FOCUS Breakout Sessions 

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 Keynote: Wednesday, November 19, 2014  8:15-9:30 a.m.

 
Providing "The Best Care Possible" Through End of Life

Ira Byock

Everybody wants the best care possible for their loved ones and themselves through the very end of life.  Of course, that phrase means different things to different people.  Delivering the best care possible, therefore, requires access to a broad array of services and coordination between providers, patients and their families.  This presentation will explore the elements that must be in place within and beyond health care and the stakeholders who must be in communication to reliably provide care that is consistent with best practice standards and with the personal preferences of patients and families.

 
Participants will learn:
1. The fundamental components of quality clinical care in the context of serious illness.
2. The elements and process of shared decision-making.
3. The structure, process, outcome approach to quality improvement.
4. The role of individuals and their families as engaged effective partners in the shared goal of achieving optimal care.
5. That dying is a critical time in the life of individuals and families.
 
 


Focus 2014
Wednesday, November 19
Breakout Sessions: "A" Series 10-11:30 a.m.  

Choose one of the following:

A1​
Imagining our Patients Well: Human Development Through the End of Life
Ira Byock

On a social and cultural level, we can easily be constrained by our collective imagination. In fact, real transformation of health care and society is possible.  It starts by challenging assumptions regarding end-of-life care and re-imagining our collective clinical and social response to the personal experiences of illness, family caregiving and dying.  By enlarging the seemingly unsolvable problem of health care for an aging population and soaring prevalence of chronic illness, we can attend to the living experience of people, rather than only the treatments for their collective diagnoses.

Participants will learn:
1. The elements and process of shared decision-making.
2. The personal nature of illness and dying.
3. The tangible role and effects of imagination on care for people with life-threatening conditions.

 
A2
All Hospice is Palliative Care But Not All Palliative Care is
Hospice
 
Jim Cleary

The basis of United States hospice and now hospital based palliative care lies in the United Kingdom and Canada.  Modern hospice was established in the United Kingdom and palliative care in Canada.  It is on this background that the comparison of hospice services will be made to palliative care services.  The impact of the development of US hospices outside of mainstream medicine will be explored as will the growth of hospital based palliative care services.

Participants will learn:
1. Hospice in Wisconsin is a provider of palliative care.
2. The historical background of hospice in the US.
3. Models of palliative care provision from other countries.
 
A3
Pain in End of Life Care: Barriers, Principles and Goals
Shaili Shah

The presentation will review common misnomers and stigmas attached to end of life pain control.  Discussion will include a detailed approach on how to decipher and treat different types of pain, while upholding hospice expectations.  Medication review, including opioid use and adjuvants, will be evaluated with special attention to indication, drug overview and its place in pain management.  During the presentation, we will discuss evidence based medicine to understand different pain treatment modules, while creating a medical plan that is patient specific.

Participants will learn:
1. Barriers and stigmas related to end of life pain control.
2. The key differences and appropriate medications used to treat varying pain ailments.
3. Use of evidence based medicine to develop and implement patient specific treatment modules to manage end of life pain.  

 
A4​
Hospice and Nursing Homes: Partners in End-of-Life Care
Cherry Meier

The number of seriously ill residents requiring end-of-life care is increasing.  The Centers for Medicare & Medicaid Services (CMS) has recognized these issues and added language for surveyors reviewing the care of nursing home residents at the end of life.  Nursing home staff is now expected to identify residents approaching end of life, initiate conversations regarding treatment decisions, and incorporate the resident's decisions into the care plan.  Hospice can assist nursing homes in meeting these expectations.  This session will discuss the regulations/licensure requirements for the partnership and provide operational guidance in developing a compliant partnership.

Participants will learn:
1. The benefits of partnering with hospice.
2. The regulations for the interface between hospice and nursing home providers.
3. Operational guidance in meeting regulatory requirements.  
 
A5​
Hospice: The Gold Standard of Medical Care
Melanie Ramey

This presentation will examine the evolution of hospice and where it is today.  Emphasis on hospice philosophy and how services are delivered. 

Participants will learn:
1. When a person is eligible for hospice.
2. How to obtain hospice services.
3. What to expect from hospice care. 

 
A6​
Pain and Symptom Management: Analgesic Use of Methadone
Paul Hutson

This breakout session will provide a symptom and systems-based approach to the selection of drugs for pain and other symptoms.  There will be additional focus on the rationale for the use of methadone for pain, including guidelines for opioid switching and risk assessment.

