Friday 24 January 2014

Personal Support Workers in Long Term Care Facilities

By Cynthia Herron
Information for Families

Choosing to live in, or have a loved one live in a Long Term Care Facility (LTC), also known as a Nursing home, can be a very difficult decision. If you are a caregiver, already taking care of a loved one full time, realizing that you are now unable to care for them can be a depressing and stressful time. Many seniors find just the thought of a nursing home very frightening. Caregivers and seniors need support and council when making these types of decisions.

In a LTC facility, there are a variety of professions employed.

Examples are:
·      Personal Support Workers (PSW) 
·      Nurses 
·      Directors of Care 
·      Administration 
·      Food service staff
·      Laundry service staff 
·      Cleaning staff 
·      Activity directors
·      Visiting Doctors


Some LTC facilities may have many other professions employed as well. Personal Support Workers (PSW), play a very large role in the care of your loved one and all people living in the LTC facility. The role caregivers take on when caring for their loved one, is similar to the role of a Personal Support Worker in LTC. Personal Support Workers are the EYES of LTC. Paying attention to the needs, wants, concerns and well being of all residents. The Personal Support Worker job description for each LTC facility varies but most factors are very similar.


Most importantly, Personal Support Workers assist the residents with their Activities of Daily Living (ADL).


Showers, tub baths and sponge baths.
Many LTC facilities have specific tub bath days for every resident. Usually, a specific Personal Support Worker for that shift performs the tub baths. Residents capable of bathing themselves, and resident’s bed ridden, have sponge baths most days. (morning and bedtime) However, each facility may have different policies, schedules and bathing equipment.

Mouth care is preformed by Personal Support Worker if resident is unable to do.
Cleaning of dentures, partial dentures, and over all mouth care. Checking inside of the mouth with the removal and application of dentures. This is to ensure there are no surface wounds of gums, tongue or any issues with any remaining teeth.

Assistance or performing any incontinent care.
Peri care is performed during every incontinent product change. Appropriate creams or specific cleaning products are used if necessary.

Assistance of dressing and undressing.
Residents who are bed ridden or have partial to no mobility, Personal Support Worker’s perform a complete dress/undress.

Applying medicated (if needed and approved) and non-medicated creams, lotions and powders.
Paying close attention to skin appearance. Checking for any surface wounds, unusual bruises, scratches, redness or swelling and signs of any potential pressure sores

Assistance with positioning in bed. Residents who are in bed for long periods of time, are repositioned and moved every two hours to prevent pressure sores from forming.

Assisting female residents with makeup application and male residents with shaving (electric usually).

Personal Support Workers ensure hearing aids are being used and working. Or other personal aids.

Personal Support Workers perform simple catheter care if needed. Cleaning around catheter site, watching for infection or any unusual concerns and the emptying and changing of catheter bags. Documenting the amount of output. Many residents with catheters have different bags for day and night. Personal Support Workers change the bag to the residents needs. Personal Support Workers work with condom, In-Out and indwelling catheters.

Assisting in transfers. LTC facilities use equipment to aid in transfers if the resident is unable to bear some or all of his/her weight during a transfer. Ceiling lifts, and mechanical lifts are used in these cases. For residents who partial weight bear, Personal Support Worker’s assist them with transfers from their bed, chairs, wheel chairs, bathrooms etc. In some cases, depending on facility policies, hip belts, floor disks, transfer boards or other transfer aids may be used.

LTC facilities have specific breakfast, lunch and dinner times. Personal Support Workers assist residents down to the dining room and back again. In some cases, residents are unable to leave their rooms and a tray of food is brought to them. Personal Support Workers will also assist residents to activities, being held in the activity room of the facility.

All facilities have a “call bell” system. When a resident needs something or needs help, there is a button or pull string in their rooms and bathrooms. When the system is used, an alarm can be heard and a Personal Support Worker comes and aids the resident.

Personal Support Workers, usually work within three shifts a day. Morning, evening and midnight shifts. Positions may be full time, part time or casual. Most shifts usually consist of the same group of Personal Support Workers.

Personal Support Workers ensure privacy of all residents during procedures or personal care routines.

Personal Support Workers document daily, and record any concerns they may have. They record intake of food and fluid, output if needed, personal care routines completed, skin condition, emotional state, update on any ongoing or recent concerns and more. Each facility has a different form of documentation (I.E. flow sheet, tick sheet, progress notes, etc.) and what is documented may vary.

Personal Support Workers stay aware of all safety concerns for the residents. Ensuring all safety equipment is being used when necessary (I.E. bed rails being used when resident is in bed)

Personal Support Workers ensure the residents are comfortable in all situations. Both physically and emotionally.  Personal Support Workers provide socialization to residents and encourage independence!

Most Personal Support Workers, residents and the resident’s families, share close relationships with each other. Personal Support Workers have many residents to provide care for but are always ensuring all the residents are in their best condition. Socialization is a huge point of care that a Personal Support Worker provides. Talking about life stories or current issues and concerns the resident is having, can really improve their overall state of mind. Personal Support Workers can talk to family members, and assist them with any concerns they may have about their loved one.

Many Personal Support Workers go above and beyond their duties in a LTC facility, making the facility as much of a home setting as possible. Loved ones living in and moving to a LTC facility have to deal with the loss of their independence. Personal Support Workers try to enable residents to maintain some kind of independence while living in a LTC facility. Whether it is encouraging the resident to perform their own personal care needs or help another resident in any way. Even residents being involved in the activities department can give them a feeling of independence.

All professions working together in a LTC facility come together and try to make your loved one and all residents as comfortable as possible in their new home. Communication among all health team members and families involved, is essential to make the resident feel independent, safe, comfortable and happy in their new environment.

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