4 Smoothie Recipes to Bust Out of Blender Boredom/wps/portal/eCPS/root/public/Resources/Resources/!ut/p/z0/04_Sj9CPykssy0xPLMnMz0vMAfIjo8zizR0dXT0cDQx93f0cXQ0CjV3C3F08wwwM3Mz0C7IdFQFCINbA/
Posted Date: Aug 03, 2022
Effective Date: Aug 3, 2022
Whether you’re rushing off to work or looking to refuel after the gym, smoothies can be a healthy, grab-and-go option. Well-made smoothies are a delicious way to help get the fruits (and veggies!) you know you need, complete with an extra boost of vitamins and minerals to give you energy to conquer your day.
But it can be difficult to find the right flavour combination (and too easy to turn your smoothie into a high-calorie, high-sugar dessert). And even if you are the most tried and true fan of smoothies, you can find yourself a bit bored of the same old smoothie, with the same few fruits, day after day.
We’re here to help bust you of out blender boredom with unexpected ingredients like mint, ginger, cinnamon, and more that add new, delicious, and healthy flavours to your smoothie list. Grab your blender and try these four Aramark chef-created smoothie recipes to make at home!
1. It’s Easy Going Green
This is sure to be your new go-to drink. In addition to the power-packed kale and spinach, it has almond milk, zingy ginger, and earthy and colorful turmeric, which is gaining popularity for its anti-inflammatory properties. Ground turmeric can be found in the spice aisle of most grocery stores.
2. Berries and Spice and Everything Nice
You don’t often see cranberries in smoothie recipes, but we think that’s about to change! Here, vitamin C- and fibre-packed cranberries get added to sweet strawberries and blended with ginger and cinnamon for a little spiciness.
3. It’s Peanut Butter Berry Time
We took the classic combo of bananas and peanut butter to the next level. This smoothie has it all – fresh fruit, extra protein, and it’s dairy-free. The chia seeds add fibre and healthy omega-3 fatty acids.
4. Tropical Fruit Meets Cool Mint
This tangy smoothie is perfect for a hot day. The fresh mint adds a cooling taste, while the pineapple and apple sweeten it up. The vanilla yogurt adds creaminess.
When it comes to smoothies, don’t be afraid to mix things up! Get creative and play around with different ingredients to find the perfect recipe that fits you.
Understanding the What and How of IDDSI/wps/portal/eCPS/root/public/Resources/Resources/!ut/p/z0/04_Sj9CPykssy0xPLMnMz0vMAfIjo8zizR0dXT0cDQx93f0cXQ0CjV3C3F08wwwM3Mz0C7IdFQFCINbA/
Posted Date: Jul 20, 2022
Effective Date: Jul 20, 2022
Dysphagia is defined as difficulty swallowing and affects a multitude of people worldwide. The modification of food texture and fluid thickness has become the cornerstone of dysphagia management around the world.
Food textures can have many different names and be defined in a variety of ways depending on where you live in the world. Even right here in Canada, there are a variety of names and definitions for the same textures. For example, a minced diet could also be referred to as soft, mashed, ground, or chopped. These multiple names can be very confusing for everyone but also present a great risk for the individual with dysphagia, possibly leading to aspiration and choking. The solution to this was the formation of The International Dysphagia Diet Standardisation Initiative (IDDSI) founded in 2013 by a diverse group of professionals from around the world. Their goal was to develop new global standardized terminology and definitions to describe texture modified foods and thickened liquids used for individuals with dysphagia.
IDDSI is a framework that consists of a continuum of 8 levels from 0-7. Each level is identified with numbers, text labels and colour codes. Food textures are shown as a downward pointing triangle starting with Level 7 (Regular) in which no texture modification is required and progressing toward Liquidized (level 3) where the most texture modification is required. Fluid Consistencies are represented by an upward pointing triangle starting at Level 0 (Thin) and progressively getting thicker through levels 1 (slightly thick), level 2 (Mildly thick), level 3 (Moderately thick) and Level 4 (Extremely Thick). You will notice that Liquidized food texture and Moderately Thick liquids are on the same level (3). Likewise for Pureed and Extremely Thick both being level 4. This is because they take on the same characteristics.
The foods in each level of the framework have their own detailed descriptions, characteristics, physiological rationale for the level and specific easy and practical testing methods to decide if the food meets that specific IDDSI level. Audit sheets have also been developed to assist when testing recipes to determine if it meets a specific IDDSI level.
The implementation of the IDDSI journey can feel a little daunting; however, it is possible (and fun) so long as you have actionable “bite-sized” steps to follow. The first step to the implementation process is appointing an IDDSI champion who will act as the spearhead for this initiative. This individual will start by learning about the importance of IDDSI for resident safety as well as the framework and testing methods. Once they feel comfortable, they will share the importance (and create a general awareness) of IDDSI throughout the home to all departments as well as residents and family members. The next step would be to set up your home’s IDDSI implementation team. This team will be led by the IDDSI champion. This would be a multidisciplinary team and include all departments affected by IDDSI. This should include a mixture of both management and front-line staff involved in resident care or feeding. This team would be responsible for reviewing current policies and practices related to resident eating and to determine the implementation tasks that need to be completed along with an implementation timeline. This team would also determine the team members who will be responsible for specific tasks and identify possible challenges that could be encountered.
Although IDDSI is not mandatory, having one national and international language to talk about dysphagia and texture modified foods is considered best practice. More and more organizations are implementing IDDSI. Manufactures are also embracing IDDSI. They have started to map their existing products to determine how their product fits into the IDDSI framework. They have also been developing and/or reformulating current texture modified products/fluids to meet the IDDSI framework. Labels of texture modified products have started to appear with either dual labelling or full transitions to the IDDSI terminology.
Members of Complete Purchasing Services are encouraged to visit the eCPS members portal to find valuable information on IDDSI which includes many articles, webinars; as well as an IDDSI Implementation Guide and Planner.
You can also visit www.IDDSI.org to find detailed information on descriptors of each IDDSI level. There’s an IDDSI YouTube channel with food- and fluid-testing videos, as well as recorded webinars on IDDSI updates and experiences of implementing IDDSI in various healthcare settings. The IDDSI site also offers publications, including research articles and reports, FAQs, and many printable consumer handouts. This information also can be accessed via the free IDDSI app (available for iOS and Android devices) and by following IDDSI on Twitter @iddsi_org. If you are considering implementing IDDSI in your facility, the IDDSI.org website also has an implementation guide which can help.
Use of the IDDSI Framework
The IDDSI Framework and Descriptors are licensed under the CreativeCommons. By Attribution Share Alike 4.0 License https://creativecommons.org/licenses/by-sa/4.0/legalcode. Attribution is requested as follows: (c) The International Dysphagia Diet Standardisation Initiative 2019 @http://iddsi.org/resources/framework/. Attribution is NOT PERMITTED for derivative works incorporating any alterations to the IDDSI Framework that extend beyond language translation. Supplementary Notice: Modification of the diagrams or descriptors within the IDDSI Framework is DISCOURAGED and NOT RECOMMENDED. Alterations to elements of the IDDSI framework may lead to confusion and errors in diet texture or drink selection for patients with dysphagia. Such errors have previously been associated with adverse events including choking and death. http://iddsi.org/framework.
About the author, Heather Stukalo
Heather joined Complete Purchasing Services in 2016 as a Registered Dietitian with the Menu & Culinary Support Team. Heather has extensive knowledge in menu planning and the International Dysphagia Diet Standardization Initiative (IDDSI), having lead the CPS Menu Development team's integration of the new framework, and is a member of OSNAC (Ontario Seniors Nutrition and Advocacy Committee) and FNAT (Food and Nutrition Advisory Team. Prior to working with Complete Purchasing Services, Heather worked in LTC for 26 years in both corporate and clinical roles. She has also worked as a Home Care Dietitian for 5 years.
