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One thing that I think is missed so often, but that
I try to do really well, is to use the RAPs to identify strengths (example, the
ADL Supplement in the manual, good cognitive function) and address them in the
care plan. It's so easy to focus on the weaknesses and problems, but I
think it's at least as important to address maintaining and enhancing the
strengths.
Also, I have worked with MDS Coordinators who felt
that if the RAP triggered, you were required to have a care plan. Again, I feel
that those folks are missing out on an important piece of the decision making
process. If I have a RAP triggered, I work through the guidelines, and
make the decision whether to care plan. If I decide against the care plan,
then I write a brief but complete explanation.
Doing work on paper that has no benefit to the
resident is a waste of resources and my time, both of which are in way too
limited supply. I like the idea on the survey of combining certain
RAPs. Feeding Tubes, Dehydration and Nutrition could certainly be worked
together, and I often do this, referring to the one complete RAP with just
minimal details on the other 2.
Is this what you were looking for,
Carol?
HS
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