Services

Medical Services

There are five physicians who regularly serve the residents of York Care Centre. Upon admission, one of the five will be assigned to a resident. Families may arrange to meet with the physician. Please inform the nurse in charge if you wish this so arrangements may be made.

Nursing Services

nursing

Organization

The Nursing Department is under the direction of the Director of Care Services, who is accountable for the overall quality of nursing care in the home. She provides professional nursing leadership and is responsible for staffing, performance management, care resources and external nursing relations.

The Clinical Care Coordinator arranges all admissions, maintains a waiting list as necessary. The Clinical Care Coordinator also addresses staff health issues and is responsible for infection control and Clinical Education.

Each unit is supervised by a Unit Coordinator, who is accountable to the Director of Care Services for the quality of care for their residents. This nurse is the principle contact point for questions and concerns for both the resident and the family.

Nursing care is provided by a team, which consists of Registered Nurses, Licensed Practical Nurses and Resident Attendants. The Unit Coordinator coordinates a comprehensive assessment of the resident’s needs, abilities and wishes. The assessment brings together the input of other caregivers, such as Physicians, Occupational Therapists, Physiotherapists, Pastoral Caregivers and Activity Directors, as well as the family. The Unit Coordinator then devises a plan of care and periodically evaluates the resident’s progress.

Day-to-day care is given by Resident Attendants and Licensed Practical Nurses, always under the direction of a Registered Nurse. We have both female and male attendants on staff. If a resident prefers a male or female as an attendant, this should be expressed to the nurse on admission.

The nursing staff gives care which conforms to nationally-recognized gerontological nursing standards. Life-long learning is emphasized and all staff is expected to keep up-to-date with current best practice in long term care.

 Other Services

Laboratory, E.C.G., X-rays and other similar diagnostic services will be provided through the DECRH and the results will be forwarded to York Care Centre. If the resident is required to go to the hospital for tests, family members are required to accompany them.  If family cannot accompany the resident, they may arrange for a family friend to accompany their loved one or rearrange the appointment. If staff are required to accompany the resident, the family will be responsible to cover the costs.

Arrangements may also be made for medical appointments outside the nursing home. The resident is responsible for any costs associated with the transportation or examinations and a family member is required to accompany them.

Trained York Care Centre staff provide foot care services and is provided monthly to those residents who would benefit from this service.

Restraints

A program of least restraint is a key element of the care program. All information on the subject has shown that restraining a person leads to frustration and loss of dignity for the resident, and may actually increase the risk of injury. Restraints are only applied on a physician’s order. Only as a last resort will we restrain our residents, when all other means have been tried, and there is a clear and present danger to the resident or others. Please feel free to ask the unit coordinator for information on this issue. An information sheet on the use of restraints will require a signature at time of admission.

Care Supplies

The Nursing Home provides one brand of products to meet the personal hygiene and grooming needs of the residents (brand name available upon request). The supplies include; soaps, lotions, oral hygiene, denture care, nail care, facial tissue, shampoo and incontinence care products.

If a resident has a diagnosed allergy an alternate product will be provided however; if a resident chooses to use a different product than the one provided by the nursing home, the costs incurred for the preferred product is the financial responsibility of the resident and requires an agreement to be signed.

Any product can be arranged to be purchased directly through the nursing home. The cost incurred is the financial responsibility of the resident and requires signed authorization.

We support a scent-reduced environment in our nursing home and require our staff, volunteers, residents and family members to use scent reduced products. If you have any questions regarding this policy, please speak to the Unit Coordinator or RN on duty.

Rehabilitation Services

transforming-care-campaign-150x150Rehabilitation services are available to our residents through the Extra Mural Program. These include Occupational Therapy, Physiotherapy, and Speech Therapy.

York Care Centre has two Licensed Practical Nurses on staff working Monday to Friday. Their role is to ensure residents are assessed, referral for rehabilitation services are made as soon as possible, to ensure resident has appropriate equipment and is enabled to function at their maximum potential.

Should services be required, the Registered Nurse completes the necessary service requisition and forwards it to the Extra Mural Program. The services are generally provided at York Care Centre.

Pharmacy Services

Under the Nursing Home act, all medications must be obtained from the pharmacy contracted by the nursing home to provide this service. Medications are ordered for residents by the attending physician and administered by the Registered Nurse/Licensed Practical Nurses. No medication can be brought in and given to the resident by anyone other than the above mentioned staff.

