACCOMMODATIONS ............................................................................. 31
       Rooms and Furnishings
       Room Changes
       What to Bring
       Visitors
    FACILITY SERVICES ............................................................................. 34
       Laundry and Housekeeping Services
       Nutrition/Food Services
       Nursing Services
       Physician Services
       Pharmacy Services
       Recreation Services
       Spiritual Care
       Palliative Care
       Volunteer Services

                           Cette publication est aussi disponible en français.
2                            This publication is also available in French.
      Social Work Services
      Maintenance Services
      Regional Services
      Services for a Fee
FINANCIAL INFORMATION ................................................................ 39
   Residential Charges / Billing
   Cost Responsibility For Goods and Services
   Trust Accounts
   Valuables
   Responsibility For Loss or Damage
   Legal Issues
   Tips and Gratuities
   Resident Leave
   Mechanical Lift Slings
DAILY LIVING ........................................................................................ 44
   Television, Telephone and Internet
   Mail
   Alcoholic Beverages
   Smoking
   Pet Visits
   Dental, Hearing and Eye Care
RESIDENT SAFETY ............................................................................... 46
   Culture of Safety
   Fire Safety
   Security Systems
   Call Bell System
   Unsafe Items
   Restraint Usage
   Fall Prevention
   Medication Usage
   Responding to Behaviour
   Safely Home Registry
INFECTION CONTROL ......................................................................... 50
   Hand Hygiene
   Immunizations
   Outbreak Protocol
FAMILY INVOLVEMENT ...................................................................... 51
   The Value of Families
   Care Conferences
   Resident Council
OTHER HELPFUL INFORMATION ..................................................... 52
   Pet Visit Guidelines
   Tips for Visitors
   Gift Ideas for Residents
   Internet Resources for Families
   Acknowledgements and Sources of Information
 PART 1 - APPLICATION AND ADMISSION PROCESS
                                                                                                           3
           APPLICATION and ADMISSION PROCESS

    What does a Personal Care Home (PCH) provide?
    A Personal Care Home provides professional nursing
    care and personal care services to individuals who can no
    longer manage safely at home with family support and/or
    community services like Home Care.

    What does Supportive Housing provide?
    An applicant is panelled specifically for supportive housing.
    Funding for Supportive Housing comes from individual
    users. Costs include rental and service packages. Basic
    service packages include meals, laundry, housekeeping,
    laundry and home care Services. The cost of medications
    and personal items remain the individual’s responsibility.

    How does one apply for a Personal Care Home/
    Supportive Housing?
    An Application/Assessment form must be completed.
    These forms are available through the Home Care office
    in the region. This assessment determines the individual’s
    level of care which identifies the individual’s degree of
    independence and the time that will be required by staff to
    meet their care needs. Individuals are assessed by a Home
    Care Case Coordinator with the assistant of the individual
    and the family in the following areas:
            Bathing and Dressing
            Assistance with meals/feeding
            Ambulation/mobility/transfers
            Elimination
            Professional Intervention
            Behaviour Management/Supervision

    On the application form, the applicant must indicate
    their first, second and third choice of personal care home.
    Applicants and their families may wish to visit several

4
homes before deciding which one(s) they would choose. Part
2 of this handbook gives a listing of all personal care homes
in the region as well as some helpful tools for applicants
and their families when choosing a home.

The Home Care Case Coordinator presents the application
at the regional Panel Review Committee meeting for review
and confirmation of eligibility for Supportive Housing or a
Personal Care Home.

Paneling is the approval process for admission to the
Personal Care Home program. The Panel Review
Committee’s role is to review the application information
to ensure the most appropriate care option has been
determined. The day the application is approved by the
Panel Review Committee is referred to as the “Panel Date”.
An individual’s place on the wait list for a home depends on
the date of panel.

If the Panel Review Committee denies the individual’s
application, the Home Care Case Coordinator will discuss
community or other options with the individual/family. A
decision may also be deferred if additional information is
required.

Is there a waiting period?
There may be a waiting period before the applicant can
be admitted to the personal care home. During this time,
home care services may be provided as necessary. If you
require admission immediately or are in hospital, you may
be asked to relocate to a different care facility until you can
move to the personal care home of your choice. If you accept
an interim facility, this does not affect your place on the
waiting list for the home of your choice.



                                                                  5
    While in the hospital waiting for a personal care home, the
    applicant is required to pay the per diem rate as set out by
    Manitoba Health.

    Can an individual’s application to a personal care
    home be refused?
    Yes. Before a person moves to a personal care home, a
    staff member from the home either visits the individual or
    consults with current care providers to ensure the home can
    meet the care needs. A personal care home may decline an
    individual’s application if the needs cannot be met in the
    home. Home Care staff will then explain the reasons for
    refusal to the applicant.

    What is Advance Care Planning?
    An Advanced Care Plan ensures that your wishes regarding
    your care will be heard and respected, even if you become
    too ill to speak for yourself. Advance Care Planning
    requires good communication with your family, your doctor,
    and other health care providers. It ensures preparation
    for decisions that may need to be made about your future
    medical care and treatment. Things to consider are your
    concerns, expectations and preferences related to your
    condition and the care that would or would not be of benefit
    to you. The Advance Care Plan contains details of the goals
    for your care, proposed treatments and directions for care
    and is kept in your health record.

    Residents and families are encouraged to have discussion
    around this topic prior to the resident moving to the
    personal care home. The resident’s wishes and expectations
    will be discussed and recorded at admission however
    residents/families can make changes at any time.




6
 PART 2 - PERSONAL CARE HOMES IN THE REGION

Choosing a Personal Care Home

Individuals may choose to live in one of the seven personal
care homes in the region or apply for a home outside of the
region.

Information on personal care homes in the region are
provided in the following pages. Individuals may want to
consider the following when choosing a personal care home:
  - location (proximity to family and friends);
  - culture / language / faith perspective of the home;
  - smoking policy;
  - contract services available;
  - outdoor areas;
  - recreation options.

We encourage individuals/families to visit several homes
before making a final choice.

The table on the following page may be helpful for
recording information when touring a facility.




                                                              7
    Personal Care Home Tour Sheet

    Things to Consider     PCH #1__________ PCH #2__________
    Location


    Specialty Units
    (ie: dementia unit,
    secured unit)

    Cultural/
    Language/Faith
    Considerations (ie.
    languages spoken,
    ethnic meals, faith
    perspective)
    Smoking Policy




    Contract Services
    Available (ie. music
    therapy, massage
    therapy)
    Outdoor Areas,
    Features (ie. paths,
    laptop gardens,
    access)
    Activities Available




                           Contact Information Contact Information



8
BETHESDA PLACE

Location: 399 Hospital Street in Steinbach, Manitoba
Mailing address: 316 Henry Street, Steinbach MB R5G 0P9
Telephone: (204) 326-6411

Bethesda Place opened in 2002 and provides a home-like
setting for 60 residents. It is adjacent, and linked for easy
access, to Bethesda Hospital.

The 36,000 square foot, single storey building is designed
in four community groupings, or pods of 15 residents, each
with their own private
room and wash room. Two
pods share a resident care
centre and secure outdoor
garden area. Each pod
features a family lounge,
kitchenette and dining area
where residents are served
their meals.

The pods are named and
each has a complimentary
color scheme: Blueberry Bay, Prairie Rose, Willow Way,
and Cranberry Cove. This unique visual identity of each
community group helps residents and visitors find their
way “home”.

Rooms have been designed with residents’ safety in mind,
without foregoing the little extras that provide a sense of
home. A large picture window in each room opens from the
top to keep drafts away and offers a barrier-free view. The
window also has a wide sill for plants and other personal
items. As well, a glass fronted memory box located in the
hallway outside each room, allows residents to display
personal treasures.
                                                                9
     Furniture can be
     arranged in several
     configurations. Each
     room has a private
     sink and toilet area.
     Three rooms in each
     pod are equipped with
     ceiling lifts for those
     who have difficulty with
     transferring. Each pod
     has a bathing room with
     a whirlpool tub. A shower
     is available for those who
     prefer.

