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Pennie

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  • Birthday 07/16/1958

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    Genelogy, Sewing, Crafts, Garage & Estate Sales, Shopping, going out on the boat/lake, researching & keeping up with the Activity Profession, my dog Shiner, & Raising Bloodhounds.
  1. Avoid Aging Parents Becoming A Burden By Linda LaPointe, MRA By not planning for the future we guarantee that we will leave our children with a tremendous burden. Just about the time they are preparing for their own retirement and their children's college education, adult children often are overwhelmed with decision-making for their aging parents. As a long term care administrator I heard it daily, I Dont want to be a burden to my children. But unintentionally most of us make it even harder for our children by not clearly defining our wishes or preferences. We can help them out by asserting control over our future health care, residential choices, and even how we will die. There are specific and discrete steps we can take to shape our own destiny. Many of these tasks only take a few moments of your time, some take a little research and others may require professional assistance. None of them are extremely costly or difficult. So why don't more of us do this type of planning? Seniors are concerned about losing control of their life and being a burden to their grown children but many just don't know what to do. For instance, the majority of people want to die at home, but very few do. Become familiar with your options and make your preferences known while thinking clearly, while free from pain and prior to an emergency or crisis. The loss of a parent is difficult enough for an adult child. We can save them additional grief by doing the following, clean house: get rid of all the worthless clutter and unimportant stuff prepare and organize those important papers and throw out the unimportant ones prepare advance directives and tell others what they contain and where they are located make our own funeral plans and ensure there are sufficient funds to pay for it leave our legacy through writings, photo albums, heirloom assignment and recording of family stories You can avoid becoming a burden to your children by taking control of your end of life with as much care, intent and forethought as you have lived the rest of your life. Linda LaPointe, MRA is an ElderLife Matters coach and author of several products to assist families experiencing aging including the pamphlet, Don't Be a Burden: 100 Tips. Get free articles and information at http://www.sospueblo.com/
  2. Let's Get Serious About the Nursing Home Tour Tammy Gonzales, Life Coach Before you tour your facility choices be sure you have done your homework. Go online and visit http://medicare.gov Medicare.gov. They have wonderful resources available to you for free. They are user friendly. Please see the end of this article for details. To narrow down your choice between two or three nursing homes or just considering the only available nursing home to place your family member or friend, it takes two visits. Take someone with you and if at all possible take the person who will be moving into the nursing home. Your first visit to the nursing home is what I call "Their Pitch". Set it up for the morning anytime before 11:00 AM on a Saturday and plan to be there at least an hour. Get there 15 to 20 minutes early with a magazine or a newspaper and let the receptionist know you are there. Take a seat in the lobby and wait. This is not wasted time. Open up your newspaper or magazine and eaves drop without calling attention to yourself. Let your senses lead the way. Have you been offered refreshments? Does the facility smell? Does the interaction of others sound pleasant? When you opened the front door into the nursing home did you smell urine, bowel movement, vomit or body odor? Did it to smell like flowers or antiseptic? Or like bad odors are being covered up by good odors. Broccoli, cabbage and brussel sprouts are the only offensive smells that come from the kitchen when they are being prepared. After a short while close up your magazine or paper and receptive to your visual surroundings. If there is someone else sitting there try to start a conversation about the nursing home and find out what they think. Listen to the tone of their voice, watch facial expression and body language. By now the admissions coordinator or someone is going to invite you into their office or take you for a tour and give you "The. When they take you into the office they are going to ask you questions. Names, name of potential resident, age, diagnosis, who their doctor is, where are they now, do they have Medicare, insurance, are you the health care power of attorney, do they have a living will, have you applied for assistance, how soon do you plan to place them here, etc. They are going to try to emotional connect with you as well. They are looking for potential problems too. Pleasantly answer their questions. If you have a few questions ask and be sure to ask if you can have a copy of an information packet or pre-admission packet. So on to the tour. The tour is about showing you the best of what they have to offer. They will introduce you to everyone and show you the facility. Let "Their Pitch" happen and go along with it. Don't ask too many questions now because you will distract yourself from observations that you need in order to make a sound choice. During the tour you will be introduced to the different department managers and shown their offices. You won't be expected to remember names and it is more important how they respond and take an interest in you. Also, during this tour pay attention to the interaction between staff and residents in every area you are toured through. This is important. Observe the residents. Are their clothes clean and in good repair? Are they wearing footwear? Do the men look clean and shaved? Does their hair look cared for or is it a mess? Do the women have appropriate hairstyles (I have seen them put pigtails on top of balding 90 year olds)? Do they still have bibs on from their last meal? Does any one look cold and not have a sweater? Do you see a number of residents that are wet or smell of urine or BM? Do the hands look clean especially under the nails? Do the wheel chairs look clean and cared for with no sharp edges or tatters? Do the residents in wheel chairs look comfortable? Are residents in wheel chairs being pushed too fast or backwards? Are residents that are being walked rushed or are they allowed to walk at their own pace? Is a resident yelling out the whole time you are there? The flooring should be clean and free from any debris. The walls should be clean. The lighting should be good. Carpets free from spots. Decorative items should look well kept. Drapery should be open to allow the natural sunlight in. You will be taken to the nurse's station. The nurses should be pleasant and responsive to the residents and family members. Listen to their tone and responsiveness in their voice. Watch their body language as they acknowledge you or others at the nursing station. Is this representative of how you would like your loved one to be responded to? One area you will be taken to, will be the Rehabilitation area where physical, occupational and speech therapies are provided. How are the therapists interacting with the residents? Are there residents in the area alone? Is privacy being respected? Is it busy with activity or is no one there? Listen to find out if they have at least a full-time physical therapist and occupational therapist, it is important to know, as your loved one may require these services from time to time. Do they mention at least a part time speech-language pathologist? It is always good to have one available to screen your loved one if they ever begin to have speech problems or eating problems like swallowing. Once at the Activities Department, observe what is going on each time you pass by. Make it a point to stop for a few minutes and observe residents and don't be surprised if not every resident in the activities room, is not doing something. Are at least 25% of the residents doing something like reading, watching TV, or doing the activity that is going on at the time? Ask to see or have a copy of the activities calendar. Observe interactions. The dining areas are a very important area to make observations. Check to see if they have more that one dining room or area? If the nursing home that you are at has 120 beds and is not specific to only Alzheimers/dementia residents, then there is a mix of residents functioning at different levels. There are usually three functional levels of dining: residents that can dine independently, residents that require cueing, and residents that need to be fed. Observe for the different types of dinning rooms or areas. If residents are dining observe for a few moments. Are they socializing, smiling, having a difficult time with the food? This is important because as your loved ones functional ability may decline and they may need cueing or to be fed from time to time. What is the facilities policy about residents dining in their room? The tour guide (admissions coordinator) will show you a few resident rooms. Most of the time they will show you the rooms of clean, fairly independent, and continent residents with good family support, a well decorated room, not the room they would be admitting your loved one into. Facilities are limited to the number of private rooms they have. Most of the rooms are semi private with a private bathroom for the two sharing the room or a bathroom that is shared with the adjoining room. Look