"I" careplans

[Nascar nurse, ASN, RN]

Fresh out of MDS 3.0 training (corporate training)- whoopee!

They briefly stated we should start doing "I" careplans, but gave us only one example of this. I'm "old school" and having some difficulty wrapping my brain around writing a careplan for a resident that begins like.. "I have diabetes. I know I should follow a diabetic diet but I chose not to", blah, blah, blah"

Is anyone else starting this? Is this really part of MDS 3.0 or is my company making things up again? Anyone know of a good website for examples or have any information they would like to share.

Thanks.

[Bella'sMyBaby]

Somewhere in the 3.0 stuff, I read something about this. CMS feels care plan goals should be based on goals residents want, not what the facility decides. In fact, the scenario I read, stated that State Surveyors are going to start asking residents what their goals are & if does not match the care plan, the facility gets a tag!

[Talino]

CMS "still" does not specify a care plan structure format. The regulation to involve the resident and/or family in developing care plans has not changed.

Chapter 4 of the MDS 3.0, pp 10-12 suggests key steps and consideration when formulating care plans. See #5 (resident/family participation) and #10 (the "I" or 3rd person subject).

I Centered Care Plans samples; a powerpoint on post #2.

Albeit, I still can't fully grasp the notion of "I" care plans on a resident who is "rarely/never understood" - "I am 96 years old and I would like to eat 75% of pureed small portions of 1500 KCal, low-fat, low-salt food for my meals and sugar-free desserts to manage my swallowing problem, HTN and weight gain."

Yet, if you ask a cognitively intact resident w/ the same conditions, a more realistic answer would be, "Heck, at 96, lemme have all the good stuff you got and watch me clean the plate! And, don't forget the 6-pack!

[aproctor]

We have talked about starting the "I" careplans with the MDS 3.0 but I am not crazy about them. How can I write down what or how the resident would describe their problems, health status, etc, especially if it is a careplan on a bedridden,tubefed resident?