     The family lounges are decorated with art, quilting, and
     pottery from local artists. This provides a cozy atmosphere
     where residents and their families can spend time together.

     As with every community, the downtown area is where the
     hair salon, laundry area, quiet room (for families attending
     to their loved ones), and Stoney Brook café can be found.
     The chapel, located nearby, features beautiful stained
     glass windows, which represent some of our rich history.
     Symbolized through this artwork are the names Steinbach
     (which means stoney brook) and Bethesda (meaning
     healing pool).

     The “great room”, at the centre of the home, is a traditional
     gathering area, the natural gas fireplace provides a homey
     atmosphere. Just off the great room is Tillie’s garden. This
     is an enclosed, inviting, garden area with many features,
     including a gas barbeque, gazebo area, fire pit, and benches
     placed along a walking path. Residents and families
     are invited to use the garden area and great room for
     gatherings.

10
MENNO HOME

Location: 235 Park Street in Grunthal, Mantioba
Mailing address: 235 Park Street, Grunthal MB R0A 0R0
Telephone: (204) 434-6496

Built in the mid-
1980’s, Menno Home
accommodates up to
40 residents in single
rooms. The single-story
home is designed in
an “L” shape, linked
to an independent
living unit operated
by Manitoba Housing
to form a “U”. A large,
interior courtyard with
patio and green space
provides an enjoyable, peaceful, and natural area for the
residents and their families.

The personal care home was incorporated in 1960 and is
owned and operated by the churches of Grunthal. Services
are provided under contract with South Eastman Health/
Santé Sud-Est.

The entry of the home opens into a large, bright, cathedral-
ceilinged area in which are the dining room, resident lounge
and activity area.

Residents’ rooms are arranged in two wings of 20 rooms
each. A nursing, administrative and service area is in
the centre of the home. Two bathing rooms with tubs are
located in this area.


                                                               11
     Residents’ rooms are
     furnished with a bed, night
     table and chest of drawers
     and have a washroom with
     sink and toilet. Residents are
     encouraged to bring some of
     their own furnishings.

     There is a small kitchenette
     in the main activity area
     where family and friends
     can prepare meals.

     Menno Home has a part-time chaplain who provides
     bible studies, morning devotional services and spiritual
     counseling. Participating churches conduct Sunday worship
     services on a rotating basis.

     An occupational therapist is available every two weeks for
     half a day. A physician visits the home twice monthly.
     A variety of services, on a fee-for-service-basis, are offered
     regularly in the home, including foot care, hair styling,
     massage therapy and music therapy. A chiropractor’s visit
     can be arranged on request.




12
REPOS JOLYS

Location: 354 Prefontaine Avenue in St. Pierre, Manitoba
Mailing address: Box 320, St. Pierre-Jolys MB R0A 1V0
Telephone: (204) 433-7611

Opened in December
1995, this bilingual
personal care home
accommodates 22
residents in single
rooms. It is part of
DeSalaberry District
Health Centre which
also includes a hospital,
physician and dental
clinics, and community
health services offices.

The foyer of the home features a gas fireplace and opens
into a large common room that serves as an activity and
dining area. Adjacent to this area is a meeting room that
can be partitioned to serve as a chapel and quiet room for
visiting family and friends. A kitchenette is available for
family in the activity area.

A physiotherapy treatment room for residents and the
general public is attended by a physiotherapist once a
week. A hairdressing salon is operated once a week by a
hairstylist, or family can use the space to do a resident’s
hair. Nearby is a sunroom that opens onto a small patio/
green space overlooking Joubert Creek. The sunroom
doubles as a greenhouse from late winter to early spring
where residents are encouraged to participate in the
gardening activities.


                                                              13
     The living area, comprised of
     a north and west wing in a “V”
     arrangement, is connected to
     the main activity area through
     a doorway that can be secured
     at night.

     A nursing station and services
     area, including bathing and
     shower facilities, are adjacent
     to the entranceway.

     A resident’s lounge, which
     can be closed to accommodate
     private family visits, is also in
     this area.

     A large patio, garden area/
     green space and walking path
     in a secured setting can be
     accessed through the lounge
     and from the end of each wing. Several elevated planting
     areas are accessible to wheelchair-bound residents.

     Each resident’s room features a photograph of the
     resident outside the door. Each room includes a bed, night
     table, built-in drawers, and clothes closet. Each room
     has a washroom with sink and toilet. There is space to
     accommodate a favourite chair providing the resident
     does not require a wheelchair. One room in each wing can
     accommodate couples.

     Group and one-on-one
     recreational activities
     are available for
     residents.

14
REST HAVEN NURSING HOME

Location: 185 Woodhaven Avenue in Steinbach, Manitoba
Mailing address: 185 Woodhaven Avenue, Steinbach MB
                  R5G 1B4
Telephone: (204) 326-2206

Rest Haven Nursing
Home had its beginnings
in 1946 with six residents
in the home. Today, Rest
Haven Nursing Home
can accommodate 60
residents in single rooms.
It is a private, non-profit,
faith based, personal care
home licensed and funded
by Manitoba Health. It
is owned and operated
by seven area Evangelical Mennonite Conference churches
that have a representative(s) on the Board. Rest Haven is
attached to Woodhaven Manor, a six story, 86 unit 55 plus
building with 66 life lease suites and 20 rent-geared-to-
income suites.

Rest Haven is committed to provide long term care to
the residents in a Christian environment. Many of our
programs and spiritual services are geared for those of
the Mennonite heritage. We also emphasize a “holistic”
approach to care which includes the physical, emotional,
social, spiritual and intellectual needs of each resident
regardless of age, race or religion. Rest Haven Nursing
Home is committed to providing care with dignity and
respect. This care extends to the residents’ families and
social communities who are encouraged to participate in
the life of the home.

                                                            15
     In addition to nursing and
     medical services, our care
     services include social work,
     recreation, chaplaincy and
     volunteer services. Rest
     Haven has a full recreation
     program schedule supported
     by many volunteers that
     work towards improving the
     quality of life for our residents.
     We provide complete food
     services, including an on-site
     kitchen, and pride ourselves on
     homemade cooking that caters
     to the Mennonite heritage.

     Rest Haven also has one respite
     room that provides short term
     care for those persons residing
     in the community, whose care
     giver is in need of respite. This
     service is accessed through
     Home Care.




16
ST. ADOLPHE PERSONAL CARE HOME

Location: 420 Main Street in St. Adolphe, Manitoba
Mailing address: Box 40, St. Adolphe MB R5A 1A1
Telephone: (204) 883-2181

St. Adolphe Personal Care Home is located along the banks
of the Red River in the quiet community of St. Adolphe,
Manitoba - a 10 minute drive south of the City of Winnipeg.

St. Adolphe Personal Care Home,
formerly a convent, has been
in operation since 1972. It can
accommodate 42 residents. The staff
members are highly qualified, caring,
trained professionals, many who are
long term staff and many who are
bilingual. These include:
• A Physician, Dental Team,
  Occupational Therapist and Foot
  Nurse all who come to the home
  on a regular rotation. A speech
  Language Therapist is available
  as required.
• There is a nurse on duty 24 hours
  a day to administer medications,
  provide treatments and monitor resident care.
• Certified Health Care Aides who assist the residents in
  meeting their individualized care needs.
• Dietary staff who provide home cooked meals, including
  specialized therapeutic diet menus. A Registered
  Dietitian is on staff to assess residents’ nutritional needs
  and develop a nutritional menu.
• Laundry, housekeeping and maintenance staff who work
  diligently to provide a clean, safe environment.


                                                                 17
     • A Therapeutic Recreation
       Facilitator, with the
       assistance of a volunteer
       contingent, plans, organizes
       and provides a wide variety
       of programming 5 days
       a week, including many
       outings into the community
       and Winnipeg.
     • Pastoral Care is provided on
       a regular basis and as needed
       by a dedicated, caring team of
       pastoral volunteers.
     • A Hairdresser works part
       time providing a full range
       of hairdressing services at a
       minimal cost.