in the bathroom if you can. There is much to consider. During the tour they will hopefully show you outdoor areas for the residents. Is it shaded from the sun? Is it partially protected from the weather like rain, snow, and wind? Do they have an area outdoors for residents who smoke? Are there seating areas? Is it visually appealing? This is usually what happens during "Their Pitch". They ask you for information and you ask questions and make observations. Just like when you are with a salesman they want you to get emotionally connected with their facility. At the closing be sure to thank them for their time and let them know that you will be in touch with them soon. Before your second visit, try and read the information related specifically to the nursing home and what their expectations are of you and the resident from the information packet or a pre-admission packet you received. Then make a list of questions for the next visit. If you can't think of any questions, Medicare's publication Guide to Choosing a Nursing Home has questions on several pages that you can tear out and take along with you to what I call the YOUR Q&A VISIT. Try to make YOUR Q&A VISIT unexpected on a weekday. Ask to speak to the admissions coordinator or some one who can answer some questions that came up. I will just tell you now, that if they respond timely to you at this visit that's how you will be responded to if your family member was in the nursing home. This is your opportunity to get your questions answered and to get any additional information that will help you make the best choice. If you live in a small town this nursing home may be your only choice and you will learn to be a good advocate. However, if you live in a large town or metropolitan area you will have a choice of several nursing homes, pick the one that suits your loved ones needs and not your convenience. I wish you the best of luck on your search. Thank you. Here are the valuable Resource Links that I promised. Just click on the title. http://www.medicare.gov/NHCompare/Include/DataSection/Questions/SearchCriteria.asp "Home Health Compare“ Will provide you data about home health agencies most recent survey and compare it to others you select for free. http://www.medicare.gov/HHCompare/Home.asp "Long-Term Care Counselor" Will help you make a determination of the type care and where the care can best be provided for you or for some that needs help or supervision. http://www.medicare.gov/LongTermCare/Static/LTCCounselor.asp Publications - Guide to Choosing a Nursing Home, Medicare and You 2020, Medicare Coverage & Skilled Nursing Facility Care http://www.medicare.gov/Publications/Search/SearchCriteria.asp Tammy Gonzales, Life Coach specializing in family and professional caregivers, the elderly, patients, survivors, those facing crisis and the end of life. Copyright © 2020 RevitaLife Coaching & Consulting, LLC Her current project, Caregiver& Aging Awareness Campaign is to provide all caregivers and the aging with useful information and direct them to the resources of free available information to complete their life planning. http://www.revitalifecoaching.com tammy@revitalifecoaching.com
  3. Bingo Is Not Just A Game! By Jerry Lynn Daniels, ADC/ALF/MC/AD/EDU, CDP ** Article describing Bingo as an assessment tool. Food for Thought ** Bingo is very popular in geriatric recreational programming. It is the most requested activity in most seniors facilities or communities. Activity Professionals for years have heard the dreaded "all you do is play bingo all day" from co-workers, friends and family alike. Bingo is not all they do but it is a very important part of their jobs. Although it is at times dreaded by professional caregivers, it should remain a part of recreational programming because of it obvious entertainment value. And of course we know if it were removed it could cause a revolt. There is a not-so-obvious reason as well. Therapists, nurses, social workers, friends, families as well as activities professionals should learn to use bingo as an assessment tool. The best part is that there are no fancy, expensive assessment packages to purchase. You use an activity which is already taking place. --------------------------------------------- Bingo can be used to assess a persons level of function in certain areas such as these: Hearing. It will become obvious if someone is constantly asking that the numbers be recalled. or if a person who normally sits at the back of the room all of a sudden asks to sit closer to the caller. Visual cards may be required. Sight. You may observe a person straining their neck or eyes. They may be leaning in closer to the card or may have many called numbers still uncovered. Speech. A person must be able to yell "bingo" but must also be able to call out there numbers once they have won the game. Cognition. A person may begin to have trouble finding the numbers once they have been called or may not be able to follow through with covering the number once called. Fine Motor Skills. Fine motor skills must be used to manipulate the cards whether slide cards or traditional cards and chips are being used. They may repeatedly knock all their chips from their card or be unable to slide the covers into place. Social Appropriateness. The persons ability to interact appropriately in a social setting is also assessed. ------------------------------------------- When using bingo as an assessment tool, one session will tell you a lot about the person. However, observing several games over a course of time is best. If you are a professional in one of the senior settings, learn to assess your clients using bingo. If you are a family member who is noticing some changes in your loved one, get them involved in games such as these. Not only will they help with socialization and entertainment but they may also help you to understand different aspects of your loved one's functional level. There are many websites where you can create your own bingo cards. Just search "free bingo cards" or go to either of these sites http://www.print-bingo.com or http://www.dltk-cards.com There are senior centers throughout Jacksonville which offer full activities calendars including bingo. For a listing of the City of Jacksonville Community Senior Centers go to http://www.coj.net/Departments/Recreation+and+Community+Services/Adult+Services/Community+and+Senior+Centers/default.htm If you have any comments or questions regarding this article or a suggestion for an upcoming article please contact me at jerrylynndaniels@yahoo.com. Continue reading on Examiner.com: Bingo is not just a game - Jacksonville elder care | Examiner.com http://www.examiner.com/elder-care-in-jacksonville/geriatric-recreational-programming-bingo-not-just-a-game#ixzz1DQWfAjX9
  4. REFLECTING RESIDENTS' SPIRITUAL NEEDS IN CARE PLANS --- By Sue Schoenbeck, R.N., Michael Rock, Jill Cullen, Carol Gabor Authors: Sue Schoenbeck, R.N., is director of resident care; Michael Rock is administrator and chief executive officer; Jill Cullen is plan of care coordinator; and Carol Gabor is a social worker at Ingleside Skilled Nursing and Rehabilitation Center, Mount Horeb, Wis. --- Far less is known about the human spirit than is known about the body and the mind. But issues of the spirit are important when caring for the elderly in long term care environments, as well as preparing residents, families, and staff for the death of a resident. Therefore, it is judicious for the caregiving team to gather information about spiritual as well as physiological, mental, and psychosocial needs. Ingleside Skilled Nursing and Rehabilitation Center, Mount Horeb, Wis., has created a spiritual assessment tool congruent with the minimum data set (MDS 2.0) to help determine each resident's spiritual needs, which then can be addressed in the care plan. to create your Spiritual Care Assessment... Ingleside's spiritual care program is rooted in a theory of logotherapy developed by Viktor Frankl, a Viennese psychiatrist who survived several World War II concentration camps. He proposed that people can find meaning in life events, including suffering, and can transcend what fate bestows. Frankl believed that people search for meaning in life up to and often through the death event. Asking questions pertinent to spiritual needs makes residents feel welcome to share their spiritual side. How a person chooses to live life is reflective of the spirit that lies within. By using an assessment tool to gather data, caregivers can build a care plan upon the experiences the resident values most and wishes to retain. The Assessment Tool The first part of Ingleside's spiritual care assessment tool (see box below) gleans information from the resident pertaining to concepts of a god or deity, religious practices, and helping others. Questions include: Do you usually attend church, temple, or synagogue? Do you find strength in your religious faith? Have you participated in or would you be interested in a Bible study group? Do you enjoy helping others? In what ways have you helped others? Ingleside Spiritual Assessment Part I: Activities Name: _______________ Medical Record # ____________ Date___________ Concept of God Is religion or a god important to you? Is prayer helpful? Does a god play a role in your life? Customary Routine: Involvement Pattern Do you find strength in your religious faith? Do you usually attend church, temple, synagogue, etc.? Are there any religious practices that are important to you? Religious Practices Has being sick made any difference in your religious practices or prayer? What religious books or songs are helpful to you? Have you participated in/would you be interested in a bible study group? Helping Others Do you enjoy helping others? In what ways have you helped others? Recommendations for care plan: __________________________________________________________________________________ ______________________________________________________ Assessor's Name _____________________ Title _______________ Source: Ingleside Inc. Part II of the spiritual assessment tool (see box below) engages the resident in conversation about sources of help and strength, relation between spiritual self and health, and impending death. Questions in this section include: What are your personal goals? Do you want to participate in or assist with religious services at the facility? Are there roles you had in your life before that now are closed off to you? What has given your life meaning in the past? What gives your life meaning now? Ingleside Spiritual Assessment Part II: Social Services Name ______________ Medical Record # ________ Date _______ Sources Of Hope And Strength Who is the most important person to you?