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Simple Graham Cracker Gingerbread Houses Icing Yields 6-8 Houses Ingredients: FOR THE HOUSES Graham crackers Sandwich-size Ziploc baggies Paper plates Candy ROYAL ICING 1 lb powdered sugar (approx. 3-4 cups) 3 egg whites ½ tsp cream of tartar (optional) Instructions To make the Royal Icing, put all ingredients in a mixing bowl and... Click Link Below for Full Recipe! RealLifeDinner.Com Gingerbread Cloud Dough Materials 8 cups flour 1/2 cup cinnamon 2 Tablespoons ginger 1 Tablespoon nutmeg 1 Tablespoon allspice 2 cups oil (you can use vegetable or baby oil) Tools Large bowl or Storage Bin Wooden Mixing Spoon Cinnamon sticks Jingle Bells Buttons Cookie Cutters Measuring cups Instructions Measure out your flour into a large bin. Add enough cinnamon, nutmeg, allspice and ginger to... Click the Link Below for Full Tutorial! SugarSpiceandGlitter.Com Old-Fashioned Gingerbread Ingredients 8-1/4 oz. (1-3/4 cups plus 2 Tbs.) flour 1-1/2 tsp. baking soda 2-1/4 tsp. ground ginger 1/2 tsp. ground cinnamon 1/4 tsp. ground cloves Pinch salt 2-1/2 oz. (5 Tbs.) butter, softened at room temperature 1/3 cup sugar 1 large egg 3/4 cup dark molasses 3/4 cup cold water For the whipped cream: 1 cup heavy cream (not ultrapasteurized, if possible) 1/4 cup maple syrup Preparation Heat the oven to 350°F. Butter an 8×8-inch cake pan... Click on the Link Below for Full Recipe! FineCooking.Com Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2810 US HWY 190 W #100-A9 Livingston, Texas 77351

Turkey Windsocks Supplies Needed to Make Turkey Windsocks: Recycled Food Can (cleaned and dried, with top and bottom removed) Brown Paint Elmer’s CraftBond Quick Dry Glue Elmer’s Medium Tip Painters Pen, Orange Large Googly Eyes Ribbons in Fall Colors Feathers, Felt, and/or Construction Paper in Fall Colors (can mix and match) Masking Tape, optional Directions: Start by painting the can brown and allowing it to... Click link below for full tutorial! HappinessisHomemade.Net How to Play Print and distribute these Thanksgiving Trivia Quiz game cards among the players along with a pen and pencil. Ask them to circle the right answer within 5 minutes. Set the timer. Ask them to put their pencils down after five minutes have passed. Check the answers using this Trivia Quiz Answer key. The person who has given all or most right answers will be the winner. Answer Key Ingredients (Serves 7-9) For the Mini Pumpkin Pies: 2 Deep Dish Frozen Pie Crusts 9 inch 1/2 cup Pumpkin Puree 1/4 cup Brown Sugar 1 Tablespoon Maple Syrup 1/4 teaspoon Pumpkin Pie Spice 1 Egg beaten 6 " Lollipop Sticks optional For the Glaze: 1/2 cup Icing Sugar 1/2 teaspoon Vanilla Extract 2 to 4 Tablespoons Maple Syrup Instructions For the Mini Pumpkin Pies: Defrost the frozen pie crusts on the counter for one hour... Click link below for full recipe! OneLittleProject.com Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2810 US HWY 190 W #100-A9 Livingston, Texas 77351

The History of Almshouses to Nursing Homes The first almshouse in United States history was founded in Boston, Massachusetts, in 1622. The original Boston Almshouse was burned down in 1682 and was rebuilt away from the heart of Boston nearly a decade later. Upon entering the almshouses in Connecticut, patients were whipped ten times. There were similar institutions developed from 1725–1773 in Pennsylvania, Rhode Island, Virginia, and New York. At the Pennsylvania Hospital, some "lunatics" were chained to a cellar wall or wore primitive straitjackets. One of the biggest problems with almshouses is that they were rarely self-sustaining. They were costly to run, and the capacity of the inmates to pay for their own keep by working at the farm, or working at the almshouse itself, was greatly overestimated. There were not enough staff, facilities were not kept up, and the poor kept coming. The Evolution 1860 Before the American Civil War, local officials regulated almshouses and did not ensure the people inside them were being cared for in the proper way or given the time they needed for help. It was not until the 1860s that more progressive states such as New York began to create boards that regulated, inspected, and reported on almshouses. 1884 The statistical analysis of the Massachusetts almshouses showed four in the city of Boston and 225 almshouses throughout the state. These almshouses housed nearly 7,000 people. Of these residents, 700 were believed to have a mental illness. Half of these almshouses did not house children. Almshouses were often multiple small terraced houses or apartments providing accommodation for small numbers of residents. The units may be constructed in a "U" shape around a communal courtyard. Some facilities included a chapel for religious worship. 