Medications are reviewed by the physician, nurse, and pharmacist every three months or as required. The current system for delivery of medication at York Care Centre is the unit-dose system through Manrex.

The Nursing Home will supply basic stock drugs to be used on an occasional basis. This includes – Acetaminophen, Maalox, Gravol, Milk of Magnesia, Abenol Suppositories and Bactobin. If the resident is unable to pay for the regular use of non-prescription medication the accounting clerk may be consulted to inquire if financial relief is available.

Should a resident require or request a brand name different from the one stocked by the home, or require the stock medication on a regular basis, he/she is to be financially responsible for the cost of the product.

Dental Services

A dental suite is available for dental visits on site in the Best wing. Dr. Mathew Moore provides a regular monthly service to residents. Appointments may be made to access this service by contacting the Unit Coordinator. Payment for the dental service is the responsibility of the resident and/or family. If the resident is unable to give consent or provide direction, or manage their finances, a family member must accompany the resident to the visit. Other dentists may utilize the suite by contacting the Unit Coordinator.

Transportation Services

There is transportation available for the resident to go from the Manor to various locations such as malls, scheduled appointments, family home for a visit, etc. This is a service paid by the family. The booking of the Dial-A-Bus or Dial-A-Taxi is done in advance. Call 460-2212.

We now currently have a wheelchair accessible van that can be used when families are unable to access transportation through other sources.  This service is paid by the families, and has a volunteer driver.  All scheduling for this service is through the Volunteer Services Manager (444-3880 extension 3111)

Due to concerns regarding potential injury, staff are not permitted to assist residents in and out of vehicles by manual transfer.

Pastoral Services

As part of its commitment to the total well-being of our residents, York Care Centre places a strong emphasis on the role of Pastoral care within the context of an interdisciplinary team approach to holistic care.

York Care Centre has a Coordinator of Pastoral Care on staff full-time, who meets with the residents and their families in an individual basis, and coordinates the Pastoral Care program within York Care Centre.

While meeting the spiritual needs of the members of the different faith groups represented among the residents of York Care Centre, the Pastoral Care program strives to be ecumenical in nature. Residents of York Care Centre are welcomed and encouraged to attend any of the church services or religious activities of their choosing.

Very often, the spiritual needs of the resident are enhanced with one on one visiting. This visiting helps ease loneliness or the distress of any issues the residents may feel, and is offered by the Coordinator of Pastoral Care, community clergy, or York Care Centre volunteers who indicate a willingness to share in this ministry.

For the general resident population we offer…

  • Worship Service each Sunday at 2:30 p.m., conducted by local churches
  • Worship Service each Wednesday at 2:30 p.m. conducted by the Coordinator of Pastoral Care
  • Monthly Memorial Service on the 3rd Wednesday of each month at 2:30 p.m.
  • Services for special occasions (remembrance day, Christmas)
  • Anglican Communion on the 4th Friday of each month at 2:30 p.m.
  • Baptist Communion on the 2nd Friday of March, June, September and December at 2:30 p.m.
  • Roman Catholic Mass on the first Friday of each month at 11:00 a.m.
  • United Church or Presbyterian Communion on the 3rd Friday of each month at 2:30 p.m.

All services are in the Friendship Centre, and family members and friends are welcome to come.

Nutrition and Food Services

The scope and function of the Nutrition and Food Services Department is to provide optimal nutritional care and quality food service for residents, staff and guests.

Delivery of this service is met by ensuring the provision of meal service that pleases and satisfies residents while meeting their nutritional requirements. Resident’s food preferences are always considered. The food services department provides a variety of foods that please and satisfy guests in a pleasant homelike atmosphere. The weekly menu is posted in each building.

Residents requiring specific dietary restrictions or texture modifications are assessed by the dietitian. Changes in diet are communicated with the physician, nursing staff, resident and family.

Catering services may be provided to families, staff and the community. Everything from fruit trays to buffets can be arranged for that special event.

The Dietitian works closely with nursing staff and other health professionals to ensure all residents nutritional needs are met. The Dietitian will visit each resident and contact family members to discuss dietary issues and concerns. Information on health and nutrition is also provided to staff and volunteers through in-services and one-on-one meetings. The Dietitian also provides input in menu planning and revisions.

