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  1. View this email in your browser Resident Rummaging, Hoarding, Hiding It is not unusual to step into a secured Alzheimer’s’ unit where you observe someone actively rummaging or searching through cabinets, drawers, and any number and any manner of subjectively intriguing storage areas, even closets and the refrigerators. It is also a common practice for residents to hide coveted items in the most peculiar places that they will likely be unable to remember later. Although the behavior can be concerning and disruptive, it provides engagement at best but can easily turn into a safety risk. Proactive measures must be implemented to ensure safety that provisions concerning this behavior prevents potential hard to self or others. It is not recommended that you eradicate opportunities for this behavior as it often helps the resident to dissipate anxiety, offers engagement and in fact often helps your resident to feel useful. Note: The behavior might have some level of logic behind the action. Residents often set about this behavior because they are actually looking for something specific, although unable to neither identify nor describe that illusive item. Understanding the Basics According to the Alzheimer's Association, hoarding and hiding behaviors usually begin in the early to middle stages of the disease, and often stem from trying to have some control in their lives. Rummaging, meanwhile, may occur when an individual with Alzheimer’s disease believes something has gone missing. More specifically, the Alzheimer's Association identifies a few possible causes -- psychological, medical and environmental -- for rummaging, hiding, and hoarding, including: Physical changes within the brain leading to confusion, memory loss and impaired judgment The individual senses loss of control The desire for a sense of security or feeling that they may "need" something Seeing and touching things gives them comfort Fear of losing items or being robbed Inability to distinguish between valued and disposable items Boredom, lack of stimulation, and difficulty initiating new activities Reasons for Rummaging Behaviors Boredom: Rummaging behavior may spring from boredom; particularly when opportunities are not abundantly available for engagement. These busy “seekers” are doing just that – keeping busy with something that is found to be self occupying- even when the behavior behind their quest becomes unwanted and has the potential to increase safety risk to self and/or others. Note: In fact, the old adage applies here: “negative attention is better than no attention at all”. Try to quickly understand and recognize what is causing the behavior and measure your response appropriately to prevent that unwanted behavior. Coping Mechanism: Rummaging can be a coping mechanism in response to the disorientation typically caused by dementia. The behavior can occur when the resident is trying to reassure him/herself or self-soothe with familiar items or when they are trying to fill a void or need, like eating when hungry. Loss of Useful Contribution: Consider that what looks like rummaging could also be a way for the resident to feel that they are doing something productive or helps them to feel useful in some way. In the days past, your resident may have fallen into that “problem solver” or “fixer” personality. These characteristics almost are always the reason for “busy seekers” to search for anything that is perceived to be lost items. Triggers: In some cases, the resident with dementia might start rummaging in response to a “triggering” event. The ability to understand the circumstances that “trigger” the unwanted behavior before it occurs puts you way ahead of the game to support a peaceful environment for your resident. Source: https://dailycaring.com/9-ways-to-manage-dementia-rummaging-behavior/ Note: Consider creating a “behavior log” to record the time of day, the surrounding environment, the individuals involved and the type of event to see if there is a repeated situation from which the resident becomes agitated. You will be looking for repeated patterns to determine what circumstances instigate the behavior. “An ounce of prevention is worth a pound of cure” Rummaging Freedom [Safe Zone] Treat rummaging as an opportunity for engagement. Include items like clothing, socks, copies of memorable photos, a fake checkbook, reading books, greeting care, or a wallet filled with old receipts, credit card “look alike” and fake money – anything that could spark interest. Hobbies or career related items from the resident history are sure to peak interest. Themed boxes like a sewing or knitting drawer, a sports basket, a costume jewelry box, a tool box, or any music related items, etc. Always show the resident where to find his/her themed box so as not to elevate anxiety levels. Review the following for more ways to create a “safe zone” for resident rummaging: Keep the person with Alzheimer’s from going into unused rooms. This limits his or her rummaging through and hiding things. Do a search to learn where the resident often hides things. Once you find these places, check them