I am a Adult Nurse Practitioner student. I am working on a project relating to pet therapy (focus on extended care facilities). I was wondering if anyone had any interesting articles that may be of use to me.
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The following is a letter that I recently sent to the editor of my local newspaper. I was wondering what opinions were out there about the new bill.

The House of Representatives recently passed a bill (H.B. 66) allowing nurses aides to obtain a medication aide certificate. The certificate allows aides to pass medications to residents in nursing homes and residential care facilities. There is currently a pilot program being conducted until July 1, 2007 to test the effectiveness of medication aides. There are 80 nursing homes and 40 residential care facilities participating in the pilot program. Under the direction of a registered nurse, the medication aide may administer prescription medications through the following routes: oral; topical; drops to the eye, ear, or nose; rectal; and vaginal medications.
To be eligible for a medication aide certificate the aide has to be at least 18 years of age, hold a high school diploma or GED, and complete a training program consisting of 70 hours of instruction. Before H.B. 66 either LPNs or RNs administered medication. LPNs attend college for 1 year and RNs attend college for 2 to 4 years.
Currently, I am a RN with a bachelors degree and am seeking a masters degree. I believe that administering medications is a tremendous responsibility. I am concerned that 70 hours of training is inadequate. As a consumer I am uneasy having my loved ones medication handled by someone receiving the new training standards. As a professional I am not comfortable passing along this great responsibility. LPNs and RNs have extensive training regarding medication. Both professions learn about the various medications and side effects. Essentially, by giving a medication you are taking a persons life into your own hands. Seventy hours of training is insufficient to prepare a person for this liability. Ultimately, the concern for both consumers and professionals is patient safety.

Thank you,
Kristen Burgess

from the diaries - joe

The new guidance for activities regs is supportive of culture change. It includes recognition that quality of life and enjoyable, stimulating activities take precedence over medical care and that, to most people (including residents), social and family life is most important. Also it encourages involvement of and responsibility of all staff in activities. The challenge is put forth to all elder care facilities to transform themselves and staff to this way of thinking. This will be challenging.

I am looking for ideas from anyone who would care to share. In the home where I am social services director, our residents express that they like to do meaningful 'work'; they like to be useful - not just 'playing games'.

We have a number of residents with low-vision and varying levels of cognition. Does anyone have any ideas for self-directed, meaningful 'work' activities for such people? I've had them assist me with mailings (applying stamps and labels to envelopes) - some need 1:1 assistance which is not always possible. I am also currently contacting volunteer organizations in the community to see if they have any needs we can fill. I would also like ideas for greater community involvement, if anyone has any suggestions. Thanks!

MC5 to meet July 14, 2006 from 10:00 am to 2:00 pm at Primaris in Columbia, Missouri.

from the diaries -- joe

Hi Pioneers,

CMS Division of Nursing Homes has graciously agreed to let me form a Culture Change Team, and now I have two colleagues, Linda O'Hara, RN, who used to work for a university, and John Thompson, almost Ph.D. who is a former worker with Charlene Boyd at Providence Mt. St. Vincent.  We are pursuing some new CMS culture change projects, one of which will be a satellite webcast called "Resident-Directed Care, What Is It?"  These broadcasts for our surveyors are also available to the public on the internet, and for sale.  Now that we've got a title, we are hoping to highlight on the show what is happening in provision of care.  Here's a chance to spread the word on changes that are happening and how they affect residents and staff.

So if you are someone who works in or consults with a nursing home that has made specific changes in such things as night care, meds and treatments, care planning, etc., please write here in this blog and tell me the story of what you have done and what happened when you did it.  If you know someone who you think would be good as a participant on the show (you included) let me know that too.  

Show is tentatively planned for December. Thanks a lot.  

If you would prefer private communication, contact me at karen.schoeneman@cms.hhs.gov