Participants will learn:
1. About starting doses of opiates appropriate to kidney or liver function for a person with somatic pain.
2. An appropriate conversion dose to methadone, including risk assessment for QTc prolongation and subsequent titration for an opioid tolerant person with chronic cancer pain.
3. Stepwise drug options for analgesia for a person with neuropathic pain. 
 
 
A7
Recognizing Death
James Milford

The breakout session will focus on some of the difficulties in recognizing patients who are approaching the end of life and the missed opportunities that result.

Participants will learn:
1. Some of the difficulties in identifying signs of imminent death.
2. How to obtain hospice services earlier so that patient needs can be better met.  
  
A8
Improving Veteran's End of Life Care

Joe Muench
Jolene Renda

This breakout session will address the Veterans Administration's (VA) mission to honor veteran's end of life care wishes through expanding access, with a focus on improving quality, outreach, and dissemination of expertise.  The VA's End of Life Care Initiative includes the Bereaved Family Survey, ICU-PC Initiatives and ICARE Initiatives.  Presenters will also address meeting the needs of veterans in the Community as well as rural veteran initiatives. 

Participants will learn:
1. Five major components of the VA's Comprehensive End of Life Care Initiative.
2. The needs of veterans in rural areas.
3. The impact of the veteran's end of life care initiatives on quality and access for veterans and their families.  
  
A9
SESSION IS CLOSED-AT CAPACITY
Consider the Conversation: A Documentary on a Taboo Subject
Mike Bernhagen

Michael Bernhagen will provide “behind the scenes” perspective into the making of the multiple award-winning PBS film, Consider the Conversation:  A Documentary on a Taboo Subject, and its associated ripple effect.  In particular, he will: 1) tell the story behind the film’s creation and its role in producing systemic change within the expert culture of medicine, 2) screen the film in its entirety, and 3) discuss how medical professionals can overcome obstacles such as lack of time, training and funding to provide excellent end-of-life care. 

Participants will learn:
1. The physical, emotional, spiritual and social burdens associated with gradual dying.
2. Ethical, physical, and moral dilemmas created by advances in medical technology and treatments over the past 50 years.
3. Awareness of the need for providing patients and families with timely and comprehensive communication at the end-of-life.
4. To better articulate a personal definition of "quality of life" and what it means to "die well."
5. How to feel more comfortable having end-of-life conversations.
 
A10
Ethical and Legal Issues at the End of Life
Robyn Shapiro

This breakout session will help participants identify and analyze ethical and legal principles that surround patient care issues at the end of life.

Participants will learn:
1. How to identify, analyze and apply ethical principles to end of life patient care situations and issues.
2. How to identify and utilize resources (such as ethics committees) to assist with bioethics and legal challenges at
the end-of-life.
 

 

Focus 2014
Wednesday, November 19
Breakout Sessions: "B" Series 12:30-2 p.m.  

Choose one of the following:

B1
The Assisted Living/Hospice Relationship: Tools and Tips for Navigating a Successful Partnership
Meg Pekarske

Assisted Living Breakout Session

Both hospice and assisted living have seen marked growth over the last decade, as the elderly increasingly desire to age in place at assisted living facilities and seek the benefits of hospice care at the end of their life.  Marrying these resident goals requires that assisted living facilities and hospices establish solid partnerships, but how is this done and what are the marks of a successful partnership?  Attendees will learn important legal and business considerations when establishing a partnership, while gaining an understanding of the risks that can arise when building a relationship and how to avoid them.  The presenter will also share her knowledge of the emerging legal issues affecting hospice care and insights for how these may affect how hospices and assisted living facilities work together in the future.

Participants will learn:
1. Key legal obligations and business considerations that ground a successful and compliant partnership.
2. Emerging issues that will impact how assisted living facilities and hospices work together to care for residents, including the Federal Office of Inspector General's review of assisted living based hospice patients and hospice coverage of drugs and other items related to residents' terminal illness.
3. Important do's and don'ts when putting your relationship into practice.

B2
All Hospice is Palliative Care But Not All Palliative Care is Hospice
Jim Cleary
This session is a repeat, see A2 for the summary of the presentation.
 
