Posts
Written By
Jessie Snowdon, New Zealand Registered Physiotherapist, Director On the Go Physio Limited, March 2022
Two years into New Zealand’s journey with COVID and these days can seem harder than ever.
We have endured lock downs and now we are in this strange no-man’s land where it feels for
many older adults, that in order to stay safe we must stay home.
Strength is IMPORTANT!
If you are not getting your usual physical activity, or if you have never been that keen on
exercise (!) then you should try and build in some structured exercise every day. Exercise can
come in many ways – gardening, bowls, walking – and although these are all excellent ways
to get in your recommended 150 minutes a week, the real hero of the story is building
strength.
As we age we naturally lose muscle strength, and our muscle fibres change – but age is NOT
a barrier to improving strength and muscle mass. We know that there is a direct link between
strengthening exercises and decreased risk of falls, and we all want that!
How can I strengthen my muscles?
In order to make change you must put your muscles under a certain load…and this means it
must be hard! The great news is that you don’t need to spend much time, if you hit the right
level of ‘hardness’. You can work through a strength programme in 10 minutes!
We recommend that you start with 10 repetitions of each exercise for a few days, and then
find the level at which doing 6-8 of the exercise feels “hard”. “Hard” means that you don’t
feel you could do any more without a rest.
When you have established that level you should work through your whole programme then
take a 2 minute rest. Then, guess what? Do it all again!
Which muscles should I strengthen?
You should strength the muscles you need for function. This means the ones you need for
every day activities like standing up from a chair, walking fast, picking up objects and helping
with balance.
The programme below covers off all of these.
Is there anything I should be careful of?
With all exercise you should be aware of and stop if you experience pain in your muscles or
joints, chest pain, severe shortness of breath or severe dizziness. Remember though that
when you work your muscles hard you can expect to have slight soreness the next day or so,
especially when you have just started.
Ok I’m ready! Show me the exercises!
As you are all individuals it is hard to prescribe one set of exercises for everyone. You will
need to apply some common sense and ensure you feel safe during each exercise. If you are
unsteady, or usually use a walking stick or frame, then ensure you are holding on to the bench
or table – or have your frame in front.
Ready….let’s go!
Exercise one – Standing up and sitting down This works the muscles you need to get from a chair but also to bend down, walk, climb stairs – it is an excellent all-round functional exercise.
❖ Start in a firm chair that you know you can stand up from.
❖ Using both hands lean forward and then stand up.
❖ Repeat this 6-8 times.
Easy? Make it harder by…
- Speeding up.
- Just use one hand.
- Use no hands (cross arms across chest).
- Sitting on a lower seat.
- Holding something heavy in your arms such as bottled water, or some weights.
Exercise two – rising up onto tiptoes
As long as you aren’t hanging on for dear life this is an excellent whole leg work out.
You need strong calf muscles to walk and for balance.
❖ Hold onto a steady surface such as a kitchen bench or back of a chair.
❖ Rise up onto your tip toes, as high as you can.
❖ Try to go straight up, not forward.
❖ Repeat 6-8 times.
Easy? Make it harder by…
- Decreasing your hand grip so you just use index fingers.
- Putting a back pack on with weights such as bottled water in it.
- Lift one leg off the ground and take all the weight on one side!
Exercise three – standing on one leg
This works the muscles around your hips and is excellent for stability and balance.
❖ Hold onto a steady surface.
❖ Make your left leg strong and gently lift your right.
❖ Focus hard to ensure your hips stay level – your trunk and shoulders shouldn’t move!
❖ Hold for 5 seconds then swap sides.
❖ Repeat 6-8 times on each side
Easy? Make it harder by
- Standing for 10 seconds
- Decreasing how much you use your hands, change to just index fingers, or no hands!
Exercise four – push ups!
Strong arms are essential for helping you pick up and carry objects, and to push yourself up from a chair, bed or the floor. We often neglect our arms so make sure to include this one!
❖ Stand with your hands against the wall, have a chair next to you if needed.
