The Heart of the Matter

By Jeff Nunham, Adult In-Home Supervisor

Adult In Home Supervisor, Jeff Nunham talks about the things we learn along the way.
We often talk about the barriers and obstacles people face who suffer with a disability. Last month, I wrote about those care givers who are “on” 24/7, giving
care to a family member with a disability and who are silently suffering under the strain that goes with that level of loving care. The primary caregiver also face enormous barriers. One which we often see is the myth that says, “No one can care for my loved one like I can.” This is one huge barrier which keeps a caregiver from reaching out and asking for help.

If this is you, then this brief note is must read.

If you have been reading my newsletters lately, you will know that I think we have an exceptional staff of very competent and compassionate people. They often amaze me. Sometimes they really touch my heart.

The typical communication I exchange with our care providers is “housekeeping” kind of things. Things like filling vacant shifts, picking up medication sheets or scheduling a meeting. It is all very important, but not memorable. However, once in a while a care provider will send me a note that reminds me of the reasons I am so confident in the quality of care we give. See what you think.

Just to set this up; our client, M.K. had been acting out in ways that were quite challenging for the care provider. After a particularly difficult shift with MK, he had written an Incident Report to which I had responded, thanking him for the way he handled the situation. This is his response to me:

“Thank you, I’m just glad that the medication seemed to help his headache and combined with redirection he was able to get back to the normal happy M.K. we all know. By now M.K. is like a brother to me, and the goal is to predict what is ailing him before it gets to the point of outburst. I believe a headache or backache lead to his frustration which eventually manifested itself to this point. It hurts me to know he is in pain and has trouble communicating it, so all I can do is help him the best I can as soon as I become aware of his troubles. Sadly in this situation it was much more acute and happened rather quickly.”

Can you hear his heart…………? Who wouldn’t want the love of a brother to shape the care your loved one gets? He is one of the reasons why we say, “This is so much more than a job for our care providers”. Our care providers are all heart.

As a supervisor, I am always looking for care providers with heart. One vital source of great compassionate care is the volunteer who serves because they love to give. A few days ago, as I was walking by one of our volunteers who helps out in the Adult Day Services program, I stopped to thank them for the work they are doing. I thanked her for giving her time to be a part of the program. Her response struck me just like the email you just read. “I just love it here” was her immediate reply. Her eyes were bright and her smile revealed her warm and loving heart. Who wouldn’t want to spend the day with people like that? Like the employee who loves like a brother, this volunteer brings that same warmth and compassion to our members.

This is a message I wish every care giver could hear. If you fear allowing another person to care for your loved one, I simply say “the heart of the matter is a respite care provider who will care like a brother and serve with the love and compassion of a volunteer.”

Better Care Notes and Documentation


better care notes requires a positive focusLately, professional documentation of care notes has been a concern for both care providers and clients. Better care notes serve as a guide for parents and their case managers to know what our care provider and their child have done during their time together. Care notes are used as data to mark the progress of the child and/or concerns that the care provider may have for this child. As a parent, please do not hesitate to ask the care provider to go into greater detail in the care notes, or request that the care notes be rewritten.

Care providers, here are some words of advice to address some of the common concerns about care notes:

How to Write Better Care Notes

1.Make sure all your documentation is professional

2.Use proper grammar in your documentation. There should be no slang.
Write “out of,” not “outta”
Write “had snot and drool,” not “was snotty” (could be misunderstood)

3.Write your name and care notes legibly and neatly. Especially on the medication sheet.

4.Remember to write the facts about what happened, not subjective opinions.
For example, stating a client was being “testy.”  This is opinionated/labeling. Please note clear facts.

5,On shift duties and medication records, be sure to sign your initials or write “n/a” on each line if the duty did not apply to you on your shift. At the end of your shift, make sure there are no blank lines.

6.Try to “paint a picture” of what happened in your documentation so that anyone who reads it has a clear idea of what happened on your shift.
For example, “his pants are wet…as of right now they are in the washer,” should be clear and state that the care provider assisted the client by changing his pants when they were wet.
7.Document when clients get their showers: if the client assisted and with what (i.e. washing their own hair and body).
8.Document the specific activities you did with each client on your shift, where you went, what they did by themselves and what you assisted with. For example, you can state, “I drove Amy to the park and pushed her on the swings. She appeared happy because she was smiling and clapping her hands.

Remember to always include what goals are being addressed!