B3
Honoring Choices Wisconsin: Improving Advance Care Planning Across the State
John Maycroft

Honoring Choices Wisconsin (HCW) is a major initiative to build system change, advocacy and education around advance care planning.  Through HCW, the Wisconsin Medical Society serves as convener, coordinator and catalyst to build clinical improvements combined with outreach in communities across the state.  Mr. Maycroft will share HCW's story, the lessons learned in the two years since its launch, and ideas for the future of advance care planning and end-of-life care.

Participants will learn:
1. The process of advance care planning.
2. HCW strategy for improving advance care planning.
3. Strategies for engaging in advance care planning conversations and participation in HCW.
B4
Hospice and Nursing Homes: Partners in End-of-Life Care
Cherry Meier
This session is a repeat, see A4 for the summary of the presentation.

B5
Do We Really Know How Long This Patient Will Live? An attempt to improve our best guess on survival of hospice patients with non-cancer diagnoses, focusing on the dementias
Dena Green
This breakout session will focus on the determination of hospice eligibility for individuals with non-cancer diagnoses, focusing mostly on the primary diagnoses of dementia-type illnesses.  The validity of the Local Coverage Determinations (LCD’s), as well as common tools used to prognosticate survival in patients with dementia will be discussed.
 

Participants will learn:
1. The current literature addressing newer tools and strategies for prognosticating survival, including the importance of comorbid diagnoses on survival.
2. The recertification process, including measurement of and recording of rate of decline in patients with dementia.
3. Identification factors that impact on survival.
 

B6
Pain and Symptom Management: Analgesic Use of Methadone
Paul Hutson ​​​
This session is a repeat, see A6 for the summary of the presentation

B7
Honoring Cultural Values, Beliefs and Traditions at End of Life
Tracy Schroepfer ​​​

Each year the clients, residents and patients served at end of life by our healthcare and long-term care system become more diverse.  The more diverse these populations, the more critical it is that professionals have the skills and practices in place to provide culturally competent services and care.  This session will provide best practices and appropriate strategies for honoring cultural values, beliefs and traditions related to receiving end-of-life care.  The influence of privilege and cultural identity on communication and service delivery to clients will be explored.

Participants will learn:
1. Barriers that present during the dying process when diversity is not honored.
2. Strategies and best practices for insuring culturally appropriate end-of-life decision-making, communication and care preferences.
3. Use of personal introspection to build skills in providing culturally competent end-of-life care.
B8
Employee Grief and the Health Care Setting
Cheri Milton

Working as a healthcare professional comes with its own unique challenges concerning grief and loss.  Employees suffer due to the regular exposure to patients who are in continuous decline and ultimately die.  The grief resulting from this exposure can significantly decrease employee's sense of well-being, job satisfaction and productivity.  This presentation will explore this topic and offer practical solutions to help prevent and address the effects of grief and loss in the healthcare setting.

Participants will learn:
1. The grief issues unique to healthcare workers.
2. How personal loss influences the losses witnessed by them in their work.
3. Practical solutions for reducing negative impact of grief and loss at work.

B9
Consider the Conversation 2: Stories about Cure, Relief and Comfort
Mike Bernhagen

American medicine's success at fighting disease and extending life has created a new problem. That is, the vast majority of our patients can now expect to die in a place (a hospital or nursing home) and in a way (with increased quantity, but reduced quality of life) that most wouldn't choose if only asked.  In this presentation, award-winning film producer Michael Bernhagen will provide 'behind the scenes' perspective into the making of, Consider the Conversation 2: Stories About Cure, Relief, and Comfort, a new documentary that examines the effect of American medicine's success on the patient/doctor relationship. In particular, he will: 1) screen and analyze several clips from the film; 2) share moving stories from seriously ill patients and the doctors who care for them; and 3) shed light on the important role communication plays in helping both patient and doctor navigate the murky waters of severe chronic disease.

Participants will learn:
1. Unintended consequences of American medicine's success at fighting disease and extending life.
2. How talking about end-of-life wishes, well in advance, can help prevent unnecessary suffering at the end of life.
3. That communication is a skill on par with diagnosis, treatment, and prognosis as something medical professionals can learn, teach, and use with therapeutic benefit.

B10
Ethical and Legal Issues at the End of Life
Robyn Shapiro
This sessions is a repeat, see A10 for the summary of the presentation.
 

 

Focus 2014
Wednesday, November 19
Breakout Sessions: "C" Series 2:30-4 p.m.  