Make the Most of Summer’s Finest Fruits and Vegetables/wps/portal/eCPS/root/public/Resources/Resources/!ut/p/z0/04_Sj9CPykssy0xPLMnMz0vMAfIjo8zizR0dXT0cDQx93f0cXQ0CjV3C3F08wwwM3Mz0C7IdFQFCINbA/
Posted Date: Jul 07, 2022
Effective Date: Jul 7, 2022
The summer season comes with many joys. But one stands out from the rest: gardens and farmer’s markets bursting with crisp vegetables and juicy fruits in their prime. From sweet corn, green beans, and summertime squash to stone fruits, heirloom tomatoes, blackberries, and more, the abundance of fresh produce this season makes it easier to eat our way to better health and all the nutrients will help you feel energized and ready to take on the day.
Here’s the scoop on how to choose, store and use your colourful summer’s bounty:
Nothing says summer quite like sweet corn. Sweet corn straight from the cob is high in fibre, packed with antioxidants and is downright delicious. Sweet corn will stay fresh for about five days if stored properly in the refrigerator, and it can be grilled, boiled, or even microwaved. Aramark Chef Scott Zahren loves sweet corn tossed with a small amount of light mayonnaise, lime juice, smoked paprika and cayenne pepper for a quick and easy version of Elotes or Mexican Street Corn. We’re a fan of adding it to our lunch grain bowls, too!
Crunchy cucumbers can help us hydrate and stay, as the saying goes, cool as a cucumber. Plus, cucumbers couldn’t be easier to eat! They are best eaten raw and can be enjoyed with or without the peel, making prep a breeze. For a simple, no-fuss dish Aramark Chef Scott Zahren recommends a fresh cucumber salad made with cucumbers, onion, fresh dill, a dash of sugar, salt, and pepper and a splash of cider vinegar. In the mood for something creamy? Take on Tzatziki, he says. This yogurt-based sauce, traditionally used in Greek-style meals like Gyros, utilizes fresh cucumber, onion, and garlic. You can even sub in Greek yogurt for regular for some added protein.
Peaches have more than 20 micro and macronutrients, including fibre, vitamins, A, C, E, and potassium. They also contain the antioxidant beta-carotene. While they are delicious with no preparation, sometimes peaches bruise. Fortunately, there are plenty of ways to use up those not so pretty ones. Try Aramark Chef Bill Allen’s Fired Up Peaches, a zesty hot sauce that you can use to add a bit of bang to your burger. To make it, put peeled peaches and tomatoes, chilis, salt, sugar, and a little water in a saucepan, bring it to a boil and reduce. Cook it until the peaches are soft, and then cool the mixture for a bit and puree. Store it in the refrigerator or enjoy immediately! Other peach options include drying slices for a nutritious, chewy snack or grilling with cinnamon or nutmeg for a tasty, healthy dessert.
Tomatoes have plenty of nutrients, including vitamins A and C and the antioxidant lycopene. And, with so many varieties to choose from, it’s easy to include tomatoes in lots of dishes. Just remember to store your tomatoes stem end up on the counter to prevent bruising and to keep them tasty. The cold temperature in the fridge weakens the flavour and prevents tomatoes from fully ripening. Aramark Chef Scott Zahren is a fan of using tomatoes in Israeli Salad. He combines Israeli couscous, fresh tomato, cucumber, herbs, and a vinaigrette dressing. The wonderful thing about this dish is that it’s so versatile! Try parsley, mint, or chives for the herbs. For additional nutrients throw in bell peppers and spinach. You can even swap out the couscous for another grain, like quinoa.
Don’t know how to select a watermelon? Look for a firm, symmetrical melon that doesn’t have bruises, cuts, or dents. Lift the watermelon and select one that is heavy for its size with a creamy yellow spot on the underside from where it sat on the ground. Watermelon is tasty and easy to enjoy sliced, but there are plenty of other ways to eat it, too. While we love a good watermelon feta or cotija salad, we’re also big fans of Aramark Chef Bill Allen’s savory Watermelon Prosciutto Salad. Mix cubed watermelon, arugula or other greens, a small amount of thinly sliced prosciutto and parmesan cheese, and olive oil and balsamic vinegar for his Italy-inspired dish. Another option is to make watermelon ice cubes. Watermelon is 92% water, so you can cut it into cubes and freeze it on wax paper. Then, use the cubes for added colour and flavour in lemonade and iced tea!
Note: Since everyone’s health history and nutritional needs are so different, please make sure that you talk with a registered dietitian to get advice about the diet and exercise plan that’s right for your residents.
Understanding Resident Mental Health Challenges in Long Term Care/wps/portal/eCPS/root/public/Resources/Resources/!ut/p/z0/04_Sj9CPykssy0xPLMnMz0vMAfIjo8zizR0dXT0cDQx93f0cXQ0CjV3C3F08wwwM3Mz0C7IdFQFCINbA/
Posted Date: Jun 22, 2022
Effective Date: Jun 22, 2022
For many residents, admission to Long Term Care (LTC) is either preceded by poorly managed mental health, or the admission itself may trigger a decline in mental health. It is imperative to determine the resident’s mental health perspective, from the time of admission and moving forward, each subsequent day. Just imagine experiencing all the losses that newly admitted residents are confronted with, without having anyone to talk to about it. Experiencing loss is an expectation as one ages, but the benefit of talking about it and having others share in the grieving experience is so important and can significantly change the quality of life for the resident.
The rate of diagnosis of depression for residents living in LTC is 44%. (Canadian Institute for Health Information, 2010, 2015) It is believed that this number is low! We know that in the general community people who are depressed are stigmatized. This stigma is even more prevalent in the elderly, so the resident does not tell anyone that they have a low mood. Staff see it, but this is often after some time has passed. The resident may not participate in activities provided in the Home, there may be a lack of social interaction with others, as well as a growing isolation away from others.
For Homes who follow a Recovery Philosophy of Care, a partnership that focuses on the individual’s strengths and values, will allow the resident to truly be their best selves and to feel supported in their daily lives.
Admission to Long-Term Care
People who have lost the ability to function independently in the community are admitted to LTC for assistance in activities of daily living (ADLs) and Instrumental Activities of Daily Living (IADLs). Changes in ability to function in the community may be related to a medical acute crisis causing delirium, advancing dementia, loss of caregiver in the home and/or poorly managed mental illness, including depression and anxiety. A history of drug and alcohol abuse may also contribute to the admission, given that as one ages the ability for the body to manage excessive drugs or alcohol diminishes.
Little is known about the difference between grieving (complicated or typical) and depression. The DSM-5 outlines the following criterion to make a diagnosis of depression. The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.
To receive a diagnosis of depression, these symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition. (American Psychiatric Association. 2017. Diagnostic and Statistical Manual of Mental Disorders. 5th edition)
1. Depressed mood most of the day, nearly every day
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
3. Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day
4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down)
5. Fatigue or loss of energy nearly every day
6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day
7. Diminished ability to think or concentrate, or indecisiveness, nearly every day
8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
Persistent Complex Bereavement Disorder
The diagnosis of Complicated Grief is now Persistent Complex Bereavement Disorder. It is a DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th ed.) diagnosis assigned to individuals who experience an unusually disabling or prolonged response to bereavement.
Persistent complex bereavement disorder causes sufferers to feel extreme yearning for a deceased loved one, usually over a prolonged period. Feelings of longing are often accompanied by destructive thoughts and behaviors, as well as general impairment in resuming normal life. (American Psychiatric Association. 2017. Diagnostic and Statistical Manual of Mental Disorders. 5th edition)
Use of the Social Readjustment Scale can help the staff determine if someone is grieving for all the loss they have had in the past year, along with any changes that are stressful. A score of 300 increases the risk of the person having a mood disorder to 80%. Some common losses/changes newly admitted residents experience are: death of a spouse; marital separation (frequently only one of the married couple is admitted to LTC); personal injury or illness; retirement; change in financial state; change in living conditions; change in residence; change in recreation; change in social activities; change in sleeping habits and change in eating habits. A loss of a care giver in the home or a change in medical condition (diagnosis of dementia, progression of life limiting illness such as COPD or Heart Failure) can cause all these other changes to occur for the person being admitted to LTC.
Understandably admission to LTC is a busy time for the staff, resident, and family. There is a period of adjustment. One step that can ease the burden on the resident is to support them in their grieving. Grieving is a natural way for people to allow emotions of shame, guilt, sadness, and anger to be present and managed. One way of supporting the person is to open the conversation by asking, “What have you left when you moved to LTC? How do you feel about everything that is happening? Have you had some control over how things have gone for you recently?” To grieve one needs to express how things are feeling for them. This may be the first time anyone has had this type of conversation with the person. Holding an unconditional positive regard for them allows for a supportive and respectful environment. It can go a long way in helping with the adjustment to living in LTC.
