Action Protocols, Records, Autonomy and Dependency

Written documents in which
detail the procedures and phases to be carried out by professionals
of the center to achieve a care of dependents, describing the
Work to be carried out by each area or professional involved.

1. Item 1

2. The
PROTOCOLS
Written documents in which
detail the procedures and phases to
be carried out by professionals
of the center to achieve a care
of dependents, describing the
Work to be carried out by each area
or professional involved.

3. •Protocol for welcoming and adapting users.
•Hygiene protocol for users.
•Protocol for administering medication to users.
•User Drop Protocol.
•Protocol for action against incontinence (urinary and faeces).
•Protocol for action against ulcers and pressure injuries.
•Protocol of physical containment measures for users.
•Other protocols set out in the plan
•of the center or that the interdisciplinary team

4. Records
•Records of the user's comprehensive history (clinical, nursing, social, psychological, etc.).
•Functional and Cognitive Assessment Registry.
•Individualized Care Plan Record.
•Individualized Care Plan Follow-Up Record.
•Record of Follow-up of the Participation in the Program of Activities of the users, recording
the name of the residents who have participated.
•Interdisciplinary Follow-Up Records.
•Diet Register, indicating person and type of food.
•Record of Maintenance Activities of the personal hygiene of the users.
•Register of Medical Prescriptions, indicating prescribing professional (signature); dosage and
distribution of doses; start and end dates of the statute of limitations; and other
considerations.
•Personal Care Registry.
•Constant Control and Water Balance Record.
•Nursing Treatment Registry.
•Register of Control of Medication-Drugs that the user has to take, keeping a record of the
person who administers them.
•Log of Falls of users, indicating the circumstances and prevention system

5. •Registry of users with Sphincter Incontinence, indicating the prescribed care
measure and the promotion of continence.
•Registry of users with Pressure Ulcers, indicating original cause, treatment, and date
of onset and healing.
•Register of BehaviouralProblems of the user.
•Registration of users with Containment Measures, prior medical prescription,
describing how to carry it out and the time and guidelines for mobilization.
•Register of the user's advance directives.
•Record of Visits, indicating the name of the resident receiving the visit, the link of
the visitors, and the time of entry and exit.
•Registration of user departures, with indication of departure and return times.
•Log-Incident Book.
•Other records that are established in the general plan of the center or that are
determined by the interdisciplinary team

6. From the moment you join, so that
you will get to know:
-Other users
-Professionals who will assist you
-Distribution and location of the
different rooms in the centre (your
own room,
professionals, salons
leisure activities, common services
area, etc.)
-Service schedules (food, toilet,
rest, rehabilitation, consultation
with professionals, entrances and
exits of the centre, visits from
relatives, etc.
Participation
From the user
IN THE DAY-TO-DAY
ACTIVITIES OF THE
INSTITUTION.

7. Autonomy

8. Law 39/2006 of 14 December 2006 on the Promotion of
Personal Autonomy and Care for People in Situations of Distress
Article 2(1) defines this concept as "the capacity to take care of
oneself, with one's own
initiative, controlling, coping with, and making decisions about
how to live according to one's own norms and preferences.“
Thus, personal autonomy is characterized by:
Be in control of decision-making.
Be able to perform daily activities (basic and
instrumental activities of daily living).

9. Dependence

10. Paragraph 2 of the same article of Law 39/2006 defines
dependency as "the permanent state of persons who, for
reasons deriving from age,
illness or disability, and linked to the lack or loss of physical,
mental, intellectual or sensory autonomy, require the attention
of another person or persons or important aids to
perform basic activities of daily living or, in the case of people
with intellectual disabilities or mental illness, other supports for
their personal autonomy."

12. Activities
Basic
OF DAILY
LIFE
According to WHO (2001), they
are classified into the following
groups:
Learning and applying
knowledge.
Mobility.
Self-care.
Domestic life.
Personal interactions and
relationships.
Major Areas of Life
(education, work and economy).
Community, social and civic life.

