[D+290] care crisis 2.0 - the regulated Chaos (6)

GuKG - Novelle 2009: fair degree of Reform or practice, legally compliant implementation of necessary?
Own experience: Plausible demands for more practicality compromise the care, safety!

Readers ' reactions to the BICEPS-article “Full Bladder? Please wait!” (See Text below):

Conclusion with care-“grey zone“?
The “important point of access to the training module of the base supply“ has been tipped for disabled carers in the last Moment by the Ministry of health from the consultation draft.
That is a good thing, because I was hoping for!
It takes in these points, no GuKG Reform, but a Reform of the legislature.
Why should it not be possible to have specially trained and qualified persons in such institutions work?
It is a shame that here on the backs of the Poorest is saved!

Who must bear the consequences of this sloppiness?
First hand I've experienced and experience it still, what does it mean to see a severely care-dependent people in a residential community living, it is a disaster for the Affected and their to anxious parents (if they still have the power to do so).
The mentally and physically severely disabled daughter of my friend was recently delivered with scalding third degree in the ICU, it happened, allegedly, probably at Baden by a special education student (!) in a Viennese GIN facility. Until today, consistently silent, how could that happen, it is played down with the words “it can happen to anyone what”.
Since when can exercise a Student nursing activities? No one cares. The head of this institution ignores such incidents; my girlfriend has the impression that it is trying to (persistent bullying), can this girl with her worried mother to get rid of.
You prefer a uncomplicated, grateful clients....
As a children's nurse I also experienced in upper Austria means (quite the insane nursing neglect of a girl, which came after a difficult surgery back in your group and no one was responsible for the elaborate care that would have been necessary renowned, of course...).
It is rather so, that being said, we've been doing this, we can – but no one does specifically, the nursing responsibility!

(Country) Saving will is above the (Federal) Law
People who have e.g. a cannula or a PEG probe, or simply not or needs speak can speak, can actually live in such a residential community, only under extremely dangerous (illegal) conditions.
This should not be, it would be to willed decision-makers that adhere to the laws and not just here to save!

Experience with pretentious care expertise
My severely disabled daughter had worn after only a few weeks of stay in the supposedly best setup NÖs by nursing neglect physical damage. (My instructions were continuously and consistently ignored because “we know better”, wrong food, incorrect storage, incorrect brushing of teeth, etc......)
It is not just about Catheterization, needle exchange, PEG supply – individual activities, where you can “get someone”!
Rather, storage, diet, stress avoidance, etc, would have to be seen in a “public care” in a holistic way, what is more important (.)

Country authorities are responsible
I hope that the efforts of my husband, to say this “prestigious” institution in lower Austria, together with their supervisors in the Prosecutor's office for illegal care, and abuse of power (controller: “already know what they do”) has shown a positive impact on the future development of this scene and severely disabled people for whom it is life denied to live in the home, at least professionally cared for.

The Postings in the Forum of BICEPS-INFO: nr=9918#fid10457 & nr=9918#fid10456 3.August 2009 09:43 & 09:22 PM

BICEPS-Posting Mrs Ulli S-H. (3. August 2009, 15:14 PM)
The contribution of Charlotte Lichtenauer:
Yes it would be ideal if people would work with (all of)comprehensive qualification for people with disabilities: Graduate of nursing training, dipl. Social-educational training, able to be respectful to the customers, to assist and not to determine.... only in reality there is no such contractors.
Currently can/do I have to decide in the employment of staff, whether the one or the other is more important. So it should be possible with an in-service training to acquire further necessary (depending on the need of the resident) qualifications, and then also use.
To accompany whether it is possible in an institution is good for people does not depend only on my experience of these statutory requirements, but the use of the carrier, its basic attitude to its customers, its ability to defend against the donors (mostly countries) and, finally, from the creativity in addition to money.
To regulate everything, to determine, by means of laws and to control then (forced to) is loose try to increase quality. Far better it would be to give the Affected a personal Budget and can choose for yourself where you can get the best performance.