❖ With fingers spread and arms close to your body allow your elbows to bend so you
come closer to the wall.
❖ Breath out and push away back into standing.
❖ Repeat 6-8 times.
Easy? Make it harder by…
- Using the bench to lean on instead of the wall.
- Increase your speed.
This is an excellent starting point with four functional exercises. If you repeat all these then
you should have a good 10-minute daily walk out. If you would like so extra balance
exercises then read on!
EXTRA BALANCE EXERCISES
Balance exercises are harder to prescribe as everyone is at very different levels and you need to keep safe! Here are some options for balance work but ensure you are by a sturdy surface and work within your abilities.
Exercise one: Standing still balance
❖ Stand with your feet together, without holding on, for 10 seconds
Easy? Make it harder by…
- Turning your head slowly side to side.
- Closing your eyes (with care).
- Changing your foot position into “step”.
Exercise two: walking backwards
❖ Carefully walk backwards alongside your bench. If you normally use a frame or walking
stick then ensure you use if for this exercise.
❖ Focus on long, slow steps.
Exercise three: walking in a figure 8
❖ In an open space you can put down two objects (salt and pepper shakers, two water
bottles) about 1 metre apart.
❖ Weave around these in a figure 8.
❖ Use your walking frame or stick if this is normal for you.
Easy? Make it harder by…
- Moving the objects closer.
- Going faster!
Congratulations!
You are now carrying out a great exercise plan. If you are able to you
should include regular walking at a good pace out in the community. You should also
ensure that once you have done your daily exercises you don’t sit down the rest of day.
Every 30 minutes you should be up on your feet, even if just for a minute or two.
If you would like more advice or and individualised treatment plan then we offer clinic,
home and online appointments and would love to help you regain and maintain your
strength.
Original Article By: Jessie Snowdon, New Zealand Registered Physiotherapist, Director On the Go Physio Limited, March 2022
As you will be aware, assisted dying will be legally available in New Zealand from November 7 when the End-of-Life Choice Act 2019 comes into effect.
The introduction of assisted dying means that a person with a terminal illness who meets the eligibility criteria can request medication to relieve their suffering and end their life.
The Act sets out the legal framework and a high-level process for accessing assisted dying, including strict eligibility criteria and safeguards.
Assisted dying is not a replacement for palliative care or health care services more generally. It provides another option for people with a terminal illness in certain circumstances.
Assisted dying remains illegal until 7 November 2021. The Ministry of Health will be responsible for the Act and has an implementation programme underway to implement the assisted dying service.
This may impact hospitals, care facilities and retirement villages across the country in an entirely new way, so we at Healthcare Compliance Solutions Ltd have been following the Ministry of Health’s guidance along the way, to ensure our policies and procedures help our new and existing clients through the process, as best as possible.
If you would like to learn more about how Healthcare Compliance Solutions can help you and your orgnisation.
“HCSL has been incredibly easy to navigate since we went live on the system on the 1st of October. Our team have people with varying levels of technology literacy and the ease of this system has meant that staff are more confident to use technology and see how it can help to improve time management by not having to double or triple up on written documentation.”
Manager
Alexander House Rest Home
We are very pleased to have recently been granted 4 year MOH Certification! No corrective actions and three Continuous Improvements.
This follows on from a fully attained Partial Provisional Audit that was required prior to opening our two new wings earlier this year with no corrective actions.
Make no mistake! HCSL policies, software and support have played a major part in these accomplishments. The HCSL software we use means we have easy access to information in real time.
I started working with Gillian of HCSL shortly after I took on the role of Facility Nurse Manager at Bethsaida Retirement Village six years ago. The facility was not using Healthcare Compliance Solutions policies at the time and perhaps this was reflected in the previous audit results.
Gillian is always responsive to emails and phone calls which is critical when timely advice is required.
The HCSL regular newsletters are interesting with relevant and up to date information on issues affecting aged care.