Meal tickets are available at the front desk, Monday – Friday 9:00 am – 5:00 pm for a fee of $4.00 per ticket.
Guests also have the option of purchasing a meal at Dave’s Place Monday – Friday 8:30 am – 10:30 am and 12:00 pm – 2:00 pm, and Saturday from 12:00pm – 2:00 pm.

Environmental Services

Environmental Services provides Laundry, Housekeeping, Maintenance and Information Technology Services. The departmental goal is to provide facilities and equipment that is functional, clean, safe, and attractive.

Laundry Services
Service is provided daily and processes approximately 750,000 pounds of laundry a year, with approximately one quarter being personal clothing. All new clothing/bedding items should be brought to the laundry for labeling before using to help prevent loss. The nursing home cannot be held responsible for personal clothing items lost or damaged. Machine wash and dry items only.

Housekeeping Services
Service is provided daily to all resident and common areas.

Maintenance
A Preventative Maintenance program which includes all facility and resident owned equipment is in place to ensure reliability and safety.  Work orders can be submitted online by any staff for required or requested service. Emergent requests can be dealt with through the phone system.

Information Technology

Cable Television service is available for a small monthly fee upon request to York Care Centre. Telephone and Internet service can be requested from a local provider and is the responsibility of the resident or family. Free Internet is available over the York Care Centre network in the Café area.  The user name and password are posted in this area.

If you have any concerns or special needs, please do not hesitate to contact the Manager Environmental Services.

Therapeutic Recreation Services

therapeutic

York Care Centre adopts a Therapeutic approach to recreation and leisure programming. This approach is rooted in the goal of creating a safe, home-like atmosphere honoring each person’s story, and empowering them to make their own choices about their lifestyle. It is achieved by considering each person as an individual and in facilitating meaningful and varied activities which promote their own personal purpose in life. Once residents have settled in to their new home, one of the Activity Coordinators will arrange a time to complete an assessment in order to find out about their interests and create an individualized recreation plan – family and friends are encouraged to participate in this discussion whenever possible, as well as to attend any program, especially those which have particular meaning to their loved ones.

There are currently 4 full-time Therapeutic Recreation Coordinators and 1 part-time Therapeutic Recreation Coordinator on staff. Each building has their own monthly activity calendar; these are posted in each individual resident’s room and on the daily information boards on each unit. In addition residents can check the bulletin boards daily for updates on the day’s events.

Below are some highlights to overview the Therapeutic Recreation initiatives happening at York Care Centre.

Narrative Program

Narrative Care is at the core of our philosophy in caring for the residents holistically and honouring their lives and experiences. Our resident biography program, ‘Celebrating Our Stories’, allows for families, volunteers and staff to work with residents in order to record their life stories in the form of a book. Upon completion of these stories, highlights and photographs are then taken to compile a DVD Tribute of the resident’s life. Residents are then honoured at monthly Narrative Ceremonies in which staff and loved ones have the opportunity to come together and get to know the true person for whom we care by watching the DVD and looking through the book and photographs. This program has long lasting positive effects on all involved and we encourage residents and families to become involved in the project when they are ready.

Sensory Stimulation Therapy

Sensory stimulation is an individual or group activity for the cognitively impaired elderly who may have difficulty in responding to their surroundings. Meaningful and familiar smells, movements, feelings, sights, sounds and tastes from their immediate and larger surroundings are presented systematically and in a format which can be understood by the individual. Residents with severe memory problems often find that even a familiar environment such as the home or ward is confusing and muddled. We often take for granted the impact of things happening around us. The noise of television, staff rushing about and people coming and going can make residents feel as though the world is happening around them. They are not involved. The Snoezelen experience allows us to make the environment more orderly and to control the sensory input that they receive. This means that their feeling of being overwhelmed is reduced.

A Snoezelen room is a quiet room in which the resident, family, staff or volunteer can actually control the stimuli in that specific area. It will be used to help calm, anxious, agitated, confused, aggressive and distressed residents. Snoezelen therapy originated from the Dutch and was originally used for autistic children however; it is now being used in long-term care facilities. Snoezelen is a combination of 2 Dutch words, meaning ‘to snoze’ and ‘to doze’. As a concept, it is a form of therapy designed to gently stimulate the primary senses without placing intellectual demands on the individual. (Pinkney 1999)

The therapeutic recreation team at York Care Centre maintains an active sensory stimulation program for residents requiring this type of programming due to their individual needs. We would encourage any family members or friends who wish to learn more about the program, or how to use our Snoezelen Therapy room, to contact the activity director in your building for more information.