1878 The Newark almshouse opened in September 1878 as a branch of the Syracuse State School. It was located on 104 acres of land within the town of Newark, New Jersey, and held around 853 patients. The nine dormitory buildings that housed the patients were able to hold anywhere from 45 to 130 people. There was also a small hospital within the almshouse that could hold up to 30 patients. There were not many employees, only about 110, to take care of the hundreds of young women admitted to the almshouse. Patients were committed to the Newark State School by superintendents of the poor as well as judges who declared them insane or feeble-minded in court. By the end of the 1800s, almshouses began to be replaced by asylums and institutions. Before the nineteenth century, no age-restricted institutions existed for long-term care. Rather, elderly individuals who needed shelter because of incapacity, impoverishment, or family isolation often ended their days in an almshouse. Placed alongside the insane, the inebriated, or the homeless, they were simply categorized as part of the community's most needy recipients. Centuries in the Making 19th Century In the beginning of the nineteenth century, women's and church groups began to establish special homes for the elderly persons. Often concerned that worthy individuals of their own ethnic or religious background might end their days alongside the most despised society, they established—as the founder of Boston's Home for Aged Women (1850). Throughout the 19th century almshouses were a last resort for those who were poor, disabled, and elderly. Residents experienced mistreatment, destitution, and inhumanity. Almshouses continued into the 19th century, until activists sought to remove children, the mentally ill, and the developmentally disabled from all almshouses and increase the number of institutions, hospitals, and asylums for them to reside in. In 1910 the state of Massachusetts, reported that 2,598 persons resided in such asylums. The great majority of these individuals were widowed and single women who had lived their entire lives, or at least a great proportion, as citizens of the state. Despite the name changes and the rosy descriptions that filled the institutions' annual reports, most people hardly looked upon the almshouse as a satisfactory solution to the demands for long-term care for the elderly. By the 1950s, the intent of policymakers to destroy the hated almshouse had clearly succeeded. Most poorhouses had disappeared from the landscape, unable to survive once their inmates no longer received federal annuities. As a result, and due to the lobbying of public hospital associations, Congress amended Social Security to allow federal support to individuals in public facilities. According to investigations of the industry in the 1970s, many of these institutions provided substandard care. Lacking the required medical care, food, and attendants, they were labeled "warehouses" for the old and "junkyards" for the dying by numerous critics. 21st Century In the twenty-first century, nursing homes became a standard form of care for the most aged and incapacitated persons. Nearly 6 percent of older adults are sheltered in residential facilities that provide a wide range of care. While these aging individuals no longer face the horrors of the almshouse, the development of the modern-day industry reflects its historical roots. In establishing monthly annuities for the old and disqualifying all residents of public institutions, the creators of Social Security took direct aim at the despised poorhouse. In shutting the almshouse door, policymakers gave birth to the modern nursing-home industry. https://en.wikipedia.org/wiki/Almshouse https://www.4fate.org/history.pdf Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org Next NAPT Class for Activity Director Training December 7th Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2810 US HWY 190 W Ste 100-A9 Livingston, Texas 77351

Are you looking for facility entertainer in the New York area.. well then, check out Mary Peck.. She has some great programs and lots of Entertainer Friends https://www.linkedin.com/in/mary-peck-7a056330/ Keep us posted! thanks Pennie

View this email in your browser Critical Element Pathway Forms The Department of Health and Human Services - Centers for Medicare & Medicaid Services (CMS) has published Critical Element Pathways (CEs) that contain guidance to assist the surveyor while investing a specific Care Area to determine whether a facility meets the associated regulatory requirements. There are currently 40 Critical Element Pathways representing a range of clinical care areas. Each Critical Element Pathway consists of three components: Guidance for observations and interviews Information about how the tool is to be used Procedures for the investigation Considerations: Did the facility adequately assess the situation? Did the facility develop an adequate Care Plan? Did the facility follow professional standards? Did the facility revise the Care Plan as necessary? Was the facility’s provision of care appropriate? “Dementia Care Critical Element Pathway” The Dementia Care Critical Element Pathway is one of the pathway guidelines used during surveys. It outlines the areas relative to a resident who displays or is diagnosed with dementia to determine if the facility provided appropriate treatment and services to meet the resident’s highest practicable physical, mental, and psycho-social well-being. In its simplest form, ‘dementia care pathway’ is the term used to describe the process of care that individuals with dementia may receive; from the moment they consult their physician with concerns about symptoms such as the loss of short-term memory to dementia diagnoses to the end of their life. Using the Form to Develop Your Dementia Program? Given the complexity and potential range of symptoms that may present with dementia (from mild to severe decline); guidance is greatly needed through best consensus practices for screening, assessment, diagnosis, and care of the dementia afflicted population. The collection of accepted and approved standards of care have been clearly laid out and outlined in the “Dementia Care Critical Element