These conversations rarely happen when one is admitted to long term care. Not being able to grieve can lead to Persistent Complex Bereavement Disorder which may result in depression and a loss of hope. The presentation of grieving a loss, or many losses, is significantly different than depression. A simple discussion with the person about what they have lost can often spark a smile or laugh as they remember how things were. In depression there is apathy (do not care about anything, unmotivated), anhedonia (lack of pleasure in anything) and in the older person we see anxiety as a primary expression of depression.
Depression signals a problem in the neurotransmitters in the brain, especially serotonin and dopamine. Antidepressants will generally be effective in treating Major Depressive Disorder (MDD). Antidepressants will not change the mood for someone who is not depressed but are instead grieving. There is also evidence that Antidepressants can account for significant medical concerns and are not effective for those who have been diagnosed with depression and dementia. This may be because the diagnosis of MDD is not accurate in this population. Perhaps they are grieving their many losses. It is interesting that this group finds supportive counselling, including Cognitive Behavioural Therapy, helpful in improving mood, quality of life and ability to perform ADLs. (Orgeta, V., Leung, P., del-Pino-Casada, R., Qazi, A., Orrell, M., et al (2022). Psychological treatments for depression and anxiety in dementia and mild cognitive impairment. Cochrane Database of Systemic Reviews).
Dementia and Depression
Many people admitted to LTC have either early cognitive impairment or a diagnosis of dementia. Staff are challenged to get a thorough history of the persons health when they are admitted and even more difficult to determine the resident’s mental health history. Families are not always aware of a diagnosis of depression, and up until this time have allowed the person to manage their own health, with their primary care provider. As challenging as it seems, a good mental health assessment should be completed.
There may be some information about the resident’s medications, and on admission a thorough medication review is completed. Frequently residents are on a very low dose of an antipsychotic or antidepressant, often prescribed to help with sleep, not to treat a mental illness. Many of these medications are sedating. (Health Quality Ontario. (2015) Looking for Balance) If the reason for these medications is insomnia, a sleep assessment needs to be completed to determine why the resident is having trouble sleeping. There may be an underlying physical or mental health concern that has not yet been discovered and diagnosed.
We have discussed the scenario for most people admitted to LTC. They have their families and supports with them and sometimes even have a say in their care if they have not been deemed incapable. But what about the other people - those admitted through hospital or from home because they are no longer functioning independently? They come with no one. No supports, or perhaps a family member who is present at admission and only visits periodically. These residents are often described as having a “difficult personality”. They present as mean and angry all the time, and if things are going well in the common area, they will disrupt the calm with outbursts and maladaptive behaviour.
Often, there is a belief by staff and other residents that these residents behave this way on purpose and families, when they are present, say that they have been this way their whole lives.
Maladaptive behaviours are often a symptom of a Personality Disorder. People who have trended a certain way in their personality will often, because of stresses and losses, follow that personality to an extreme. When the behaviour affects their social and occupational functioning, it becomes a disorder. Examples are Narcissistic Personality Disorder, Borderline Personality Disorder and Obsessive Compulsive Disorder.
Personality Disorders begin with trauma and/or neglect in childhood. During childhood the immature brain tries to make sense of the abuse/neglect from someone who should be caring and nurturing them. Core beliefs are changed in these individuals. The core beliefs of someone with a personality disorder are:
1. The world is a dangerous place
2. No one loves me
3. I am unlovable
Of course, the person does not have access to these core beliefs and their behaviour is subconsciously driven. Because of the trauma the amygdala (fight or flight center of the brain) is left in the “on” position, citing danger to the person subconsciously when things are good, when things are neutral and when things are bad. There is a sense that because the person survived the trauma in childhood, they are more comfortable when things are bad. Often in good times they will sabotage the environment affecting those closest to them. This then causes a break in the relationship. Another aspect of the person with a personality disorder is that they are always the victim. Because the behaviour is driven subconsciously, they have a difficult time taking responsibility for the behaviour, and when addressing the maladaptive behaviour, we often hear, “you made me do it”.
Personality Disorders are described in the Psychiatric world as Axis II, preceded by Axis I diagnoses such as Major Depressive Disorder, Schizophrenia, Bipolar Disorder. There is no medication to manage Personality Disorder. In LTC what works is a consistent, assertive approach by all staff. This approach must be gentle, kind, and supportive, and when staff realize that childhood trauma is the cause of the personality disorder, they find it much easier to be supportive. Unfortunately, very little attention is given to the person with a Personality Disorder. We rarely see a diagnosis, and often the person has never had any mental health care. What they do have is many broken relationships, and in LTC they have burned all their bridges and are left with little to no family support.
The mental health of residents admitted to and living in LTC is impacted significantly by mental illnesses such as Depression and Personality Disorders (with a history of trauma). Many residents have also experienced losses over a short period of time and have not been assisted in grieving these losses. Instead, they have been moved away from a familiar, personal environment to a congregate LTC setting with many other older people. When left unsupported many residents may feel hopeless and depressed. A Recovery Philosophy of Care can support these residents by respecting the individual and encouraging them to share their story in all its beauty, hope, and sometimes yes, with despair.
About the Author
Franzis Henke, Nurse Practitioner.
As a Silver Meridian Associate, Franzis provides extensive expertise in Palliative Care, working with the dying and their families, Geriatrics, and Geriatric and Adult Mental Health. She is also a Mental Health Specialist and is the co-facilitator of RecoveryCare Mental Health Program. https://silvermeridian.com/resident_focus/mental-health-recoverycare/
Silver Meridian is pleased to present a new program, developed and presented by Franzis, “New Approaches to Palliative Care in LTC: Embracing the Opportunities” starting in early July. Details for this 10 hour accredited CEU certificate program are available at https://silvermeridian.com/new-approaches-to-palliative-care-in-ltc/
For details on all Silver Meridian programs visit https://silvermeridian.com
Palliative Care in Long Term Care: Re-thinking the Purpose and Approach/wps/portal/eCPS/root/public/Resources/Resources/!ut/p/z0/04_Sj9CPykssy0xPLMnMz0vMAfIjo8zizR0dXT0cDQx93f0cXQ0CjV3C3F08wwwM3Mz0C7IdFQFCINbA/
Posted Date: May 19, 2022
Effective Date: May 19, 2022
Care for the dying has been an important and expanding function in Long Term Care (LTC). Over the past 10 years the typical length of stay has been shortened to approximately 18 months and the stay usually ends in death (Canadian Institute for Health Information, 2015). Many care centers have been supportive of a person-centered, palliative approach to care, but unfortunately, others have not made this adjustment.
Palliative Care, death and dying have been practiced, experienced, and accomplished in Long Term Care (LTC) for as long as these institutions have existed. However, until the first death from COVID 19 occurred and subsequent deaths, very few of the general population had any sense of what LTC looks like and how it is for the residents living there, and the staff working there. As residents and staff continued to contract and die from COVID 19 the lens on LTC, especially by the media, was adjusted and the government ultimately held accountable. Statistically LTC residents accounted for 3 % of the COVID cases and 43% of all deaths by COVID in Canada (Canadian Institute for Health Information (CIHI), and National Institute on Ageing; COVID 19’s Impact on Long-Term Care, December 9, 2021). This truth has led to changes in The Long -Term Care Act that include a need for adoption of a Palliative Care Philosophy in LTC. (Ontario’s Regulatory Registry. Fixing Long-Term Care Act, 2021; Phase I Regulations).
The Long-Term Care Act is now asking for the following to be adopted into LTC during Phase I. “Requiring that integration of a palliative care philosophy include a holistic and comprehensive assessment of a resident’s needs and when needed, improvements to a resident’s quality of life, symptom management, psychosocial supports and end of life care, always subject to a resident’s consent.” (Ontario’s Regulatory Registry. Fixing Long-Term Care Act, 2021; Phase I Regulations).