Music Therapy/iPod Program

Music therapy is the clinical and evidence-based use of music interventions by an accredited music therapist to promote, maintain, and restore mental, emotional, physical, social, and spiritual health.  The music therapist develops individualized goals based on the client’s abilities, preferences, and needs, then implements the appropriate music-based interventions which most effectively address those goals.  Within the therapeutic relationship, objectives such as self-expression, communication, and personal development can be pursued using music. (Arpeggio Music Therapy) Since 2009, York Care Centre has been able to have a contract with Arpeggio Music, where the certified Music Therapist facilitates sessions through the facility.

In 2012, the pilot project Well-Tuned between the Institute of Music and Neurlogic Function (www.imnf.org) and Music and Memory (www.musicandmemory.org) commenced.  The Atlantic Institute on Aging coordinated the implementation of the Well-Tuned program in 3 New Brunswick long term care facilities; York Care Centre was one of the lucky ones chosen, and thus creating the iPod Program.

The iPod Program is simple, we create a simple playlist of music that the resident has chosen specifically or that we have gathered from the family members, we upload this playlist to an iPod which has either been donated or purchased by family members.  Once the playlist has been uploaded the resident is able to use the iPod at their leisure.

The iPod Program offers many benefits to residents in long term care. It has been proven residents are happier and more social; relationships are built with staff members and other residents in the facility.  There is growing evidence that a personalized music program gives professionals one more tool in their effort to reduce reliance on anti-psychotic medications.

 
Pet Therapy

Part of the Therapeutic Recreation Departments philosophy is to provide residents with access to animal assisted therapy whenever possible (if it is desirable to the resident).  As such, we have adopted several animals over the last several years. We currently have 2 cats, 1 rabbit, 1 bird, many fish, and 6 guinea pigs! All of these animals are fed and cared for on a daily basis by recreation staff.

The Goal of Pet Therapy is to improve the resident’s social, emotional, or cognitive functioning.  Advocates state that animals can be useful for educational and motivational effectiveness for participants.

Below is a list of some of the goals the department of Therapeutic Recreation strive for:

  • Enhanced quality of life
  • Reduce Loneliness
  • Reduce anxiety
  • Assist in reminiscence
  • Enhances socialization with other residents and staff members
  • Increases physical activity
  • Provides sensory stimulation and improvement of fine motor skills

Outings

The department takes particular pride in the number of creative outings that are offered to residents – from favourite annual trips such as the Trail Hike, Apple Picking, Tours of the Foliage in Fall and Christmas lights in December, to regular outings such as Tim Horton’s, lunch outings or shopping trips. These outings have been made even more fun with the addition of our state of the art 24 passenger wheelchair bus.

Fitness Program

York Care Centre is fortunate to have Therapeutic Recreation staff certified in fitness for older adults through the nationally recognized program – CANFIT PRO. The fitness program has been established to offer to residents the opportunity to maintain their physical and mental wellness while they live in long term care. This program is a combination of deep breathing/relaxation exercises, range of motion stretches, as well resistance training also known as Isometric training which uses their own personal weight to increase their endurance and function.

The goals of the program are to ensure residents are properly exercising and stretching, offering skills to expand their breathing, and muscle expansion.

We have also been fortunate to have a weekly Tai Chi program with a qualified instructor over the past 4 years; in this time we have seen a large number of regular attendees and many benefits to resident mood as a result.

Resident Spaces

Various activity areas are available for residents who wish to book space for special occasions such as birthday parties, holiday get-togethers or simply to have a quiet time with family and friends. Many of these areas are equipped with dishes, dining room tables, and a nearby kitchen to facilitate a cozy, private environment with all the comforts of home.

In addition, there are a number of spaces available in order for residents to continue independently with their hobbies and interests. Residents who have established hobbies are encouraged to bring any materials with them on admission. In particular our 3 resident libraries function well for card games, puzzles, or quietly reading a book or the newspaper.

Volunteer Services

We are fortunate to have an active Volunteer Department with a part-time Manager. Volunteers fall under various categories such as juniors (ages 12-18), Pastoral Care, Entertainment Groups, Community Support Facilities as well as other general volunteers who provide on-going service to supplement many of the York Care Centre activities.