______________________ Are there roles you had in your life before that are now closed off to you? If so, how do you feel about this? What has given your life meaning? What gives your life meaning now? In what ways do others help you? What helps you most when you feel afraid or need special help? What is your source of strength or hope? Goals What are your personal goals? Do you want to participate in and/or assist with religious services at Ingleside? Relation Between Spiritual And Health What do you think is going to happen to you? Has being sick made any difference in your feelings or beliefs about God or religion? Is there anything particularly frightening or meaningful to you now? Impending Death Do you want a bedside service? __ No __ Yes Clergy: Your own? ______ Parish _______ Phone _______ Other? _______ Parish _______ Phone_______ Do you want it in your room or chapel? _______________ Do you wish to be present or would you prefer it be held without your presence? Are there any special words, prayers, songs, or thoughts you would like expressed at the service? Recommendations for care plan: ___________________________________________________________________________________ ______________________________________________________ Assessor's Name _____________________ Title _______________ Source: Ingleside Inc. Once the caregiver has completed the resident interview, information from the spiritual assessment tool is incorporated into the individual's care plan. For example, when a resident reports prayer as a daily part of his or her past life, staff can include "provide private times for prayer" in the care plan. A resident with Alzheimer's disease for whom evening prayer had been a ritual can be guided by staff each evening in this routine. Staff can assist family members to record familiar prayers for playing to their loved ones. Furthermore, resident prayer and hymn requests can be incorporated into a weekly nondenominational service. If the assessment shows the resident is experiencing spiritual distress, care plan approaches may include pastoral counseling, psychotherapy intervention, and medication regimen evaluation. But caregivers should not assume that residents' feelings will remain static. Entering a nursing facility does not mean a person stops growing and changing. Residents often reevaluate and change what they value. Therefore, spiritual needs must be regularly monitored and changes to the care plan made accordingly to guide staff in providing the support the resident needs. Bedside Closure Service It is understandable that residents and families have heightened spiritual needs as death approaches. But facility management should remember that staff, too, will have intensified needs because of their close interactions with residents. Therefore, Ingleside holds a bedside closure service to comfort those left behind. Part II of the assessment tool provides information about whether or not a resident and family want a service and what they would like incorporated into the service. The service is designed not only to honor the resident in the manner requested, but to give staff the opportunity to say good-bye and to share with family, friends, and the departed some of the good times experienced together. For example, at an Ingleside bedside closure service for a man who communicated only by repeating two syllables, certified nurse assistants (CNAs) told family members how they had learned what the resident wanted by his intonation of the two syllables. Another CNA thanked the family for the opportunity to care for a man who had taught her she wanted to make a career of helping people with speech impairments. A housekeeper commented he would miss joking around and seeing the resident's broad smile. Ingleside staff has assembled a bedside closure service guide that includes some of the songs and prayers most frequently requested by the facility's population. This guide is printed in large type for ease in reading. A staff-written prayer book is given to each new resident and staff member to help people find words with which to pray together. Program Benefits In 1995, Ingleside conducted an exploratory descriptive study of the value of its spiritual care program for residents, families, and staff. Results indicated that the program led to increased knowledge of and response to residents' spiritual needs. Impending deaths were more openly discussed, leading staff to communicate with residents about their last wishes. The quality of life near death was enhanced as individual wishes were honored. Families also benefited. Positive written responses have been received from the families of residents for whom a bedside closure service was held. A daughter wrote on behalf of her family, "We felt the service for Mother was helpful and thoughtful. We felt she was liked and respected although we know she was a trying woman." Giving spiritual care offers staff the opportunity to get to know the spiritual side of the residents and, with residents and families, explore the meaning of life.
  5. Best Laid Plans by M. Celeste Chase, AC-BC, ACC, CDP, CMDCP A best-laid plan refers to when things gone awry or simply stated, something that has not turned out as well as one initially had hoped for. The expression the best-laid plan carries the implication that one should not expect everything to always turn out as planned. Easier said than done… right? The idea that no matter how much thought or pre-planning gets devoted towards a certain task or endeavor and it may still turn out unsuccessful is disheartening to say the least. That said, when things do not go as expected, it is completely normal to feel as though someone has just taken a bit of a bite out of your self-confidence. Such is the scenario when the appropriate time has been dedicated to review resident assessments, history, clinical status and pursuits of interest to develop the perfect mix of calendar events for your resident. Surprisingly and low and behold – your resident does not want to participate in the event. In fact, your resident very unapologetically lets you know that your event was a total flop. Adding salt to the wound, that is the same resident initially expressed an interest and requested the event to begin with! Yikes yet again! It Happens Without a doubt, many of us if not all of us in this field have been there. Sincerely and earnestly planning what we believe to be on target “person centered” pursuits of interest. Only to have the very same residents who had asked for the program to flat out reject it. So what happens when those “best laid plans” go off the rails and turn out all wrong! When your plans hit the fan, you can either fuss about it and go negative or choose to take the opportunity to cultivate an optimistic viewpoint. How it that done anyways? It’s a question of rolling with the punches – and acquiring the ability to remain flexible – not take the rejection personally – and lastly, learning from the experience. “Adversity can - make you stronger!” Why? Humans have the capacity and the determination to avoid the same outcome previously experienced. Resiliency is a gift and one that we all posses - it’s time to pull up those boot straps ladies and gents and look at the process to find out why that well planned event was not well received by your resident. Resident Planning Committee Make it your mission to involve the residents in planning the calendar every time a new one needs to be created. The consistent and routine resident participation in planning events will lead to a number of great benefits for both you the professional and the residents you serve. Start the process by searching for two residents that seem excited about contributing ideas for calendar events. These two residents will become your “volunteer ambassadors”. These “ambassadors” should be good communicators, warm and friendly residents willing to personally visit fellow residents to talk about all the ways he/she can contribute to facility programming and thereby adding their valued ideas. This “buddy resident” system is a successful approach for both new and existing residents. New Residents Consider that newbie residents may be shy and undecided about starting interactions with the large existing (perhaps scary) group of residents. When the new resident is approached by two friendly, outgoing and happy residents; he/she may find it less intimidating and more likely open to be part of the Resident Planning Committee. Existing Residents “Buddy resident” system makes for great ambassadors to help current residents as well. The pair can help to revitalize interest and help fellow residents to feel valued once again. It just takes a couple of energetic residents to give a gentle nudge now and then. Committee Structure and Process If you have more than one resident interested in chairing the committee, ask residents to assume the resident chair position on a rotation bases. This gives everyone that desires to do so a turn and gives a well deserved break to those that have previously served as chair. Write the resident ideas for events on a white board – keep them up on the white board till the next meeting. Why? 1) This allows you to erase events after they have been put on the calendar. Thus, you can keep adding and erasing as you are able to schedule them in any given month. Additionally, this is a great visual for the resident to see his/her ideas actively go from the white board to the calendar and gives the resident a sense of achievement. 