So, what does it mean to incorporate a Palliative Philosophy of Care? From Bill 37 (Part II) the elements that must be included are:
1. Quality of Life Improvement
2. Symptom management
3. Psychosocial support
4. End of life care
Let’s step back for a moment to pre COVID. In 2019 people were moving into LTC for various reasons. Most could no longer function independently at home, even with some support. This may have been for medical reasons, such as final stages of a life limiting illness (Dementia, COPD, Heart Failure, Cancer…), a serious and poorly managed mental illness leading to an inability of the person to care for themselves, or the loss of a primary caregiver (often a spouse) due to death. The Social Readjustment Scale is a helpful tool that indicates all the losses many people experience prior to and on admission to LTC.
So why are people coming to live in LTC.? For physical care of course, and potentially for some improvement in function now that they have support, and the little talked about, but yes, to die. The first two items are always talked about as encouragement to come and live in LTC and in an attempt to persuade the person to leave their home and all that they know from a social perspective. Rarely is the person told that their dying time will probably come while they are living in LTC and that this will be their last home of this life.
So now the expectation is that discussion about the Palliative Philosophy of care is completed prior to admission to LTC. Wow! How is that discussion going to go when we live in this death phobic society where death happens to us, but really against our will. Many say, “we are born to die” and yet we see the struggle to even discuss what our death may look like and how we would like it to go. When we do talk about our death at all, it is way in the future, or we ask to prolong it and get “more time” for as long as possible.
Let’s briefly discuss this concept of “more time”. Stephen Jenkinson discusses this in his writing in Die Wise: A Manifesto for Sanity and Soul, 2015. People who are dying will ask for medical treatment to get “more time”. What they mean by this is more life or longer life, but what often happens is that dying is prolonged. The quality of life is not what people were hoping for and yet when treatment is offered, they grab the chance to have more time, not knowing what this will look like. With a Palliative Approach to care, we must be honest in our discussions with people. If they are asking for “more time” or being offered treatments which may give them this time, we need to paint the picture of what this “more time” may look like. Most are surprised that the treatment, at best will prolong their death, not improve, or increase the time of their living.
The requirement to now discuss Palliative Care prior to admission is really a requirement to discuss life in LTC and death during the stay. Re-thinking a palliative approach is so important for people so they to have a say in their last days of this life. Using a Palliative Approach to care means that conversations about how the person may die (disease projection) are discussed with the person along with any treatment options, quality of life and symptom management, and who their people are, including Substitute Decision Maker (SDM). They may come into LTC with an Advance Care Plan already in place and this would need to be revisited. Often no discussions about their dying time have happened and now it is up to the LTC staff to have this frank and difficult discussion perhaps for the first time.
Included in the new LTC Act is the need for consent to give care following a Palliative Approach to care. This has long been a concern for some working in the LTC sector, as people are often admitted to LTC because they are deemed incapable to live independently. This includes difficulty completing Instrumental Activities of Daily Living (IADLs) and Activities of Daily Living (ADLs) independently. Persons admitted to LTC often come with a broad diagnosis of Dementia and families, caregivers and staff often believe that this diagnosis predetermines that the person can no longer make decisions or give consent for any treatment or care. This belief is false. It makes great sense to always include the person coming to LTC in all discussions so that they have the opportunity to give consent.
The easiest way to talk about someone’s dying time is to respect their input. And listen. These difficult conversations need not be so difficult. Ask the person why they have come to live in LTC. They will tell you about of all the changes and losses in their lives. And here there can be hope! By living in LTC they are able to talk about their dying time coming, without it being minimized or brushed aside. They will see co-residents complete their dying here, and with an open discussion about this life ending soon, people can enjoy their lives without the doom of the unspeakable and not talked about event of their last days here.
Staff in LTC have such difficulty in having these discussions with people and yet these discussions should come so naturally, especially if people know that they are approaching the end of this life. And that is the key - people do not know that their dying time is coming soon. Instead, what is discussed is that the reason they have come to LTC is because they are no longer able to manage their life and health independently, and they need a higher level of care. Families may, on some level, know that this is what is happening and still it is rarely discussed. Maybe if we don’t talk about it, it will not happen. Still, we will all die and come to this time in our lives.
We discussed the shorter length of stay in LTC from compared to the past. Most people who enter LTC will die there so length of stay is mostly a measurement of time from admission until the time the person dies. LTC staff members, thus, see a lot of dying. So why the discomfort in talking about it? We would expect that most staff have seen people go “kicking and screaming” to their death. But most have also seen what would be called a “good death” with pain well managed, and family supporting, sometimes in vigil with, their loved one until death. Most of the discomfort in talking about dying must then come from the not so pleasant view of dying. As well, when the dying person does want to discuss their imminent death (which they instinctively know is coming soon) they get told statements such as “don’t talk like that, you have years to live” or “don’t worry, you will get better.” Yet we must question why we would worry about dying when we all know that all of us will die?
Of the 4 elements that need to be included in the palliative philosophy of care, one of the most difficult requirements may be quality of life. Quality of life is a subjective experience, so how do we even measure that? This question should be asked of the resident. But is it? For many people entering LTC making decisions is not left to them. Caregivers and family members make these decisions because “the person is not capable.” That is why they are coming to LTC. And yet the language is very clear that we must have the resident’s consent for decisions. Capability is not a black and white status. It fluctuates and where people may no longer be capable to look after their own finances, for example, they can decide if they want a certain treatment or another, whether they want to proceed with their dying in LTC or whether they want to have treatment (if possible) in another setting. To ask these questions of a resident, they must first know that they are coming close to their dying time.
Having that frank and honest conversation with someone can be a synergistic time for all involved. How freeing it is to talk about your own dying, when you know you are doing it, with someone who is comfortable talking about it. I have been with so many people who are dying and there are common themes which can make these discussions much easier to have. First of all, look to the psychology world where Erikson says that people progress through stages in their life, and which way they go can greatly influence quality of life and death. For the population living in LTC we will look at 2 Stages. Age 40-65 years old is covered by Generativity versus Stagnation. Age 65-death we look at Integrity versus Despair. So. if we do not encourage conversations about what coming to LTC means we will often see stagnation and despair. When speaking to many staff working in LTC, what they see is older people, with many losses recently in their lives, brought to LTC by family and left there without having a sense of what changed in their lives to bring them here. The Palliative Philosophy brings an honesty to the conversation. Yes, you will probably die here, but how can that life look before death. Is there an opportunity for Generativity and Integrity? Probably not if the person being admitted is not involved in the conversations. It is important for staff to have the person being admitted present and giving their consent to all care offered. No matter their capability, they should be present and included always in these conversations. (Erik Erikson’s Stages of Psychosocial Development. (Kendra Cherry, July 18, 2021).
What we have also seen is that at the end, just before death (weeks to days), people struggle to leave their legacy. Legacy leaving is interesting, but what we see is an attempt, often very late, to show one’s true self or self actualize (as Maslow would put it). How one shows their true self would mean another article, however in simple terms it means showing who you are from a strengths and values perspective, being free now of all defense mechanisms and maladaptive behaviours. We often, throughout our lives put up walls and wear different faces, our perception being that we will be more pleasing to others if we act the way we think they want us to. This does us and others a disservice, and at the end of our lives we try desperately to come clear of this.
We also see such mystery around our dying time. Again, do we ever talk about this to our resident’s. Do they know that near their death they will probably see their dead (loved ones who have already died) and that they will find great comfort in this? Most of us, who have worked in LTC have seen these mysteries. What a great opening to relate these stories to move to a discussion about your resident’s dying time. We need to find out what quality of life means to them, and it goes beyond symptom management. It is so much about leaving a legacy of who they are for those they are leaving in their dying.
In summary, we are regulated now to provide a Palliative Philosophy of Care to all residents in LTC. As noted, consent for this care must be given by the resident. Let us proceed with the honest conversations, which, yes, are sad in that we will all die and leave this life as we have known it, but what a glorious time this dying time can be if we just open up to its importance as the last significant act we will do in this life.
About the author, Franzis Henke, Nurse Practitioner.