During the summer months we host a Junior Volunteer Program.

We encourage family participation and would welcome those who express an interest in any of the above. Volunteers are our most valuable natural resource.

Please contact our Manager if you wish to volunteer. (444-3880, extension 3111)

Financial Services

Business Office
The Business Office is located inside the main entrance. The office is open Monday to Friday, 8:00 am to 4:30 pm.

Nursing Home Rate
The daily rate is negotiated with the Department of Social Development and approved by the Board of Directors. While the Nursing Home operates on a non-profit basis, rates must be adjusted periodically due to rising costs. The daily rates cover the individual residents’ cost per day, regardless of whether or not it is a semi-private or private room.

Personal Property
York Care Centre will not enter into an agreement, or contract involving the disposal of resident’s personal property. This is the sole responsibility of the family and/or the resident’s legal trustee. If neither is available a public trustee can be appointed.

Resident’s Care Account
It is the responsibility of the resident, or his/her sponsor, to see that the resident’s account is paid on time. The resident’s account can be paid at the Business Office or by electronic payment. Room charges will commence on the day of admission, regardless of the time the resident arrives, and will continue until the resident’s belongings are removed from the room after discharge or death. It is the family or their representative’s responsibility for removal of the belongings.

Assistance for Residents
When a resident’s personal finances are depleted, or when on admission, it is determined that a resident does not have the financial resources to pay for their care, it is the resident’s responsibility, or his/her representative, to make arrangements with the Department of Social Development for financial assessment for government assistance. When a resident becomes eligible for government assistance, it is the responsibility of the resident, or his/her representative to apply for such assistance.

Comfort and Clothing Allowance

Residents of licensed nursing homes who are receiving provincial assistance from the Department of Family and Community Services are entitled to retain part of their OAS/GIS monthly income as a personal Comfort and Clothing Allowance.

Procedure

    It is expected that the Comfort and Clothing Allowance will be used to cover expenses associated with:

    • Personal items
    • Haircare
    • Clothing
    • Cable
    • Prescription fee for drugs not covered by the PDP Program
    • Over the counter medication not routinely supplied by the nursing home
    • Transportation to appointments such as hospital or dentist

    The comfort and clothing allowance may be allowed to accumulate. York Care Centre holds the right to evaluate amounts deemed excessive.

    When assigned as Trustee, it is the Executive Director’s responsibility to monitor and report the additional revenue. It is the Executive Director’s responsibility to advise that resident or trustee, whether it be family member or other person, of the Departmental policy as well. The Department’s written material may be used for this purpose. A Fund Management Agreement must be signed upon admission.

    The Comfort and Clothing Allowance is to be considered as the resident’s asset, and any accumulation of such monies at the time of death should be applied against funeral expenses whether incurred by the family or the Department of Social Development.

    Where there is no funeral expenses incurred any accumulation of Comfort and Clothing Allowance is to be treated as part of the estate.

Education Services

The Manager of Human Resources coordinates the orientation program for all new staff and organizes an extensive staff development, in-service education, and training program. She/he maintains close links with a number of educational/academic institutions and programs.

York Care Centre is committed to providing education, information, gerontological research and development material, to families, staff and volunteers. Frequent inservicing, focus groups, guest speakers, and the use of in-house expertise are some of the approaches used to deliver this service.

We welcome students at York Care Centre, and support their clinical training. Students may be providing care to residents, under supervision of their clinical instructors and York Care Centre staff. Residents are at liberty to refuse to have their care given by students, however there are many benefits for both the residents and students who participate.

Liaison with Universities and other educational providers is a multifaceted opportunity that often enhances the life of residents, staff and students.

Any research projects conducted at the manor require the prior approval of the Ethics committee. Residents are given the opportunity to participate in such research.

Any request for education, or information on a given topic can be requested through the Manager of Human Resources. (444-3880, extension 2515)

Families

We have purposely left this topic to the last, not because it isn’t important, but because we feel it is the most important subject and we want to emphasize the importance of family involvement. Since there are no restrictions on visiting, we would like to see the entire family visiting and would especially welcome children of all ages. If the residents like animals, we have no objection to their favorite animal visiting also.

We encourage suggestions from family to improve care for the resident, and if there are any concerns or special requests, please pass them on to us.