     As this is the Resident’s home,
     they are encouraged to voice
     their opinions and there is
     an active Resident Council
     facilitated by the Recreation
     Director. There are large
     private and semi-private
     rooms located on two floors.
     The Residents are encouraged
     to bring in personal effects to
     create a homey atmosphere.

     Staff at the St. Adolphe
     Personal Care Home are
     dedicated to providing resident-
     focused, individualized care and
     services.


18
VILLA YOUVILLE

Location: 15 Charriere Road in Ste. Anne, Manitoba
Mailing address: 15 Charriere Road, Ste. Anne MB
                 R5H 1C9
Telephone: (204) 422-5624

The Villa Youville is a
Francophone Personal
Care Home which
officially opened on
September 27, 2002,
replacing an existing
facility that was first
constructed in 1964.

Villa Youville combines
a new state of the art
single story 46,000 square foot personal care home with
an 85-suite seniors housing complex and a soon to be built
(2009) additional facility containing 24 supportive housing
and 5 assisted living units. It can accommodate 66 residents
in single rooms. The facility is located in a park-like setting
on the banks of the Seine River, 25 minutes east of the city
of Winnipeg on the Trans-Canada highway.

The view from inside features our beautifully landscaped,
quiet river lot. Adjacent to the entrance, our café area
serves both the seniors complex and families and friends
visiting the personal care home. It overlooks an extensive
patio/green space area which is open to visitors and
residents. Various spaces within the facility can be utilized
for small family gatherings.

The proximity to the church, hospital, medical clinic,
pharmacy, chiropractor, physiotherapy and a dentist

                                                                  19
     office (all within the
     same block) makes us
     somewhat unique in the
     quality of services that
     we can offer.

     Life at Villa Youville is
     greatly enhanced by the
     numerous volunteers
     who come from the
     community at large as
     well as from the adjacent
     Elderly Persons Housing
     complex. They provide the link
     to acquaintances and life outside
     the Villa. Numerous school
     programs also contribute to the
     development of community spirit
     by promoting the inclusion of
     the Villa clients in the daily life
     of the students. A connection to
     the religious community is also
     assured by a live broadcast of the
     Sunday mass in our great room.

     One of the attractions
     of Villa Youville is the
     ability to live in the
     Elderly Person Housing
     complex and be close to
     a loved one living in the
     attached Personal Care
     Home.




20
VITA PERSONAL CARE HOME

Location: 217 First Avenue West in Vita, Manitoba
Mailing address: Box 160, Vita MB R0A 2K0
Telephone: (204) 425-3804

Vita Personal Care Home
is located in the Vita and
District Health Centre
which also includes
a hospital, doctors’
clinic and community
health services offices.
On entering the home,
visitors and residents
are greeted by a mural
depicting a country scene
of bygone days.

This personal care home was built in 1976 with renovations
and the addition of 14 rooms taking place in 1992. The “L”-
shaped home has two single-storey wings; cedar lane and
spruce trail that accommodate 44 residents in single rooms.
The two wings branch from a central area that includes the
nursing station, bathing and shower rooms, and residents’
lounge.

The facility has a large courtyard which offers a restful
soothing place to lounge during the summer with its green
space and paths located in a secure setting.

The facility offers a gated park-like setting known as the
“Dr. Toth Memorial Park”. The park offers a grape arbor,
resident accessibility, elevated planting areas that are
wheel-chair accessible for residents to plant small gardens,
a flower garden, a water fountain and park benches.

                                                               21
     Residents’ rooms are furnished
     with a bed, dresser, mirror,
     night-stand and chair.
     Residents can bring some of
     their own furniture. Each
     room has a telephone jack,
     cable television hook-up and a
     private washroom with toilet
     and sink.

     The dining room and activity area are accommodated in a
     large common area with a kitchenette in the activity area
     and a small tuck shop.

     Large and small group activities as well as one-on-
     one recreational activities are available for residents.
     A program of activities include such things as baking,
     exercise groups, games and outings. A calendar of the
     month’s activities is posted in each of the residents’ room
     at the beginning of each month. A birthday party is held
     monthly for residents with entertainment provided by a
     singing group.

     There is a chapel with services held weekly led by
     multicultural denominations. A chaplain is available on
     site to provide spiritual care of patients in the hospital
     and residents of Vita Personal Care Home.

     The staff at Vita Personal Care Home provide caring
     and person-centered approach services. Residents of
     Vita Personal Care Home have access to a variety of
     professional services including; weekly hairdressing,
     physiotherapy and occupational therapy. Foot care is
     also available. All initiatives are intended to enrich and
     enhance the daily lives of residents.


22
      PART 3 - GENERAL INFORMATION ABOUT
              PERSONAL CARE HOMES

                  INTRODUCTION

Welcome

We trust that this Handbook for Residents and
Families will be helpful as you transition into your new
home. We are aware that this move is another one of the
big changes you have had to make in the past years and we
wish to make the adjustment both pleasant and positive.

Learning as much as possible about this new environment
can help relieve the stress associated with a new home. In
this handbook, we have tried to answer some of the most
commonly asked questions. You are encouraged to keep
this handbook so that you and your family can use it as a
reference from time to time.

As staff, we strive to live
out the concept that
we work in your home
rather than
you live in our work
environment.

This affects how we
interact with each other,
how we do our daily tasks
and how we see our job in general. We want our facility
to not only “look” like home, but “feel” like home.




                                                             23
     The following Mission, Vision, and Values statement and
     the Resident Bill of Rights provide the basis for all resident
     care throughout the region.

     Vision - Mission - Values

     Vision
     To achieve wellness and the best possible health by
     partnering with individuals, families and communities.

     Mission
     To pursue our Vision by providing quality health services
     supported by evidence-based decision making.

     Values
     We believe in INTEGRITY and are committed to being
     transparent and honest with our staff, our partners and the
     communities and people that we serve.

     We believe in a SHARED VISION and will work with
     our staff, partners, and community to ensure that a clear
     understanding of this vision informs all of our planning and
     work.

     We believe in RESPECT and recognize the value, equality,
     resourcefulness and resilience of individuals including
     staff, volunteers, patients and community members and are
     committed to responding with empathy, compassion, and
     respect for community diversity.

     We believe in PATIENT SAFETY
     and SERVICE EXCELLENCE
     and encourage all parts of the
     regional health delivery system
     to seek creative and innovative

24
solutions to deliver safe,
integrated, and quality health
services while maintaining
a willingness to change
and openness to continuous
learning and improvement.

We believe in demonstrating
PERFORMANCE
ACCOUNTABILITY by
providing a safe, responsive,
and sustainable health
care environment, through
responsible governance
and management practices,
prudent stewardship of
resources throughout the
organization, transparency
and good communication, and
by demonstrating integrity and
ethics in the interactions of the
total organization

We believe in COLLABORATION and are committed to
teamwork, consultation, and two-way communication with
our partners and regional communities in order to deliver
services in the most effective manner while respecting the
different needs and priorities of those with whom we work.

(Note: This is the South Eastman Health/Santé Sud-Est
Inc. Vision, Mission and Values document. Contract and
private homes may have a modified document which reflects
their religious or cultural background.)




                                                             25
     Resident’s Rights and Responsibilities

     South Eastman Health/Santé Sud-Est Inc. long term care
       facilities are dedicated to the provision of quality care.
       The document outlines the rights that every resident is
     entitled to, and supports the cooperation between residents,
                    family, and staff of the facility.

     Every resident has the right to information and
     freedom of expression:
     • To be informed of those matters which directly concern
        him or her within the centre.
     • To be informed of his or her medical condition,
        treatment and proposed course of treatment.
     • To have access to his or her health record in accordance
        with centre policy.
     • To give or refuse consent to treatment, including
        medication, and to be informed of the consequences of
        giving or refusing treatment.
     • To expect staff to identify themselves and the role they
        serve.
     • To have access to the procedures for initiating
        complaints or commendations.
     • To have access to any law, rule, or policy affecting the
        operation of the centre.
     • To own and display personal property in his or her room
        adhering to safety requirements and the rights of other
        residents.