As a Silver Meridian Associate, Franzis provides extensive expertise in Palliative Care, working with the dying and their families, Geriatrics, and Geriatric and Adult Mental Health. Silver Meridian is pleased to present a new program, developed and presented by Franzis, “New Approaches to Palliative Care in LTC: Embracing the Opportunities” starting in early July. Details for this 10 hour accredited CEU certificate program are available at https://silvermeridian.com/new-approaches-to-palliative-care-in-ltc/
For details on all Silver Meridian programs visit https://silvermeridian.com
Posted Date: May 11, 2022
Effective Date: May 11, 2022
The concept of “liberalized diets” has been around for some time within senior living but it is receiving increased attention as more is being understood about the role diet can play on quality of life and seniors health. This approach is also now being published in reference guides such as the Dietitians of Canada document, Menu Planning in Long Term Care (2020) - an influential guide for planning your menus in Canada. If you have not done so already, now is the time to start evaluating if this approach would work in your home.
What exactly are liberalized diets? Simply, a liberalized diet is one that is a non-restrictive or non-therapeutic diet. In practice, this means that residents who have diabetes for example, are not given a separate “diabetic diet” and instead receive the regular diet. Based on this simple definition, liberalized diets can often be misunderstood to mean that the residents’ health is not important, when in fact this is not at all the case. Instead, the adoption of liberalized diets represents a shift in priorities for the older adult. Whereas a younger person with diabetes living in their own home may have a goal of maintaining good blood sugars; that same individual 30 years in the future and now living in a care setting, may have the primary goal of enjoying life and maintaining their body weight. It is not that blood sugar control for the older adult does not matter, it is just that it does not matter as much as it once did. Quality of life is now paramount and weight loss and malnutrition are a greater risk to their health than elevated blood sugars. Indeed, this exact approach is also endorsed by Diabetes Canada, which states, “In older long term care residents, regular diets may be used instead of ‘diabetic diets’ or nutritional formulas.” This shift in priorities for older adults is what drives homes to liberalize their diets but doing it right is just as important as doing it at all.
Many people may question the safety of adopting a liberalized diet approach. Clinical staff, family members and the residents themselves may be concerned about what a change to the resident’s diet will do to their health. These concerns could be addressed by promoting the change through a presentation to staff and a separate one to residents and family. There are numerous organizations that have endorsed this approach, especially in long-term care. The Pioneer Network, the American Dietetic Association as well as the Dietitians of Canada Menu Planning in Long Term Care (2020) document, all have especially useful information about this approach and why it should be considered. These could be used to build the case for moving toward liberalized diets in your home.
Most importantly for adopting liberalized diets however is ensuring that the regular diet will continue to meet the residents’ needs, even if they have diabetes. The diabetic diet cannot simply be eliminated, and all residents moved to the regular diet without some adjustments to the base regular diet. For those in long-term care with diabetes, the type of carbohydrate is not as important as the timing and consistency of amounts received. Having a “regular” piece of cake with dinner is ok, so long as the amount of carbohydrates at each meal and is consistent from day to day. Not surprisingly, this approach is called “consistent carbohydrates” and is recommended for those with diabetes in care settings. In addition to consistent carbohydrates, evenly distributed protein between meals is shown to be effective at reducing unintentional weight loss in older adults and should be considered on all long-term care menus. Both approaches require menu management software with nutrition analysis to ensure your carbohydrates are consistent and proteins evenly distributed, day to day.
Finally, if you choose to adopt liberalized diets and eliminate some of your therapeutic diets, there will still be exceptions to the regular menu for some residents. This is where the clinical staff will need to develop individual meal plans or changes to the standard menu, as they do today. This process will not change; however, the default menu for new residents will be the regular menu until there is reason to change it, instead of the other way around.
With an increasing emphasis on resident quality of life in seniors' homes, liberalized diets are no longer an innovative trend and are now something worth considering for all homes.
Why “Now” is Not the Best Time to Quit!/wps/portal/eCPS/root/public/Resources/Resources/!ut/p/z0/04_Sj9CPykssy0xPLMnMz0vMAfIjo8zizR0dXT0cDQx93f0cXQ0CjV3C3F08wwwM3Mz0C7IdFQFCINbA/
Posted Date: Apr 27, 2022
Effective Date: Apr 27, 2022
For anyone working in long term care, the pandemic has become the primary talking point and focus of attention in almost every conversation. The pressures and demands on staff have resulted in unprecedented levels of absenteeism, turnover and staffing shortages. If people were considering retirement or a career change, for many this has been seen as the ideal time to move on.
While such decisions may seem prudent in the heat of the moment, pausing to reflect may prove to be the wiser choice. In the face of many challenging realities, there are compelling reasons to step back and reconsider a decision to quit working in long term care. This period of change and uncertainty is providing “golden opportunities” to grow and excel, for those who embrace the challenges.
When there is a shortage of magic wands to deal with major disruptions, with insight, some people are able to embrace golden opportunities, and make their own “magic.” We want to share some examples of these golden opportunities.
While not everyone may be able to incorporate every opportunity listed here to make magic in their personal workplace experience, there are enough opportunities to ensure that every employee can find a way to embrace the challenge, and realize more positive realities for themselves.
Opportunities Abound. The bad news is, many people are quitting. The good news for you – many people are quitting! With this much turnover, your chances of advancing are dramatically improved – where you are working now. You have automatically moved up the ladder, whether it is in terms of seniority, experience or workplace knowledge. Your skills are probably more in demand now than they have ever been. A golden opportunity to move to a new position or role you have been wanting.
Which leads to…
Leverage to Negotiate. You are now in a better position to discuss these personal “upgrades,” whether it is a change of role, responsibilities, an increase pay, or perhaps requesting more coaching, training or education to upgrade your skills. Don’t be shy about talking to your manager about what you want – it not only reflects your personal motivation, but reinforces your commitment to your work.
From The Pot Into the Fire? Yes, you are dealing with significant challenges in your long term care role today. But, you do know what you are up against. Do you really know what another place is going to be like? When you talk to other employers, are you really getting the full picture? Over the years we have witnessed people who have left for the “greener pastures” (such as increased compensation), only to return because the picture looked much different, once they were on the inside. Step back, look around at what you have, and consider the positives of your current workplace.
Friends and Acquaintances. Never minimize the importance of the relationships you have in your current workplace. It has taken time to develop your workplace relationships, those connections built on mutual trust and respect. Do you really want to start over somewhere new? Think about it – when you enter a new workplace, you have to seek out and work on developing new and strong relationships, among people who don’t need you for that – they already have their own relationships in place before you arrived!
And while we are talking about relationships…
Your Mentor or Advocate. If there is someone in your workplace that values you and supports you in your role, then you already have a built-in relationship that works in your favour. Leave now, and go somewhere else? Maybe for a while the person who hired you will be in your corner, but the pressure will be on you to prove yourself quickly. You have had an extended period of time to foster the relationship with your current mentor or supervisor. These troubled times are a great time to cement that relationship even further, by letting them know how committed you are to your work, and to your Home.
Your Reputation. If you are known as someone who works hard, gets things done, works well with others, is an effective leader…whatever…remember that you are known for those qualities where you work now. If you decide to leave to work elsewhere, you might tell people you have these qualities, but without the benefit of time and experience, they won’t have a reason to believe you. You have earned your reputation – don’t waste it.
Self-Reflection and Insight. So, you are considering leaving your job because (fill in the blank). Before making such a decision, take a long, hard, and honest look at why you are considering such a move. Make a list of all the reasons. Then, when you are done, beside every item on your list, write down what you have done to address each of these reasons for leaving. Have you shared your concern with your peers, your supervisor or someone who might be able to support you? Have you honestly dealt with the person who is the reason you want to leave? In other words, by reflecting on what you have done, and what you haven’t done, it might provide you with some insight as to what you should do before making the decision to leave. Remember the earlier Pot and the Fire example. Maybe there are some things you can do now, and avoid a bigger “scorching” somewhere else!
Now That I’m Hired – I Quit! How many times have we seen the newly hired employee who maybe completes their orientation, and then quits within a matter of days? So frustrating for the Home, and so disrespectful of the residents. We know, you didn’t know it was going to be this hard! But before you jump ship, think about this: 1) Why did you start down this long term care path, and if was to make a difference in the lives of residents, then that IS what the job is all about. So don’t give up on your dream; and (2) if it was easy, everybody could do it! It’s not easy work, but the joy and sense of accomplishment you will feel as you gain experience and confidence, and realize the impact you are having on your residents, will make it all so worthwhile.
