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Monday, June 8, 2009

Take Precautions for Facility Outing?

Activities directors, other healthcare professionals and caregivers, here is some important information about outings
NCCDP Newsletter
By: Sandra Stimson CALA, ADC, CDP, CDCM
Residents diagnosed with dementia and or who live on a dementia unit may go on supervised outings. But the team needs to put thought and planning for facility trips. As a general rule, anyone that the team feels is not a flight risk should attend outings. As long as there is appropriate staffing to provide supervision, observation and monitoring at all times. Only take the number of residents that can be safely monitored.
On all trips there should be an activity assistant, nursing assistant and a bus driver. Or two activity assistants and a nursing assistant. A nursing assistant should accompany all residents as they are trained in areas of ADL’s. Additionally, if you have only one activity assistant and a resident has to go to the rest room, who will be left to monitor the residents? Administrators and Director’s of Nursing must make it a policy to have appropriate supervision when resident’s have a diagnosis of dementia are on facility outings. The facility is leaving themselves open for possible accidents, elopements, fines and law suits should anything happen
But what if the person is a flight risk? Flight risk may be anyone who is ambulatory or in wheel chair or motorized cart who has wandered away before. But be aware that a dementia resident who wanders away may never have wandered away from a controlled area before. Staff must be alert to this possibility at all times. Plan for it, Expect it.
The team for the dementia unit must meet and decide as a team what the safety issues are, how you will meet those safety issues and which staff will provide the monitoring and observations. The team should make the decision on which residents will attend facility outings. This should not be a decision made by the activity staff. Obviously, anyone who is a flight risk must have one on one staff supervision at all times.
At times you have families who insist that their loved one attend a resident outing. However, safety must come first. If you are not prepared to take this resident on an outing due to inadequate staffing, supervision and monitoring concerns than you must explain to the family. You might ask the family member or responsible party if they would like to attend the trip and assist with their loved one. Many people have no concept of how hard a trip is and what is involved in a trip. It may be one of the hardest and most exhausting of activities.

Pick the location well, as if a life depends on it. The Activity Director should visit the location prior to the trip to access the environment, crowds, bathroom facilities, parking lot and number of exits for the location. Smaller venues are recommended such as;
Small diners
Small pet shops
Small stores
Small stores such as five and dime vs. a large shopping mall.
Drive to a resident’s old neighborhood
Small zoo
Ice cream parlors
Garden center
Plan your time well. Probably the best time to go on an outing is 10:00 A.M. and return by lunch time. A long trip is probably not recommended as they tire easily. There are times through out the year that you may want to take residents on trips where they do not leave the van such as viewing holiday lights or observing fall foliage. Keep in mind the weather and dress the residents accordingly.

Always communicate for success. Let the residents know where you are going. When you get off the bus, let the residents know what they will be doing. When they return, state to the residents,

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