2) Visually displays what the Resident Planning Committee has created for all to see. This is particularly useful for memory impaired residents as they can become agitated or upset when they do not like or recognize a program idea even though they initially suggested it. NOTE: Memory issues are the commonly seen contributor relating to event rejection and refusal because the resident does not recognize what they asked for in the previous moments. 3) Residents can be fearful that their ideas may not be well liked by others. Create an “anonymous “idea box” to keep the identities of those that would not otherwise give up what they secretly want you to add to facility programming. Memory impaired residents may perhaps make up the majority of the group you serve. When a program event is rejected by this group, whether it was initially the residents’ idea or not, do not take it personally. Remind yourself that his/her behavior is a product of related memory issues. The most effective response for you as a professional is to quickly “redirect” your resident to something else to prevent further emotional or behavioral escalation. Know Your Audience Knowing who your audience means that you can adapt the content of your presentation to address the main concerns of your audience. Professionals leading a group of seniors regardless of the group size must know and understand why the group wants to be present, what motivates the group, and whether you are matching your information to their level of understanding and interests. It’s an ongoing day to day learning experience for the Activity Professional and we all know that you have the knowledge and the skills – Remember that you got this! The best-laid plans of mice and men often go awry. No matter how carefully a project is planned, something may still go wrong with it. The saying is adapted from a line in “To a Mouse,” by Robert Burns: “The best laid schemes o' mice an' men / Gang aft a-gley.” Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org BUY Now Our MEPAP 1&2 Courses 2 Course Formats www.ActivityDirector.org - 1.888.238.0444 Structured Class (16 Weeks) - Begins the First Tuesday of each Month Self Paced Class (13 Weeks-1 Year) - Enroll and Begin Anytime 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 © 2019 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351
  6. Hi. your facility routine is definitely unique .. it doesn't follow regulation but it seems that the only thing missing is a way to communicate to the Coordinator the information from the Activity's Dept as to whether or not there is a significant change in activities. All departments know of the residents with significant changes within a facility, you might take a copy of the Sec F and mark the information as it pertains to each resident and leave it for the Coordinator before hand. Anything to promote teamwork, it makes life so much less stressful.. thanks Pennie " A significant change is determined by 2 departments usually nursing and dietary. Therapy also determines a significant change. Activities would not trigger, but reinforce one determined by the other depts. When you look at section F it would never change from the initial documentation. I know that the MDS would remain the same. Activities rarely triggers a significant change. Kathy"
  7. Programming for Deaf and Visually Impaired Elderly Vision and hearing loss are particularly prominent in the older adult population. The most common senses that are “lost” are sight and sound. These senses are specifically controlled by the visual and auditory cortex, respectively. It is possible to lose the senses of taste, smell, and touch, but these are much less common. While vision loss can have a profound negative impact on a person's perception of the world, hearing loss diminishes a person's mode of communication and can lead to social isolation. Leisure pursuits for the deaf and visually impaired aging are paramount to preventing feelings of isolation and lack of independence brought on by physical deficits. Visual and auditory loss can make everyday activities more difficult and significantly contributes to the sense of exclusion from society. Adapted leisure opportunities offer those moments of inclusion that seem to be without disabilities and significantly improves overall quality of life. Compensating for Sensory Loss Studies conclude that when you no longer need to use that part of the brain to process images (for example), more energy and processing power is shifted to the senses of hearing and touch. The brain automatically compensates to improve your ability to move through the world. Such is the case for blind individuals who often use a technique called “clicking”, in which they make small clicking sounds and then interpret the echo they hear to determine the environment around them. This echolocation technique can even allow people to determine specific objects and walk normally without bumping into walls or obstacles. Look for senses that remain intact to help your resident navigate and relate to his/her environment. Sense of Touch: Using the sense of touch feel the shape, surface texture, weight and size combined to identify the unknown object which cannot be seen. Sense of Taste: Offer a variety of food items and ask what ingredients can be identified. Often a specific food will be remembered from childhood days – encourage those memories. Sense of Smell: A particular fragrance can also evoke memories. Perhaps apple or pumpkin pie made with grandma’s love and care. A fragrance distinct to flowers, candles, colognes or spices can be identified and all may elicit memories from days past. The “Golden Rule”: Focus on the senses that still remain to lead the way to programming success. Tapping into the remaining senses helps to keep minds active by doing things that require inquisitive thought and intellectual problem solving strategies. Stimulating and success oriented programming allows residents to feel useful again, despite their physical disadvantages. The Hearing Impaired The hearing-impaired elderly are often at risk of having social challenges and not being able to fit in with mainstream groups. This is largely because “communication” is primarily language-based. But there are many available types of leisure pursuits for the hearing impaired that help foster communication and contribute to a feeling of community. A little ingenuity will go a long way towards the discovery of hearing impaired leisure pursuits. These include: Computer Skills: Computer savvy skills are integral for keeping up with those that are not close by. Studies have shown that older adult with computer skills were less likely to experience mild cognitive decline as they aged. Art: From drawing and coloring to painting and weaving, art promotes creativity and expression. Hearing-impaired adults can work with clay and ceramics, as well as all types of sewing activities. Bingo: Options for the hearing impaired are available. Such as large calling cards with a yellow background that can be held up for those who can't hear the numbers being called. Video Games: Video games are no longer just for children. Studies revealed that video games improve cognitive reflex and help to sustain cognitive processing for adults over 60 years of age. Board Games: Board games and card games are suitable for hearing impaired seniors. Generally hearing impaired with no visual loss can read game board “how to play rules”. Sports: Other options for those who are hearing impaired with good mobility include playing pool, foosball, bocce ball, and shuffleboard. Headset: If the resident is not completely deaf, a good set of headphones can make listening to music or audio books enjoyable again. The Visually Impaired Age-related vision loss is common as we grow older and can often be corrected with glasses, eye drops, surgery and other medications. Some eye conditions however, such as macular degeneration, glaucoma, cataracts and other diseases may evolve into blindness or partial-blindness presenting considerable challenges to those affected. There are many game products are available in adaptive versions for blind seniors. https://www.maxiaids.com/board-games Some of these games include: Monopoly: All of the properties and spaces are in large type and accompanied by braille. All of the cards are in braille and large print. The dice and money notes are in braille as well. Checkers: Each space and piece is marked in a way that the blind and visually impaired can enjoy this game just as much as sighted people. Bonus points for knowledge of braille not being required to play. Chess: There are bumps on the white pieces to differentiate them from the black ones and the black spaces on the board are slightly raised. Scrabble: There is an overlay grid that prevents shifting pieces, as well as braille markings on said pieces. Here are a few topic oriented books that may be of particular interest to the visually