Choose one of the following:

C1
The Assisted Living/Hospice Relationship: Tools and Tips for Navigating a Successful Partnership
Meg Pekarske
This session is a repeat, see B1 for the summary of the presentation.

C2
Pain in End of Life Care: Barriers, Principles and Goals
Shaili Shah ​​​
This session is a repeat, see A3 for the summary of the presentation.

C3
Honoring Choices Wisconsin: Improving Advance Care Planning Across the State
John Maycroft
This session is a repeat, see B3 for the summary of the presentation.

C4
Improving Veteran's End of Life Care
Joe Muench
Jolene Renda ​​​
This session is a repeat, see A8 for the summary of the presentation.

C5
Do We Really Know How Long This Patient Will Live? An attempt to improve our best guess on survival of hospice patients with non-cancer diagnoses, focusing on the dementias

Dena Green ​​​

This session is a repeat, see B5 for the summary of the presentation.

C6
Recognizing Death
James Milford ​​​
This session is a repeat, see A7 for the summary of the presentation.

C7
Honoring Cultural Values, Beliefs and Traditions at End of Life
Tracy Schroepfer ​​​
This session is a repeat, see B7 for the summary of the presentation.

C8
Employee Grief and the Health Care Setting
Cheri Milton
This session is a repeat, see B8 for the summary of the presentation.

C9
Consider the Conversation 2: Stories about Cure, Relief, and Comfort
Mike Bernhagen
This session is a repeat, see B9 for the summary of the presentation.
C10
Ethical and Legal Issues at the End of Life
Robyn Shapiro
This session is a repeat, see A10 for the summary of the presentation.
 
C11
SESSION IS CLOSED-AT CAPACITY
Non-drug Strategies for Symptom Management at the End of Life
Kristine Kwekkeboom

This presentation will identify common symptoms experienced at the end of life; describe various types of non-drug strategies and the evidence-base to support them.  It will address challenges in implementing these non-drug strategies across care settings and among patients with changing capacities as illness progresses.

Participants will learn:
1. Common aspects of end-of-life symptoms not relieved by medications.
2. Various types of complementary, non-drug strategies for symptom management.
3. Strategies to facilitate inclusion of non-drug strategies in the care of patients at the end of life in home or long-term care settings

 
 

 Keynote: Thursday, November 20, 2014  8:30-9:45 a.m.

 
Dementia Beyond Disease: Enhancing Well-Being
Allen Power

This presentation will describe the limitations of our dominant biomedical model of dementia and present a more expansive, experiential view.  It will outline the limitations of both traditional pharmacologic and non-pharmacologic approaches to dementia and present a proactive, strength-based approach that focuses on enhancing seven domains of well-being.  The presentation will use case studies and other examples to show the benefits of a well-being approach to understanding and supporting people who live with dementia.

 
Participants will learn:
1. Three drawbacks of a narrow, deficit-based view of dementia.
2. The definition of the experiential model of dementia and how it contrasts with the traditional view.
3. The seven domains of well-being used in the approach. 
 
 

 

Focus 2014
Thursday, November 20
Breakout Sessions: "D" Series 10:15-11:45 a.m.  

Choose one of the following:

 

D1

Session is Closed-At Capacity
Dementia Beyond Disease: Transforming the Care Environment
Allen Power

Dr. Power will expand upon the model described in the keynote by discussing how various aspects of the care environment can cause excess disability for people living with dementia.  The process of "culture change" will be outlined with respect to transforming physical, operational and personal aspects of our approach to daily life and care, and will be applied to all living environments.  The session will also outline examples of ways in which the seven domains of well-being can be enhanced through operational shifts.

Participants will learn:
1. The three types of transformation needed to create an enlightened care environment.
2.  Three examples of ways in which one's own home can also become an institutional environment for the person living with dementia.
3.  Two ways in which two chosen domains of well-being can be enhanced through operational shifts.
 
D2
Intimacy and Sexuality in Dementia Care
Lynda Markut

This program for professionals will provide insights into this controversial topic.  Challenges for families and caregivers arise regarding values and roles, and ethical and legal challenges must be considered by professional caregivers and institutions.  Through video clips and exercises, participants will gain insight into the challenges persons with dementia and their families face.

Participants will learn:
1. Behavioral challenges faced by persons with dementia and how caregivers can add to those challenges.
2. To recognize and understand the need for intimate connections for the person with dementia and their family caregiver.
3. How these needs impact the lives of persons with dementia and their caregivers from real life video clips.
 