13. Autonomy
IN BASIC ACTIVITIES
OF DAILY LIVING
A variety of measurement scales
can be used to assess ABVDs, the
most commonly used being the
following:
•Barthel or Barthel Index
•Basic functional or ADL
classification
•Katz Index
•Red Cross Physical Disability
Scale

14. Autonomy
IN INSTRUMENTAL
ACTIVITIES OF DAILY
LIVING
The activities you need to live
at your best
regardless of possible in their
community, make up the
Instrumental Activities of the
Daily Life (IADL).
Although there are numerous
Methods for the evaluation of
of these activities, the most
commonly used is the Lawton
and Brody scale.
also referred to as the Index of
Lawton or AVD instrumentals.

15. of the user
ACCORDING TO THE
INSTRUCTIONS OF THE
RESPONSIBLE
PROFESSIONAL
Participate in the activities set forth in your
Individualized Care Plan, Participation
Accompaniment of the user could be extended as well :
•The general organisational activities of the
centre: collaborating in the drafting and
•modification of the internal regulations, of
the statutes, in the organization of its
•daily routines (check-in and check-out
times, menus, meal times, etc.).
•The planning and organisation of leisure and
cultural activities in which you would like to
•participate.
•Collaboration in some activities
•Domestic activities: gardening, clothing
repairs, auxiliary kitchen activities, etc.
•Participation in a 'Users' Assembly'
democratically elected by the residents.

16. •Mutism or isolation.
•Restlessness or agitation.
•Radical changes in your mood.
•Strange or difficult-to-explain behaviors.
•Behavioral alterations with respect to other
residents or facility staff.
•Increased aggressiveness.
•Insufficient personal hygiene.
RED FLAGS

19. Action protocol
The actions of the care professional
will be aimed primarily at the
Improving the autonomy of the user through:
Promotion of the acquisition of habits of personal
autonomy through:
Help where necessary and reinforcement of
autonomous behaviors.
Adaptation of the environment and use of aids
techniques.
Animation and enhancement of the user's self -esteem.

20. Activities
Optional,
voluntary, and
mandatory.
In institutions, it is common for
there to be mandatory activities
aimed at the
recovery or assistance in
basic activities of daily living, as
well as voluntary leisure, cultural
and educational activities, in a
greater or lesser offer,
depending on each center.

21. Activities
Optional and/or
Voluntary
Depending onwhatthe
individualizedcareplan
stipulates, they would
find,
Theseinclude,butarenot
limitedto:

22. Activities to be
carried out taking
into account the
cognitive and
functional state.

23. Activities to be carried out in
a situation of good cognitive
state.
Foranydependentorindependent
user:
Newspaperreading, memory
training, conversationgroups,
Social SkillsDevelopment, Tables
gymnastics, pelvicfloorexercises,
outdooractivities, outdooroutings,
advancedand instrumental
activities
ofdailylife, labor therapy,
Play therapy, psychomotorskills,
mutual helpgroups, senior
classrooms, etc.

24. Activities to be carried out in
a situation of good cognitive
state.
For independent users with technical
assistance or partially dependent on another
person (in addition to the activities described
in the previous section):
Gait training and adaptation or training in the
use of aids
techniques.
Ergotherapy, mechanotherapy,
kinesitherapy, polytherapy and re-education
in
transfers for those with partial dependency.

25. Activities to be carried out in
a situation of good cognitive
state.
. For people with great
dependency, the inclusion of
the following should also be
assessed:
-Maintenance of instrumental
activities
-Standing position and passive
mobilizations.

26. Activitiestobecarriedoutin
asituationofcognitive
impairment.
Foranydependentorindependent
user:
Newspaperreading, stimulation
cognitive, memorytraining,
conversationgroup,
gymnastics, pelvicfloorexercises,
outdooractivities, outingstothe
Outdoor, ActivityMonitoring
residual instruments, playtherapy,
labor therapy, psychomotorskills,
adaptationtotheenvironment,
mutual help, etc.

27. Activitiestobecarriedoutin
asituationofcognitive
impairment.
For users
Independent with technical support
(in addition to the activities described
in the previous section):
Gait training and
adaptation or training in the use of
technical aids.