Pathway”. Consider the elements included within this form your road map to developing a quality dementia program. Taking time to be familiar with the information contained in this document will ensure that you are ready to meet specified guidelines and help you to feel confident and assured that your survey experience will go smoothly and result in positive outcomes. Advantages and Disadvantages Resident, family, and/or resident representative interviews are part of the process of investigation during this survey. It is very important for you to become the active agent to facilitate communications with all parties in the continuum of care. Failure to involve the family and/or resident in care planning and goal development will be cause for further investigation. Critical Element Pathways assist the surveyor in asking specific questions in order to determine compliance. But it should also be used to guide staff to better understand the surveyor and survey team approach. Surveyors act responsibly during the process of carefully observing something or someone in order to gain information and they possess the ability to notice things, especially significant details. That said, surveyors will also take into account; a remark, statement, or comment based on something one has seen, heard, or noticed. Given the chance, make every effort to point out all improvements and enhancements that you have implemented in the development of your dementia program to ensure that the survey is comprehensive. Although the “Dementia Care Critical Element Pathway” guidelines outline the best of quality care for the dementia population; your added input and will help you to effortlessly pass surveyor inspections. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/GuidanceforLawsAndRegulations/Nursing-Homes Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org Classes Begin Next Tuesday Nov. 2nd - Enroll at ActivityDirectorUniversity.org Classes Begin Next Tuesday Nov. 2nd - Enroll at ActivityDirectorUniversity.org Activity Resources QISstateoperationsmanual.pdfAppendix-PP-State-Operations-Manual.pdfCMS-20072_General.pdfQISstateoperationsmanual.pdfiahpc-manual-08.pdf Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2810 US HWY 190 W Ste100-A9 Livingston, Texas 77351 Want to change how you receive these emails? You can update your preferences or unsubscribe from this list. Dementia Critical Pathway Form.docx

View this email in your browser Celebrate Chia Pet Day November 29th I am sure we all remember Chia Pets. They took the world by storm years before any of us realized that the spouts they created are also mega superfood status. Have residents create their own unique chia pets and once they have fully spouted, plan a superfood feast to celebrate. These sprouts are very mildly flavored and go great on sandwiches, salads and Buddha Bowls. Celebrate International Tongue Twister Day November 8th The 14 toughest tongue-twisters in the English language Source: Morgan Cutolo , Reader's Digest 1. 'Pad kid poured curd pulled cod.' A team of researchers from Massachusetts Institute of Technology say that this is the most difficult tongue twister in the world. Can you say it ten times fast? The psychologists who created this tongue twister said that people who attempted to say it either stopped right in the middle of saying it because it was too difficult or could only get through it once and weren't able to repeat it. [The Guinness Book of World Records disagrees...scroll down to see their top pick.] 2. 'Brisk brave brigadiers brandished broad bright blades, blunderbusses, and bludgeons—balancing them badly.' 3. 'If you must cross a course cross cow across a crowded cow crossing, cross the cross coarse cow across the crowded cow crossing carefully.' 4. 'How can a clam cram in a clean cream can?' 5. 'Imagine an imaginary menagerie manager managing an imaginary menagerie.' 6. 'Send toast to ten tense stout saints' ten tall tents.' 7. 'Rory the warrior and Roger the worrier were reared wrongly in a rural brewery.' 8. 'Six sick hicks nick six slick bricks with picks and sticks.' 10. 'The thirty-three thieves thought that they thrilled the throne throughout Thursday.' 11. 'The sixth sick sheik's sixth sheep's sick.' [According to The Guinness Book of World Records, this is the world's hardest tongue twister, not #1 on this list. You be the judge.] 12. 'Can you can a canned can into an un-canned can like a canner can can a canned can into an un-canned can?' 13. 'Thirty-three thirsty, thundering thoroughbreds thumped Mr. Thurber on Thursday.' 14. 'Six sleek swans swam swiftly southwards.' This article has been condensed for space. Check out the whole shabang below... Full Article Celebrate National Nacho Day November 5th Mmmm...nachos. This IS a day to celebrate! You can setup your nacho bar as an actual bar or you can fire up the cart for a room to room delivery service. There are two school's of thought on whether chips should be provided with melted cheddar on them or if a crock pot with liquid cheese is the way to go. For our purposes, a crock pot is probably the best bet to keep things fresh, warm and convenient. For an added perk, this lady created a Desert Nacho Bar, which I think your residents will be all about! I know I am! Next Class Starts November 2nd Visit https://activitydirectoruniversity.org for more information. Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2810 US HWY 190 W #100-A9 Livingston, Texas 77351

