soduspoint

It is important to set up a regular schedule for reviewing infection control, and to make sure that all policies and procedures are in place. This may include services that are conducted in a resident's room, payment, and infection control. If linen department delivers towels make sure that you know the schedule, and I would find out if it is a cost out of your budget. Communicate with housekeeping to make sure they have a good understanding of the cleaning process for the beauty shop. Make sure you have the license posted, and that you have a contract with the hair dressers that are up to date and reviewed periodically. If you are new to understanding the process, you may want to conduct a quality improvement study to make sure that all aspects of the beauty shop are running smoothly. Find out how the hair dressers communicate with the units to let them know who has an appointment, find out what barriers exist, and find out what quality the equipment is in, in case you need to make adjustments in your budget. Shelley

NCCAP has a survey on their web page, that may give you some additional information

If you haven't already done so, document in a file that you would keep for yourself, all verbal conversations that you had with the employee and the outcomes of the conversations. Also keep notations of all the conversations you have had with your administrator and the outcomes. This is going to sap your energy really fast, and you don't want to risk losing the details. If you do choose to the end the working relationship with this person, you need to make sure that you have followed all policy and procedures, or she will win any case she could bring against you. Refer to HR for the days and times that she was hired for specifically. This employee is still on probation however, and if you document thoroughly, you can end the relationship through that probationary opportunity. You are not getting the support you need in this situation with management continuing to cow to her demands. She has learned that she can manipulate and this employee will use that against you every chance she gets. The bottom line is she is choosing to not work for what she was hired for. It is hard enough to have administration agree that TR needs the staffing. Don't lose any hours you may have gained by letting this employee not have to work holidays or weekends. She has to work the holiday. period. Then if she does not show up, you have more grounds to end the relationship.

I will be there. I have never attended an activity conference before, so I am looking forward to getting new ideas.

There is a full time position open in an aggressive therapeutic recreation program in Newark, New York. The hours are 8-4:30 Tuesday -Saturday with Thursday hours 11-7:30. Responsibilities include completion of MDS, care plans, RAPS, TR assessment, progress notes and resident participation in activities. The planning and implementation of TR programs are for a living center with a diverse population, mostly geriatrics. This high performing team is highly recognized in the system for resident satisfaction. Those interested can log onto viahealth.org and apply. Bachelor's degree required with experience in long term care therapeutic recreation. Valid NYS driver's license also a requirement.

We actually cut back on activities that bring individuals together from different units. We let people rest and get better. We currently have one wing closed due to flu and one closed because of a GI bug. The residents on the unit with the flu still have their programming offered for those who are able, but it is on a lower key than usual. Those on the floor with the GI bug have received decreased programming. Why put individuals in a room together, who may be harboring the bug, and let them expose them to others in a smaller environment. The higher functioning residents who are able to leave the floor and who are healthy, do. Each unit already has a box of activities that include appropriate movies and music that can be put on for those they feel may be bored. Infection control is very important. If our resident's are ill, we give them time to rest and get healthy.

I would like more information. I complete calendars for a neuro behavioral unit, and adult day health care, a dementia unit, and long term care. My newsletter uses the format from activity connection and I plug in my own data. You can send e-mail to jevans02@rochester.rr.com

Our department runs programs every day of the week and two evenings a week. We work either Sunday - Thursday, or Tuesday - Saturday. Our facility scores in the to 90th percentile for resident satisfaction largely due to our consistent offerings of TR programs

I just finished the class in September. We can take this thread of conversation off line. jevans02@rochester.rr.com

I use M&N international, Musician's Friend, Oriental Trading, NASCO, Gary Grimm and Associates, MMB music, S&S, Economy Handicrafts, Burpee, J&A Handy-crafts, Inc. and Suzuki. Shelley MT-BC

I have read the CMS guidelines for this and taken a look at the tools on the elder4activites web page. Is this a program that an organization just begins, or are you trained in it for a fee ( like the Eden Alternative)

I would also like to see what others are doing, especially with the QI. Please e-mail to shelley.evans@viahealth.org. Thank you very much, I appreciate the opportunity to improve.

I am the Director of Therapeutic Recreation for a long term care facility that is attached to the hospital, I cover the Adult Day Health Care as well. Shelley

The Alzheimer's Care Guide that is put out by Frieberg Press has an article that you can read and fill out a post test for, for CEU's. You could obtain copies of that to submit.