impaired: Touching the Rock: An Experience of Blindness - by John M. Hull Autobiography; instructive and profoundly touching. The Country of the Blind - by H. G. Wells A mountaineer named Nunez slips and falls into a valley cut-off from the rest of the world where inhabitants are all blind. If You Could See what I Hear - by Tom Sullivan Blind from birth, Tom tells you stories that will make you laugh out loud. Stars Come Out Within - by Jean Little Autobiography of Canadian children's author Jean Little, blind since birth. A Dolphin in the Bay - by Diana Noonan A young boy's relationship with a dolphin helps him overcome his fears. Tips for Communicating with Visually Impaired People In general, observe first -then ask if your resident requires help - ask for instructions on how they want you to help. Don't raise your voice – or be excessively louder than normal volume. Use normal language- there's no need to avoid words such as "look", "see". Don't point or say 'over there'- be specific; "It is on the bed to your left". Identify yourself as you enter- "Hi Mary, it's Linda". It is acceptable to describe colors, patterns and shapes. Never patronize- do not assume that you have to make things 'easy' for them. When walking, describe the terrain- number of steps, texture of walking surface (carpet, grass . . .). Always respect the person's individuality, dignity and independence. What Is Available? Reach out to clubs and organizations for those who are deaf to encourage individuals who are deaf-blind to participate in social activities to reduce isolation. YMCAs/YWCAs Church leagues/synagogue leagues Community leagues Local associations for the blind Ski for Light - https://www.sfl.org/ University- or college-affiliated programs Local deaf club Lastly, but most importantly- Remember that your program must be “interest based” and “person centered”. You will always have a successful program when you ask your residents to guide you. Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org ENROLL Now Our MEPAP 1&2 Courses 2 Course Formats www.ActivityDirector.org - 1.888.238.0444 Structured Class (16 Weeks) - Begins the First Tuesday of each Month ... Starts Tuesday October 1st ... Self Paced Class (13 Weeks-1 Year) - Enroll and Begin Anytime 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 © 2019 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351
  8. Hi Everyone!! I promised I'd be back soon!! Here it is, the Flyer.. please feel free to print it out and post it wherever laugh loving Seniors are!! And did anyone catch my offer for the First 5 100- year olds who have proper I.D. They get to enjoy the show for Free!! How bout that? See age does have it's benefits!! Nevertheless, I hope you have a marvelous weekend and that the sun is shining for you wherever you are!! P.S. Menu to follow soon... Always, I Live to Laugh! Bonnie Barchichat Executive Producer Senior Comedy Afternoons.com 714-914.2565 The Proud Bird P.P.S. Sponsor Opportunities are available.. you don't want to miss this show! Contact me directly and say you want to be a part of it, send me your info! ©2019 Senior Comedy Afternoons LLC. | 2313 Nelson Avenue, Redondo Beach, Ca. 90278
  9. Meaningful Memory Care Planning Individuals afflicted with Alzheimer’s and dementia complications go through a number of different stages during the disease progression. Leisure pursuits are crucial for residents living with Alzheimer’s disease, particularly those which offer and encourage engagement opportunities and much needed cognitive stimulation. The Approach to discovering leisure pursuits to offer engagement and stimulation is the same as any resident assessment process with one very significant distinction: Look at what the resident can still do rather than what they can no longer do. Establish consistent routines. Why? The day is a little less scary when the daily pattern is predictable and somehow familiar. Many of us operate on autopilot whilst going about our daily business but memory deficits can cause a snafu in the normal retrieval process. Thus, even our firmly embedded auto pilot can malfunction. While structure and routine is important, there are countless opportunities to do “meaningful” things in unexpected places and times. Daily everyday tasks such as bed making, sweeping, dusting, and watering plants for example are small yet simple though they can provide rich opportunities for engaging residents who perhaps show no interest in bingo, movies, or other group activities. Planning Tips Continuously adjust and accommodate to match to the changing needs of the disease progression. Plan for times during the day when the resident tends to function at their best. Use adaptive strategies and techniques that focus on strengths/skills in which the individual still possesses. Allow the individual to retain as much control as possible to help foster a sense of personal dignity. Simplify tasks: break down step by step. Move to the next step in the sequence only when the first step has been accomplished. Attention span may be limited so plan programs in no more than 20 to 45 minutes segments. Programs are most effective when they are multi-sensory and spanned over consecutive days (facilitate memory input) and are connected to a related theme. Remember: Loss of memory creates an inability for the individual to remember what they did in the past for themselves to find amusement. However, this population may still have the ability to [be amused] well into the disease process. Incorporate events that “elicit” a response through use of basic sensory stimulation and awareness of his/her body movements. Sensory Integration would focus on any combination of the following: -Visual (eyes) -Auditory (ears) -Proprioceptors* (awareness of body position) -Vestibular (balance) -Tactile (touch, feel) -Olfaction (smell) -Gustatory (taste) Proprioceptors* sensory receptors in muscles, joint capsules and surrounding tissues, that signal information to the central nervous system about position and movement of body parts. Activity Starters The following list has been provided as inspiration and motivation only. You will need to look at the individual resident with a Dx of Alzheimer’s to create a “person centered” care plan uniquely suited to the skills that remain and the specific stage of the disease as per nursing assessment. Stuffed Toys Offer stuffed animals and other soft toys to cuddle. Check for any materials that could be removed and become a choking hazard. Baby Dolls and Baby Doll Clothes Provides opportunity to foster nurturing characteristics. The goal is not to dress the doll properly, but rather to “elicit” the desire to change the doll’s clothing whilst working on hand eye coordination. Pet Therapy Animals of varying types are well documented to improve well being and boost emotional connection to something other than themselves. Music and Movies Foster emotional connections via music, videos, and movies. Keep the time frame brief, only watch/listen for 5 to 10 minutes but if they are engaged, keep allowing them to enjoy the experience for long as continue to be engaged. Sensory Sensory deprivation is one of the hallmarks of Alzheimer’s disease. Use everyday objects to arouse one or more of the five senses (hearing, sight, smell, taste and touch), with the goal of evoking positive feelings. Exercise Any physical activity can be beneficial, from a simple walk to yoga. Use props, such as tambourines, clappers, top hat, streamers, maracas, batons, pom poms, stretch bands, scarves, or stretch bands. Bird Watching Hang a bird feeder that will not allow individuals to access the food. Provide chairs or benches to stop and watch the birds. Sunshine and Fresh Air Plan time for the outdoors (weather permitting) for 10-15 minutes. Supply sun protection with wide brim hats and sun lotion on arms and legs. Avoid the sun between 11 and 3 pm. Offer cool drinks. Read Aloud Studies reveal that those afflicted with Alzheimer's disease may be able to hear until very late into the illness. Read articles in magazines and newspapers that the person enjoyed in former times. Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org Our MEPAP 1&2 Courses 2 Course Formats www.ActivityDirector.org - 1.888.238.0444 Structured Class (16 Weeks) - Begins the First Tuesday of each Month Self Paced Class (13 Weeks-1 Year) - Enroll and Begin Anytime 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 © 2019 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351