D3
"Alive Inside: A Story of Music & Memory" A Documentary Film Presentation
Pat Benesh
Kevin Coughlin

This session presents the documentary film, Alive Inside:  A Story of Music & Memory, winner of the 2014 Sundance Film Festival Audience Award.  The film reveals a remarkable, music-based breakthrough that has transformed the lives of persons with dementia.  Spearheaded by social worker Dan Cohen and captured on camera by filmmaker Michael Rossato-Bennett, we learn that songs from a person's past can awaken memories and emotions that have been asleep for years, sometimes decades.  Within a moment of hearing 'I Get Around' by the Beach Boys, Marylou, a person with Alzheimer's is seen dancing around the living room and expressing euphoria her husband hasn't witnessed since her illness took effect.  The film includes conversations with renowned neurologist Oliver Sacks and musician Bobby McFerrin, as well as powerful firsthand experiments conducted by Dan Cohen in nursing homes.

Participants will learn:
1. How Dan Cohen discovered the power personalized music has to awaken memories in people with Alzheimer's disease and other dementias.
2. How music can trigger memories from a person's past and provide enjoyment and contentment.
3. What created the buzz at the 2014 Sundance Film Festival.
D4
Is the Wound a Pressure Ulcer, Incontinence Associated Dermatitis or Something Else?
Joyce Black

Superficial wounds on the pelvis and perineum can develop from pressure, shear or exposure to urine/stool. Distinguishing one type of wound from another is imperative in order to develop a reasonable prevention and treatment plan.  Ulcers from medical devices will also be addressed.

Participants will learn:
1.  To compare and contrast the presentations of pressure ulcers on the pelvis and perineum, incontinence associated dermatitis and combination wounds.
2. Treatment plans for pressure ulcers and incontinence associated dermatitis.
  
D5
Care Transitions in the Assisted Living Setting
James Lett
Assisted Living Breakout Session

Readmission to the hospital setting is a significant problem in the health care system today.  The presentation will discuss the sources of readmissions, programs to reduce those readmissions and options for assisted living sites to initiate actions to improve status with residents, families and referring hospitals while respecting patient choice and focusing on patient-centered care.

Participants will learn:
1. Trends which have contributed to issues causing readmissons in the health care system.
2. Programs currently in place to reduce readmissions in the long-term care continuum.
3. Actions to reduce hospital readmissions.
 
D6
Using Advancing Excellence Tools to Measure Quality
Alice Bonner
Nursing Home Breakout Session

This presentation will review the available goals, tools and resources on the Advancing Excellence website and how to use them to improve and measure quality.  The presenter will address at a minimum the infections and rehospitalizations goals, tools and resources.

Participants will learn:
1. How to use data to drive improvement efforts. 
2. How Advancing Excellence utilizes the data that providers enter. 
 
D7
Reducing Anti-Psychotic Usage for Nursing Home Residents with Dementia
Victor Molinari
Nursing Home Breakout Session

This breakout session will show why a prescription of anti-psychotic medication, to address the behavior problems of nursing home residents, is problematic.  It will include four studies that were conducted at the University of Southern Florida on mental health in Florida nursing homes.  The presenter will discuss the recent national Centers for Medicare and Medicaid Services initiative to reduce anti-psychotic medications and the different strategies utilized.  It will conclude by discussing conceptual models for understanding and treating behavior problems for nursing homes residents, including an online training module for nursing home staff (CARES).

Participants will learn:
1. Why anti-psychotic medications have black box warnings regarding usage to treat behavior problems of nursing home residents with dementia.
2. About studies conducted in the State of Florida that shed light on why there is limited non-psychopharmacological care for nursing home residents.
3. About different conceptual models that have been proposed to understand and treat behavior problems of nursing home residents.
4. The positive and negative features of the Preadmission Screening and Resident Review (PASRR) process.
 
D8
Using the Serial Trial Intervention to Assess and Treat Unmet Needs of People with Dementia
Christine Kovach

This breakout session will help participants to use a systematic process for assessing and treating unmet needs of individuals with dementia exhibiting behavioral symptoms.  The Serial Trial Intervention uses assessment and treatment steps, as well as trials of treatments, to respond to behaviors of individuals with advanced dementia that are not improved by basic care interventions.  Specific care strategies will include discussion of pain management, infection, environmental stressors, and regulated inner retreat.  Staff responses to behavior change, categorized as dismissive, reactive, static and comprehensive will be used to highlight optimum care.