View this email in your browser Entertaining Residents on the Weekend Take a quick tour through the Activity Directors Network Facebook feed and you will find the common topic of entertaining bored residents over the weekend. Peppered into some of the suggestions, hints of frustration poke though about the idea that Activity Directors are somehow expected to entertain the residents 24/7. Of course, this is not possible, but it does suggest an insatiable entertainment need for some of our more active residents. Let’s look at some of the fantastic suggestions made by some of our fellow Activity Directors: Open Closet Create an accessible closet stocked with items for entertainment and add or rotate new items in. Items to include: Boardgames Video Game Player and Games Packs of Playing Cards Word Games Magazines Books Blank Greeting Cards Art Supplies (for painting, drawing, collage work, coloring, crafting) Paint by Number Movies Radio Boredom Packets A couple of the comments mentioned creating packets that the residents could grab and work on whenever they choose. You could make it a contest or have them turn them in for a treat or prize on Mondays as incentive, but if you can make them interesting enough with some sort of hook you may not need to. Items to include in your packet: Interesting Articles Funny Stories Riddles Journal Page Coloring Pages Trivia Look and Find Crossword Word Search Weekly Newsletter Health Brochures Scavenger Hunt Set a scavenger hunt for the residents to do over the weekend. One AD mentioned she hid pictures all over the facility and the residents had to find each one of them. Those that found all of them, received a prize on Monday. We made a FREE Halloween Scavenger Hunt for you to use with your residents this weekend! Click below for a printout of the pictures for hiding and the form to hand out to interested residents. FREE Activity Worksheets Movies Everybody loves a movie, especially on the weekend. This one is always a biggie and with the right movie selection it can be a serious weekend event. Keep your movies fresh and circulate new options constantly. Surprise your residents often by adding to your classic movie selection. This is an easy event to get help pulling off. You only need one volunteer to pop some popcorn and get the movie going. Where to Watch Classic Movies Online: The 7 Best Sites and Services Source: WhatNerd.Com 1. Criterion Channel As the name suggests, the Criterion Channel is a digital streaming version of the Criterion Collection of films. You won’t find every single film in the collection here, but new movies do rotate in and out each month. The selection is large however and doesn’t just include the films themselves but features around various movies and film in general. At $10.99/month or $99/year, this is a major value for film buffs. 2. Watch TCM No, I’m not just suggesting that you watch the Turner Classic Movies channel on your TV provider of choice. Watch TCM is a TV Everywhere app that lets you sign in with your TV provider and then watch movies on demand at no extra cost. The only downside of this service is that modern streaming cable replacements like Sling TV don’t seem to be supported, so this is only for those with cable or satellite TV. 3. Fandor Self-described as a service for movie lovers, the main emphasis of Fandor is on independent and foreign movies. This includes several classic films as well, which make up a sizable portion of the more than 4,000 movies offered via the service. This is one of the more affordable services on this list too, costing just $5.99/month or $49/year. 4. Kanopy If you have a library card, you need to be using Kanopy. This service works with libraries and universities throughout the US to provide streaming movies for members. This includes a wide range of various films, but it includes a large library of classics. 5. Archive.org You may know Archive.org at the home of the Wayback Machine, but as the name says, it’s an archive of various sorts of digital media. This includes a vast selection of public domain films. If you’re a fan of shorts from this time period, the Prelinger Archives are hosted here as well, with various educational and promotional short films to keep you busy for hours on end. 6. Netflix Classics While the selection isn’t what it used to be, you can still find some classic movies on Netflix. Depending on how you access the service, they can be difficult to find. One of the easiest ways is to hop on to your computer and point your browser to the website, then select Classics from the genre selector. Some of the movies you’ll find are newer than what I think of when I think of classics, but you may view this as a plus. 7. Hulu Classics There was a time when Hulu was one of the best streaming services for classic movies, as it hosted much of the Criterion Collection. Now that that’s a separate service, you won’t find many of them on Hulu any longer. That said, there are still a fair number of classic films available on the service. If you subscribe to Starz, either as an add-on or as part of Hulu with Live TV, the number of classics available grows considerably. Don’t Forget About Discs If you’ve got DVD copies of older films, don’t just assume that a streaming version will look better. In some cases, the streaming version won’t look any better than your DVD copy, and it could even look worse. If you have a Blu-ray, it will almost certainly look better than streaming. Hire Entertainers If you are able to hire entertainers or book special volunteers at least