About Your Care Plan.

When you are admitted to St Andrew’s, staff will involve you or your representative in numerous assessment activities. Finding out about things that are important to you is part of this process.

All of this information goes into developing Your Care Plan, which is individually tailored to reflect your capabilities, needs and wishes.

Your Care Plan:

Contains details about your medical, physical, social, emotional, lifestyle cultural and spiritual care needs. It outlines how you wish care to be delivered. It can also contain information about family arrangements (e.g. who visits you regularly, emergency contacts and information about Advance Health Care Plan.

Review and update your care plan.

Ask for Your Care Plan to be reviewed and updated whenever you wish to make alterations or amendments.

Updating Your Care Plan (CP)

Care Plans are evaluated regularly and reviewed every 6 months. We will schedule these reviews and involve you and your representative in the process, making sure a printed copy of your Care Plan is available for you to review. Should you wish to have a copy, a summary Care Plan can be made available to you.

You can also request changes to Your Care Plan based on alterations to your preferences. Your nurses, GP/NP and other health care Staff will consult with you to update Your Care Plan when changes are necessary.

Wheelchairs & Mobility Equipment

On admission from the community, our Registered Physiotherapist assesses the suitability of your equipment for use at St Andrew’s Village. We will return any unsuitable funded equipment to the supplier. The resident will typically use equipment supplied by St Andrew’s Village.  

However, the resident or their family may purchase personal equipment for use.  We suggest that if the family is considering purchasing a personal item of equipment they liaise with the Physiotherapist to ensure items fully meet the requirements and needs of the resident. St Andrew’s Village permits electric wheelchairs following an assessment by a registered Physiotherapist.

All electric-powered wheelchairs must be set at a low speed to ensure the safety of all other people who use the Centre.

Pastoral & Spiritual Care Team

St Andrew’s Village has a two-member Pastoral Care Team who care for residents, staff and family/Whanau of any belief or denomination and are available to discuss personal and/or spiritual matters with them. Please let a staff member know if you would like to talk to a pastoral team member.

Weekly interdenominational services are led on alternating weeks led by Anglican and Presbyterian churches. Services are held in the Chapel on Thursdays at 1:00 pm.

Other Services Offered

Services, ceremonies and rituals to mark various occasions are led by the Pastoral and Spiritual Care Team.

In addition, we regularly visit residents in their houses and rooms. These visits are a chance to build friendships and to offer support, a listening ear, comfort and prayer if desired.  We are also very happy to ‘just be’ with you if that is what is needed.  And of course, we are there for residents and their families experiencing times of difficulty or distress.

Our Pastoral Care Team provides a weekly choir workshop and regularly plays the piano in the houses. Special arrangements can also be made for residents to see their own kaumatua, minister, vicar, priest, pastor or elder.  Please speak to the staff or the Pastoral and Spiritual Care team.

Room Blessings

Each room is blessed before a new resident enters it and after it has been prepared by staff.

Pastoral and Spiritual Care Team

Phone:   (09) 585 4020 ext 257 or 293

Email:  pastoralcare@sav.co.nz

We appreciate the significant transition involved when someone moves into a specialist memory care unit.  Some people may experience a period of increased confusion until they become accustomed to their new home. It can also be hard for family members. We understand this, and we will do what we can to make the transition as smooth as possible.  You are very welcome to talk with our Clinical Manager at any time.

Our locally based GPs and Nurse Practitioners, experienced with people with dementia, will readily consult specialists at Mental Health Services for Older People as required.

We would love to talk with you about what we offer, and how we can work together, and we know you will have more questions than a simple leaflet can answer.  Come along and join our “walk through” experience for yourself where you have an opportunity to discuss options and concerns.  We will also provide you with the St Andrew’s Village general information brochure.

Our unit staffing ratios are very good, and all Clinical Assistants working in the unit must hold a Careerforce Dementia Certificate.  In addition, all staff in the unit hold other qualifications relevant to nursing care ensuring staff are skilled and experienced in this specialist area of care.

Activities and daily events

The Activities staff and volunteers work with the rest of the team to engage residents in meaningful activities aligned with their preferences and routines.

Activities may be group sessions or individually focused.  Activities range from bus outings, Inter-Resthome bowls competitions, Intergenerational Kindy Kid visits, pet therapy, arts and crafts and visits to the local café on Roberta Ave.

Families and friends are free to be part of any activity.  We will ensure you receive an invitation for any scheduled special events.

Pet visits are encouraged at St Andrew’s Village, and if you would like to bring your pet please discuss this with the team leader.

The displayed activity planners are in each resident’s room, on the House Noticeboard and on “The Street” notice board next to the Chapel outline planned events.

Weight loss may be part of the process of dying with dementia.

Watching someone with advanced dementia lose weight, despite them being fed enough food, can be frightening. It is quite normal to feel this way.

We will talk to you about any weight loss issues your family member is facing and support you.

When weight loss continues.

Weight loss may continue even though the common reasons for weight loss have been managed.  Weight loss can be inevitable due to an advanced disease called cachexia (ka/kek/sia).