often, without the residents’ knowledge. Keep all trash cans securely covered or out of sight. Alzheimer’s residents may not remember the purpose of the container or may rummage through it. Check trash containers before you empty them, in case something of value has been hidden there or thrown away by accident. Note: A resident that often disposes of dentures, hearing aids and/or glasses can make for a very unhappy family member. In addition, loss of such adaptive devices has the potential to further increase resident agitation and increase unwanted behaviors. More ideas to ensure safety and less disruption as follows: Lock up dangerous or toxic products, or place them out of sight and out of reach. Keep backups of frequently lost items to prevent the start of yet another frantic search. Example: Several similar look-a-like handbags stored out of sight will do the trick when the original one becomes lost. You will always be viewed as the hero when you help your resident find that missing handbag. Remove spoiled food from the refrigerator (if accessible) and cabinets. Food gone bad simply becomes a doctor’s visit when consumed due to the resident's lack of judgment and/or sense of taste. Make commonly used items easy to find. The resident behavior may be valid if they are looking for something specific, but can’t find it. This is particularly frustrating when the resident is unable to explain nor describe what they are looking for. Consider putting things in clear containers or specific drawers and label contents. Or keep similar items together, like similar clothing in the same drawer – underwear, tops, bottoms, socks, etc. Failed attempts to stop a resident from hiding, rummaging, hoarding, and or re-organizing things can cause increased agitation and paranoia for the resident that is bound and determined to engage in such behavior. You can mitigate agitation and manage the behavior through creative and inventive ideas that allow the behavior while maintaining a safe and less disruptive environment. In doing so, the resident will regard you as a supportive partner rather than viewing you as someone that is interfering - - and that’s exactly where you want to be. Reference: https://www.nia.nih.gov/health/when-person-alzheimers-rummages-and-hides-things?utm_source=NIA+Main&utm_campaign=8c48100ffd-20190409_rummaging&utm_medium=email&utm_term=0_ffe42fdac3-8c48100ffd-7499965 Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2810 US HWY 190 W #100-A9 Livingston, Texas 77351
  2. Our residents no longer have their fathers to celebrate this day with, however they are always together in spirit. Have residents create a special rock with their father's name on it and a picture or drawing that speaks to them. Place the rocks around in a garden to create a Father's Day Garden. A beautiful reminder that will help the residents to feel more connected. Share Tweet Share Pin Forward The Best and Worst Dads of All Time by History.com This Father’s Day, we bring you five men who exemplify some of history’s finest parenting—along with five others you’ll be glad you never had to call Dad. 1. Charlemagne King of the Franks and emperor of the Romans in the late eight and early ninth centuries, Charlemagne had 20 children, some with wives and others with concubines. He insisted that they all receive a thorough education, including the girls. When one of his sons, known as Pepin the Hunchback, was found guilty of participating in a plot to kill Charlemagne, it was expected that he would be executed along with his co-conspirators. Instead, the emperor took pity on Pepin, ordered his sentence commuted and sent him to a monastery. Nicholas II, the last emperor of Russia, in 1914, with his wife Alexandra and his children Olga, Tatiana, Maria, Anastasia and Alexei. (Credit: New York Public Library/Getty Images) 2. Czar Nicholas II The last Russian emperor, Nicholas had five children with his wife, the German-born Alix of Hesse. A loving father, Nicholas was especially concerned with the health of his only son and heir, Alexei, who suffered from hemophilia. Their child’s illness led the czar and his wife to consult the controversial healer Rasputin, whose influence over the royal family compromised their standing on the eve of the Russian revolution. 3. Mark Twain Mark Twain and his wife, Olivia, had three daughters during their 34-year marriage. Though he doted on all his children, Twain was particularly close with his oldest, Susy, who shared his love of acting and writing. He based at least two major characters in his novels on her. When she died of meningitis as a young woman in 1896, Twain fell into a deep depression. Later, he included passages written by Susy about her father in his autobiography. 4. Cicero A prominent ancient Roman statesman and philosopher, Cicero adored his daughter Tullia and was devastated when she died of complications from childbirth in 45 B.C. Inconsolable despite his friends’ many letters of condolence, some of which are still in existence, Cicero isolated himself for several weeks at the home of his friend Atticus, where he read texts by Greek philosophers about how to overcome grief. He later divorced his second wife, Pubilia, supposedly because she had not been sufficiently saddened by her stepdaughter’s death. 