one weekend a month your residents will be thrilled! The question is where to find these entertainers. Some are fairly easy to find through forums, Facebook, internet searches, or word of mouth. Other’s however may not present as Entertainers but are. See examples to catch my drift: Book Club- Read a book written by a local author and invite the author in for a reading and book signing. Cake Decorating- Invite a local baker to come in and do a cupcake decorating demonstration. Adaptive Fitness- Ask a local trainer from a gym to come in and show the residents some low impact moves they can do to stay more active. Church Choir- Live music is loved by most. Invite a local singing group or choir to come and put on a performance for your residents. Computer Class- Invite someone from a local technology store or computer repair shop to come in a give a lesson on how to use the computer for a specific purpose (ie edit photos, search The Met’s database for art, find good book suggestions on Goodreads.com, etc.) Oktoberfest- Invite someone from a local brewery to have a tasting and discuss the process for making beer. We just added a new section to the Forum for Facility Entertainers. Add any you have used or have heard of to help each other out. The list will grow from here! Facility Entertainers Forum Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2810 US HWY 190 W #100-A9 Livingston, Texas 77351

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Title"Bonnie Barchicchats Senior Comedy Afternoons Bonnie Barchichats Senior Comedy Afternoons View full entertainer

Activity Director Needed - Facility is WhiteOak of Lancaster North Carolina Ask for Brittany...

View this email in your browser Wandering Residents In residential aged care facilities there are many factors that may influence residents to wander. These commonly include: Inactivity/boredom – lack of activity may lead the person to wander around looking for something to do. In some instances wandering dissipates loneliness and the behavior in and of itself, is often a substitute for lack of social interaction. In contradiction, wandering surprisingly may also be a response to overstimulation and overwhelming situations. Fear, agitation, and confusion commonly lead to “dementia” wandering outdoors or in public environments. Some emotional cues that can cause wandering include: increased levels of stress or fear. Residents with “dementia” who wander are moving about in ways that may appear aimless but often have purpose. People may wander in response to an unmet basic need like human contact, hunger, or thirst; a noisy or confusing environment; or because they are experiencing some type of distress, like pain or the need to use the toilet. Wandering can be helpful or dangerous, depending on the situation. The Balancing Act It’s a balancing act for sure but it is important to look beyond the words or behaviors to discover the feelings that the resident might earnestly be trying to express. Strong emotions may also be caused by unmet needs. Staff must implement the process of deduction to work out what needs are not being addressed and meet the resident “where they are” when possible. Residents may wander for any number of reasons: Physical needs Psychological and social needs Cognitive needs Non-goal-directed wandering requires a response in a manner that addresses both safety issues and an evaluation to identify root causes to the degree possible. Moving about the facility aimlessly may indicate that the resident is frustrated, anxious, bored, hungry, or depressed. Although people who wander may gain social contact, exercise, and stimulation, the resident may consequently become lost or exhausted. Hence, they may become overwhelmed and over tired, which predictably causes sudden outwardly hasty behaviors such as wandering or higher probability of injuries to self and/or others. Person-Centered Care for Wandering Behavior Simply stated, some basic principles for people with dementia stems from understanding and supporting the residents’ rights. To be sure, the onset of dementia does not preclude inherently due personal rights. Understand that the individual beyond the “dementia” is becoming increasingly hidden rather than lost. This means that he/she is still there, and it’s your mission to reclaim the essence of the individual that once was and bring them out of hiding. Those who were highly sociable and had an active lifestyle prior to having mental decline are most likely to wander. The use of certain antipsychotic medications can cause side effects that increase the desire to wander and be in perpetual motion. Sedating medications can also increase the risk for wandering due to confusion. Other causes of wandering include the following: Memory deficits Poor vision Disorientation Language deficits Searching for security Searching to fulfill an unmet need such as to relieve hunger, thirst, pain, constipation, and the need to urinate Searching for a loved one Boredom Person centered care plans must consequently demonstrate this principle. Here are some examples of appropriate goals: Personalize the resident’s surroundings. Interpret behavior from the resident’s viewpoint. Acknowledge and validate the resident’s feelings. Involve the resident with dementia in decision-making. Create target goals for the resident to achieve based on resident history and his/her skills that have not yet been lost. Focus on the journey- not the results. Evaluate the Behavior Physical Needs: Does