Thanks...........that is also the thought process I had. The guideline has to be if a Residents care plan would change and in this case, it would. I sometimes think there is a power play in place and the other team members dont want to give the RAC "too much power". As the one that does most of the MDS, why would I be advocating for a significant change so I can get more work?? Sometimes, ya gotta laugh......Thanks for the response!
>From: "carol maher" <[EMAIL PROTECTED]>
>Reply-To: [EMAIL PROTECTED]
>To: <[EMAIL PROTECTED]>
>Subject: Re: Splitting hairs?
>Date: Tue, 16 Mar 2004 18:11:26 -0800
>
>Each bullet on pages 2-8 to 2-9 are not to be taken as 1 change. A good example of this is ADLs , even though it is listed as one bullet, if there are 2 ADLs that change a SCSA is called for (if consistent and meets definition of change). Page 2-8 states, "This may include two changes within a particular domain (e.g., two areas of aDL decline or improvement)." I would include behavior symptoms and Mood in this category. So, your resident would have had 2 changes.
> ----- Original Message -----
> From: Gail RN
> To: [EMAIL PROTECTED]
> Sent: Tuesday, March 16, 2004 4:15 PM
> Subject: Splitting hairs?
>
>
> We have a Resident who had a sig change done in January and had moods and behaviors, both not easily altered. He now has NO moods OR behaviors after successful new medications. I wanted to do a significant change on him but there was team disagreement because on page 2-8 of the RAI manual, a sig change for decline is indicated if the Resident has 2 or more of the following and moods and behaviors are listed SEPERATELY whereas on the next page for improvement, where 2 or more are also indicated, moods and behaviors are both on the same bullet line! The team feels that mood and behaviors should be treated as one area because of this. And didnt want to proceed to a significant change for this reason. I have always seen moods and behaviors as seperate (depression doesnt necessarily mean a behavior problem and vice versa).Aslo too, where they werent easily altered prior and now dont exist at all is even more reason. Anyone have any input into this?
> PS As it turned out, we did a sig change but only because he improved in feeding skills.
> Thanks
>
>
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