5. Charles Darwin The father of modern evolutionary science was also a devoted dad to 10 children, of whom two died in infancy. He played a central role in raising and educating his brood at a time when childrearing was seen as women’s work. The death in 1851 of 10-year-old Annie was a crushing blow for Darwin and his wife, Emma, and some have speculated that it caused him to lose his religious faith. 6. Peter the Great The ambitious and erratic Peter, who ruled Russia from 1682 to 1725, fathered 14 children (many of whom died young) with his two wives. Not known for his warm parenting style, he famously contributed to the death of his first-born son, Alexei, who had been convicted of conspiring to kill his father, despite a lack of concrete evidence. Before his planned execution, Alexei died in his prison cell of wounds sustained during a torture session. 7. Constantine the Great The Roman emperor Constantine, who ruled from 306 A.D. until his death in 337, fathered six children with his two wives. He had a close working relationship with his eldest son, Crispus, who oversaw many of his father’s military campaigns. For reasons that remain unclear, Constantine ordered his son’s execution in 326; Crispus’ name was erased from official records and monuments dedicated to him were destroyed. 8. Thomas Boleyn Born into a noble English family around 1477, Thomas Boleyn spent his career currying favor with King Henry VIII, earning a succession of prestigious appointments. He may have had a hand in the romantic involvement of both his daughters with Henry, who first had an affair with Mary Boleyn and later pursued her older sister, Anne. As Henry’s obsession with Anne grew, so did Thomas’ standing in court, and some have speculated that he pressured his daughter to insist on wedding the king, who was already married at the time. Three years after the controversial marriage, Anne, having failed to produce a male heir, fell out of favor and was beheaded for high treason; her brother George suffered the same fate. Thomas, meanwhile, had done nothing to protect his two children despite his influence and the fact that they were almost certainly innocent. "Ivan the Terrible Killing His Son" by Ilya Repin. 9. Ivan the Terrible A successful czar who expanded the borders of his realm but was probably plagued by mental illness, Ivan ruled Russia from 1533 until his death in 1584. It is likely that his nine children suffered years of abuse at his hands. In 1581 he beat his pregnant daughter-in-law as punishment for wearing revealing clothing, causing her to miscarry. Her husband, also named Ivan, angrily confronted his father, who had banished his son’s first two wives to convents after pronouncing them infertile. Incensed, the czar struck his heir on the head with his scepter. The younger Ivan died a few days later as his remorseful father prayed by his bedside for a miracle. Credit: Hulton Archive/Getty Images 10. Herod the Great King of Judea from 37 to 4 B.C., Herod is remembered as an ambitious but cruel and paranoid ruler who infamously ordered the executions of several members of his own family. These included his second wife, his mother-in-law, his brother-in-law and three of his sons. Share Tweet Share Pin Forward The Worst Father's Day Gifts EVER! Source: www.krforadio.com Share Tweet Share Pin Forward Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351
  3. View this email in your browser Celebrate National Garden Week June 6-12th, 2021! The healthy benefits of gardening for seniors cannot be overstated. Research studies have consistently shown that physical, mental and emotional improvements are but only a few examples of the benefits of gardening. There is an innate sense of control over one’s environment and the task of cultivating new plant growth is often predictive of good health and higher quality of life among the elderly. The benefits of gardening for seniors include: Exercise and burning calories. Planting and pulling weeds can help you burn 200 to 400 calories an hour. Gardening gets the body moving by requiring some bending, squatting, stretching and pulling. Muscle-strengthening. You don’t have to push around a heavy wheelbarrow to keep your muscles from weakening. A few hours of gardening per week will give you the workout you need. Vitamin D. While you don’t want to overdo it, a few hours of exposure to sunshine will give you more vitamin D than your nightly glass of milk. Stress-reducing. Gardening increases hand-eye coordination, which helps to keep the brain and body in sync. It also lowers stress-producing cortisol levels and raises serotonin; a calming chemical in the brain that puts you in a good mood. Decreases risk of dementia. The physical demands of gardening and critical thinking skills regarding what to plant and how to take care of it keeps the mind active and engaged. Adaptive Equipment Some elders may need a little help to comfortably take on the physical tasks required to garden and there are many ways to alleviate or reduce some of the physical challenges