the resident need to use the bathroom? Is the behavior due to medication side affects? Is the resident: Hungry, thirsty, or generally uncomfortable? Searching for a place that is warmer or cooker, darker or lighter? Looking for a place that is more familiar (does the resident have familiar belongings in his/her room)? Responding to physical illness, e.g., dehydration, infection, congestive heart failure, etc.? Psychological and Social Needs: Is the resident: Restless or agitated and trying to relieve anxiety? Bored, lonely, or seeking company? Following a previously familiar imprinted routine: acting out movement to and from the bus stop to pick up the children – going to work? Cognitive Needs: Is the resident: Disoriented or lost? Disoriented due to medication side affects Overstimulated or understimulated? For the resident, wandering may be positive if it fulfills a need for exercise, sensory stimulation, or purposeful behavior. Many nursing homes provide a safe environment on a locked unit for this reason. The negative side of wandering is it may lead to falls, excess fatigue, anxiety, accidental exposure to certain chemicals, altercations with other residents and unintended wandering outdoors where more danger may be waiting to cause harm. Make it your mission to find the balance in the day and life of your resident by looking beyond the words or behaviors to discover the feelings that the resident might earnestly be trying to express. Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2810 US HWY 190 W #100-A9 Livingston, Texas 77351

View this email in your browser WHAT IS THE LONG TERM CARE OMBUDSMAN PROGRAM (LTCOP)? The Ombudsman program advocates for resident of nursing homes, board and care, assisted living and other similar adult care facilities. State Ombudsmen and their designated representatives work to resolve problems individual residents may encounter and effect change at the local, state, and national levels with the objective of improving the quality of care for the elderly population. The ombudsman service offers a way for older adults to voice their complaints and have concerns addressed so they can live with dignity and respect. Ombudsman provides information about how to find a facility and what to do to get quality care. They are trained to resolve problems and assist the resident with complaints. However, unless the resident gives the Ombudsman permission to share his/her concerns, these matters are kept confidential. Federal Older Americans Act (OAA) Under the federal Older Americans Act (OAA) every state is required to have an Ombudsman Program that addresses complaints and advocates for improvements in the long term care system. Each state has an Office of the State Long Term Care Ombudsman, headed by a full time State Long Term Care Ombudsman who directs the program statewide. Staff and thousands of volunteers are designated by the State Ombudsmen as representatives to directly serve the individual resident’s needs. What is the role of the ombudsman in a healthcare setting? The healthcare ombudsman is employed by the state department of insurance, and works with consumers to resolve conflicts, determine long-term care needs, and provide guidance in bringing insurance carriers and the people who need them together. A nursing home ombudsman advocates for the residents of long-term care facilities. Nursing home ombudsmen protects vulnerable residents and help defend their most basic rights. They handle complaints related to physical and verbal abuse, neglect, and other forms of improper care. NOTE: A Long-Term Care Ombudsman can address most any issue that arises in a long-term care or assisted living facility. Commonly, Ombudsmen will investigate any violations of residents' rights and dignity, and any physical or mental abuse, whether intentional or not. What Concerns Does an Ombudsman Address? Below are a few of the most commonly sought after complaint resolutions that the Ombudsman may need to address: Slow responses to resident calls Poor facility food quality Staffing issues (mistreatment, shortages, inadequate skills, etc.,) A lack of social opportunities & interactions Disruptions in sleep Violation of residents' rights or dignity Physical, verbal, or mental abuse, deprivation of services necessary to maintain residents' physical and mental health, or unreasonable confinement Poor quality of care, including inadequate personal hygiene and slow response to requests for assistance Improper transfer or discharge of patient Inappropriate use of chemical or physical restraints In addition to identifying, investigating, and resolving complaints, Ombudsman programs responsibilities will include: Educating residents, their family and facility staff about residents’ rights, good care practices, and similar long term services and supports resources; Ensuring residents have regular and timely access to ombudsman services; Providing technical support for the development of resident and family councils; Advocating for changes to improve residents’ quality of life and care; Providing information to the public regarding long term care facilities and services, residents’ rights, and legislative and policy issues; Representing resident interests before governmental agencies; and Seeking legal, administrative and other remedies to protect residents. Ombudsman programs do not: Conduct licensing and regulatory inspections or investigations; Perform Adult Protective Services (APS) investigations; or Provide direct care for residents. Residents’ Rights Ombudsman programs help residents, family members, and others understand residents rights and support residents in exercising their rights guaranteed by law> most nursing homes participate in Medicare and Medicaid, and therefore must meet federal requirements, including facility responsibilities and residents rights. Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. How to Become an Activity Director in the US Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2810 US HWY 190 W #100-A9 Livingston, Texas 77351