Quality Assurance reports are often requested by the Department of Health. It can be an invaluable tool at evaluating your department. Quality assurance data collecting can be time consuming. I have 6 units to assess. I look at 25% of the charts to review TR assessments, progress notes, RAP's and care plans. I have a tool that I mark off it is done correctly and timely. I review each TR program offered and look to see if it is for our 1:1, low, middle, or high functioning population ( many overlap). I then do the same measurement with each resident. I find the percentage and then make sure I am providing enough programming for each population. I do kitchen audits and infection control audits in the beauty shop. I also require my staff to do peer reviews and that is also QA. Each year I do a survey of the resident's satisfaction with TR programs. I hope this helps. Good Luck. I think that using QA as a tool to demonstrate the importance of TR is a good decision.

Stacy, Be sure to make the resident's goal measurable. To maintain her current level of sensory stimulation you need to have clearly defined her baseline. If you are unable to provide this service daily, don't set yourself up for failure. You may be observing the resident for a change of breathing - more relaxed, a facial reaction of any sort, eye movement. Your approaches do fall in line with the resident's needs, you may want to be more specific. for example - recognize resident enjoys gospel music, liked cats, and was employed as a secretary. Then your sensory items could be the auditory stimulation of live or taped music, the soft fabric or an actual cat, and a pen or a piece of paper placed in her hand. The resident who is unable to give you feedback is your most challenging. She is lucky to have a caring staff who are trying to meet her needs.

Kudos to you for noticing employee morale and the willingness to make a change. The most simplest and effective way of increasing morale is by saying Thank You. Follow that verbal thank you with a hand written card that you hand directly to the employee. You may also make a copy and put it in the employee's HR file. Morale is often low because people feel unappreciated. Congratulations on making the first step to a better working environment.

We use a 3 tier rubbermaid cart. It is narrow enough to stay in your office space, but has enough shelves and room to hold a variety of organized items

We have had much success with both music and art therapy. Please remember that you have to have a licensed professional facilitating the groups to call them art and music therapy. Therapists conduct their groups based on assessments and they are goal based, either in a small group or 1:1 session. Art and music activities can be conducted for every functioning level and are effective also in a 1:1 setting. A music therapist is not needed for music activities such as sing alongs and reminisce based groups that incorporate music. For music activities you may try a sing along, a name that tune game, or take some time to make a music bingo game. If your facility can not hire an art therapist, there is a training program through the Alzheimer's Association called Memories in the Making. After 5 hours of instruction about the disease and the art process, one becomes a volunteer through the AA and then facilitates the group with selected individuals with dementia. Good luck and have fun with their creativity.

If the job has a job description, I would review it. If this individual is not complying with the written job description. This may include them not completing required paperwork, or developing/implementing TR groups as assigned. There has to be a paper trail for any kind of disciplinary action. Keep a private notebook of things that you have noted if you are a peer. Don't stop making the management staff aware. If they do not know of a problem the only answer they will give you is that they can't do anything about something they don't know about. Good Luck. It is very frustrating, I have been there.

We make sure that every resident has a package to open on Christmas morning. They are gathered around the Christmas tree with the C N A's and open their gifts. We have a worship service in the afternoon led by our chaplain. As activity staff we give our all, all year long, working extra hours, for no extra pay, delighting in the smiles we see on the resident's faces. But, working in this profession for as long as I have, I feel that life is too short and I also need to be making memories with my family. The resident's understand. Have nice holiday

I am the Director of Therapeutic Recreation in a long term care facility that is attached to a rural hospital Our hospital has an Adult Day Health Care. The TR staff are part of my department. I have a book of policy and procedures specific to Adult Day Health Care. The Department of Health does complete surveys, certificates are for 3 years, although when they come in to survey the nursing home, they can also go to ADHC. My team members with specialty area backgrounds, such as music therapy, also implement groups in the ADHC program. We average 7 programs a day as participants are there from 8-4:30 or any times in between. They are taken out to the community on outings and complete community service projects. We do post a large TR calendar and send the calendar home as part of a monthly newsletter. We have at least 3 large events a year where their family and caregivers are provided an opportunity to come and spend part of the day with them. Good Luck, you have a great opportinity. Shelley Evans MT-BC

I look at some different areas for quality improvement. I do a complete look at all residents in our facility, catorgorizing them in 1:1, low functioning, mid functioning and high functioning. I take the percentage of each. I then look at every activity we offer and do the same analysis. I then compare the percentages to see if we are meeting all needs. I also look to see the numbers of visits residents receive from TR staff. I have a minimum number required and take a percentage. My threshhold is that 80% of residents will receive required number of visits. My TR survey of resident's view of activities is included in my QI as well. I look at 25% of each unit's charts per quarter and have a check off sheet for each item required - assessment, progress notes, care plsns, RAPS, etc. I also have to look at the cleanliness of our hair dresser and TR rooms where our baking and groups occur. I hope this helps. Shelley Evans