     Every resident has the right to privacy:
     • To be afforded privacy in treatment and in caring for his
        or her personal needs.
     • To communicate or meet in private with any person
        without any interference.
     • To send and receive correspondence without any
        interference.

26
•   To expect that his or her personal, financial and medical
    records will be kept confidential and will be revealed
    only when essential.

Every resident has the right to hold responsibility
   and to participate:
• To make choices about his or her personal life or to
   designate a responsible
   party to act on his or her
   behalf in the event that
   health conditions preclude
   personal representation.
• To retain his or her
   autonomy and to receive
   assistance towards
   independence consistent
   with his or her abilities.
• To choose whether or not
   to participate in activities and to participate at a pace
   appropriate to him or her.
• To organize or belong to an association, and to express
   his or her opinions, recommendations and suggestions
   in the form of a Resident’s Council.
• To pursue social, cultural, religious and other interests.
• To exercise the rights of a citizen to raise concerns
   without any form of reprisal.
• To manage his or her finances in accordance with the
   law.

Every resident has the right to respect and dignity:
• To be treated with courtesy, dignity and respect in a
   way that fully recognizes the client’s uniqueness and
   individuality. Indicative of this respect is to honour
   the wish of the resident to be addressed as he or she
   desires.


                                                               27
     •   To be properly sheltered, fed, clothed, groomed and
         cared for in a manner consistent with his or her needs.
     •   To live in a clean, safe, and home-like environment.
     •   To be free from all forms of abuse.
     •   To die in peace with dignity and comfort in the presence
         of his or her family and friends.
     •   To enjoy outdoor activity through access to protected
         areas on the facility property.

     (Note: This is the South Eastman Health/Santé Sud-Est
     Inc. Resident Bill of Rights. Contract and private personal
     care homes may have a modified document which reflects
     their religious or cultural background.)

     Abuse Policy / Protection for Persons in Care

     Abuse of a resident is not tolerated in any personal care
     home in the region. All residents are to be treated with
     dignity and respect by everyone at all times.

     All homes ensure compliance with The Protection for
     Persons in Care Act (proclaimed in 2001) which is a law to
     help protect adult residents, patients or persons receiving
     respite care from abuse and to provide a reasonable level of
     safety while receiving care in a personal care home, hospital
     or any other designated health facility.

     In accordance with this legislation, it is mandatory to report
     suspected abuse promptly. Under this law, the definition
     of abuse includes physical, sexual, emotional and financial
     mistreatment. Any of these alone or in combination is
     considered “abuse” if the mistreatment is likely to cause
     death, serious harm or significant property loss.




28
Anyone having a reasonable basis to suspect a resident
is, or is likely to be abused, must promptly report this to
the Protection for Persons in Care Office which can be
contacted at:

        Protection for Persons in Care Office
                Telephone: (204) 788-6366
       Toll Free: 1 866 440-6366 (outside Winnipeg)
                    Fax: (204) 775-8055
               Email: protection@gov.mb.ca
        Website: www.gov.mb.ca/health/protection

Ethical Framework for Decision Making

South Eastman Health/Santé Sud-Est is committed to
making evidence-based decisions which incorporate the
values and beliefs of the region. Ethical dilemmas arise
on a frequent and ongoing basis in healthcare, including
personal care homes. An ethical dilemma occurs when there
is tension between loyalties, responsibilities, duties, rights,
or values which cannot all be satisfied in a particular
situation. There will be situations where there is no “one
right answer”.

Many dilemmas and issues are effectively managed by the
Board and its health care teams without need of a formal
process. However, for those occasions when an ethical
dilemma or issue arises of a nature that require/inspire/
challenge personal values versus professional and/or
organizational values, a more formal process needs to be in
place. The Clinical Framework/ Guideline for Ethical
Decision-Making may be used to guide professional/
clinical decisions. The Ethical Lens Guidelines will also
be used to direct and support any policy development as
they ensure that Ethical Principles and Regional Values
are reflected in the policy or procedure being developed.

                                                                  29
     A copy of the Ethical Decision Making Framework or the
     Ethical Lens Guidelines can be obtained at each personal
     care home.


     Confidentiality

     Under the Personal Health Information Act, all resident’s
     personal health information, recorded or exchanged
     verbally, is confidential. This confidential information
     is kept on the resident’s health record and is provided
     only to those individuals authorized to have access. This
     information is collected and shared between caregivers on a
     “need to know” basis in order to meet the resident’s ongoing
     care needs.

     Each resident/family must give written permission to
     disclose information such as birthdays, anniversaries, or
     photos within the home and/or local newspaper. All homes
     take all possible steps to ensure the individual rights of
     each resident are respected.

     Questions about the practices of collecting personal health
     information can be directed to the manager of the home.
     More information on the Personal Health Information Act
     can be found on the MB Health website at:
     www.gov.mb.ca/health/phia.


     Service Concerns

     Residents and/or families can direct any concerns to the
     applicable department manager or the facility manager.
     Verbal concerns should be directed to the first level
     supervisor, while written concerns in most cases can be
     directed to the Facility Manager. Most concerns can be
     successfully resolved at this level; however, if the concern

30
remains unresolved, individuals have the option of
meeting with the Vice President - Community and Long
Term Care. All service concerns are tracked regionally
and used for quality improvement purposes. Staff in all
homes strive to improve care and services. Furthermore,
resident/family comments and feedback are valued. Each
home distributes a Resident/Family Satisfaction Survey
on an annual basis to evaluate services.

Personal Care Home Standards

All personal care homes follow standards set by Manitoba
Health. These standards are taken from the Personal
Care Homes Standards Regulation. Personal care
homes must meet the performance measures for each
standard to maintain their licensing requirement.
An important part of the standards are educational
requirements for staff of personal care homes. A
Consultant Team from Manitoba Health visits all
personal care homes in the province on a regular basis to
evaluate each PCH’s compliance with the standards and
the performance measures.

A copy of the Personal Care Home Standards can be
obtained at each home. The Personal Care Homes
Standards Regulation can also be accessed through the
Manitoba Health website at:
http://web2.gov.mb.ca/laws/regs/pdf/h035-030.05.pdf.


               ACCOMMODATIONS

Rooms and Furnishings

Most homes have single occupancy rooms. Each room
comes equipped with a single bed, dresser, nightstand and
closet or wardrobe, a full length mirror, a chair, window

                                                            31
     dressings and a private washroom consisting of a toilet and
     sink. (St. Adolphe Nursing Home has shared rooms and
     shared washroom facilities.) Tub/shower rooms are shared
     within the facility and bathing is done with the assistance
     of nursing staff.

     Personalizing rooms is encouraged by hanging pictures and
     the use of personal comforters/bed spreads. Televisions,
     radio clocks, telephones can be brought in by the resident/
     family. Personal chairs can be accommodated if space
     allows however upholstery cleaning is the responsibility of
     resident/family.

     Room Changes

     Occasionally, changes in a resident’s abilities may require
     a room change. In this situation the home will assume the
     cost of cable and/or phone reconnection and will assist with
     moving personal items. Resident/family may also request a
     room change however the costs of the transfer would then
     be the responsibility of the resident/family.

     What to Bring

     Residents should bring all necessities on the day they move
     in. Residents who have dentures are encouraged to have
     them engraved with their full name.

     All clothing and linens brought in should be washable.
     Wool or dry clean only items are discouraged and are the
     responsibility of the resident/family for cleaning. All homes
     have a clothing labelling system which is provided by the
     laundry department for a fee. For easy tracking, clothing
     will need to be labelled before being placed in resident
     rooms.



32
Suggested clothing to bring:
  adequate dresses, pants, blouses, shirts
  (4-6); cardigans/sweaters (2-4); casual/
  comfortable leisure;
  outfits (3-4); appropriate underwear/
  stocking/socks (6-8); 1 or more pair, non-
  marking, skid free shoes and slippers;
  nightgown/pyjamas (4-6); housecoat;
  seasonal outerwear.