View this email in your browser Celebrate Grandparent's Day September 12th, 2021 Not everyone has their grandparent as they grow to be an adult. It is a special thing and the day to celebrate it is coming up. Grandparent's Day falls on September 12th this year. Today's activities are geared towards the resident's grandchildren, but don't necessarily involve direct contact in case that is prohibitive due to COVID or distance. These canvas transfers work best with printed or photocopied pictures, making acquiring them a bit easier and cheaper. Ask residents families to email some of their favorite pics of the resident's grandchildren and get them printed out before the activity. Once completed, encourage residents to display their pictures for Grandparent's Day. Activity Spin-Off Invite staff to bring in pictures of their grandparents and display them on a designated bulletin board. Your residents will love getting to know more about the staff and their families. Full Tutorial The following is a list of 28 questions for your residents regarding their past. Buy inexpensive composition books for participating residents and have them answer one question per day in their books. Encourage them to elaborate on each answer and fill as many or as little pages as they wish. Upon completion of the 28 day prompts, your residents will have a very special book they can send to their grandchildren to treasure. Use the list below as your list or as a jump off point for inspiration for a list of your own making. FREE Printable 23 Things You Loved About Your Grandparent’s Kitchen By: Tiana Rogers Source: SoYummy.com Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2810 US HWY 190 W #100-A9 Livingston, Texas 77351

View this email in your browser Resident Rummaging, Hoarding, Hiding It is not unusual to step into a secured Alzheimer’s’ unit where you observe someone actively rummaging or searching through cabinets, drawers, and any number and any manner of subjectively intriguing storage areas, even closets and the refrigerators. It is also a common practice for residents to hide coveted items in the most peculiar places that they will likely be unable to remember later. Although the behavior can be concerning and disruptive, it provides engagement at best but can easily turn into a safety risk. Proactive measures must be implemented to ensure safety that provisions concerning this behavior prevents potential hard to self or others. It is not recommended that you eradicate opportunities for this behavior as it often helps the resident to dissipate anxiety, offers engagement and in fact often helps your resident to feel useful. Note: The behavior might have some level of logic behind the action. Residents often set about this behavior because they are actually looking for something specific, although unable to neither identify nor describe that illusive item. Understanding the Basics According to the Alzheimer's Association, hoarding and hiding behaviors usually begin in the early to middle stages of the disease, and often stem from trying to have some control in their lives. Rummaging, meanwhile, may occur when an individual with Alzheimer’s disease believes something has gone missing. More specifically, the Alzheimer's Association identifies a few possible causes -- psychological, medical and environmental -- for rummaging, hiding, and hoarding, including: Physical changes within the brain leading to confusion, memory loss and impaired judgment The individual senses loss of control The desire for a sense of security or feeling that they may "need" something Seeing and touching things gives them comfort Fear of losing items or being robbed Inability to distinguish between valued and disposable items Boredom, lack of stimulation, and difficulty initiating new activities Reasons for Rummaging Behaviors Boredom: Rummaging behavior may spring from boredom; particularly when opportunities are not abundantly available for engagement. These busy “seekers” are doing just that – keeping busy with something that is found to be self occupying- even when the behavior behind their quest becomes unwanted and has the potential to increase safety risk to self and/or others. Note: In fact, the old adage applies here: “negative attention is better than no attention at all”. Try to quickly understand and recognize what is causing the behavior and measure your response appropriately to prevent that unwanted behavior. Coping Mechanism: Rummaging can be a coping mechanism in response to the disorientation typically caused by dementia. The behavior can occur when the resident is trying to reassure him/herself or self-soothe with familiar items or when they are trying to fill a void or need, like eating when hungry. Loss of Useful Contribution: Consider that what looks like rummaging could also be a way for the resident to feel that they are doing something productive or helps them to feel useful in some way. In the days past, your