Participants will learn:
1. To recognize the clinical characteristics of pain in people with dementia.
2. Assessment needs of individuals with dementia exhibiting behavioral symptoms.
3. To identify non-pharmacological interventions for responding to behavioral symptoms associated with dementia.
4. The steps of the Serial Trial Intervention (STI).

 
D9
Energy Suckers: How to Deal with Bullies in the Healthcare Setting
Barbara Bartlein

Bullying is an epidemic in healthcare and appears to be increasing.  Bullying, belittling and backstabbing are so common in healthcare that Joint Commission on Accreditation of Healthcare Organizations issued new regulations on reporting, disciplining and preventing bullying situations.  Research has shown that a healthcare workplace with intimidating and disruptive behavior can foster medical errors, contribute to poor patient satisfaction, increase the cost of care and cause qualified professionals to seek new positions in a more positive environment.  Bullying costs millions with high turnover, low productivity and poor morale.  Why should you attend:  There is legislation pending in most states for new guidelines on bullying in the workplace.  Employers and managers in healthcare will need to have clear policies, guidelines and training programs in place to deal with workplace incivility or face possible legal consequences.  Bullying will now be treated as a form of discrimination with severe penalties for employers.  According to a study of U.S. workers, 41% reported experiencing psychological aggression at work in the last year. Workplace incivility in healthcare is a major factor in nurse retention and patient satisfaction.

Participants will learn:
1. The Joint Commission standards on bullying and workplace incivility.
2. What you can do if you are being bullied.
3. How to make your organization bully free.
D10
Reducing Antibiotic Treatment of Asymptomatic Bacteriuria
Christopher Crnich ​​​
Nursing Home Breakout Session, can apply to other providers

Overuse and misuse of antibiotics is a common problem in nursing homes.  Urinary tract infection (UTI) is the most common indication for prescription of antibiotics in this setting. However, studies demonstrate that a substantial proportion of treated residents actually have asymptomatic bacteriuria rather than a true infection that requires antibiotic therapy.

Participants will learn:
1. The adverse consequences of inappropriate antibiotic use in nursing homes.
2. Factors that promote suboptimal prescribing behaviors and the strategies that nursing homes can employ to improve prescribing patterns among their providers.
 
D11
Infection Surveillance as a Tool for Quality Improvement
Nimalie Stone
Nursing Home Breakout Session

This session will review the current infection surveillance resources available for long-term care providers, including an overview of the Centers for Disease Control, National Healthcare Safety Network for reporting infections in nursing homes.  The session will also discuss ways in which infection surveillance data can be used to implement quality improvement activities in a facility.

Participants will learn:
1. The reporting and analytical features of the National Healthcare Safety Network (NHSN) infection surveillance system for long-term care facilities.
2. Ways to implement and apply infection surveillance criteria/definitions.
3. Strategies for using infection surveillance data to improve antibiotic use.
  
D12
Re-Thinking Wandering Behavior: Assessing and Meeting Needs
Joy Schmidt
Good care requires compassion, empathy, knowledge and creativity.  Learn how your understanding of dementia, your resident, and your self can improve your care for those who wander.  What causes wandering behavior?  What types of wandering occurs for those with dementia?  In this breakout session you will learn to re-think wandering behavior as you learn to assess and meet the needs of those residents who are motivated, active, determined and energetic.  A strength based approach to care.
 
Participants will learn:
1. How to identify those whose wandering activity may create potential harm as well as how to evaluate the needs behind the actions.
2. Ways to use your own creativity and problem solving skills to find solutions.

 

 

Focus 2014
Thursday, November 20
Breakout Sessions: "E" Series 12:45-2:15 p.m.  

Choose one of the following:

E1
SESSION IS CLOSED-AT CAPACITY
Dementia Beyond Disease: Caring, Communicating, and Decoding Distress
Allen Power ​​​

In this breakout session, the experiential model will be expanded upon to show how enlightened communication and facilitation techniques can empower those living with changing cognitive abilities.  Basics of communication and working through tasks will be reviewed with an eye toward the experience of the person.  An outline of three "audits" for distress will be shared, and then a radically different approach will be described that uses the well-being framework to understand even the most hard-to-decipher examples of distress.