Clothing tips for families:
   for residents in wheelchairs or geri-chairs, family should
   consider loose-fitting, warm clothing of appropriate
   length;
   pants should allow for ease in toileting (i.e. suspenders,
   belts, and difficult fasteners/buttons are discouraged);
   gowns are provided for residents confined to bed;
   however, residents are encouraged to wear their own
   clothes whenever possible;
   families are asked to regularly check dresser drawers
   and closets to ensure contents meet the needs of the
   resident and removal of out of season clothing or unfit
   clothing;
   residents’ physical limitations may require the use of
   open back clothing. Families will be consulted when
   this need arises. We recommend the purchase of this
   clothing through specialized clothing companies. The
   home can assist families with purchase information and
   procedures.

Visitors

As this is the resident’s home, visitors are welcome anytime
of the day and evening. Your consideration is requested
when visiting at very late or early hours when nursing care
is taking place.

                                                                33
     Because our residents live in a community of others, we
     do ask that visitors are considerate of other residents.
     Children are encouraged to visit, however small children
     should be under adult supervision.

     All homes lock their doors during night time hours. Visitors
     can gain access through the doorbell or buzzer system.
     Families will be oriented to the security system of the
     home. All homes have free visitor parking. Please check
     with your home regarding specific visitor parking areas.

     All homes have safe access to outside areas that are
     available to residents and visitors. Please check with your
     home as some have rooms that can be booked for special
     events.


                     FACILITY SERVICES

     Laundry and Housekeeping Services

     All homes provide laundry services free of charge to
     residents, and include collection and delivery of clothes
     to the resident room. Minor repairs such as buttons,
     seam repairs and closures will be provided by the home.
     Housekeeping staff provide regular cleaning services in
     resident rooms.

     Nutrition / Food Services

     All homes have communal dining rooms which provide
     socialization as meal time and snack time are important
     daily social events for everyone. A daily menu board
     is posted in each home and meals can be purchased
     by visitors. All residents are assessed by a Registered
     Dietician who regularly visits to monitor all residents’
     nutritional status. All residents are assessed when they

34
move in for their swallowing
ability and risk for choking so
any adjustments can be made
to their diet to best meet their
needs.

When food is brought in by
families, we ask that only small
quantities be brought in to
be served by family during your visit. Family should also
consult with the nurse in charge prior to bringing in food to
ensure it is appropriate for the resident and before sharing
food with other residents. All personal care homes adhere
to the Manitoba Guidelines for Food Handling for resident
safety.

Nursing Services

All homes provide 24 hour nursing care with a nurse on
duty. Nurses and Health Care aides work together to
provide resident care.

Physician Services

There are designated physicians for each home in the
region. When a resident moves in, they will be assigned
to be under the medical care of one of the designated
physicians. Physicians visit the home on a regular and as
needed basis. There is a physician on call after hours for
any urgent medical needs. Laboratory and x-ray services
will be accessed at the nearest hospital offering the
required service.

Pharmacy Services

Pharmacy services are contracted out to a local community
pharmacy. A licensed Pharmacist is available for
                                                                35
     consultation and is involved in regular resident medication
     reviews. For safety reasons, medications cannot be kept in
     resident rooms. All over the counter and herbal medications
     must be approved by the physician and kept in the
     medication room. Medications prescribed by the physician
     are administered by nursing staff. The cost of most
     medications and supplies is covered by Manitoba Health.
     Residents/families are encouraged to inform staff at least
     24 hours prior to any planned leave so medications can be
     prepared to be sent with the resident.

     Recreation Services

     Recreation services offer a wide variety of programs
     designed to enhance the resident’s quality of life,
     emphasizing self-worth, enjoyment and socialization.
     Individual and group programs attempt to meet each
     resident’s desire for involvement. Activities vary by facility
     but generally include exercise programs, outings, music
     programs and special celebrations throughout the year.

     Spiritual Care

     If the resident’s life included regular church attendance,
     families are encouraged to have the residents’ pastor
     or priest visit regularly. Most homes have access to a
     Chaplain. Chaplains enhance the spiritual community
     among the residents and complement the relationships
     residents have with their home congregations.

     Palliative Care

     Every stage in the life of each resident is to be valued and
     respected. When life reaches the terminal stage, our focus
     is to provide for a comfortable and pain free death. Cardio-
     pulmonary resuscitation will not be done when the heart
     stops, unless this is specifically requested by the family.

36
At the end of life, most residents choose to remain at the
home rather than be transferred to a hospital. The Regional
Palliative Care Team and palliative care services are
available to the family and the staff. Nearing the time of
death, families are encouraged to stay with the resident.
Arrangements for overnight stays can be made with the
staff at each home.

Volunteer Services

Volunteers provide an invaluable service in each home.
Volunteers assist in many areas including transporting
residents to and from programs, reading, providing music,
assisting with outings and provide valued companionship
for residents. All volunteers are required to submit a
Criminal Record Check.

Social Work Services

The services of a Social Worker are available in some
homes. The Social Workers assists in preparing the
resident/family for the move into the home and provides
ongoing assessment and support to both resident and
family.

Maintenance Services

The maintenance department assists in providing a safe,
comfortable, environment for residents. Please notify
maintenance or nursing of any safety issues that arise. The
maintenance department will assist with hanging pictures,
checking appliances, room repairs, etc.

Regional Services

All residents have access to an occupational therapist or
physiotherapist. Residents will be assessed and appropriate

                                                              37
     individual programs will be outlined and modified as needs
     change. Rehabilitation services also assist with testing
     of the residents’ ability to operate motorized wheelchairs
     safely.

     Mental Health Services for the Older Adult are available on
     a consult basis through-out the region.

     Services for a Fee

     The following services are offered to residents on a fee
     basis. Residents can sign up for these services at anytime.
     Each requires the consent of the resident or designate
     before service can begin. Please check with your home for a
     list of current prices.

     Some facilities may provide the following services. Please
     check with your facility as to which services are offered.

         Foot care: Foot care services are encouraged for all
     residents. These services are provided by a qualified foot
     care nurse on a regularly scheduled basis.

          Hair care: Qualified hair dressers provide hair cuts,
     sets and perms in the home.

          Massage Therapy: A licensed massage therapist is
     available to provide massage therapy for relaxation, pain
     relief, and stress relief to promote health and well-being.

         Music Therapy: A certified music therapist can
     provide music as a therapeutic tool to restore, maintain and
     improve mental, physical and emotional health.




38
           FINANCIAL INFORMATION

Residential Charges / Billing

Residential charge rates are set by Manitoba Health. The
residential charge is actually only a portion of the total
daily cost, with Manitoba Health subsidizing the balance.
This charge is based on a sliding scale depending on the
resident’s income as per the Notice of Assessment from
Revenue Canada from the previous year. The assessed rate
is revised annually and the new rates are effective August 1
of each year.

Each resident may apply for a reduced rate by completing
an Application for Reduced Residential/Authorized Charge
form. These forms are available at each home.

Helpful information for families on residential charges as
well as all forms can be accessed at the Manitoba Health
website at: www.gov.mb.ca/health/pcs/index.html.

The residential charge is payable in advance, on or before
the first day of each month. A monthly invoice will be
sent to the appropriate financial designate. Payment
arrangements should be made with the Business Office
when the resident moves in. Expenses such as hairdressing,
foot care, massage therapy, petty cash, etc. which are
incurred by the resident will be added to the resident’s
monthly billing statement.

Cost Responsibility for Goods and Services
The Personal Care Services Insurance and Administration
Regulation under The Health Services Insurance Act
states which services and goods are the responsibility of
the resident and which are the responsibility of the home.
These charges are outlined in the following table.