  10. I was recently passed an interesting article from our instructor Kathy Hughes, ADC that I think we can all relate to. Nursing home food is often compared with hospital food and is rarely accused of being appetizing. However, the nationwide push to make care homes more person-centered has extended well beyond care and is now attempting changes in the dietary department. It may be hard for some to believe but prior to November 2016 family members weren’t allowed to bring outside food in. The value of sharing recognizable comfort food with a loved one in the throes of dementia could easily be recognized by the family, but couldn’t be executed until this all important CMS update in 2016 that was over 20 years in the making. According to the article: The new and modified regulations explicitly state that menus at facilities participating in the Medicare and Medicaid programs must now reflect the religious, cultural, and ethnic needs of residents, be updated periodically, and undergo review by a dietician or nutrition professional (who, according to the new regulations, have higher certification requirements than in the previous iteration). Also, for the first time, nursing homes can officially grow their own food or buy it directly from local producers, and allow residents to eat food brought in by friends and family. Finally, meals and snacks can now be served whenever works best for the residents, not just at designated feeding times. The changes these updates are making can be felt already in many homes, perhaps even yours. Rather than regular American staples day in and day out residents are now enjoying more ethnic foods being served right in their dining rooms. The ability to participate in CSA (community supported agriculture) programs opens a whole new way to plan activities for your community as well, providing pathways for field trips, vegetable, fruit and herb education, harvesting and preparation, increased health education and the lists goes on and on. Better food isn’t just about better taste and nostalgia either. Nutrition is critical in determining how one’s life will unfold particularly at this leg of life. Fresh and accessible food, from a variety of trustworthy sources increase intake in general and nutritional levels greatly. The article discusses many advantages to these CMS updates, but its central point remains that the boost in mental well-being received by these residents is really what counts. The ability to feel autonomous and to be reminded of the good times in life go a long way in contributing to joy. A care home should not feel like a jail and access to a variety of food and lifestyle experiences is a basic freedom. The updates are a huge step in the right direction however there is a stark difference between policy change and implementation. Positive effects are being felt as are the negative effects that variety can have on an ever decreasing dietary budget. The article references some worst cases scenario numbers that come in at less than $1 per meal. Think about that. Staffing issues also remain a concern that block many attempts above and beyond the norm of how things have always been. Even still, these changes are good changes and they were a long time coming. It allows residents to remain in contact with food, which is such a cornerstone of all of our lives and interactions therein. It is true progress and I for one was fascinated to read the article. I grew up in an Activity Department because my Mom was an Activity Director and I can remember the food vividly. I really hadn’t realized that food could be or was regulated in that way and that dietary had such restrictive guidelines and budgets (even though I should have because my Mom’s best friend Debbie was the Dietary Manager and she complained about it constantly!). I am glad to see these changes going into place and it gives me great hope about the type of facilities we are all pushing for together. The future is certainly brighter….and tastier. Article Referenced: Nursing home food is getting better. But the journey is far from over. by Jillian D' Onfro Nov. 27, 2017 Read the Article ENROLL Now 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. Activity Directors are the key to creating environments that we ourselves would be excited to live in. We envision facilities that feel like homes, not institutions. Facilities that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe providing the best education available, with the most talented teachers we can find, 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 © 2019 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351
  11. Progress Notes by Kathy Hughes, ADC ActivityDirector.org Recently there has been conversation on social media sites concerning the need for activities to complete progress notes on a quarterly basis. This can also mean a quarterly and annual reassessment of the resident. Let us look at what a “Standard of Practice” is for Activities: Standards of Practice are a “how to” of a discipline. They can include policy statements, standard operating procedures, activity practice protocols and procedures for specific activities. Policy statements clarify the scope and authority of activities stating who, what and when an activity takes place. It also covers the scope of practice for the activities department. A scope of practice may be that activities cannot diagnose a specific disease or disability. The Standards of Practice also include the documentation requirements as set forth by the federal government and regulations of each state. These standards may not appear in the Activities section of the regulations but may appear in the Clinical records portion of the regulations. A policy is written by the Activities Director for the Activities Department. Once a policy is instituted the Activities Department must abide by what is written. A procedure is how the policy will be performed and how the Activities Department will do the activity. When being inspected, a surveyor might look first at the federal regulations then the state regulations and if there is a question then the facility policy and procedure. In the past some facilities received a deficiency when they did not follow their written policy and procedures. We have looked at the federal regulations for the US and found information that there were some references to progress notes for all disciplines, but not activities specifically. Although there are no regulations for having to do quarterly progress notes for activities, it is a Standard of Practice for the Activities profession. It is also a policy and procedure in most nursing homes. Surveyors are directed to look at “Physician’s, nurse’s, social worker's and other staff members progress notes, as applicable” in many areas of the CMS (Center for Medicare and Medicaid Services) regulations. “Other staff members progress notes” would be where the Activities Department falls. State by State Regulations Some state regulations specifically state that quarterly progress notes are required by the Activities Department. There are other states that only follow the CMS Regulations. It would be up to the Activities professional to find their specific state regulations for the need for a progress note. Here is a link to the “Clinical Records Regulations” for each state: http://www.hpm.umn.edu/nhregsplus/NH%20Regs%20by%20Topic/NH%20Regs%20Topic%20Pdfs/Clinical%20Records/category-administration-clinical%20records-final.pdf You can access your state regulations for activities by using this link: http://www.hpm.umn.edu/nhregsplus/NH%20Regs%20by%20Topic/Topic%20Quality%20of%20Life.html#statecompare You can also go directly to your state Department of Health and do a search for your specific regulations. In Summary... The Activities Department should do quarterly progress notes as a Standard of Practice. We have valuable information to share with the staff, the physician and the other teams. The residents have unique needs and interests that need to be documented and their progress in activities could impact their medical conditions and their progress in the facility. In our never ending quest to be accepted as a valuable member of the facility team writing progress notes, actively contributing to the care plan and having a detailed Initial Activities Assessment lets others recognize the Activity professionals as a modality to improve the residents quality of life. Have a question for Kathy? Email questions and comments to kathyhughes@activitydirector.com. Thank You. ENROLL Now 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. Activity Directors are the key to creating environments that we ourselves would be excited to live in. We envision facilities that feel like homes, not institutions. Facilities that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe providing the best education available, with the most talented teachers we can find, 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 © 2019 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351
  12. There is generally some level of dread when state comes in for a survey. No matter how prepared you are there is always a chance that something could not go according to plan or there may be something you have overlooked. We often see members of the network discussing this possibility on social media and there seems to be a need for some Quality Assurance. For this reason, we have created a couple of forms for you to use as an evaluation tool. It allows you to get some perspective, evaluate your direction, adjust accordingly and improve your department and the lives of your residents. It’s a win, win that helps replace the dread of a survey with the excitement of being on top of it. How To Use These Forms There are two forms that will need to be completed on at least a quarterly basis. Use your judgement as to whether this time frame needs to be adjusted. Quality Assurance: Activity Program Review Utilize this form to evaluate your overall department’s performance. Each quarter have a different person complete it. For example, each quarter you could survey one of the following community members: family member, assistant, volunteer, admin, other department head, receptionist, a resident, a nurse and so on. This will give you a great deal of perspective and helps foster a sense of inclusion and teamwork in your work environment. Quality Assurance: Resident Quality Assurance Utilize this form to evaluate the level of quality that your department is delivering to each resident. It would be impossible to survey every resident every quarter. For this reason, survey at random a good cross section of your population and do the best you can. In Conclusion, making use of these two forms as part of your department's policies is one of the best things you can commit to. Evaluation is such an important component to motivation and creativity. When you ask your community to get involved with what you are trying to accomplish things can only improve and your vision can only gain clarity. These forms are complimentary from BEST SELLING book The Activity Directors Bible by Pennie Bacon. Click the link below to Download Quality Assurance FORMS BUY Now 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. Activity Directors are the key to creating environments that we ourselves would be excited to live in. We envision facilities that feel like homes, not institutions. Facilities that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe providing the best education available, with the most talented teachers we can find, 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 Our Network. Copyright © 2019 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351 ------------------------------------------------------------------------------------------------------------------------------- Dementia Care - Critical Pathway Forms Help Identify Programming Deficiencies