If you took this job because you needed a job, and are not passionate about making a difference in the lives of residents, then please quit – now! You are getting in the way of people who care.
Because You Are You. The thought of people leaving the long term care sector reminds us of one of the many stories about Steve Jobs. As the young founder of Apple, Jobs was trying to lure the top-level Pepsi CEO, John Scully, to manage the company. When Scully turned Steve’s offer down, Jobs leaned in close to Scully and said, “You want to sell sugar water for the rest of your life, or do you want to come with me and change the world?”
Jobs challenged Scully to reflect on how he wanted to be seen and remembered. These are challenging times for everyone working in long term care. What you do every day, is about changing the world – the world of the residents you serve. As a human being, your beliefs about who you are as a person are measured not by what you say you stand for, but by how you respond in the face of such challenges. We all need to ask ourselves, “When I reflect back on my life, what do I want to see in my rear-view mirror?”
We believe that because of where you are today, having gone through what you have experienced over the past two years, who you are as a person is not in question. The question now is, are you up to what we hope and anticipate is the final stage of this most horrific challenge of our collective lives?
Hopefully, we have shared some insights that will inspire you to seize one or more of these golden opportunities, to help you make it over the top, and realize new successes in your career, and in your personal life.
You deserve it.
Your residents are worth it.
You can do it!
About the Co-Authors
Darlene Legree has over 35 years of diverse experience in long term care, from direct care provider, registered nurse, to management and staff education positions. With additional education in Nursing Informatics, MDS and Adult Education, and receiving her Gerontology Certification from the CNA, Darlene provides training and consulting in clinical, documentation, leadership and organizational practices. Darlene sits on the executive of Gerontological Nursing Association of Ontario – Central East Chapter and is the co-owner of Silver Meridian.
Ron Martyn (BSc Recreation, MSc Gerontology) has served as a Recreation Director and Administrator in long term care, and as a Retirement Home Owner. For over 20 years as the Co-Owner of Silver Meridian, Ron and the team have helped LTC managers hone their leadership skills, by empowering and energizing people, and becoming recognized as Inspired Leaders in the provision of care (English only). Go to Silver Meridian (https://silvermeridian.com) for more details.
Ingredients for a Healthier Tomorrow in Senior Living/wps/portal/eCPS/root/public/Resources/Resources/!ut/p/z0/04_Sj9CPykssy0xPLMnMz0vMAfIjo8zizR0dXT0cDQx93f0cXQ0CjV3C3F08wwwM3Mz0C7IdFQFCINbA/
Posted Date: Mar 25, 2022
Effective Date: Mar 25, 2022
This year’s month of March 2022 marks Dietitians of Canada’s 40th anniversary for Nutrition Month, which is an event shared and promoted by Dietitians across the country. Complete Purchasing Services (CPS) is happy to share this year's theme “Ingredients for a Healthier Tomorrow”, with a focus on senior living and long-term care. Under this theme, a popular topic is a use of “Sustainable Healthy Diets”, which is described by the World Health Organization as healthy diets with minimal impact on the environment. We believe there are 3 areas where seniors homes can have an impact on health and sustainability:
1. Sustainable food sourcing
2. Reducing food waste
3. Use more plant-based foods
The goal of this article is to encourage you to question what changes you can make for a healthier tomorrow.
Sustainable Food Sourcing
Sourcing food ingredients that have less impact on the planet is becoming more important as the world evolves. The awareness of climate change is increasing, and the way we run our food operations will affect future generations. One way you can make a change is by sourcing responsibly in your establishment, which involves choosing suppliers that are local, or have sustainable production methods. This can include local produce, or food products with certifications like Energy Star, Green Seal, Fairtrade, and more.
At CPS we are committed to sourcing our food products responsibly, that are made or grown locally across Canada, including Indigenous suppliers. We source humanely raised proteins and are the first food service provider to have a membership with The National Farm Animal Care (NFACC). We also have a partnership with MSC (Marine Stewardship Council) and certifications to have responsibly sourced wild-caught seafood products. For other food categories, we partner with suppliers who have a variety of certifications such as Fairtrade, Organic, Rainforest Alliance, and many more.
Reducing Food Waste
A major barrier to reaching sustainable goals is the significant amount of food wasted in Canada, which according to WRW Canada is estimated to be 58% of all food produced. Amongst senior homes, some contributing factors can include the food demonstration plates (show plates), or lack of implementation of waste prevention practices.
There are several solutions you can implement in your home to minimize food waste. One major tip involves training staff to minimize food waste by monitoring portion sizes, taking inventory, and following best practices for food storage. Leftover food should be recorded to track areas of over production, and inventory should be rotated properly using the first in first out rule (FIFO) to avoid spoilage. Kitchen staff can also be trained in how to cook with food parts often discarded in recipes like broccoli stems for example. Dining rooms can use tablet software such as CPS’s ShowPlates app, to show residents appealing menu images, instead of food plates that get discarded. Finally, your home can minimize food waste by taking resident preferences into account by gathering feedback on menus. Each of these steps can help minimize your home’s food waste impact.
Use More Plant-Based Foods
Our third point for a healthier tomorrow is to include more plant-based foods on your menu. They are full of nutrients, colorful (pleasing to the eye), cost-effective, and can often be sourced locally. They are also useful in targeting nutritional goals recommended in the Dietitians of Canada Long Term Care Meal Planning Guide such as 100g of protein and 30g of fibre daily. These nutrients play a large role in preventing common risk factors in the elderly like malnutrition and constipation. One ingredient to start including in your recipes is beans! They are packed with protein, iron, and fibre, and can be utilized across many recipe categories. Here are some ideas:
Starter: make soups and salads heartier and more colorful by adding beans
Entree: use lentils to replace ground beef in recipes like meatloaf or shepherd's pie
Dessert: try black bean brownies or chickpea blondies
Snack: try new hummus flavours to impress your residents like roasted garlic or fresh herbs
There are many topics to address under the umbrella of sustainability but starting with just one can already bring you towards a healthier tomorrow. Reviewing your supplier list, tracking food waste more closely, or even adding a Meatless Monday to the calendar are a few of the many ways to begin.
At CPS the health of the clients we serve is important to our team and we always strive to make sustainable menus that meet Canada’s Food Guide. We also have vegetarian menus, offering more plant-based options to residents, which you can use in your home. If you would like more information about our menus or food products, please visit ecps.ca.
Happy Nutrition Month!
Monica Chackal, RD
Bilingual Registered Dietitian
Complete Purchasing Services
Keep Calm and Keep Disinfecting!/wps/portal/eCPS/root/public/Resources/Resources/!ut/p/z0/04_Sj9CPykssy0xPLMnMz0vMAfIjo8zizR0dXT0cDQx93f0cXQ0CjV3C3F08wwwM3Mz0C7IdFQFCINbA/
Posted Date: Mar 16, 2022
Effective Date: Mar 16, 2022
Make your visitors feel safe when it counts the most.
After two years of trying to keep COVID-19 under control, pandemic fatigue is becoming a real problem. News of another variant makes the return to normal life seem that much further off, which can make it difficult to stay motivated to keep up with the seemingly constant changes. Louise Taillon, Sani Marc’s Director of Training, has been helping clients clean for both health and appearance for more than 30 years. In ‘Your questions in good hands’, Louise answers some important questions about how to stay the course in the fight against COVID-19.
What do new COVID-19 variants mean for building owners?
As new variants emerge you have to keep being vigilant in your efforts to maintain a clean and healthy environment. Even before COVID-19, disinfecting has always been essential for breaking the chain of infection and preventing the spread of germs that make people sick. This includes influenza, noroviruses and E. coli, all of which can be transmitted by hands and high touch surfaces. According to a 2020 report published by Deloitte, 62% of hospitality customers consider cleaning surfaces between interactions as essential to customer safety. 73% of property management employees want to see cleaning taking place throughout the day in order to feel safe, and 83% of retail customers say their perception of a store’s hygiene practices greatly influences their decision to shop there. During this time when people are fearful of entering facilities and interacting with others in close quarters, businesses must adopt new methods of cleaning.
Why is the added vigilance important?
It reassures clients, building users and employees that your building is safe, and it goes a long way towards building consumer confidence. Pandemic fatigue is real, but people still want to feel safe and they welcome any efforts made to protect them from contracting the virus.