                                                               39
      FACILITY RESPONSIBILITY          RESIDENT RESPONSIBILITY
     CLOTHING: Laundering              CLOTHING: Purchase,
     and minor repairs (ie. button     replacement, labelling, major
     replacement, seam repairs).       repairs, alterations, dry cleaning
                                       of owned items (ie. dry
     ROOM SET-UP: Cleaning, paint cleanable items such as drapes,
     touch up, clean linen, (*name     blankets).
     identification plate).
                                       ROOM SET-UP: Television,
     PERSONAL CONSUMPTION phone and internet hook-up
     / USE: General personal           and monthly charges, including
     hygiene and skin care products charges for moving phone, cable
     e.g. body lotion, denture cups,   or internet service to a preferred
     toothettes, shampoo, body         room.
     cleanser including soap, perineal
     cleanser, barrier products.       PERSONAL CONSUMPTION
                                       / USE: Cosmetics, deodorant,
     EQUIPMENT: For occasional         mouthwash, toothbrush &
     use by more than one resident:    paste, denture cleaner, facial
     Mechanical lifts and slings,      tissue, non prescription lotions,
     commodes, transport               creams, sun screen, ointments,
     wheelchairs, basic walkers,       personal hygiene products where
     overhead trapeze bars, crutches the resident prefers a type not
     for short term use, raised        supplied by the facility, support
     toilet seats, portable oxygen     hose, compression stockings,
     tanks, regulators, and oxygen     compression garments, alcohol.
     concentrators and supplies,
     restraint devices, preventative   PERSONAL AIDS: Labelling,
     maintenance of all facility       repair and replacement of
     owned equipment, (*bedside        dentures, denture adhesive,
     floor mats)                        eye glasses, hearing aides and
                                       batteries.




40
  FACILITY RESPONSIBILITY           RESIDENT RESPONSIBILITY
 MEDICAL/NURSING                    PERSONAL SERVICES: Hiring
 SUPPLIES: Dressing/                of additional private services
 wound management supplies          such as hairdressing (shampoo,
 compression dressings,             cut, color, perm), manicures,
                                    pedicures, massage therapy,
 treatments for venous ulcers.      chiropody, companion care or
                                    private duty nursing.
 Needles, syringes, lancets,
 supplies and monitors for         EQUIPMENT: For personal use
 assessing blood glucose           that remains personal property:
 levels, routine diagnostic        Lift slings, commodes-not to
                                   be shared, transfer belts for
 testing materials, catheters,     personal use, transfer poles,
 drainage bags, tube feeding and   wheelchairs (WC) for daily use,
 ostomy supplies, disinfectants,   or custom fitted ones, personal
 antiseptics etc., incontinence    WC cushions, specialized WC
 care products.1 (*includes “pull  seating, pressure reduction/
 on” type disposable protective    relieving. Walkers, crutches,
 underwear)                        canes for long term use;
                                   compression garments, portable
                                   oxygen for outings other than
 DIETARY SUPPLIES: Food,           approved recreation programs,
 including special and therapeutic insurance for repair or loss of
 diets, dietary supplies,          personal belongings, repair and
 thickeners, supplements.          preventive maintenance contract
                                   for owned equipment.
 DRUGS: Prescribed drugs and
                                    MEDICAL/NURSING
 over the counter preparations      SUPPLIES: Incontinence care
 approved by Manitoba Health.2      products preferred by the resident
                                    and not supplied by the facility.1
 (*) denotes items whose
 cost will be covered by the        DIETARY SUPPLIES: Personal
 facility as per approval by the    use aids and utensils.
 Regional Management Team in        DRUGS: Resident requested
 consultation with the regional     products not prescribed by a
 Long Term Care Team.               physician or extended practice
                                    nurse.2
1: See Incontinence Care policy
2: See Prescribed Drugs policy
                                                                         41
     References: Manitoba Personal Care Home Administrative
     Manual, Insured and Non-Insured Personal Care Services,
     February 15, 2006

     Trust Accounts

     Please see the Business Office in your facility for
     information on Trust Accounts for miscellaneous
     expenditures and petty cash.

     Valuables

     All residents are strongly discouraged from keeping any
     items of value or money on the premises.

     Responsibility for Loss or Damage

     Homes cannot be responsible for any items or money
     that is lost, stolen or damaged. Please report any losses
     immediately to the nurse in charge.

     Residents/families are encouraged to consider personal
     insurance on individual/personal property including
     hearing aids, glasses, and dentures as applicable.

     Legal Issues

     Families are asked to make arrangements with the Social
     Worker, Director of Care or Facility Manager prior to any
     lawyer visiting a resident or the resident signing legal
     documents. Residents must be deemed mentally competent
     to be able to sign legal documents.

     Tips and Gratuities

     Staff in all homes undertake their work conscientiously and
     with the resident’s best interest in mind and therefore do

42
not expect tips or gifts.

Resident Leave

Whenever a resident leaves the facility with family or
friends, staff must be aware and the Resident Leave
log sheet filled in. This is important in the event of an
emergency in the home.

A leave of absence can be arranged for varying lengths
of time, provided that the physician has granted medical
approval. Advance notice is requested to ensure all
necessary care arrangements including medications can be
provided. The residential daily charge continues to apply
when the resident is on any leave. There are three types of
leave:

    Social Leave: Social leave is an absence of not more
than three days at any time during the course of one week.
These days are exclusive of the annual twenty-one day
extended leave. While on a leave, it is the responsibility
of the care provider to ensure medications are taken and
resident care needs are met.

    Extended Leave: Residents are entitled to twenty-one
days of extended leave during each year. Extensions to this
leave may be granted in certain circumstances and should
be discussed with the Facility Manger. While on a leave, it
is the responsibility of care provider to ensure medications
are taken and resident care needs are met.

    Hospital Leave: Hospital leave is the absence of
a resident from the Personal Care Home because of
admission to a hospital. This absence should not exceed
21 days for each period of hospitalization. Exceptional
conditions should be discussed with the Facility Manager.

                                                               43
     Mechanical Lift Slings

     If the resident requires the use of a mechanical lift to assist
     with transferring, the resident/family is asked to purchase
     two personal slings for this purpose. These slings are sized
     and used only by the resident. Staff will order all slings to
     ensure correct sizing and type to best meet the resident’s
     needs and ensure compatibility with the make of the lift.
     These slings are inspected on a regular basis and will need
     to be replaced if deemed to be worn or unsafe.


                           DAILY LIVING

     Television, Telephone and Internet

     Cable and telephone jacks are available in each resident’s
     room. The installation cost for the telephone, cable or
     internet hook-up as well as the ongoing monthly charges
     are the responsibility of the resident/family. For safety
     and space reasons, it is recommended that televisions in
     resident rooms be no larger than 20”. Televisions and VCRs
     or DVDs are also located in the Living Room areas in each
     home.

     Mail

     Mail is picked up and delivered daily, Monday through
     Friday at each home. Mail should be addressed directly to
     the resident at the address of the home. Families should
     re-direct applicable mail such as invoices or cheques to the
     designated person.

     Personal newspapers (daily or weekly) can be ordered and
     delivered to the resident’s room. The resident/family is
     responsible for all personal billing charges incurred.


44
Alcoholic Beverages

As alcohol may have adverse reactions with some
medications and health conditions, residents need to receive
physician approval prior to consuming alcoholic beverages.
Purchase of alcoholic beverages is the responsibility of
the resident/family and all alcohol must be kept in the
medication room and dispensed by staff.

Smoking

As the health of residents, staff and visitors is highly
valued, most homes in the region are smoke free and
smoking is not permitted in the home or on the grounds.

If smoking is permitted, residents must comply with the
home’s policy on smoking.

Pet Visits

We recognize that animal visits can enhance the quality
of life for many residents. Guidelines for pet visits must
be followed to balance infection control, environmental
and safety requirements with those that encourage the
emotional well being of residents. Prior to any pet visit,
the owner must obtain approval from the home. The
owner must be aware and adhere to the “Guidelines for Pet
Owners Visiting Long Term Care Facilities” which can be
found at the end of this booklet.

Dental, Hearing and Eye Care

Regular dental, eye and hearing check-ups are very
important for all ages but often get neglected as people age.
We encourage all residents to have regular dental, eye and
hearing examinations to maintain the resident’s optimal
health, quality of life and safety.