that come with the territory, regardless of whether you suffer from arthritis, back pain or are confined to a wheelchair. Here are some suggestions that should help minimize the physical challenges of gardening as well as some tips on better gardening practices: Raised Beds Middle-aged backs easily get stiff and sore if they're not given the proper care. Waist-high raised beds are one way to eliminate bending altogether. With tall raised beds, seeding, weeding and harvesting are a snap. But beds that are only 1' or 2' off the ground can make gardening easier on the back too. Vertical Gardening Cucumbers, squash, melons, beans and many other vegetables grow well when trellised. Patrolling the garden for bugs, spraying and harvesting are all easier when everything is within close reach. Kneeler Stool A kneeler stool has a thick foam pad that's comfortable on the knee joints. And it has hand grips that make it easier to get up from a kneeling position, since you can use your arm strength to help you stand. Once you're up, flip the kneeler over and it becomes a comfortable stool to sit on while tending your plants. https://www.diynetwork.com/how-to/outdoors/gardening/easier-gardening-for-seniors Safety Outdoors Being outside for even a few minutes can be a hazard, especially in later years, follow some simple outdoor safety guidelines. Wearing sunscreen. Even when the sun doesn’t feel especially hot, ultraviolet rays may lead to red and burning skin. Severe sunburns can be serious. Latching gates and repairing damaged fencing. This will help keep unwanted animals out. Securing the area also is important if memory loss or wandering is an issue. Keeping a first-aid kit handy. Tend to cuts, bruises and insect bites as soon as possible. Storing all gardening tools in their proper place. Spades, trowels, rakes and the like can be tripping hazards. Take special care when handling electric and battery-operated power tools. Knowing your limits. Especially when you’re outside gardening in hot weather. Take needed rest periods and encourage ample liquid consumption to keep your residents hydrated. Gardening Tips No matter what you plan to plant, set yourself up for success by following these tips: When planting outdoors, determine what works best in the sunlight or shaded areas of your garden. Flowers, fruits and vegetables grow differently in various soils. Have a water source nearby to more-easily irrigate plants if they are not getting enough rainfall. A light watering can or hose is perfect. Add 2-3 inches of mulch around each plant to help keep moisture from evaporating and pests at bay. Plant food or fertilizer may or may not be necessary, but if you use it, go organic! Tools to have on hand include a spade, hand trowel, clippers, gardening fork and thick gloves. The health benefits of gardening for seniors don’t stop once everything is planted. Make sure the garden is “senior-friendly” by setting out comfortable chairs or benches underneath shady areas. Rest and check out the scenery! Tend the garden in mornings and evenings when the temperature is cooler. Wear gardening gloves, solid shoes, a wide-brimmed hat and sunglasses. When you are watering and pulling weeds in the hot sun, be sure to stay hydrated! Drink a lot of water. Meaningful Engagement All Year Round Bring the Memories of outdoor Garden success indoors in the winter. Plan to bring the outdoors back inside when the cold weather season returns. Create programs to dry the past summers garden bounty of spices to keep throughout the winter months to sprinkle and make food tastier. Plan programs that dry cut flowers from your summer garden to craft beautiful framed flower art for the walls to remind your residents of their personal garden success stories as an avid gardener. Potpourri Create a potpourri mixture of dried, naturally fragrant plant materials, used to provide a gentle natural scent. It is often placed in a decorative bowl. The word "potpourri" comes into English from the French word pot-pourri. https://www.youtube.com/watch?v=yXdTuNuLcbM Sachet Bags You can also make scented sachets bags to collect those wonderful summer scents to promote sensory engagement. A small scented cloth bag filled with herbs, potpourri, or aromatic ingredients. A sachet is also a small porous bag or packet containing a material intended to interact with its atmosphere; for example, desiccants are usually packed in sachets which are then placed in larger packages. https://www.youtube.com/watch?v=0sDylb2Y4Iw Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351
