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Trouble Areas


What are your trouble areas? If other please post below... thanks Pennie  

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  1. 1. What are your trouble areas? If other please post below... thanks Pennie

    • In Service Meetings
    • Participation Records
    • CarePlanning
    • Mens Activities
    • QA Quality Assurance
    • Regulations
    • F-Tags
    • Bed Bound Residents
    • FPA Facility Population Assessment
    • Newsletter and Calendar

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It seems like there is always an area that we have trouble with (questions) and can't seem to get any answers to.

1. Ex: I remember that when I started out my area was Care Plans. I just could not understand them and was unable to get the answer that I understood.

So is there a trouble area for you, that we all share and just don't realize it?

2. I did buy books on CP's but none of them seem to help me. I also bought books on In-room activities. I would love a book on Policy & Procedures.

3. My "Bible" is the MDS book, & I like the ones that help me with the required paperwork we have to do.

This is just a sample of how to answer te poll questions.

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Definetly Men's Activities. Since the population is so small, and men have a "particular way about them" I need guidance with approach and followthrough.

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Mine is QA. I have the hardest time finding new idicators and setting them up. I think a book with examples and all the set up would be great.



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Care Plans remain a mystery. I am not good at writing goals. I have bought all the books but they have not dealt with the problems of my residents. I definetly need a policy and procedure book. I need something to take to the Administrator because he does not have a clue of all the things an AD does.

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Definetly Men's Activities. Since the population is so small, and men have a "particular way about them" I need guidance with approach and followthrough.

Mens Activities... this is an area that was hard for me... I figured out over the years that it wasnt the activity, men are simple... (Jeff Foxworthy said "men are simple, just give em a beer, and something naked. and they're happy") they dont want to play bingo they want to build a new bingo table, they want to be useful, to work, to be thanked and praised. They have lost they're position in the world, and just like youth, they want it back... badly.. if only for a second. I always approached my men residents as my doers, my work force, my "get er done" guys

I didnt stop by their rooms to ask if they wanted to play bingo, I asked them to help find something for the next activity, or help prepare the room for a meeting ... guys like nothing better than to help a lady in distress... my male residents were eventully always out and about looking for ways to help. Bird houses to hang, ballon wreaths to make... once they were out and among one another the Domino Competions started the football parties, NASCAR, projects etc.. they wrote their own activity plans....


have fun :hammer:

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On Men's activities....


I may be using a simple answer, but I have foud the best way to program for men is to ask them. Most of my guys were in leadership roles. So when I first started I tried to make them happy and let them lead or be in a position of power.


That did not work. I found that most folks, whether they are men or not. Prefer to be heard.....that is, they did things in the past and the best way to get them involved is have an activity that they did in the past. So sit down and talk to them. Get feedback on what they did and ask them what they miss, what they want to explore, what they need. That is the best way for me.


Now, I am a guy, so there may be an advantage for me. So I will relate the way that I program for my ladies. The same way!


Now, I said that was too easy. So here is the worst case scenario.



I have found that if you get other residents on board with what you do, they can be your best recruiters. I have several residents that I assign to my "hard to reach" folks. These residents will go talk to the difficult ones for me and that way it is a little easier to break the ice.


Hope this helps.



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  • 2 months later...

:hammer: My trouble area would definatly be the daily activity log. Who participated in what. The company we are with require us to use a certain form. The only problem is, The form stinks!! It has all these items on it. But most of them are not applicable with my residents. There is absolutely no way to Personalize it. So half the time, it looks like they are not doing much. if anything at all. I tried a different form one time, and got in trouble because it wasn't a "company approved" form. I have also tried to explain this to company people. Do they care? no, they want the approved form and everything else be.. well you know. Sometimes I feel like I'm slamming into a brick wall. (of course that could very well be what their heads are made of!) :-D Any ideas would be soo greatly appreciated.

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  • 2 weeks later...

8-) I don't know about you guys, but for me the hardest thing is bed bound or 1:1 visits. If 1:1 visits were genuinely "bed bound" that wouldn't be my problem...it is having so many 1:1 visits due to the fact that staff either will not consistantly get residents up, or they get them up to a recliner or the like within their room which just reinforces isolation.

I have tried different groups to help with this problem and I found that it did not help....it is as if they (CNA's) resent being asked to have residents up for specialized groups. I always try to be polite and friendly - anyone have any ideas on this? How 'bout you BigChris? You are so informative at our state convention.

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  • 2 weeks later...
Guest janna

hey guys, i was wondering if you can help me out a bit...

does anyone of you know any agencies that use "Reminiscence therapy" as an activity or a therapeutic program in order to increase individual's socialization..?


thanx for your time!