                                                                45
     Families are responsible for arranging appointments.
     Some homes have professional staff visit the home to
     provide basic examinations for those residents who find it
     difficult to attend a local clinic setting.

     In keeping with the Manitoba Health Cost Responsibility
     policy, residents/families are responsible for any fees or
     costs incurred with examination and follow-up as well as
     purchase and repair of glasses, dentures, hearing aids and
     batteries.


                      RESIDENT SAFETY

     Culture of Safety

     All homes strive to provide safe, competent and ethical
     care to residents through a positive culture of safety. This
     is an environment which promotes flexibility, open and
     honest communication, as well as learning by reporting and
     analyzing errors and near misses.

     Fire Safety

     Fire drills are conducted monthly in all homes with all staff
     being trained annually in fire safety. When the fire alarm
     rings, some doors will close automatically and magnetically
     locked doors will automatically unlock. Residents and
     families should follow instructions and directions from staff
     members. DO NOT use the elevator when a fire alarm is
     ringing.

     Security Systems

     Each home has a door security system to ensure safety
     for those residents who are at risk for wandering outside
     unattended. Families will be orientated to the specific

46
security system of the home when
the resident moves in.

Call Bell System

Call bells are located at each
bedside, each bathroom and in
all tub rooms. This system is
used for residents to call for help
whenever nursing assistance is
required.

Unsafe Items

To provide a safe environment,
all small appliances and
electrical equipment must meet
CSA requirements and be checked by the Maintenance
Department before being placed in the resident’s room.
Personal items or furniture may need to be limited or
removed in a resident room if they pose a safety hazard
for the resident and/or staff. Beds are positioned to best
facilitate resident care and safety.

Refer to your home for their policy on fridges and
microwaves in resident’s rooms.

   Unsafe items - not to be kept in resident’s rooms
   Toasters                Heating pads / Magic bags
   Heaters                 Electric blankets
   Hot plates              Scatter rugs
   Kettles                 Matches/lighters
   Irons                   Coffee percolators
   Candles/sparklers       Halogen lamps
   Pocket knives           Scissors



                                                             47
     Restraint Usage

     All homes adhere to a philosophy of “least restraint” which
     means that restraints (ie. seat belts on wheelchairs) are
     used only as a last resort for the resident’s safety when all
     other alternatives have been explored, tried and exhausted.
     It must be the least restrictive approach that considers the
     resident’s autonomy and dignity while maximizing safety.
     Residents and/or family members must consent before a
     restraint is applied. Restraints are used in keeping with
     the regional restraint policy which is based on standards
     set by Manitoba Health. The use of restraints is reviewed
     every three months at a minimum and checked according
     to the regional policy. Please refer to the regional brochure
     “Restraints: What Is the Right Choice” available at each
     home for further information on restraint usage.

                    Fall Prevention

                     All homes are committed to reducing
                     the number of resident falls and the
                     number of fall-related injuries through
                     the implementation of a regional fall
                     prevention strategy. Residents are assessed
     for their risk of falling when they move in and quarterly
     at a minimum. Residents who are at high risk for falling
     have a decal placed in their room and on their equipment
     to alert everyone to the risk and have individualized fall
     interventions listed in their care plan. Fall prevention is
     everyone’s responsibility and information on the resident’s
     and/or the family’s role is provided in the regional brochure
     “Fall Prevention in Long Term Care – Information for
     Residents & Families” and through the fall prevention
     posters in each home.




48
Medication Usage

All homes have a process in place to ensure that all
resident medications are regularly reviewed and medication
usage is monitored. All residents have a quarterly review
of their medications involving the nurse, physician and
pharmacist. Homes also complete
regular medication usage audits which
include:
▪ ensuring the resident’s pain is
    being adequately controlled;
▪ noting any drug interactions or
    adverse effects;
▪ ensuring the resident/family’s
    input is incorporated into
    treatment decisions;
▪ ensuring care strategies and non-
    medication interventions are
    implemented when behavioural
    concerns arise rather than
    “jumping to” use of a medication.

Responding to Behaviour

Staff from all facilities are trained in the P.I.E.C.E.S.
strategy which gives understanding and better care for
residents with complex physical and cognitive/mental
health needs and behaviour changes. The P.I.E.C.E.S.
program places the person and family at the centre of care
and uses a team approach to assessment and care planning.

Safely Home Registry

All residents with Alzheimer ’s disease or dementia and
who are at risk for leaving the facility unattended should
be registered with the Safely Home – Alzheimer Wandering
Registry. This is a nationwide program designed to help
                                                             49
     find a person who is lost and assist in a safe return home.
     Once registered, confidential information about the person
     can be accessed by the police in the event of a search
     for a missing resident. Information on the program and
     application forms are available at each home or through the
     Alzheimer Society website at: www.alzheimer.mb.ca.


                   INFECTION CONTROL

     Hand Hygiene

     All visitors should wash their hands or use the alcohol-
     based hand sanitizer when entering and leaving the home.
     Hand hygiene is the single most important thing you can do
     to prevent the spread of germs and to protect the residents
     from illness and infection. Visitors should remember to
     wash their hands before and after assisting with feeding
     residents and before and after providing care to residents.

     Immunizations

     All residents, staff and regular visitors and family members
     are encouraged to receive a flu shot every year. The flu
     shot is given to residents, upon consent, by a nurse every
     fall. Others are encouraged to get a flu shot by attending
     a public health community flu clinic or visit their family
     doctor. Influenza (the flu) can lead to serious respiratory
     illness or death in the elderly. Staff and visitors decrease
     the chances of spreading the flu to the residents when they
     get a flu shot every year. Residents are also encouraged to
     receive the pneumoccocal vaccine if they have not already
     had it. The pneumococcal shot usually does not need to be
     repeated.




50
Outbreak Protocol

In the event of an outbreak, precautionary measures
may be taken such as the administration of antiviral
medications for influenza and restricted visits. In this
event, family members can be in touch with the home by
telephone to check on the well-being of their loved one.

DO NOT VISIT IF you have symptoms of influenza (fever,
cough, sore throat, aches/pains) or gastrointestinal illness
(vomiting or diarrhea). When you do visit, PLEASE WASH
YOUR HANDS.


             FAMILY INVOLVEMENT

The Value of Families

Family members are often the main care providers for
individuals before they move into a personal care home.
Family members may no longer be the primary caregiver,
but their involvement in their loved ones life in their
new home is invaluable. Staff in the home strive to assist
residents and their families maintain this important
relationship. In addition to visits, families are encouraged
to be involved in care planning, decision making and in the
everyday life of the home.

Care Conferences

A Resident Care Conference is held annually at a minimum
for each resident. The resident’s plan of care, progress
and goals are reviewed and evaluated by the care team.
Residents/families are an integral part of this team and are
encouraged to attend and participate in these meetings.
Residents/families will be notified of the date of the Care
Conference through the home.

                                                               51
     Resident Council

     This council is intended to provide the resident and family
     with a forum where issues that concern residents can be
     discussed, including the services provided to residents in
     the home. Resident council meetings are held on a regular
     basis with minutes posted for all residents and staff.
     Council meetings occur a minimum of five times per year in
     each home.

            OTHER HELPFUL INFORMATION

     Pet Visit Guidelines
     With the recognition that animals can enhance the quality
     of life for residents, individuals should consider the
     following before bringing a pet to visit:

     Does the resident want to see the pet? For some residents,
     visits from a pet may be more stressful than not seeing
     the pet at all. A pet visit may be too confusing for some
     residents; others may be more saddened than cheered by a
     brief visit from a pet they cannot have at their side all the
     time.

     The facility will be a new and unfamiliar environment to
     the pet. Does your pet do well in unfamiliar situations, or
     does it become nervous or irritable? Your pet’s behaviour
     at the vet’s office may be a good indicator of its possible
     behaviour in a facility situation.

     NEVER bring an excitable or nervous pet, or a pet that has
     ever bitten a human being.

