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About Vanessa

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  1. I am an AD for a 44 bed dementia unit in LTC. I am a COTA so I do a lot of tasks that utilize those skills. I plan all the activities and have two program assistants who carry out a good portion of them. Our activity staff works 365 days a year. We also do evening activities and campus-wide events which includes our independent residents. I direct the volunteers assigned to my unit - unit orientation, program set-up, basic and ongoing unit training and troubleshooting. I oversee (along with the rest of our leadership team) the front-line staff on the unit including program assistants, CNAs, nurses, and housekeeping. I have a leadership team meeting once a week, QA once a month (boo - no free lunch!), I do the ADL, REP and activity sections of the MDS along with associated RAPS and progress notes, chart audits, positioning, rehab dining for two meals a day, and assigning of all equipment for the residents. I am responsible for all unit photography - med book pictures, chart pictures, wound pictures, positioning pictures, how-to pictures (example: putting on/taking off a prosthesis). I do room and resident audits. I audit other areas of our campus. I tour prospective residents and their families. I am on a ton of teams: Falls, psychosocial wellbeing, new employee orientation, KOPE, QA, leadership, unit work team, and I'm sure I am forgetting a few. I am pulled in on an as-needed basis for other department teams. I attend careplanning weekly. I pretty much do whatever is needed - toilet residents, make beds, clean-up spills, work with resident and family issues, etc. My work week is supposed to be 40 hours, but never has been. But I love my residents and I love my job. I have a lot of freedom to try new things and implement new programs. >Vanessa
  2. I'm very lucky at my facility. We don't use any formulas such as a certain dollar amount attached to the number of residents x the number of days in the month. My budget is project-based. For instance, I am working on a book with my residents. The budget is based solely on the projected costs - paper, printing, binding, book party. My cooking groups are based on how many groups I intend to have that year and a base cost plus extra added in for cooking groups that may cost a little more. I may project that each cooking group is going to have a base cost of $15.00. So if I do two cooking groups a week each week of the year, I would project my budget to be $1560 plus I would probably add in $100 - $150 for any potential overages or for rising costs. I do this with each potential group. I have the ability to "borrow" from one project budget for another. I also have a discretionary fund available for projects that come up during the year that were not budgeted for. >Vanessa
  3. We also bake and sell Otis Spunkmeyer cookies. We now only do it on paydays - to do it more often takes away that it is a special treat. When we were selling cookies weekly, our sales took a dive after about a month or 6 six weeks. So we cut back. We don't sell cookies at all in December and during the summer months. We have found a homeschool group of kids to do the baking and selling. Their parents have worked this into their math cirriculum. It has worked out very well for us. Good luck! >Vanessa
  4. State just left our facility on Thursday. I was a little disappionted. They observed two activity groups and that was it. I questioned staff (i.e., CNAs and nurses), but they were not asked about their roles in activities at all. When asked if they wanted to see the activity calendars, the surveyors said that they did not use them to evaluate anymore - the new interpretive guidelines instructs them to be more focused on individuals - not groups. I'm afraid all of my work inservicing staff on how activities are the responsibility of all is going to go down the drain now! I was hoping the surveyors would reinforce what I've been preaching.
  5. Thanks to all who replied! I ordered the cookbook and just received it - I can't wait to try out some of those recipes! >Vanessa
  6. I was recently at a meeting for AD's and someone was talking about cooking in a bag that works great for low functioning residents. Apparently, all of the recipes in this cookbook require measuring the ingredients into a ziplock bag and then everything is mashed together. I thought I heard it was produced by a company called Elder House(sp?, but I cannot locate it on the internet. Has anyone used this method or know where I can locate the cookbook or recipes? Thanks! Vanessa
  7. We use a graph to determine average time in activities. It goes through time awake, time unavailable, and actual time in activities (group and individual). It is a great resource for when survey is here and asking questions! We put it right in the MDS and it becomes permanent record. The author has given permission for it to be copied as long as her credit remains on the sheet. If anyone would like me to fax a copy, please feel free to contact me at vfrank@EvergreenOshkosh.com.