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  • 1 month later...
8-) I don't know about you guys, but for me the hardest thing is bed bound or 1:1 visits. If 1:1 visits were genuinely "bed bound" that wouldn't be my problem...it is having so many 1:1 visits due to the fact that staff either will not consistantly get residents up, or they get them up to a recliner or the like within their room which just reinforces isolation.

I have tried different groups to help with this problem and I found that it did not help....it is as if they (CNA's) resent being asked to have residents up for specialized groups. I always try to be polite and friendly - anyone have any ideas on this? How 'bout you BigChris? You are so informative at our state convention.

I have been in your postion as I am sure alot of others have too. When you get to many 1:1/s and In-rm visits it is just about impossible to get everything done that is required. So I finally had to take a stand for myself. During CP meetings I wrote CP's that stated res. would be out to certain act. on certain days and times. I made sure I had a selection so that I could see if one shift was more willing to get res. to an act. than another shift.

The approaches stated that CNA's would ass't res. to act, have res. out of bed (OOB) an ready etc..

of course I kept daily part. records and if the res. was not at any of the act. I would check after it was over to see if s/he was OOB, or what happened. And I write on the Part. records under that res. name why they did not attend. I placed the blame where it needed to go. Next CP meeting this was discussed sometimes it brought about changes and if it didn't I tried to speak with DON, ADON and/or Admin. However when State came in they saw the Part Records and sometimes a defiiciency would be written up but not on Act. but nursing.

I will bend over backwards to help any other person/dept/staff I give them all respect but in turn they must also respect me and my dept. Sometimes you have to fight back to get this. Hope this helps in some way. P

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The hardest part of my job is NOT being able to do the activities. We have meetings, conference calls, appts to run, volunteers to orient and recruit, supplies to buy, plans to make, newsletters to publish, calendars to publish, marketing, hospital visits, entertainers to book, budgets to establish and maintain, networking, bla bla bla....bla bla bla...you get the idea ;-) :-o


There is a reident here that is very vocal about thinking that I do NOTHING around here because I am not leading the activity, calling bingo, or whatever. Whe is always telling me that I am the Activity Director but I never do my job....I always deligate it out. I can not argue with her because there are days that this is true. I also can not argue with her because I agree with her. I try to make a joke out of it by saying "I know...all I want to do is play BINGO and they are making me go to another meeting". I know that my role is what it is and I can not pend the day playing games and such but I still WANT to.


Another thing is that it is company policy that our care managers do the activities. If I have a spare minute I play bingo with them or excersise with them (as the are manager leads it). Also, I implimented a program where all of the Department Heads (and anyone else who would like to...ex the beautician) lead at least one activity a month. I make sure I am always the one to go on any outing with either of our neighborhoods so that I at leaste get to spend that time with them. There are times that I think I would be happier as an assistant so that I would get to spend more time with the residents. I know I will not go backwards in my career but sometimes I do daydream....LOL.


Just a vent....I will get over it.



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Guest Tinki

I believe it would work well to have to AD in Nursing Homes. One that is required to do paperwork and meetings and one to implement activities. I have found through my classes that some AD's love the paperwork side and some love being on the floor. I guess it has to do with your strengths as an AD. It would be nice to be hired knowing that you are going to do most of one or the other. I know I would be happy with one or the other but not both at the same time. It seems extremely difficult to complete both task.


Overall, it seems that it is the resident whom ultimately lose out.


Karen :cry:

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I find it difficult to provide support for bed-bound residents. Our policy is that no students or volunteers can be in a resident's room unattended so it is very difficult to do anything other than one-on-one's done by myself.


I'm actually excited now doing the participation charting after reading about a new format right here on this site. I use my calendar and highlighting system, and it is so easy, and tells more about how a resident spends their day!

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Guest tigger

Hello to all and thanks for all the advice I get from this web site. I also have a problem with my 1-1 program. And that problem is no time. I work in Oregon and the good thing is I can have my 1 and only volunter do my 1-1s. but she is only here 1 day a week. and I have residents that get a 1-1 twice a week. I am the AD and the assistant. We are now in survey,, lol,, I had an outing planned so I could not change that. I also had 4 raps due. A CNA. did not show up for the am shift so I got to start getting residents up. Did not have time to do my raps before the outing, got back from the outing 30 min. after my shift was over. I did have time to have a chat with a surveyer when she asked me to. She wanted to take about my 1-1 program of all things. Any advice would be helpful. This is my first year to be the AD. Im hoping I said everything right to the surveyer. Im a little stressed out tonight. :-o

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Hi, Folks!