In response to the above reader post:

Dear Mrs. S-H,

Professional quality is possible and should cover all needs for help
of course I know that there is such a “Jack of all trades”, only a very few in the institutional area. Actually, that's only the closest Confidants!
However, it must be possible to have in each group of each qualification of a specialist, who will pay for your “area” of responsibility.
It is not so, that there is only disabled people who need only an “accompaniment”. Some people, such as my daughter needs more. Her condition as a persistent vegetative state requires a similar level of quality care and comprehensive care in addition to social and educational component!

Reality of “approved” services and facilities
I also experience that there are Diplomiertes staff, which had never do with a (severely)disabled people and it will still be sent to me as a “specialist personnel” in the house.
As an Intern to my training in home nursing for children I experienced in 2004 in Axams, a residential group, part of the severely multiple disabled children with a PEG probe, where the leadership of this group had no professional training!
I almost had a shock when a supervisor said, the doctor prescribed antibiotics for a child had to reduce it a little so it goes “longer”...

Claim on individual needs-covering “Personal Budget” would be the solution
Unfortunately, it is really so, that the Manager must makers compete for money in a variety of costs, THE SHOULD NOT be ALLOWED to BE SO!
You have the right to make the helpless Attempts of political leaders as COMPLETELY INKOPETENTE LAYMEN's provisions in this area, will continue to fail, until EVERY disabled person in Austria is going to be SUFFICIENT personal Budget, which he (and / or its supporting trust people) for their individual help in a self-responsible managed!
The discriminatory attitude towards mentally impaired people takes place, unfortunately, in this area still!

The Postings in the Forum of BICEPS-INFO: nr=9918#fid10459 3. August 2009 At 19:35

Article in BICEPS-INFO – Text: Dr. Franz-Joseph Huainigg (29. As of July 2009)

Full Bladder? Please wait!
If professional interests are put before the needs of people with disabilities, the bladder, the bowel unentleert and the breathing cannula life-threatening clogged.

Luise F. lives in an upper Austrian group home for disabled people. If you drink due to the heat a little too much water or too much water containing fruit has eaten, it may be that suddenly at 15:00 your bladder is full. Although you could do it, none of the handicapped supervisor authorize inner catheter.
Luise will have to wait until 18:00, then the mobile comes a nurse, and with her the relief. Until then it is pain to endure, spastic convulsions, endure, and possibly even damage to Health caused by Urine backflow into the kidneys risk.
You have to face up to the fact that not all disabled people can live at home. When communities, large care homes, small residential and small group homes (up to 8 people) would like to replace, you have to adapt the framework for the care of disabled people according to their needs.
In family-like residential structures may not be about the clock, a nurse on-call. Therefore, it is necessary that nursing activities for a specific disabled Person can be delegated to the WG from a nurse to a supervisor.
In the 2008 amendment to the health and nursing law (GuKG), it was established the important principle of Delegation. This nursing activities of nursing and care professionals at elder care can be delegated in the framework of the 24-hour care and personal assistants. It is quite incomprehensible why exclude qualified disabled carers in residential groups, from the principle of Delegation. The current legal regulation in the GuKG leads to some absurd situations in residential communities:
A laxative only the qualified professionals to administer, may suppository, simple associations are not allowed to changed, despite the risk of infection of the disabled, their carers and even the respiratory cannula may be extracted in mucilage only from a diploma nurse-terminated sick. Even in the case of emergencies, a corresponding mobile service is to contact to. Who knows that after three minutes without breathing, brain damage will occur, sees the irrationality of these regulations.
Don't be stressed, it's about quality. Because a ventilation cannula well and professionally suction, can members after a Training of personal assistants as well as nurses. It is a Union instead of obsolete occupation is the Care of the benefices secure, a functioning Case - and Care Management. Thus, not only disabled people but also to care professionals would benefit from new areas of responsibility.
The nail sample between professional interests and the basic needs of disabled people happened in the Council of Ministers, where the GuKG amendment was on the agenda.
The important access to the training module of the base supply has been tipped for disabled carers in the last Moment by the Ministry of health from the consultation draft. Likewise, there is no approach of a delegation principle. Existing is firmly concreted, and the flexibility of the approaches are missing. It urgently needs a GuKG-Reform, but not this one!

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