Prepare staff to use all of their senses
Senses and sensitivity inservice does the trick
Aides are more than hourly workers when it comes to home care. Nurses often say aides are the eyes and ears of an agency because they often spend more time in the home than nurses and therapists. But aides are even more than just eyes and ears. They can employ all their senses - and their intuition - to help patients.
"The home health aide is a very close person to the patient, and many times the entire staff relies on what home health aides have picked up in caring for the patient and in using their senses," says Agene Parsons, RN, BSN, MPH. She is former director of quality improvement and education for Housecall Medical Resources Inc. in Atlanta, which is part of Housecall Manage ment Services in Centreville, AL, a company that owns more than 100 home care agencies and manages more than 40.
Parsons, who retired from her position April 30, created an inservice for the Alabama company on using all the senses in patient care. Called "Senses and Sensitivity," the inservice covers the six senses, including intuition, and it has a section on teaching aides how to be sensitive to their patients' difficulties and disabilities. (See summary of senses and sensitivity inservice, inserted in this issue.) She came up with the ideas for the inservice from seminars, articles, and other literature she has read over the past 15 years.
"When you use your senses, you can identify problems that you should communicate to other home care team members," Parsons says.
For example, an aide might use the sense of sight to observe the patient's environment, looking for clues in answer to the following questions:
· Is the patient isolated?
· Does the patient prefer white surroundings?
· Does the room have safety features?
· How does the caregiver appear?
Using the sense of touch, an aide might ask the patient these questions:
· Does the room feel warm or cool?
· Is the bath water too hot or cold?
· Are the bedsheets too scratchy, or are they soft?
· How does the patient's skin feel?
· Does the patient complain of pain when touched?
Using the sense of hearing, an aide might observe the following:
· Is the room too noisy?
· Are there frequent outside noises?
· Is there complaining or fighting?
· Are there pleasant sounds in the home?
· Is the caregiver a frequent complainer?
· Does the patient make noise when breathing?
Using the sense of smell, an aide might ask the patient:
· Is the home well-ventilated?
· Are there any irritating odors or pet odors?
· Does the patient have any body odors?
Aides should trust their instincts
Using intuition, an aide might note:
· What is the aide's gut feeling?
· Is there a possibility of abuse or neglect?
· What is the patient's body language?
· What do the patient's or caregiver's tone of voice and actions say?
· Is the patient becoming too attached to the aide?
"They should discuss their feelings with team members or a supervisor," Parsons says. "They need to use their intuition to see that the patient receives better care."
The sense of taste has less application in the home care setting, she says, but an aide could evaluate a patient's taste and ask if the patient has experienced any changes in taste.
Aides also could ask these questions, based on the patient's sense of taste:
· Does the patient eat or drink enough?
· Do the family members try to force the patient to eat?
The inservice's section on sensitivity attempts to show aides how it might feel to be old, disabled, or ill, Parsons says. "We're helping the aide to identify with the frustrations the patient can feel."
Instructors may set up simulations in learning booths or stations to help the aide experience different disabilities. "It works better if you have a large group of aides to have another person help you do this."
At one learning station, an aide might be instructed to smear petroleum jelly on a pair of sunglasses to simulate impaired vision and lack of depth perception.
"Then have the aide [wear the sunglasses,] walk around the room without assistance, and try to go downstairs with these glasses on," Parsons says. "Have the aide try to identify different toiletries."
Encourage discussion
Another learning station might instruct aides to place cotton balls in their ears, which is a simple way to simulate decreased hearing. "Then have the aide repeat instructions given by another aide and have the radio turned up to a level the impaired aide can hear adequately," Parsons suggests. "Then have the aide take the cotton balls out so they can hear how loud the radio really is."
After the sensitivity training, Parsons suggests education managers encourage the aides to talk about what they felt and experienced. Managers can begin those discussions by asking the following questions:
· What techniques of assistance did the "impaired" aides find most helpful during the training?
· Did the aides who were assisting their "impaired" colleagues find that using their sense of touch when providing care helped the colleagues improve?
After-training discussions tend to work better than written exams to measure and reinforce learning among aides, Parson says.
"If you have a good discussion afterwards, that's more of a test than having them take a quiz," she says.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content