  13. Dehydration and the Elderly A widespread blanket of increasing rising temperatures is expanding across much of the country. . . . And of course, hot weather always increases the risk of dehydration. Older aging populations are vulnerable to climate change-related health impacts for a number of reasons. The body’s normal aging process causes the body’s systems mechanisms, that are meant to protect us from dehydration, to work less efficiently as we age. The elderly population does not have the same internal thirst signals with age progression and consequently do not take action to reach the necessary liquid consumption. Experts generally recommend that older adults consume at least 57.5 fluid ounces or 7.1 cups within a 24 hour period. (https://link.springer.com/article/10.1007/s12603-009-0023-z) NOTE: Elderly people should not be encouraged to consume large amounts of fluids at once but rather small amounts throughout the day. Factors that put older adults at risk for dehydration include (includes but not limited to): Chronic problems with urinary continence, which can make older adults reluctant to drink a lot of fluids. Memory problems, which can cause older adults to forget to drink often, or forget to ask others for something to drink - even mild dehydration, can cause noticeable worsening in confusion or thinking skills. Mobility problems associated with aging, such as muscle and bone loss, which can make it harder for older adults to get something to drink. Older adults are more likely to be taking medications that increase the risk of dehydration, such as diuretic medications, which are often prescribed to treat high blood pressure or heart failure. Dehydration can also be brought on by an acute illness. Older adults are also more likely to have a chronic health condition, such as diabetes, that requires medications for treatment. Vomiting, diarrhea, fever, and infection are all problems that can cause people to lose a lot of fluid and become dehydrated. Dehydration also often causes the kidneys to work less well, and in severe cases may even cause acute kidney failure. Additionally, chronic mild dehydration may further exacerbate constipation problems. Physical signs of dehydration may include: high heart rate (usually over 100 beats per minute) low systolic blood pressure dry mouth and/or dry skin in the armpit less frequent urination dark-colored urine delirium (new or worse-than-usual confusion) sunken eyes Caffeine and Dehydration Coffee or Tea please! We all know only too well how important it is for our seniors to enjoy a nice cup of coffee or tea while gathering in morning socials to shake off those morning cob webs and get ready for the day’s events. Is there any other way to start the day? Technically caffeine is considered a weak diuretic. By definition, a diuretic is a product that increases the body’s production of urine. Hence water, or any drink consumed in large volumes, is a diuretic. It should be noted that urinating more does not inevitably lead to dehydration (excessive loss of body water). http://theconversation.com/health-check-does-caffeine-cause-dehydration-73965 Current studies suggest that caffeinated coffee or tea is not proven to be particularly dehydrating in people who drink them regularly. Caffeine, however, may worsen overactive bladder symptoms, so there may be other reasons to be careful about fluids containing caffeine for our senior population. Feel free to offer decaffeinated drinks but if an older person particularly loves his/her morning cup of (caffeinated) coffee, there is no reason why they cannot partake unless it is physician ordered to avoid such liquids. Help Them Stay Hydrated Here are some reasonable approaches to help your seniors remain hydrated during current rising temperatures: Identify continence issues that may make the older person reluctant to drink. Consider a toileting schedule, which means helping the older person get to the bathroom on a regular schedule. This can be very helpful for people with memory problems or mobility difficulties. Offer fluids in small amounts throughout the day; consider doing so on a schedule. Ensuring the appeal of the beverages you offer – they will drink more if they enjoy it. Determine if your senior prefers drinking through a straw. Enlist interdisciplinary staff in your efforts. Track in a journal how much the person is drinking; be sure to note when you try something new to improve fluid intake. Offer more fluids when the senior is ill (seek nursing oversight). Reducing Swallowing Problems By Making Liquids Thicker While you focus on actions to prevent dehydration issues be mindful of anyone with a swallowing disorder, often experienced in the elderly. Normal aging causes reduced muscle tone in the pharynx and esophagus and other changes that affect swallowing. Thickened drinks are normal drinks that have a thickener added to make them thicker. They are often recommended for people who can no longer swallow normal fluids safely, because normal drinks go into their lungs, causing coughing, choking or more serious risks such as chest infections and aspiration pneumonia (seek nursing oversight). More Ways to Keep Seniors Cool in Hot Weather Offer a cooling snack like popsicles (use cupcake liner to catch drips). Place a cool washcloth on the back of the neck and a pan of cool water close by to periodically re-cool the towel. Meals should be cold like chicken or pasta salad instead of heavy hot dishes like pot roast. Encourage clothing that is lightweight and in light colored cotton so it’s easy to adjust to the temperature throughout the day by removing layers of clothing. https://dailycaring.com/10-tips-to-keep-seniors-cool-in-hot-weather/ Calendar Programs Older people can have a tough time dealing with heat and humidity. The temperature inside or outside does not have to reach 100°F (38°C) to put them at risk for a heat-related illness. Be mindful of the temperatures when planning programs. Restrict your events to locations that offer cool environments. For outings; seek senior-friendly places that offer air conditioning (Restaurants, Shopping Mall or Stores, Public Library, Art Museums, Movie Theaters). Senior exercise programs may need to shortened in duration and restricted to easy and simple range of motion programs to prevent over- exhaustion. Don’t forget the hydrating liquids! Stay Cool! Have a topic request or question for Celeste? Send them over to Celestechase @ activitydirector.org Introducing a NEW course from Best-Selling Teacher Kathy Hughes, ADC... ENROLL Now Our MEPAP 1&2 Courses 2 Course Formats www.ActivityDirector.org - 1.888.238.0444 Structured Class (16 Weeks) - Begins the First Tuesday of each Month Self Paced Class (13 Weeks-1 Year) - Enroll and Begin Anytime 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 © 2019 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351
  14. ---------------------------------------------------------------------------------------------------------------------------------------------------------------------- View the Seminar Brochure Behavioral Gerontology and Activity Approaches (Final) (1).pdf View and Print the Application Behavioral Gerontology and Activity Approaches Form (1).pdf
  15. Activities for Men While walking through most Long Term Care facilities you will easily take note that the ratio of female versus male residents is significantly tipped towards the female population. Women residents outnumber men at the rate of about 2 to 1 (partly due to the fact women live longer than men). Contributing factors that tip the scale further is that it is not uncommon to find that approximately 80% of the staff is also female and the majority of visitors in general are female as well. Men are simply outnumbered in Long Term Care facilities. http://digg.com/2017/sex-ratio-america-map “this map of America shows the male/female sex ratio for all the states and counties — It's worth noting that, at a glance, the most populous counties in America seem to tilt towards female”. Upon further glance it may appear that a vast number of activity calendars have more programs geared for women than men. Activity calendars often do reflect a variety of feminine-based domestic activities such as cooking, baking or “unisex” geared activities. One might speculate that Activity Directors focus on meeting the needs of the majority (female) residents but it is more the case of how much more challenging it is to create male oriented programs than it is for the female persuasion. Consider some of the following factors that contribute to the increased challenge in planning for men’s activities. Of the less than 30% of male residents in Long Term Care facilities, approximately 1/3 of the population present