Gillian is a lovely person to deal with. She is thoughtful, professional, pragmatic and I have always found her to be keen to help, with practical advice on any issues that might arise in the management of a retirement facility.
I thoroughly recommend HCSL to all aged care facilities.
Tracy Holdaway (RN BN)
Facility Nurse Manager
Bethsaida Retirement Village
Thank you, Gillian, for all your support. The Healthcare Compliance Solutions Ltd (HCSL) aged care program gives a structured clear pathway through the obstacle course of Certification.
The HSCL program was extremely user friendly and appears very nicely laid out and easy to locate care plans and patient’s information. The general feedback from the staff has been positive.
The policies and procedures were easy to follow, and well presented. We appreciated how thorough these policies were, and how much work had gone into developing them.
We all felt well supported throughout, and it was so nice knowing that you were on the end of the phone/email or zoom. Even when we met in person, you were incredibly positive and encouraging, thank you!
We would recommend this system to anyone needing assistance with the challenge that is Certification.
Barbara Adams
Board Chair-person /Acting Manager.
One thing new and seasoned managers often fear is having a staff member raise a personal grievance against them. We asked Rainey Collins Law Associate Jaenine Badenhorst for some ideas to support management avoid personal grievances. The following advice was the response:
We would recommend that you do these key things to help avoid a personal grievance being raised against you/your business.
- The first key thing to do is to hire the right candidate in the first instance. (Yes, we know that isn’t always easy)! You want to make sure you have a robust interview and reference checking system in place. You could also consider your existing team meeting the candidate to make sure there is a good personality fit. There is also the possibility of a work trial or probation period, depending on the circumstances.
2. Have a written employment agreement which clearly sets out the parties expectations (for instance about work hours, flexibility, responsibilities, reporting lines, raising problems, and so on). It is helpful for these matters to be discussed beforehand, so that everyone is on the same page. This helps to avoid confusion and misunderstandings. Employee manuals can also be very helpful to cover more detailed rules and guidelines (for example internet use, health and safety, bullying and harassment, etc.).
3. Keep accurate employee records and files. This should cover hours worked, leave taken, superannuation or other agreed deductions, discussion around various work conditions and so on. The employee file should also cover any issues with performance or misconduct (detailing fair processes followed, and outcomes reached).
4. Act in good faith towards each other (by being honest and approachable; as well as open and communicative). Being a good employer, and having a relationship with employees where they feel free to raise issues early on is the best way to resolve problems before they turn into formal grievances. Regular catch-ups (like weekly or monthly meetings) is a good way of checking in with employees, and letting them know if there are any issues with their conduct or performance.
5. Knowing your obligations around the law and the contract you have with your employee is also very important. This way you are less likely to cause issues which will turn into grievances. If you are unsure of your obligations, you should seek professional advice.
Thanks Jaenine, we hope that helps managers of services who might be struggling with this issue. Following due process and keeping accurate records will also support why you have made decisions and how. Even with the best processes in place, sometimes you cannot completing avoid a grievance but follow professional advice and you can certainly minimise risk of a claim against you or your organisation.
There will be further articles published here supplied by Rainey Collins Law in relation to supporting your employment processes.
Receiving emails from our clients who have made the transition from paper-based to digital give us a lot of satisfaction. One provider who had been under DHB monitoring after an audit that didn’t achieve as well as they could have said they saved $100,000 after implementing the HCSL programme. They had been spending a lot of time researching, writing and submitting corrective actions to audit findings for quite some time. This doesn’t happen anymore. They have no findings!
Comments which reflect how very easy they found the process of transition reinforce our concept of where possible we opt for one click instead of two in our design processes. Some client had used other digital packages in the past which they described as cumbersome and clumsy. Those packages didn’t integrate with other packages so to find all the information needed, staff had to use multiple sources of information. This made some reluctant to try something new. Arriving on site at a client one day Gillian was taken to meet two care staff. Both were very excited to tell her how due to them both having dyslexia, neither had been able to write their own notes before. Now with the simplicity combined with spell-check in the digital progress notes, they were able to write their own notes.