28. Activitiestobecarriedoutin
asituationofcognitive
impairment.
For partially populated
dependent on another (in addition to
the activities described in the
previous section):
Ergotherapy, mechanotherapy,
kinesitherapy, polyotherapyand
Re-education in transfers.

29. Activitiestobecarriedoutin
asituationofcognitive
impairment.
For people with great
The inclusion of:
-Maintenance of instrumental
activities
-Standing
-Passive mobilizations.

30. Activities to be carried out in
a situation of mild dementia
For any dependent or
independent user:
Residual ABVD Training,
Scheduled Urination, Reality
Orientation Therapy,
memory training,
playtherapy, psychomotor
skills, maintenance of the level
of
literacy, adaptation to the
environment, etc.

31. Activities to be carried out in
a situation of mild dementia
For independent users with
technical help and individuals
partially dependent or heavily
dependent on another:
occupational therapy,
mechanotherapy, kinesitherapy,
poleotherapy, maintenance of
technical aids and gait training
(except in people with high
dependency).

32. Activities to be carried out in
a situation of mild dementia
In people with high or partial
dependence, the
Inclusion of activities of:
-Transfers
-Standing
-Passive mobilizations.

33. Activities to be carried out in
a situation of moderate
dementia
These people do not have independence because
their autonomy is affected by functional incapacity
and they are in a situation of independence with help
technical, partial dependence, or great dependence
on another person:
Residual ABVD Maintenance, Timed Urination, Reality
Orientation Therapy, Therapy
reminiscence, environmental adaptation therapy,
psychomotor skills, occupational therapy,
kinesitherapy, pennytherapy, play therapy and
transference (except for psychomotor skills).
with technical aids). Also, walks, training in walking
and maintenance in the use of technical aids, except
for people with great dependency.

34. Activities to be carried out in
a situation of Severe
Dementia
These people,duetotheir
functionalimpairment,areina
situationof
high dependence, so the
activitiestobecarriedoutmay
be:
Passivemobilizations,
respiratoryphysiotherapy, postural
andsittingcontrol,
sensorystimulationand
sensory-perceptualstimulation.

35. Handling of the most
common materials
for carrying out
activities

38. Incident Log
Anyincidentobservedinthepersonalandsocio-sanitarycircumstancesoftheuser,aswell
asintheorderandconditionofthematerials,mustbereportedtotheinterdisciplinary
teaminordertoadopttheappropriatemeasuresfortheinterventionoritsresolution,
throughtheIncidentRegisterthatmayhaveaconfiguration.
Thisdocumentwillbecompletedbytheprofessionalsofeachshiftinchargeofattending
totheusersofthecenterandtakingcareofthematerialsusedinthedevelopmentofthe
programmed activities.
Everythingthatisincludedinthesesheetsmustbesupervisedandsignedbythepeoplein
chargeofeachshiftandarea.
Inaddition,eachincidentrecordedwillbereflectednotonlyintheincidentregistration
documentthatwehavealreadymentioned,butalsointheIncidentSheetthatwillbe
includedintheIncidentBookforcorrectregistration.

39. Arturois80yearsoldandsuffersfromdementia.
Untilthreeyearsago,hewasquiteathisdaily
routine.Shehasbeenlivingwithherdaughterfor
twoyears,whoworksataschoolfrom9:00a.m.to
2:00p.m.andsomeafternoonsaweekfrom4:30
p.m.to6:30p.m.Untilnow,Arturospenthis
morningsathisdaughter'shouse,takingcareof
cleaningupthehouseandmakingsurethatthe
foodishotbythetimehisdaughterarrives.Butthe
situationhasworsenedconsiderably,Arturohas
sufferedaverynoticeablecognitivedeterioration,
hehasmemoryproblems,disorientation,little
attention.Herphysicalabilitieshavealsodeclined,
resultinginhernolongerbeingabletodo
householdchores.Arturo'sdaughterisvery
worried,shewouldliketotakecareofhimallday,
butsheworkseverymorningandherfathercan'tbe
leftalone,sosheisthinkingaboutwhichprogram
mightbethemostsuitableforhim.

40. Thank you very much
for your attention