  8. Could you be more specific? Is the adult ed for your residents, are you opening up your facility to the community, or is it for staff? What kinds of education are you offering? Have you formed a partnership with a local universityor community college? >Vanessa
  9. We also record our restorative exercise groups, fitness center groups and aquatic center groups on our acitvity calendars and participation records. State was here in the past month/six weeks and they did not voice any concern. >Vanessa
  10. What about a raffle or drawing for them - its completely random! You could also use them as prizes throughout the fall months. >Vanessa
  11. I had the same problem - even with printing on 11x17 paper. About a year ago I transitioned to a weekly calendar. It runs Sunday through Saturday and allows me to make last minute changes. My residents like it as it is not overwhelming to look at as a monthly calendar sometimes was, the typeface is large enough that almost all of the residents can read it. It is more work - I am doing 4 calendars instead of one, but quite a few of the activities repeat such as exercise group, painting class, cooking, etc. so its not too bad! >Vanessa
  12. My facility promotes person-centered care. We define it, however, as normalizing their life to their premorbid pattern. Its got be all about the individual and their lifestyle-meeting their individual needs. I formulate a plan through the activity assessment done upon arrival. I look at what what was their normal routine - everything from what time they got up, what they normally ate for breakfast, to what they did all day and incorporate it into my activity program. For example, I had a resident who was a master woodworker. He did that for a living and he did that for a hobby. When he came to our facility he was in the end-stages of Alzheimer's disease. I really couldn't take him to the woodshop to use the planers and saws, but I did take him to the woodshop to sort and sand wood by hand. Another woman cooked for a church. I had her looking at cookbooks, choosing recipes (the kitchen even made and served some of her suggestions), in all the cooking groups, helping out at mealtimes and helping me to organize a cookbook for family members. It certainly takes some planning and you have to strike a balance with all of the residents you serve. I need the help of our nursing assistants in order to meet each resident's needs. Our nursing assistants carry care cards which list each resident they are responsible for and how their cares should be completed. I have an area on the care card in which I list things they can do with the residents to help acheive person-centered care. I hope this helps! >Vanessa
  13. I work for a CCRC in Northeastern Wisconsin. We have condos, apartments, studios, cottages, 3 CBRF's, an RCAC, and a SNF. We range from the very active elderly (we have an age minimum of 55 years old) to the very frail elderly. I really enjoy the CCRC atmosphere because you get a chance to interact with resident's in all phases. We have many trips and outings for residents to choose from. We have big campus wide events for all to enjoy, plus unit based activities. There is a wide variety of activities and burn-out from boredom is not an issue! The downside is finding a balance (paperwork, meetings, etc. vs. face to face time with the residents) and dealing with the well elderly who do not want to be exposed to the frail elderly. My facility is non-profit and I agree that it does make a huge difference in wages, budgets, staff hours, etc. Good luck! >Vanessa
  14. I do both the Timeslips program and Memories in the Making proram. They are both awesome tools! I have residents in their 90's who are painting for the first time in their lives and are fabulous. They would have never thought of trying it on their own (and needed some encouragement to try). Their families are now taking their paintings to art stores to be matted and framed! I found a website, www.enchantedlearning.com, that has great coloring pages by great artists - Monet, Mondrian, O'Keefe, etc. I totally agree that the programs need to be stage appropriate over age appropriate. Some of the art projects we do are silly (like making May Day hats out of paper plates) and some are more serious (photographing aged hands for an art display), but my residents love it all and are willing to try anything once. >Vanessa
  15. The facility that I work for was the first in Wisconsin to utilize the neighborhood concept. We opened our second generation neighborhood last July. We do not, however, have universal workers. We have found that it works better if our CNA's have specific tasks. We do make them responsible for one-to-one activities for those residents who may not be in an organized group activity. Our SNF is divided into 3 units which are subdivided into households. There are between 9 and 11 residents living on each household. The environment is a very important aspect of the neighborhood concept. We have a neighborhood center (which is a common area for larger group activities and gatherings) and off each neighborhood center is 4 households (like spokes). Each household is self-contained: a kitchen, dining room, living room, utility room, sunroom and bedrooms. The tub room is between two households as is the courtyard. This environment has worked awesome for us - especially with our residents who have dementia. We have totally eliminated the need for alarming doors and wander guards. Our activity program is set up with two activity professionals (a COTA who is the AD for the unit and a program assistant) on each of the three units. So each unit program staff must deliver activities to between 36 and 44 residents each day. We often run mutliple activities at the same time in different households. For example, we may be doing an exercise group in household 6 while a craft group is happening in household 7 and a musical event is in the garden. It takes a lot of forethought and preparation, but it is definitely worth it. We still struggle with getting our nursing staff more involved, but we have seen challenging behaviors decrease since our move to the new unit. We keep each of the kitchens fully stocked as you might in your own home. Families and/or nursing staff will bake cakes or holiday cookies. We have nursing staff who really like to bake with the residents each morning just after breakfast. This environment seems so much more relaxed and calm and it shows in the resdents! If you want more info, please feel free to e-mail me at vfrank@EvergreenOshkosh.com
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