The co-design of solutions with our clients maintains the philosophy of simplicity being as easy to use as a basic mobile phone or Facebook.
Early on we identified inequity between the resources available to corporate owned multi-site providers and independently or small group owned aged care services. This inequity, in conjunction with shortages of staff led us to work alongside aged care, retirement village and community services to design a one-stop-shop programme and in 2015 HCSL aged care software went LIVE. It has continued to be developed since then to a fully cloud based solution.
Clients said they’d like everything in one place. Despite there being other options we were continually pressured to create a NZ specific product that supports not only benchmarking, quality and risk but also all aspects of providing care while incorporating compliance throughout each aspect of the programme.
The integration with Medi-map medication administration systems will further streamline access to resident care information for remote assessment and treatment planning. More integrations are underway currently to support as seamless flow of resident information regardless of where those needing information to provide care are situated. Clinical records are now accessible and able to be updated from anywhere with an internet / wi-fi connection.
Having been appointed as the step-in temporary manager at Rosewood Resthome and Hospital during the COVID-19 outbreak, Gillian Robinson was able to implement HCSL cloud-based software for telehealth support. This programme was literally set up overnight and being used by staff with no training as there simply wasn’t time. The great test for the system was to note the staff were able to successfully use the digital online care-planning and progress notes without any training other than to be supplied their login. The uploading of a photograph of a wound for the doctor to review remotely was able to done easily after watching the 5 minute instructional video on ‘how to’.
Community, Disability services and mental health residential services along with retirement villages throughout NZ are now enjoying efficient cloud based records. To find out how you can use this ready to use, NZ specific programme contact us.
Boards of any organisation should be well placed to provide strong and transparent governance. This means the members of the board all need to understand the organisation structure, strategy, finances, client base, market changes and employees for the context in which they are operating. This includes knowledge of behaviours, culture and ethics. The behaviours of all organisational board members gets reflected in employees to set the culture within the workplace which is experienced by the clients and those advocating for them, their family/whanau and friends.
The skill of judgement is necessary for board members to base decision-making on a set of agreed standards or a clearly defined constitution, organisation vision/mission or philosophy. To have a progressive Board, there is the need to recruit board members with greater skills than already exist within the board. This ensures progressive diversity of thinking and culture based on more than gender and ethnicity. A greater diversity is needed to also include creativity, innovation, current commercial practice knowledge, information givers and information seekers to increase depth of conversation and concepts being explored. The Board member profile could do well to include these attributes, abilities and skills. Collectively they need to advance the organisation purpose, vision/mission or philosophy in a way that meets client current and future needs.
Boards are not the place for the faint-hearted or those at the end of career who simply ‘want to give back’ who may base todays decisions on yesterday outdated models. Diversity will become a more visible part of boards with the introduction of the new Health and Disability Service Standards later this year. While they are currently in draft, it seems clear the final version will require more diversity within boards. This will include increased desire for Maori representation and inclusion on Boards. As American diversity advocate and activist Verna Meyers says, “Diversity is being invited to the party, inclusion is being asked to dance”.
If Maori representation isn’t part of your board make-up, it may be advantageous to look at forming relationships with local Iwi who fit the attributes needed to fit your board member profile. All Board members will need to be available, ethics driven, commercially aware and able to contribute. The Board Chair will need to show these same attributes and also provide consistent innovative, clearly communicated strategic leadership. The Board as a whole will also need to be agile in their response to unplanned events. 2020 and the emergence of COVID-19 reminded us of this. It appears 2021 and into the foreseeable future will also present the need for agile thinking and innovation. I suggest now is the right time to review how your board is made up and how effectively they perform. How can this be improved in your organisation?
Contact Info
Level 2 / 9 Baigent Way, Middleton, Christchurch, NZ
+ 027 601 6401 (Support) or
+ 027 601 6400 (Director)
+ 027 601 6400 (Director)