We would like to see families taking part in birthdays, anniversaries, and other special events, and we will assist the family in making arrangements. We also encourage families to take their loved ones out for a drive, to a community event, to their local church, or home for an overnight visit. We firmly believe that the continued involvement of the family with the staff plays an important role in enhancing the quality of life for the resident at York Care Centre. We encourage family members to discuss their plans and concerns with the Unit Coordinator, Director of Care Services or the Executive Director.

Each building has a Family Information Board (located in front entrance areas) to keep families informed of related events.

The Family Advocacy Group holds meetings on a regular basis. A notice of the meeting will be included each month along with the billing. New members are always welcome. Signs are posted to remind families.

There is a quiet room available in the Best Park for use of residents and families who require privacy.

Prescription Drugs

Private Plans
All residents who are admitted to a nursing home and have a private prescription drug plan are required to maintain their plan while they are a resident in the nursing home. Details on the plan should be given to the nursing home staff.

New Brunswick Prescription Drug Program
Residents who do not have private prescription drug plans will be registered with the New Brunswick Prescription Drug Program and will be issued a prescription drug card.

Community Links

York Care Centre works closely with the community to provide job opportunities for clients with the Jobs Unlimited program and Work Ability program.

Some community links that families might find helpful:

The Alzheimer’s Society of New Brunswick 459-4280

Mental Health New Brunswick 459-3878

CHIMO Helpline 450-4357

Miscellaneous Policies and Services

Valuables
York Care Centre cannot be responsible for the security of valuables such as jewellery, money or ornaments. If a resident insists on having valuables, they are responsible to protect them.

Mail
All mail should be addressed to the resident in care of:

YORK CARE CENTRE.
100 SUNSET DRIVE
FREDERICTON, NB E3A 1A3

The resident’s mail is sorted by administrative personnel and delivered to the resident’s room.

Scent Policy
Medical evidence shows that scented products may be harmful to those with allergies, environmental sensitivities or chronic heart or lung disease. In support of its commitment to the provision of healthy and safe environment for residents, staff, volunteers and visitors, York Care Centre supports a ‘scent reduction policy’. This policy is designed to eliminate the presence of personal scented products which may adversely affect residents, staff, volunteers, and visitors.

Visiting Policy
York Care Centre has no specific visiting hours, however, we ask that all visitors check with the Nurse Supervisor on duty before visiting residents between 10 PM & 7 AM.

Privacy and Intimacy
York Care Centre supports the resident’s rights to provision of space to meet their needs. Please contact the nurse for assistance in ensuring accommodations for this purpose are made available.

Pets
Pet visitors are encouraged, however pet owners must ensure that the pet is restrained by a pet leash at all times. Keep in mind, that not all residents may want a pet visitor.

Alcoholic Beverages
The consumption of alcoholic beverages is at the request of the resident and in consultation with the physician and the nurse.

Smoking Policy
This policy is currently under review.

 

Leave of Absence for Resident
Each Nursing Home resident is entitled to a 30 day leave of absence within each fiscal year. This cumulative 30 day period constitutes the total annual leave for any purpose including hospitalization. The 30 day leave of absence is available effective on the day of admission. Continuity of payment for the retained bed is required in accordance with the resident’s financial status assessment.

Additional days may be requested by the Nursing Home through a request form, which is forwarded to the Nursing Home Consultant, Nursing Home Services for approval.

The above leave of absence is in accordance to the Directive 61-01-03 in the Directives Manual for Nursing Homes of New Brunswick.

Hairdresser and Barber Service
Licensed hairdressers and barbers will provide hair care services to residents of the nursing home.

Each resident is responsible for the normal charge for this service.

Resident Council
The residents meet monthly with management staff to provide an opportunity to contribute suggestions on improvements to the physical aspects of the nursing home, along with services provided to them.

Hospital Services
In the event of a medical emergency or a need for immediate assessment by a physician, residents will be transported by ambulance to the DECRH. A copy of all pertinent medical information, medication records and resuscitation wishes will accompany the resident and the family will be contacted.

If it is necessary for the resident to go to the hospital for tests, the family will be contacted to transport them if possible or meet them there to accompany them during the procedure. Volunteers may be utilized but if unavailable the cost of staff to accompany must be paid by the family. In the event of an emergency staff will be sent if necessary.

 

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