with less ability to communicate than women due to their respective medical or mental status. Some men suffer from strong fear of failure; particularly relating to starting a new skill in which they may appear incompetent to others. Men of past generations may feel embarrassed or self consciousness relating to their particular disability and how it may cause unsuccessful outcomes. Career responsibilities that have long since pasted may leave a sense of loss or void that may damage self-esteem, and instill feelings of uselessness. All of the above are useful information when planning for men’s activities but are only a fraction of the possible scenarios that today’s Activity Director needs to consider while planning for a balanced and purposeful activity calendar. Additionally, there are lifestyle differences that contribute to men’s personal attitudes regarding leisure pursuits between white collars versus blue collar workers. White collar workers engaged in less physical job related labor, shorter work hours and benefited from higher paying salaries than blue collar laborers. Thus, white collar workers were more likely to feel more energetic, have additional time in the day for leisure choices and possessed the financial means that allowed him to select from a range of interests and pursuits. Below are some considerations that may help you to best identify how to plan for men’s activities, specific to Blue Collar Workers. Men put in exhaustive long hours and often were left with little or no time for leisure pursuits thus they tend to be lacking in leisure related skills. What little available free time in any given day was spent with family members, particularly with their children. Minimal earnings did not allow for financial means to spend on leisure activities. Starting Point – the assessment /gender reviewed: Most likely you already have a standardized assessment form. Take some time to review your assessment form and activity check sheet and take note of the types of activities that may be more specific to male residents. You can create a framework of questions that will help you probe for more details regarding his preferences. As you check those areas of interest expressed by your resident make it your mission to elicit and document more information describing what makes his specific selection particularly appealing. Example - Resident selects Sailing: Questions to ask: Can you describe what your sailboat looked like? Where is your favorite sailing destination? What time of day do you like go sailing? Who do you like to be with when you go sailing? How often did you go sailing? How do you take care of your sailboat? Your resident’s answers can be used to engage him in a conversation at a later time about this past time experience and will aide in re-affirming a particularly meaningful memory. Men of this generation often thoroughly enjoy exchanging stories of past days of glory, sports or children and grandchildren’s accomplishments. Look within your male population to group residents with common denominators that you can foster in friendship and mutual camaraderie. Once you incorporate your residents noted interest/s in the activity calendar and highlight care plan objectives you are well on your way to providing for the needs and interests of your resident as a unique individual within the facility community - thereby meeting federal laws for nursing homes. Men might be the minority in this club but given the opportunity, appropriate resources and a thorough comprehensive assessment, men may not only be able to participate but contribute greatly by adding to the overall program enrichment through a well balanced activity calendar schedule. NOTE: Although the Activity Director professional will primarily focus on planning these activities keep in mind that the ALL staff members are charged with ensuring that the needs and interests of each individual is met to attain or maintain the highest practical physical, mental, and psychosocial quality of life possible. Such programs are essential to the health and well being of all men and women living in Long Term Care facilities today. Below are a number of ideas for your consideration but remember, that you’re objective is to find a “match” between your resident’s needs and interests to the many potential ideas you come across. Train Hobby Club – The collection for the train hobbyist is numerous, everything from the train itself to the landscape and surrounding villages will keep your resident busy. Look for a location in the facility where you can leave the train convoy permanently set up for residents to watch throughout the day. Men’s Choral Group – Rehearse all time men’s favorite songs to musical accompaniment or acapella style. Let your residents listen to past male entertainment groups (Miracles, The Four Tops, The Platters, etc.) Car Talk – Collect car magazines and new car brochures and solicit a discussion about new cars vs. the old cars, foreign vs. domestic, manual vs. automatic transmission, 2-door, 4-door, convertibles, etc. Car Wash – A simple hose, bucket, soap, sponges, and towels is all that’s needed. Solicit facility staff members to volunteer their car for washing. Each resident may choose whether to wash, rinse, dry, or just watch the scrubbing and polishing busy work. Rope Tying – Former professionals and wanna-be ship mates will enjoy trying and re-trying various rope techniques to get it right - while sharing sea worthy tales. If there is no sea captain in the crowd just purchase the many rope tying teaching books out there and dawn your sailor hat to get the ship moving. Santa's Workshop – Doll houses, airplanes, train kits, bird house, mailboxes etc., make for a super great Santa Shop assembly line. Finished product can be donated to non-profit organizations such as Toys for Tots during the holidays. Your men will love knowing how meaningful their labor of love will be to a child. Sports Time – Watching a live or a pre-recorded horse race, ballgame, boxing match on a big-screen will get the crowd in the mood. Set out peanuts, popcorn, and pretzels. Serve non-alcoholic beer and soda. NOTE: Keep in mind any issue with potential chocking risk/consult with nursing. Competitors Club – Horseshoes, bean bag tosses, badminton, bocce ball, and balloon toss are fun games that involve a lot of movement while encouraging interaction, socialization, and teamwork. At the Movies – Ask the residents to select a film (a western, war movie, or mystery). Schedule a matinee or an evening showing. Supply hot-buttered popcorn, movie-style candy, and soda (if permissible- relating to potential chocking/consult with nursing). NOTE: War movies may be triggering for some residents. Be sure to vet your residents for potential behavior relating to aggression that may be triggered from viewing war movies. Honoring Veterans – Military veterans are often eager to exchange stories about the war days as a way to bond and honor veterans and the past memories. Create a list of “military positions” held by your residents and post in an easily visible location to honor their service. Casino Night – Organize a game of dominoes, checkers, chess, or a card game (poker or Blackjack). Be sure to decorate with all the ambiance and glitz and glamour to set the tone. Arches ranging from roulette wheel to gleaming gold circle to let the residents make an entrance. Tool Bits – Provide a variety of different sized nuts, bolts, and washers and a few empty containers. Either direct the resident to sort the items or assemble the items and start up a conversation and provide pictures about what each item might be used to make. NOTE: Be aware if there is any evidence whereas you believe that your resident may want to ingest non-consumable items. Trade Show – Journey out to a local hardware store, such as Home Depot or Lowe’s. Make a project list and ask the men to find the supplies to complete the job. Many men enjoy discovering new tools and many will spend countless hours at a hardware or home-improvement center. Shoe Shine – Contact a local shoe shop to enlist the tradesman to come to the facility to show off his craft to the men of the house. Your residents can wear their Sunday best shoes for this shoe renovation. Offer newspapers, magazines, books for reading while resident shoes get a new lease on life. The smell of shoe polish may evoke memories and provide opportunities to reminisce. Card or Coin Collection Club – Many men collected and traded baseball cards or coins when they were young. Gather a collection of baseball cards or coins and set up a sorting/organizing station. Obtain detailed information about the items to share with the residents. Encourage the men to talk about their baseball or coin favorites and share how they acquired their treasures. Career Day – Gather a collection of photographs with a focus on jobs, occupations, and careers. (Also consider: colleges, military service, sports activities, clubs or organizations, hobbies or leisure activities.) Encourage the resident to discuss the photographs and their past employment. Pass around various hats representing different careers and ask residents to talk about which occupation they think the hat belongs to. Share information about each career such as, educational requirements and potential earnings. Have a topic request or question for Celeste? Send them over to Our MEPAP 1 & 2 Courses Begin Aug 6th, required for NCCAP Activity Director Certification. Contact Us at ActivityDirector.org - 1.888.238.0444 - admin@activitydirector.net 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 © 2019 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351
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