     Owners must respect the fact that not all people are
     comfortable with animals and some may have allergies. All
     residents have the right not to be exposed to visiting pets.
52
    Prior to any pet visit, the owner must obtain
        approval from the Facility Manager,
       Clinical Resource Nurse or designate.


Pet Visit Requirements
All visiting pets and owners must adhere to the following
requirements during visits:

a) only one animal visitor is allowed at a time, unless
previously approved by the facility or part of a pet therapy
program.

b) pets must be healthy, clean, free from fleas and other
parasites, and up-to-date rabies shots and distemper
vaccinations. A record of vaccinations, signed by the
veterinarian should be available
if requested by the facility. The
recreation department shall keep
a vaccination record of all pets
involved in pet therapy programs.

c) the pet should be freshly brushed
so it does not shed hair in the facility
and its nails trimmed.

d) pets must be restrained at all
times. This means a collar and short
leash (3-4 ft.) for dogs and a harness
and leash for cats. Animals should
never be left unattended. Cats,
small dogs, and other small animals
are best transported to and from the
facility in a pet carrier.



                                                               53
     e) the animal must be obedient and toilet-trained with
     the handler having complete control over the animal at
     all times with no excessive noise, unfriendly behaviour
     towards other animals or people. The pet must not get
     underfoot in a situation where it could trip a resident or
     staff member.

     f) pets are not allowed in dining areas, food preparation
     areas, laundry areas, medication rooms or supply/storage
     rooms.

     g) the pet owner shall be responsible for cleaning up a
     mess attributed to the animal, including elimination on the
     property. The courtyard or garden areas are not suitable
     areas for animal elimination. Gloves and paper towels are
     to be used to clean up any excrement, followed by cleaning
     with facility approved disinfectant. Any fecal matter is to
     be bagged and discarded. The owner is responsible for the
     cost of any damage caused by the pet.

     h) the length of the pet visit should take into consideration
     the therapeutic value of the visit. Facility staff have the
     right to ask for the pet to be removed from the facility at
     any time.

     i) an excitable or nervous pet, or a pet that has ever bitten
     a human being must never be brought into the facility.

     j) owners must respect the fact that not all people are
     comfortable with animals and be aware of residents who
     have allergies or asthma. Owners must check with staff
     before allowing their pet to interact with other residents.

     k) hand hygiene with soap and water or an alcohol-based
     hand rub must be performed for all individuals after any
     contact with the animal, its equipment or other items with

54
which the animal has been in contact with. Pets should
never be kissed on the mouth.

l) a protective pad must be placed between the resident
and pet or the furniture and the pet.

m) reptiles (lizards, snakes, iguanas and turtles) or wildlife
(raccoons, rodents, ferrets, etc.) should not be brought into
the facility to prevent disease transmission.

Tips for visiting with a pet
When you enter the resident’s room, do not immediately
place the pet into the resident’s lap. Allow the resident time
to acknowledge that the pet is there. Likewise, allow the
pet time to adjust to its new surroundings. Dogs will want
to sniff around for a few minutes. Allow a cat a few minutes
to check out the situation before you remove it from the pet
carrier. Make sure the resident is seated or in bed when the
pet is presented, especially if it is a medium-to-large sized
dog. You don’t want a large dog to jump up on a standing
resident whose balance is poor.

Bring the pet to the resident slowly. Allow the resident
time to stroke and touch the pet while you hold the animal.
Assist the pet and resident with lifting the pet onto the
resident’s lap. Keep the pet’s leash in your own hands at all
times. Don’t expect the resident to control the pet if it gets
excited and jumps off the resident’s lap.

Both pets and residents get tired. When either the pet
or resident shows signs of fatigue, irritability, anxiety or
restlessness, it is time to take the pet home.




                                                                 55
     Tips for Visitors

     Visiting should be enjoyable for both parties. It should be
     a source of stimulation and interaction that brings a sense
     of mutual satisfaction. Some tips for making visits rich
     and interesting are:
     ▪   bring children to visit keeping in mind the resident’s
         tolerance for activity and noise
     ▪   treat female residents to manicures or hair care
     ▪   write letters or cards together
     ▪   bring along a game (some games are available at the
         facility) or work on a puzzle
     ▪   bring photographs of events
     ▪   if unable to visit frequently, make a phone call
     ▪   take the resident out for wheelchair rides, drives,
         visits or a coffee or meal outing
     ▪   join the resident for a meal at the facility (make
         arrangements with the kitchen in advance)
     ▪   enjoy a picnic on the patio or outdoor area
     ▪   bring along some favourite music on a tape or CD
     ▪   share the local newspaper and talk about current
         events
     ▪   bring the church bulletins and encourage church
         members and pastors to visit
     ▪   escort the resident to outside appointments
     ▪   attend special events with the resident in their home
     ▪   assist in volunteer programs.




56
Gift Ideas for Residents

▪   washable comforter for bed
▪   toiletries (no powders)
▪   blank greeting cards (can be filled
    in during visits as an activity for
    individuals unable to write)
▪   digital picture frames loaded with
    pictures of family and friends
▪   photo albums with pictures of
    family and past events
▪   music CDs or audio books on CD
▪   DVD of family or events
▪   washable clothing – sweaters,
    nightgowns, pyjamas, housecoats
▪   slippers (must be sturdy, snug fitting and good grip
    sole)
▪   edible snacks applicable for that individual
▪   framed photographs, large print calendars
▪   hanging decoration for door of resident’s room
▪   puzzles, books
▪   gift certificate for massage therapy or music therapy
▪   cordless phone (can be kept in wheelchair or on
    walker)
▪   newspaper or magazine subscriptions.




                                                           57
     Internet Resources for Families

               Topic                        Sources
     Alzheimer’s disease and      Alzheimer Society of
     dementia                     Manitoba:
                                  www.alzheimer.mb.ca
                                  Alzheimer Society of
                                  Canada: www.alzheimer.ca
     Diabetes                     Canadian Diabetes
                                  Association:
                                  www.diabetes.ca
     Health services available    South Eastman Health/
     in the region                Santé Sud-Est Inc.:
                                  www.sehealth.mb.ca
     Heart Diseases and Stroke    Heart and Stroke
                                  Foundation of Manitoba:
                                  www.heartandstroke.mb.ca
     It’s Safe to Ask – Medica-   Manitoba Institute for
     tion Care                    Patient Safety:
                                  www.safetoask.ca
     Lung/respiratory diseases    The Lung Association of
                                  Manitoba: www.mb.lung.ca
     Palliative Care              Hospice & Palliative Care
                                  Manitoba:
                                  www.manitobahospice.ca-
                                  Canadian Virtual Hospice:
                                  www.virtualhospice.ca
     Parkinson ’s disease         Parkinson Society of
                                  Canada: www.parkinson.ca




58
Acknowledgements and Sources of Information

FRONT COVER PHOTO
Margaret Loeppky, resident of Rest Haven Nursing Home,
with her great-granddaughter.


Assiniboine Regional Health Authority
Personal Care Home Handbook, February 2008

Winnipeg Regional Health Authority
Personal Care Home Program Hand-Out, October 2007

Manitoba Association of Personal Care Homes
Social Workers - Information on Personal Care Homes in
Manitoba, October 2000




Printed in September 2009                                59
     Personal Care Homes in South Eastern Manitoba

     Bethesda Place ............................................(204) 326-6411
     399 Hospital Street in Steinbach, Manitoba

     Menno Home ................................................(204) 434-6496
     235 Park Street in Grunthal, Manitoba

     Repos Jolys ..................................................(204) 433-7611
     354 Prefontaine Avenue in St. Pierre-Jolys, Manitoba

     Rest Haven Nursing Home .......................(204) 326-2206
     185 Woodlawn Avenue in Steinbach, Manitoba

     St. Adolphe Personal Care Home............(204) 883-2181
     420 Main Street in St. Adolphe, Manitoba

     Villa Youville ...............................................(204) 422-5624
     15 Charriere Road in Ste. Anne, Manitoba

     Vita Personal Care Home .........................(204) 425-3804
     217 First Avenue West in Vita, Manitoba




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