What can be done to keep staff and visitors motivated to fight COVID-19?
Let your staff know that by taking extra care in disinfecting and allowing themselves to be seen doing so, they are becoming part of a much bigger solution. Their efforts will not only reflect well on them as employees, they are helping to protect themselves as well as their families, and they are contributing to the clients’ reasons to believe in the company and its values. On a more practical level, encourage good hand hygiene by providing disinfecting wipes and hand sanitizer and keeping restrooms well stocked with hand soap. Use infographic posters to demonstrate proper handwashing technique. Taking steps like these shows that your organization makes customer and staff health and safety a top priority.
What should we disinfect first?
Disinfect what matters. 80% of germs are spread by hands and viruses can live on hands for five minutes. Identify hand touch points (high touch points) and create a schedule to disinfect them several times during a day. There’s no need to disinfect all surfaces several times a day; only surfaces that are touched by multiple people.
When is the best time to disinfect?
Disinfect touch points during the day when building users are present. This helps to create a sense of security, that the building is safe. Clients and visitors who see this are more likely to return.
What is the most important thing to remember when disinfecting?
Respect the contact time or dwell time of the product you are using and make sure your surfaces stay wet with the disinfecting solution for the amount of time indicated on the label. For information about products, tools and turnkey solutions you need to help with COVID-19, visit https://www.sanimarc.com/disinfectant-product/.
Five Tips to Protect Your Property During Winter Months/wps/portal/eCPS/root/public/Resources/Resources/!ut/p/z0/04_Sj9CPykssy0xPLMnMz0vMAfIjo8zizR0dXT0cDQx93f0cXQ0CjV3C3F08wwwM3Mz0C7IdFQFCINbA/
Posted Date: Mar 02, 2022
Effective Date: Mar 2, 2022
One of the smartest things you can do as a business owner or property manager is to implement a winter disaster preparedness plan which will allow for you to be prepared for issues that might arise. The colder months not only bring plummeting temperatures but also ice, heavy winds, freezing rain, blizzards and snow that can wreak havoc on your business and your bottom line if you aren't prepared.
Winter storms can create a higher risk of car accidents, hypothermia, frostbite, carbon monoxide poisoning, and can knock out heat, power, and communication services. Know your area's risk for winter storms and pay attention to weather reports and warnings of freezing weather and winter storms. Sign up for your community's warning system or visit The Emergency Alert System (EAS) for emergency alerts, so you can stay on top of any potential threats related to winter weather conditions.
With the potential threats that the colder months can bring, businesses need to take every step possible to winterize commercial facilities including:
1. Avoiding Frozen Pipes and Plumbing Issues: Take steps to avoid frozen pipes by checking exposed exterior pipes for signs of cracks and openings that can lead to water leakage and freezing. Seal any cracks that are identified. Keep interior temperatures at a minimum of 55 degrees at all times during the colder months.
2. Checking and Inspecting Building Insulation: Have an expert come in to check your HVAC systems to see if interior or exterior insulation needs to be replaced. Routinely replace all building air filters. Old or inadequate insulation and filters can lead to higher energy costs.
3. Inspecting Roof Space and Clearing Debris: Clear your building's roof space of leaves and debris that can cause blockage of gutters. Doing this will allow melting snow to properly drain away from the building. Clearing debris can prevent ice dams and heavy snow from buildup on your roof which will prevent excessive loads on the roof and can cause unwanted structural damage.
4. Routinely Checking Property During Cold Periods: Check your commercial spaces regularly, at least once per week during the coldest months and winter storms, to identify a potential issue before it becomes a problem.
5. Partnering with a Restoration Professional: Develop a partnership with a professional restoration company that offers emergency planning services, so you are prepared if the worst happens despite all of the preparation. A trusted restoration company can help you create an emergency response plan in the event of winter weather related emergencies.
About FIRST ONSITE
FIRST ONSITE is Canada’s leader in disaster restoration for commercial properties focused on prevention, preparedness, response, mitigation and recovery. Locally-based and backed by extensive national resources, they can be first to arrive and first to make a difference when (or before) you need it most. Their unmatched speed, scope, and scale combined with and excellent team of professionals committed to excellence, service, and doing the right thing, ensures they can help your business whenever their services are needed...no matter what!
When Confronted by Complainers - Reframe!/wps/portal/eCPS/root/public/Resources/Resources/!ut/p/z0/04_Sj9CPykssy0xPLMnMz0vMAfIjo8zizR0dXT0cDQx93f0cXQ0CjV3C3F08wwwM3Mz0C7IdFQFCINbA/
Posted Date: Feb 02, 2022
Effective Date: Feb 2, 2022
Complain, complain, complain! What’s with the constant complaining!!!
Hey, we know you have one, or two, or maybe even a whole posse of complainers. Unfortunately, when left unchecked, a few complainers can gain momentum, and have a damaging effect on those around them.
So, let’s stop complaining about all the complaining. If we take a few minutes to understand why people complain, we can then “reframe” the complaining – and achieve new, and hopefully, more positive outcomes.
Understanding Why People Complain
To deal effectively with complainers and their negativity (both new complainers and chronic complainers), it helps to step back and look at what may have triggered the negativity, or why these people are so invested in being negative, for so much of the time.
There is no one reason why people complain. As with all human behaviour, there are many possibilities. Here are a few common examples:
Scenario 1: The “Done-Wrong-By” Response - The person who feels they have been misunderstood, mistreated, or just plain missed! The infractions (both real and perceived) may be based on something you have done, or that your predecessor was responsible for, or were done by a previous employer, or may even be based on life circumstances beyond the workplace (such as the “mom always liked you best” cause for complaining!)
Scenario 2: I Need to Feel Important - Rather than gain recognition as a result of making positive contributions in the workplace, some may derive a sense of importance or significance through complaining. When constant complaining results in action, or reaction, the person feels (and may be seen as) important, which of course serves to reinforce the complaining behaviour.
Scenario 3: You Made a Mistake! - Yes, sometimes people complain because you really have done something wrong, or that they disagree with your decisions or actions, and they let you and everyone else know about it. Guess what - it happens! As a human being, you do make mistakes. In such cases, it becomes an issue not because the complainer is complaining, but rather how they bring forth the concern.
Regardless of the scenario, whether this is a rare occurrence, a periodic response, or constant behaviour, before responding we must remind ourselves of the universal truth of all such human behaviour:
People do what they do because of what they get when they do it!
People complain because it works for them, or because it has worked for them enough in the past that they have decided to make it a part of their response process. Without beating up on ourselves too much as parents, aunts, uncles, etc., we all know how challenging it can be to NOT give in to the complaining child (we are using that term graciously here!) who makes a fuss over something they want in the mall. The point is, we have all learned that complaining can be productive!
Complaining behaviour in the workplace becomes a challenge based on
• when it is done (constantly, or at inappropriate times),
• why it is done (for self-gain without consideration for others, or not for improving things), and
• how it is done (such as loud and aggressive, or a personal attack on others).
So, whether the person is complaining to improve things, to gain recognition, to get back at someone, or to be left alone, if handled poorly, it can be very destructive to the culture of the organization.
Responding to Complaining
Because every situation is different, and every person brings their own unique way of responding, there is no “one-way” response to complainers. However, there is one common approach when dealing with complainers that heightens your chances of breaking the negative cycle of constant complaints, and that is by reframing the discourse.
Reframing involves changing the frame, or view, through which the other person is approaching a situation. When you prompt them to look at the issue differently, the situation can take on a different meaning, thereby changing the way the person is thinking about and responding to the situation.
If you change the way you look at things, The things you look at change!
What this means in practical terms is that since people do what they do because of what they get when they do it, by reframing our response to the complainer, responding with something they don’t expect, they are confronted by an outcome that is “not normal.” When we reframe from a positive perspective, it forces the complainer to think and respond differently, and gives you the opportunity to help them and you embark on a more constructive path of discourse.
Just as the complainer has learned to complain, most of us have developed our own response habits as well. Reframing requires practice, and at times, a thick skin – to avoid falling into the usual pattern of back and forth defending, and even counter-attacking, in response to complaining.
We have coined a few names for different reframing approaches, to help you quickly focus on a direction, when you are trying to formulate a reframed counter response to the complainer.