Participants will learn:
1. Five essential elements of basic interpersonal interactions for engaging a person with dementia.
2. Three types of audits to consider when a person presents with distress.
3. The emotional/symbolic message behind various words and expressions, and suggest better ways to respond than the traditional approach.
 e

E2
Financial Exploitation and  Identity Theft Against Seniors
​John Hendrick

This breakout session will present three surprising facts about elder financial exploitation.  It will include warning signs of financial crimes.  The presenter will describe the Triangle of Cooperation between social services, law enforcement and financial institutions.  It will also discuss recovery from identity theft.

Participants will learn:
1. Who are the typical perpetrators and what are the weapons of financial exploitation of seniors.
2. How to spot financial crimes in different contexts.
3. How to recover from identity theft.
E3
Supporting People with Intellectual Disability to Age in Place
Barbara Bowers
Assisted Living Breakout Session

This presentation will provide background information concerning the aging of people with intellectual disability including; changing trends, challenges caring for people aging with intellectual disability, and health disparities experienced by people aging with intellectual disability.  The session will include presentation and discussion of a training manual for staff in group homes and assisted living to support them caring for people with intellectual disabilities who are experiencing age related health conditions.

Participants will learn:
1. Challenges faced by people aging with intellectual disability.
2. Challenges faced by caregivers of people aging with intellectual disability.
3. How to better support people aging with intellectual disability.
 

E4
Is the Wound a Pressure Ulcer, Incontinence Associated Dermatitis or Something Else? 
Joyce Black
This session is a repeat, see D4 for the summary of the presentation.

E5
Care Transitions in the Long-Term Care and Skilled Nursing Facility
James Lett
Nursing Home Breakout Session

Readmission to the hospital setting is a significant problem in the health care system today.  This breakout session will discuss the sources of readmissions, programs to reduce those readmissions and options for long-term care and skilled nursing facilities to initiate actions to improve status with residents, families and referring hospitals while respecting patient choice and focusing on patient-centered care.

Participants will learn:
1. Trends which have contributed to issues causing readmissions in the health care system.
2. Programs currently in place to reduce readmissions in the long term care continuum.
3. How to initiate actions to reduce hospital readmissions which will increase patient/resident satisfaction and patient-centered care.
 

E6
Using Advancing Excellence Tools to Measure Quality
Alice Bonner
Assisted Living Breakout Session

This presentation will review the available goals, tools and resources on the Advancing Excellence website and how to use them to deliver quality care.

Participants will learn:
1. How to apply the five elements of QAPI to every day practices in Assisted Living.
2. How to collect and enter data on the Advancing Excellence website.

E7
Reducing Anti-Psychotic Usage for Nursing Home Residents with Dementia
Victor Molinari
This session is a repeat, see D7 for the summary of the presentation.
 
 
E8
Sexual Abuse in Long-Term Care
Rick Harris
Lisa Tripp

This session will address the difficult questions:  When is it sexual abuse and when is it something else?  The presenters will assist participants in making sense of ethical approaches to dealing with sexual abuse and dealing with sex offenders who are placed in long term care facilities.

Participants will learn:
1. Methods for assessing capacity to consent.
2. When the facility is obligated to perform background checks on residents.
3. Why consistent policies and procedures matter.
E9
Infection Surveillance as a Tool for Quality Improvement
Nimalie Stone
This session is a repeat, see D11 for the summary of the presentation.

E10
Nursing Home Falls Prevention Mentoring Program
Kevin Coughlin
Sara Karon ​​​
Nursing Home Breakout Session

This session shares how the Department of Health Services, LeadingAge WI, Wisconsin Health Care Association, State Ombudsman Program, MetaStar and the Center for Health Systems Research & Analysis have collaborated on an innovative mentoring program to improve fall prevention in a pilot program of nursing homes.  Come and hear the exciting results of this three year study and find out the next steps to expand beyond the pilot.

Participants will learn:
1. How the Fall Prevention Mentoring Program got started.
2. The results of an evaluation of the 3-year pilot.
3. How nursing homes can use the lessons learned from this pilot to implement their own mentoring program to improve fall prevention. 
 
E11
The Role of the Nursing Home Medical Director in Long Term Care
Joe Boero ​​
Nursing Home Breakout Session

Dr. Boero will review the requirements needed to become a Certified Medical Director.  He will also review the duties of the nursing home medical director and illustrate with examples of actions, tasks, and collaborative intervention.

