INDIVIDUAL ABUSE PREVENTION PLAN Date Developed: ___________
A. Assessment of Susceptibility to Abuse, Including Self Abuse (Within 30 days of admission)
This is the identification of characteristics which make the individual susceptible to abuse and how these characteristics cause the individual to be susceptible to abuse. ____, ____, ____, ____1. Unable to express self ____, ____, ____, ____8. Isolation ____, ____, ____, ____2. Blind or limited vision ____, ____, ____, ____9. Malnutrition ____, ____, ____, ____3. Wheelchair bound ____, ____, ____, ____10. Self-abusive ____, ____, ____, ____4. Ambulation losses ____, ____, ____, ____11. Hard of Hearing ____, ____, ____, ____5. Requires assist with transfers ____, ____, ____, ____12. Requires assist with ADL ____, ____, ____, ____6. Dementia/Confusion ____, ____, ____, ____13. Other _______________ ____, ____, ____, ____7. Requires medical monitoring d/t __________________________________________
B. Measure taken to minimize the risk of Abuse
These are the actions staff will take to the measures addressed in the Individual Plan of Care. The actions must be identified here and in the Individual Plan of Care. ADLS ___Assist client with clothing prn ___Client on 2 hour toileting schedule ___Staff will empty clients catheter bag and monitor ___Assist with feeding ___Assist with toileting ___Staff will assist prn with all tasks requiring fine motor skills AMBULATION/TRANSFERS/WHEELCHAIRS: ___Assist with all transfers and/or ambulation due to side effects of diagnosis ___Provide T-belt and assist with transfers and ambulation ___Transfer client with the appropriate staffing needs ___Encourage client to ambulate short distances with walker and provide wheelchair for distance ___Ensure client uses cane and/or walker ___Provide stand-by assist due to periods of dizziness ___Provide stand-by assist when client ambulates prn ___Provide assistance PRN for propelling wheelchair ___Use appropriate wheelchair restraint for safety issues resulting from diagnosis ___Encourage independent use of wheelchair BEHAVIOR: ___Monitor clients agitation level and redirect when appropriate ___Provide 1:1 when agitated ___Remove physically aggressive client from program area involving other clients
COMMUNICATION:
Adult Day Services Policies and Procedures Manual 10-017.16
___Encourage verbalization of needs/concerns ___Encourage to voice needs and concerns to appropriate staff ___Listen carefully, encourage use of gestures and/or written communication ___Try to anticipate needs due to inability to express them ___Observe body language/gestures to assist in anticipating clients needs ___Encourage voice and breath support due to expressive aphasic ___Allow adequate word-find time ___Encourage use of communicator DEMENTIA: ___Monitor whereabouts due to wandering ___Monitor clients agitation level and redirect when appropriate ___Provide reminders/R.O. as needed due to confusion, forgetfulness ___Provide quiet time when environment affects behavior ___Give simple step-by-step direction ___Decrease stimulation in environment during mealtime ___Report hallucinations to caregiver ___Provide monthly calendar to client and daily inform client of activities taking place ___Provide wake-up call daily for client when attending CEBD DIET: ___Provide appropriate diet ___Food will be cut into small pieces ___Monitor fluid intake ___Monitor client when eating and/or drinking fluids EXERCISE: ___Encourage participation in range of motion exercises through exercise program ___Provide adaptive exercises to maintain physical function ___Encourage periodic exercise for client during the day such as walking HEARING: ___Speak distinctly; use gestures ___Seat client near group leader during group activities ___Get attention by touch prior to speaking and use gestures as needed ___Ensure client is wearing hearing aids ISOLATION: ___Encourage socialization due to isolation in home environment ___Anticipate needs due to language barrier (i.e. does not speak English) MEDICAL MONITORING: ___Monitor skin integrity ___Monitor physical symptoms due to diagnosis and report significant changes to nurse, caregiver and physician ___Monitor physical and emotional comfort for diagnosis
Adult Day Services Policies and Procedures Manual 10-017.16
___Monitor need for and/or reaction to medication ___Medications will be monitored and/or administered appropriately ___Provide skilled nursing treatment ___Encourage naps and/or rest period ___Monitor hypertension and inform caregiver/doctor of changes in blood pressure ___Monitor for shortness of breath. Monitor number & types of activity & rest when experiencing S.O.B. ___Monitor client for extreme weight changes and report significant changes to nurse, caregiver and physician ___Monitor chronic pain ___Monitor number and types of activities and rest periods when appropriate MENTAL HEALTH: ___Motivate client to join in activities that are beneficial to client ___Encourage client to express feelings ___Monitor anxiety level & intervene when appropriate ___Encourage regular attendance for socialization and stimulation ___Offer emotional support ___Observe for symptoms of depression and notify appropriate staff/caregiver ___Encourage independent decision making ___Encourage social interaction to assist in increasing clients self image ___Provide client with choices of programming to encourage independent decision making ___Provide activities in which client can be successful SENSORY: ___Provide and encourage participation in activities for stimulation ___Provide variety of sensory groups to maintain current cognitive level VISION: ___Approach from (R) side and remind to turn head to compensate for field cut ___Approach from (L) side and remind to turn head to compensate for field cut ___Provide verbal cues ___Ensure client is wearing glasses and clean prn ___Encourage client to position self to front of groups to maximize visual ability ___Aware of client wearing contact lenses