I’m So, So Thankful
When you receive a legitimate complaint (remember, you do make mistakes on occasion!), don’t just accept it, but show your gratitude! Be thankful. Rejoice! Share that you value the person’s willingness to share the concern, and appreciate the opportunity this provides you to make things right. If the situation applies, ask the person for their opinion as to how they think the issue could be resolved. By reframing the situation, you have subtly turned the complaining process around, and made it a positive, collaborative problem-solving opportunity for both of you – which reinforces a positive approach to making improvements.
Dumb as a Post
The complainer has started a rant, saying that everyone in the department is upset about the new policy, and that it only makes things worse. Rather than defend the change, play dumb, and ask questions. With sincerity, ask “Really? Tell me more about why it will make things worse, I really need to know.” By asking about the complainer’s position, you are accepting the person’s concern as legitimate, and then you are able to elicit more details as to what they see as the limitations in the change. This might lead to greater insights for you, and it will alert you to any misperceptions that this person (and probably others) might have. You are now in a position to thank the complainer for bringing this to your attention. Your reframing has disarmed them because of your openness, and they are more likely to be receptive to listening to any explanation you might want to share.
Oh really?...Thank you!
This is the same approach as the previous one, but viewed from the perspective of a complaint about you. When the complainer tells you that you have really screwed up, and everyone is talking about you, be surprised and thankful. “I had no idea that you might see my actions that way! Thank you for bringing it to my attention. I will certainly make a point of explaining myself better with others. Thank you again!” If the person was truly trying to be helpful, you have shown your appreciation of their feedback. If they were just trying to take a shot at you to get a reaction, your reframing has totally disarmed them by turning them into a helpful colleague (in spite of their intentions).
Mining For Nuggets
When the person is on a full-blown complaining rant, going through a wide range of items, listen carefully to every point, looking for something you can agree with. Then ignore all the other stuff, and say something like, “You mentioned (the one “nugget” you do agree with), and I agree, this is a concern to me too. What do you think would help us deal with it more effectively?” Responding to complainers is similar to handling conflicts – finding something we can agree on builds trust and helps us connect with others, which increases the chances of working together in a more collaborative way. Always be on the lookout for common ground between you and the other person.
What an Opportunity!
Turn the complaint into an opportunity. In fact, if this person is coming to you to complain about an issue, then you must accept that there are likely others who share the concern. So, if you embrace the complainant’s issue as a chance to improve, you have reframed the negative into a positive. “Wow, if we can fix this, what an opportunity to show how great we really are! Thank you for helping us live our Mission, and move closer to our Vision!”
So Glad You Care – You Need a Promotion!
When the complainer raises the issue, try, “This is really an important issue. I appreciate your level of concern, and you have so much insight. You have so much to offer, and could really help us overcome this challenge. How about it?” Perhaps try focusing on past positive experiences where you have been able to work things through, to win them over to the idea of working with you. Encourage them to think about what will be the benefit to them when the current negative situation has been overcome.
There are times when you really don’t have the time to deal with the complaint, or the complainer has caught you off-guard with a touchy issue, and you are concerned that you might resort to an ugly back-and-forth with them. Give yourself permission to take a time-out – with a defined time to re-connect. “Thank you for bringing this to me. I have a call I have to make right now, so when can we meet so you can tell me about this concern without interruptions?” This is a respectful, non-avoiding response, and ensures that you have time to collect your thoughts and compose yourself should it be a contentious issue.
One Small Step For Mankind…
Chronic complainers tend to be tenacious about issues, repeatedly bringing up old issues, or jumping from issue to issue without trying to resolve anything. Complaining for the sake of complaining, and repeatedly going over the same issue won't do either of you any good. If the complainer is in the “jumping” mode, keep quiet, start writing each item down so they can see what you are recording. When they run out of steam, say, “Is that everything? OK, let’s look at this list, and determine your priorities. What do you see as the most pressing issue?” You have respected their need to unload, and have demonstrated you are willing to systematically address the concerns.
Time To Move On
Sometimes you are not the right person to deal with the concern. If the issue is out of your hands as a manager, say something like, “Given your concern is about ______ , who should you be talking to about it?” If they don’t know, tell them. If they do know, say, “I agree. So, when are you going to talk to ________ ?” – and seek a commitment from them that they are going to talk to the person responsible for the concern.
If these approaches all start to sound the same, it is because they are! The intent is to provide short, memorable trigger words that describe the response type, as a way for you to quickly reframe your approach and thinking.
Regardless of the starting point, the approaches focus on considering complaining as an opportunity to help the person and you overcome a challenging situation (or behaviour), rather than as problem behaviour unto itself. If you are always on the lookout for common ground between you and the other person, it reframes the dynamic for the complainer, and increases your chances of moving towards constructive exchanges.
About the Author
Ron Martyn (BSc Recreation, MSc Gerontology) has served as a Recreation Director and Administrator in long term care, and as a Retirement Home Owner. For over 20 years as the Co-Owner of Silver Meridian, Ron and the team have helped LTC managers hone their leadership skills, by empowering and energizing people, and becoming recognized as Inspired Leaders in the provision of care (English only). Go to Silver Meridian (https://silvermeridian.com) for more details. For information on the new Winter intake for the, Online DOC/ADOC Leadership Certificate Program (Accredited), click the following link: https://silvermeridian.com/employee_focus/the-doc-adoc-leadership-certificate-program/
5 Tips to Keep Your Performance Resolutions/wps/portal/eCPS/root/public/Resources/Resources/!ut/p/z0/04_Sj9CPykssy0xPLMnMz0vMAfIjo8zizR0dXT0cDQx93f0cXQ0CjV3C3F08wwwM3Mz0C7IdFQFCINbA/
Posted Date: Jan 31, 2022
Effective Date: Jan 31, 2022
For many, a New Year marks the start of a new fitness routine. But with our busy lives, competing priorities and other factors that can get in the way, those fitness routines can quickly fizzle out before January is over. We rounded up our top 5 tips for sticking to those performance resolutions. Although we’re focusing on New Year’s resolutions, these tips can be leveraged any time you’re embarking on a new fitness journey.
1. Choose an exercise that you enjoy
When embarking on a new exercise routine, the biggest secret to success is taking part in exercise that you like to do! It may seem obvious but participating in an enjoyable form of exercise leaves you significantly more likely to continue with it, and even look forward to it. The last thing you want is to sign up for something that feels like a chore.
2. Create a plan
Before you start with your new routine, structure yourself a plan that is both realistic and convenient. Scheduling time in your day that is dedicated to exercise makes you more likely to stick to it. Whether exercising on your own at home, with others, or at the gym, scheduling time will mean you’re more likely to do it.
Going from newbie to marathon runner is extremely daunting and unrealistic, so set a goal that is safe, manageable, and achievable for your best chance of success.
3. Hold yourself accountable
Exercising with a friend or family member can help to keep you accountable to your plans. Being able to encourage each other can keep the determination. Better yet, it doubles up as social time! If exercising alone, finding a community (in person or online) of those who enjoy similar activities can help to give a motivational boost. Depending on your activity and your own goals, tracking your progress (whether that’s weight lifted, run distance or time, or points scored) can also help. You’ll physically see the improvements over time, increasing your desire to continue.
4. Take it easy
Think of your resolution as a lifelong commitment to your health rather than a short-term habit. You are much more likely to be successful and maintain your routine if you take it easy at the beginning and build around your current fitness abilities. Just because someone else trains six days a week doesn’t mean that’s optimal – start slow, keep it light and enjoyable, then work your way up.
5. Be realistic
New Year’s resolutions are notoriously impractical and unachievable. Setting goals and targets can help to give you something to work towards, but make sure they suit you, your abilities, and your lifestyle.
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When Confronted by Complainers - Reframe!
Everyone complains. Whether it is initiated by something big or small, complainers are everywhere. Some can look on the bright side relatively quickly, while others take a bit more time or need some guidance. Ron Martyn with Silver Meridian outlines how to help ‘complainers’ think outside the box and “reframe” the complaining to achieve new, and hopefully, more positive outcomes.
5 Tips to Keep Your Performance Resolutions
Follow these tried and tested tips for sticking to those New Year’s resolutions!