  4. View this email in your browser The Unsung Hero of Long Term Care Facilities The COVID-19 pandemic has come in like a lion (through infection); ruthlessly and relentlessly devouring the physical well being of the individual from which this disease takes claim. The other less recognized, less publicized, and profoundly less understood yet equally sinister devastation bestowed by this infection is the retaliatory affects of social isolation and other psychological stresses affecting our aging population living in nursing homes during this pandemic. In addition, the sudden onset of COVID-19 has unceremoniously and expeditiously eliminated the once familiar daily routines that residents have come to know and expect. The Challenges The impact of current pandemic related stressors and social isolation cannot be overstated. Facilities have justifiably but abruptly ended group stimulation, social interactions and temporarily paused self-directed choices that have been deemed necessary to reduce high risk infection spread for facility residents and the staff. Long Term Care Facilities’ residents suddenly and unexpectedly find themselves confined to their rooms without social dining, interest based group pursuits, and no longer allowed to have in-person family visits. Emotional disruptions of such magnitude may perpetuate mental health conditions such as, post-traumatic stress (PTSD), depression, loneliness and anxiety that may lead to life-threatening status and failure to thrive. Highly elevated emotional stressors may be detrimental to the functioning of the individuals’ immune system. Additionally, elevated loneliness, anxiety, and unrelenting fears may further lead to a number of deleterious consequences, such as high blood pressure, depression, and suicidal thoughts. The Unsung Heroes Claim Their Place Amongst the tenacious and dedicated nurses, doctors, and therapists is a member of the Interdisciplinary Team that goes unnoticed. These healthcare professionals work day in and day out in the midst of this pandemic to support the emotional health of our elderly population living in Long Term Care facilities. These are the Long Term Care nursing home “Unsung Heroes” of the Covid-19 epidemic. The nursing home Therapeutic Programming Professional takes responsibility for resident “engagement” and partners closely with the other IDT members in the continuum of care dedicated to delivering “whole health and wellness”. These professionals create facility programming intended to support the residents’ emotional well being which in turn, greatly helps to reduces imposed epidemic related stressors. Consequently, leading to better immunity and that is a “golden ticket” with unlimited value. These professionals focus on the residents’ personal interests and individualized needs. They create the pathway for each unique resident so they may continue enjoying the same leisure quality of life interests which they had previously come to treasure during their lifetime. Supporting the residents’ choice to continue enjoying deep roots preferences allows them to continue being connected to their personal identity well into aging years. The Spirit to Succeed One can only imagine the immense challenges brought on by the pandemic social distancing and mask infection control practices or the spirit and tenacity these professionals must draw upon to support and maintain resident connectivity at a time when imposed limitations curtail even the best of those well laid out plans. These programs may help residents spend time constructively, thereby decreasing loneliness and anxiety while maintaining social distancing. In addition, these trained professionals collaborate with the clinical staff and therapists to utilize clinical & psychology approved therapeutic approaches. Here are several suggestions to help reduce social isolation and improve engagement with residents: Non-group or solitary interventions, such as laughter therapy, horticultural therapy, and reminiscence therapy, can be more effective in reducing residents’ feelings of loneliness. Staff have transformed into surrogate family members with frequent and more lengthy contacts. Have them wear photos and name tags on top of their PPE. Regular video chats with family members facilitated by social work and/or therapeutic programming staff is essential. Regular telehealth visits should be provided by doctors and other therapists. Celebratory, fun, and interesting snacks, treats, and programming (e.g., music therapy) can be brought to the door, room, and bedside. Drive-thru family visits to the facility can be set up, using masks and social distancing. Offer in rooms stimulation via video and/or closed-circuit TV. We must remember that ALL front line caregivers are true heroes, facing daily stress that can be overwhelming for the benefit of those they serve. Heartfelt gratitude to every healthcare “Essential Personnel”! Whether in Long Term Care or Hospital Critical Care, it cannot be overstated that family members and close friends lack adequate words, in any language, that will sufficiently convey the level of gratefulness and thankfulness to those devoted nurses, doctors and therapist and Therapeutic Programming Professionals that remain dedicated despite potential exposure and personal risks. From each and everyone one of us! https://www.psychiatrictimes.com/view/the-impact-of-covid-19-on-mental-health-in-long-term-care-settings Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org Buy Now We Proudly Support : Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network. Copyright © 2021 Activity Directors Network, LLC All rights reserved. Our mailing address is: 2010 US HWY 190 W Ste 120 Livingston, Texas 77351
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