Participants will learn:
1. Responsibilities of the Medical Director.
2. Strategies to effectively utilize your medical director to continually improve the quality of care to the residents in your nursing home.
3. How you can use your medical director to provide feedback to your clinical providers that can change practice behavior.
 
E12
Re-Thinking Wandering Behavior: Assessing and Meeting Needs
Joy Schmidt
 This session is a repeat, see D12 for the summary of the presentation.
  
 
 

Focus 2014
Thursday, November 20
Breakout Sessions: "F" Series 2:30-4 p.m.  

Choose one of the following:

 
F1
Wheelchair Positioning and Safety for Healthy Outcomes
Kimberly Coplien
Mary Ann Willgrubs
Brenda Schmidt
Bruce Ellarson

This session will provide an overview of wheelchair positioning for optimal function, comfort and safety; including basic wheelchair maintenance and safety checks.

Participants will learn:
1. How to identify points included in optimal wheelchair positioning and basic techniques to achieve optimal wheelchair positioning.
2. Benefits of good wheelchair positioning.
3. How to do a basic wheelchair safety check and maintenance.

F2
Reducing Antibiotic Treatment of Asymptomatic Bacteriuria
Christopher Crnich
This session is a repeat, see D10 for the summary of the presentation.

F3
Supporting People with Intellectual Disability to Age in Place
Barbara Bowers
This session is a repeat, see E3 for the summary of the presentation.

F4
Financial Exploitation and Identity Theft Against Seniors
John Hendrick
This session is a repeat, see E2 for the summary of the presentation.
 
F5
SESSION IS CLOSED-AT CAPACITY
Mistakes are Inevitable: The Role of a Complaint and Grievance System and Other Similar Systems in Improving Care
Rick Harris
Lisa Tripp
This session will focus on the role of a Complaint and Grievance System in assisting with early detection of problems in the facility.  An effective System serves as a window into what residents and staff are really thinking and is an important source of information about things that need to be fixed.

Participants will learn:
1. The differences between a robust complaint and grievance system and one that merely is there to satisfy a regulatory requirement.
2. How to create a culture that aggressively seeks to learn about problems.
3. How to create a culture where residents and families feel comfortable communicating problems to facility staff.
F6
The Role of the Nursing Home Medical Director in Long Term Care
Joe Boero
This session is a repeat, see E11 for the summary of the presentation.

F7
Intimacy and Sexuality in Dementia Care
Lynda Markut
This session is a repeat, see D2 for the summary of the presentation.

F8
Using the Serial Trial Intervention to Assess and Treat Unmet Needs of People with Dementia
Christine Kovach
This session is a repeat, see D8 for the summary of the presentation.

 

F9

Session is Closed-At Capacity
An Individual Service Plan (ISP) is Only as Good as the Assessment

Alfred Johnson
Kathy Klika
Mary Kunz
Margie Reichwald
Phyllis Witter ​​​

Assisted Living Breakout Session

The Bureau of Assisted Living and the University of Wisconsin-Green Bay are in collaboration to provide an interactive panel discussion on the topic of Individual Service Plans (ISP).  The panel discussion will provide insight and training techniques to the assisted living community in regards to utilizing a comprehensive assessment in the creation of a resident’s individualized service plan.

Participants will learn:

1. Multiple factors that influence a resident assessment/ISP.
2. How to recognize negative outcomes due to lack of information provided in a resident assessment/ISP.
3. Practical strategies to complete a compliant resident assessment/ISP.
 
F10
Energy Suckers - How to Deal with Bullies in the Healthcare Setting
Barbara Bartlein
This session is a repeat, see D9 for the summary of the presentation.

F11
Music and Memory Wisconsin Initiative
Pat Benesh
Kevin Coughlin

This breakout session shares how the Department of Health Services brought personalized music to 100 Wisconsin nursing homes to benefit 1500 residents with Alzheimer’s disease or a related dementia.  Come and hear about how this initiative got started, what we hope to learn from the University of Wisconsin-Milwaukee evaluation and where we go from here.

Participants will learn:
1. How the Wisconsin Music and Memory Program got started.
2. How personalized music can provide enjoyment, maximize positive outcomes related to behaviors and decrease anti-psychotic medications for people with dementia.
3. What the evaluation will tell us.

Register Online!

 

 Sponsored by: 
The Department of Health Services, Division of Quality Assurance​