resident may have fallen into that “problem solver” or “fixer” personality. These characteristics almost are always the reason for “busy seekers” to search for anything that is perceived to be lost items. Triggers: In some cases, the resident with dementia might start rummaging in response to a “triggering” event. The ability to understand the circumstances that “trigger” the unwanted behavior before it occurs puts you way ahead of the game to support a peaceful environment for your resident. Source: https://dailycaring.com/9-ways-to-manage-dementia-rummaging-behavior/ Note: Consider creating a “behavior log” to record the time of day, the surrounding environment, the individuals involved and the type of event to see if there is a repeated situation from which the resident becomes agitated. You will be looking for repeated patterns to determine what circumstances instigate the behavior. “An ounce of prevention is worth a pound of cure” Rummaging Freedom [Safe Zone] Treat rummaging as an opportunity for engagement. Include items like clothing, socks, copies of memorable photos, a fake checkbook, reading books, greeting care, or a wallet filled with old receipts, credit card “look alike” and fake money – anything that could spark interest. Hobbies or career related items from the resident history are sure to peak interest. Themed boxes like a sewing or knitting drawer, a sports basket, a costume jewelry box, a tool box, or any music related items, etc. Always show the resident where to find his/her themed box so as not to elevate anxiety levels. Review the following for more ways to create a “safe zone” for resident rummaging: Keep the person with Alzheimer’s from going into unused rooms. This limits his or her rummaging through and hiding things. Do a search to learn where the resident often hides things. Once you find these places, check them often, without the residents’ knowledge. Keep all trash cans securely covered or out of sight. Alzheimer’s residents may not remember the purpose of the container or may rummage through it. Check trash containers before you empty them, in case something of value has been hidden there or thrown away by accident. Note: A resident that often disposes of dentures, hearing aids and/or glasses can make for a very unhappy family member. In addition, loss of such adaptive devices has the potential to further increase resident agitation and increase unwanted behaviors. More ideas to ensure safety and less disruption as follows: Lock up dangerous or toxic products, or place them out of sight and out of reach. Keep backups of frequently lost items to prevent the start of yet another frantic search. Example: Several similar look-a-like handbags stored out of sight will do the trick when the original one becomes lost. You will always be viewed as the hero when you help your resident find that missing handbag. Remove spoiled food from the refrigerator (if accessible) and cabinets. Food gone bad simply becomes a doctor’s visit when consumed due to the resident's lack of judgment and/or sense of taste. Make commonly used items easy to find. The resident behavior may be valid if they are looking for something specific, but can’t find it. This is particularly frustrating when the resident is unable to explain nor describe what they are looking for. Consider putting things in clear containers or specific drawers and label contents. Or keep similar items together, like similar clothing in the same drawer – underwear, tops, bottoms, socks, etc. Failed attempts to stop a resident from hiding, rummaging, hoarding, and or re-organizing things can cause increased agitation and paranoia for the resident that is bound and determined to engage in such behavior. You can mitigate agitation and manage the behavior through creative and inventive ideas that allow the behavior while maintaining a safe and less disruptive environment. In doing so, the resident will regard you as a supportive partner rather than viewing you as someone that is interfering - - and that’s exactly where you want to be. Reference: https://www.nia.nih.gov/health/when-person-alzheimers-rummages-and-hides-things?utm_source=NIA+Main&utm_campaign=8c48100ffd-20190409_rummaging&utm_medium=email&utm_term=0_ffe42fdac3-8c48100ffd-7499965 Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2810 US HWY 190 W #100-A9 Livingston, Texas 77351

The N.A.P.T. Course is accepted by and prepares each Student for APNCC National Activity Professional Board Certification The APNCC.org AP-BC is the certification recognized under CMS.gov F Tag 680 & 658. For more Information Visit ActivityDirectorUniversity.org Send in a NAPT Course Enrollment Pack to get started! The NAPT course provides all the CE requirements for Path 1 or 2 See if you qualify! Check APNCC Standards Its your Choice! ...Your Affordable Choice ! While you are enrolled and working towards your, or any Accredited Certification Requirements you meet the F680 regulations set forth by the CMS.gov to insure each Activity Professional can complete their accrediting bodies standards. Here is the Federal Regulation For Activity Professionals from CMS.gov Most States do not have a State License or AD Register, these States are governed by F680 (most States) 483.24(c)(2) Section (ii) A . The Activities Program must be directed by a Activity Professional who is Eligible for Certification as a therapeutic recreation specialist or as an activities professional by a recognized accrediting body on or after Oct 1 1990.