Cachexia is a normal process caused by advanced diseases such as dementia, cancer, heart, liver, kidney and lung failure.

When people have cachexia, they can’t absorb the nutrients from food, even when they are eating and drinking enough.  They lose weight, have no appetite, and become tired and weak.  The person’s body slows down and prepares for death.

What can be done about continued weight loss?

When cachexia is present, the best choice is to carefully feed the person using food he/she likes and can swallow.  This way the person can still enjoy the social contact that comes from being fed.  Tastes and smells from favourite foods can stimulate the appetite.  Family members and friends can help feed the person if they want to help.

A person with cachexia should never be forced to eat.

Making decisions is hard

The decisions around feeding and weight loss are hard.  When a person has advanced dementia and can’t tell us what they want, it’s even harder.

Talk to the Nurses and GP/NP who all know your loved one well.  They all want your loved one to be comfortable and their wishes respected.

If you remain worried and concerned, we are also able to offer the services of our Pastoral team on our staff who can offer you extra support.

At St Andrew’s Village, we aim for a restraint-free environment wherever possible, and any restraint used must be the least restrictive possible

Restraints are only used as a last resort after all other options have failed, and in a situation where the resident may do something to harm themselves, including loss of dignity.

A decision to use restraint is made in partnership with the resident or their representative, and the team

When might restraint use be considered?

Restraints can help prevent residents from:

• Falling out of bed
• Falling while getting up quickly from a chair
• Mobilising without essential supervision could lead to a fall
• Severely compromising their hygiene or safety needs.

Restraints authorised for use at St Andrew’s Village are:

Bed rails; lap belts; low height for chair or bed; placing a nightingale table in front of a chair; or gentle holding during care, for example: showering.

Other methods which are tried before restraint is proposed

• Talking with the resident and their family about their care and activity needs
• Having a family member or volunteer spend time with the resident
• Using sensor mats to alert staff to a resident’s movements
• Creating a tranquil or interesting environment
• Providing activities to draw attention away from actions which may cause harm to the resident or others
• Reviewing pain control
• Additional efforts to ensure comfort.

Are there risks associated with using restraints?

Yes, which is why they are considered only as a last resort with full discussion with residents and their families, the GP/NP and the Clinical Team.

Depending on the type of restraint being considered, risks can include: loss of dignity (always a risk); falling over bed rails’ entrapment; skin tears and bruising; immobility and its consequences; frustration or aggression.

When are restraints removed?

Restraints must be released at 2 hourly intervals throughout each day.

Preventing Falls

St Andrew’s Village takes the resident’s well-being extremely seriously and we have a range of information for residents, family, friends and staff aimed at keeping residents safe and confident. 

What activities put you at high risk?

Research tells us that the following activities pose as a high risk for falls:

1. Getting in or out of bed
2. Going to or from the toilet
3. Getting in or out of a chair
4. Reaching for things

Why is preventing falls important?

• 40% of falls result in an injury,
• 5% are serious
• Other injuries affect the quality of life

But mainly, they reduce your confidence and sense of well-being.

Things that increase your risk of a fall:

• Research shows us that people at the highest risk of a fall are those who:
• Have had a previous fall
• Are able to stand but need help to transfer
• Have moved to a new home
• Have frequent toileting needs
• Have agitation, confusion, or dementia
• Are taking many medications.

We aim to keep you safe by…

1. Helping you get settled into and used to your surroundings
2. Assessing your risk of a fall and discussing that with you, your family and other team members, such as the Physiotherapist
3. Developing a care plan with you aimed at reducing risk
4. Keeping areas uncluttered and removing rugs
5. Keeping your call bell within reach and responding to you quickly
6. Arranging a sensor mat or any other related equipment, if you can’t call out
7. Reacting calmly and confidently should you have a fall, to minimise any extra harm
8. Encouraging the use of hip protectors and the consumption of Vitamin D

What you can do:

• If you wish to stand after lying down, sit until you feel steady
• Talk with staff about concerns or ideas about safer mobility
• Ensure your footwear is firm and supportive
• Please consider hip protectors: some falls are not preventable but hip injuries can be
• Tell staff of any hazards
• Participate in as much physical activity as possible

Don’t hesitate to ask for help.
Many people feel they don’t want to “be a nuisance”. Assisting you is what we are here to do.

So… please ring!

What are the risks?

• Loss of freedom, independence and choice
• Falls from climbing over the side of the bed
• Fractures/death from such falls
• Fractures from entangling legs between uncovered bed rails.
• Entrapment (limb, head or neck caught between bars).

What are the benefits of using bed rails?

• Enhanced bed mobility
• Feeling of safety
• Residents who request rails can use them as aids for comfort or mobility

How are decisions made?

Decisions are made by the Clinical Team (nursing and medical staff), and sometimes the Physiotherapist, in partnership with the resident and their family.

They weigh up the benefits and risks, and also whether or not the use of a bed rail will be a restraint.

X-Rays

When required a portable x-ray can be arranged to take place at St Andrew’s Village, however, the cost of the x-rays is at the expense of the resident unless covered by ACC.