If your loved one has been a patient in a hospital or rehab facility, or a resident in a senior care community, you may hear the terms “Plan of Care” and “Care Plan Meetings.” In this article, we’ll focus on care planning in medical settings such as hospitals and rehabs.
Under any circumstances, it is very important to have a plan in place so that the patient or resident receives the best care possible. However, in this COVID-19 environment, it is even more crucial to prepare and participate fully in the care plan process. Since family visits are restricted right now, family members’ access to information about their loved ones’ status and care needs can be incomplete or inconsistent. Opening lines of communication with the care team who are with your loved one may be your only means of obtaining information, especially due to current restrictions.
A plan of care, or care plan, is a “game plan” or “strategy” for how the facility’s staff will care for and meet the needs of a patient. The plan must be in writing and include significant details. It explains to each staff member what needs to be accomplished and when. One reason the care plan is so important is so that everyone is on the same page: doctors, nurses, aides, physical therapists and any other staff members who may be attending to your loved one. Without detailed instructions, care staff may not know what your loved one’s needs are. With a care plan in place, the patient should receive individualized, consistent and safe care. This can provide the family with an extra layer of reassurance while they cannot visit in person.
Care plans must be reviewed regularly to make sure they are up-to-date and revised as needed. The best care plans make the patient feel like their needs are being met. If staffing allows, reviews may need to take place more often during our pandemic to allow the patient and family to have peace of mind.
At a care plan meeting, medical staff, the patient and their families discuss all aspects of life in the facility – meals, activities, therapies, personal schedule, and medical health needs. COVID-19 policies and precautions should be explained. Patients and families can ask questions or offer information to help staff provide the best care.
If possible, the patient and his or her family should participate in the care plan meeting. Since in-person meetings can’t happen right now, video calls are the next best method. The staff should listen and use language that is understandable. If you don’t understand something, ask that they explain it to you. If you ask for something and they tell you no, ask why. Attempt to get specific answers to your questions and take detailed notes on what was said and by who. Communication breakdowns can occur so these steps are extremely important.
Care plan meetings should occur when there’s a major change in a patient’s physical or mental health that requires an adjustment in care. Typically, the care plan must be completed within 7 days after an assessment. Assessments must be completed within 14 days of admission with reviews every three months. The quicker the care plan happens, the better it is for everyone as this reassures the family and avoids calls to staff whose workload may already be increased due to COVID-19.
Patients have the right to make choices and be involved in their care, services, daily schedules and issues of general well-being. Here are some tips for before, during and after the care plan meeting:
Before the Meeting
- Don’t wait for the care plan meeting to be involved. If they’re available given our pandemic, tell staff what you need, what’s working, and what’s not working. Let staff know your concerns, and ask questions. Plan your questions, problems and goals so you don’t forget anything.
- Ask the doctor or staff about the patient’s condition, medication, care and treatment.
During the Meeting
- Discuss options for care and for meeting the patient’s needs and preferences. Ask questions if you need medical terms or procedures explained to you.
- It’s important to understand and feel assured that the care plan meets the needs of the patient, especially if they are not able to understand or advocate for themselves. Ask for a copy of the care plan and find out who is the right person to talk to if changes need to be made.
After the Meeting
- Patients and family members should continue to evaluate whether the care plan is being followed. This can be more challenging since visits are not possible during our pandemic but establishing a consistent communication plan can help. Talk with nurse’s aides, other staff or the doctor if questions arise. Your consistent communication and advocacy for your loved one will help ensure they receive optimal care as well as staff accountability.
Throughout all of these steps, patience is paramount. COVID-19 has impacted our healthcare providers intensely. Ultimately, trust that they are doing the best they can for your loved one, even if it doesn’t feel that way sometimes. Their resources may be limited and you don’t know what they are truly dealing with on a day-to-day basis. Respectful communication and a deep breath or twp can de-escalate difficult interactions. They will appreciate a sincere “Thank You” for their service!