I just have to get my 2 cents worth in on analyzing men's activities. Here is the problem with men compared with those of women.... :pint:


If you are a MAN...


Your last name stays put.


The garage is all yours.


Wedding plans take care of themselves.


Chocolate is just another snack.


You can be President.


You can never be pregnant.


You can wear a white T-shirt to a water park.


You can wear NO shirt to a water park.


Car Mechanics tell you the truth.


The world is your urinal.


You never have to drive to another gas station restroom because this one is just too icky.


You don't have to stop and think of which way to turn a nut on a bolt.


Same work, more pay.


Wrinkles add character.


Wedding dress $5000. Tux rental-$100.


People never stare at your chest when you're talking to them.


The occasional well-rendered belch is practically expected.


New shoes don't cut, blister, or mangle your feet.


One mood all the time.


Phone conversations are over in 30 seconds flat.

You know stuff about tanks.


A five-day vacation requires only one suitcase.


You can open all your own jars.


You get extra credit for the slightest act of thoughtfulness.


If someone forgets to invite you, he or she can still be your friend.


Your underwear is $8.95 for a three-pack.


Three pairs of shoes are more than enough.


You almost never have strap problems in public.


You are unable to see wrinkles in your clothes.


Everything on your face stays its original color.


The same hairstyle lasts for years, maybe decades.


You only have to shave your face and neck.


You can play with toys all your life.


Your belly usually hides your big hips.


One wallet and one pair of shoes one color for all seasons.


You can wear shorts no matter how your legs look.


You can "do" your nails with a pocketknife.


You have freedom of choice concerning growing a mustache.


You can do Christmas shopping for 25 relatives on December 24 in 25 minutes.


No wonder men are happier!


(Received in an e-mail)


Have fun! ;-)

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Hi Tigger,

Your survey my be over now as it is friday, if so hope all went well. It is hard to do everything yourself, especially when you are new AD or at a facility. But the fact is that without working way beyond your 40 hours a week it usually can't be done. This leads to so much stress, effects your home life and eventually leads to burn-out. So the best thing that could have happen to you (most of the time, depends on admin attitude) was for state to be in the facility. Because this can show that you alone can not meet all of the needs of your res. and what is required of you by state and the company policy. It is the prefect time to ask about getting an ass't in there to help you out. Use this to your advantage. Sometimes you have to take the slap on the hand prove a point. If you do all of the work yourself then the powers that be will let you do it! Let us know how you got by.


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  • 4 weeks later...


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  • 2 weeks later...

We have a new Director of Care. She wants the tiles on each entrance before each room iwith the persons name in Hostel to be removed and replace with something else. Showing the residents name. Any suggestions for me please? What do you use.

Krysia (Based in Australia)

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Hi Hrysia,

I don't know exactly what you are looking for but a couple of things I have done or seen done:

Placing a picture of the resident along with their name outside the door. The pictures are placed into a plexiglass frame that is mounted on the wall/door. This way the pictures are easily changed by sliding them in or out.

The other thing I saw at another facility that O loved was a shadow box outside of the residents room. This was mounted in the wall, either some money would need tobe spent to do this or make some shadow boxes up to mount on the wall. Each resident had one outside of their room inside was a place to put their name and a few special items that means something to that resident. (Ex: Mrs. Smith collected or loved to sew so hers had needles, pin cushion, small amouth of material etc.. Mr. Smith displayed pictures of his grandkids etc..) The family members bring up the items that go in these boxes. The boxes lock and can only be opened up by certain staff people. I really loved these and when you walk down a hallway it was interesting and had a welcome feeling. You got a feel of the people who lived in those rooms and what a great conservation starter. Even after all of these years I still remember the facility because of this!

Hope these are useful. P

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  • 4 months later...

What a wonderful group of people you are. After reading some of the posts I decided to reply.


I have been an Activity Director for 15 years. I started in a 40 bed long term care facility and now I am in a CCRC (health center, assisted living, alzheimer's unit and Independent living community). I have experienced many of the same things you have or are experiencing.


For the Director who feels bad when a resident says she isn't doing her job because she isn't leading activities. Does the Director of Nursing give medication? Not in my facility! I plan four activity calendars a month and DIRECT my staff to lead those activities. I do some here and there but not often. It is necessary for me to be at meetings, complete documentation and do the planning that my staff cannot do. It is also necessary that I teach my staff to lead the activities. One of me, six of them, they cannot do my documentation and I cannot do both my job and theirs. I finaly did a managers coffee once a month where a manager met with residents, had coffee and explained what their role was. It has helped many directors in our facility.


One on ones: Volunteers! Put a FREE Training Ad in the local papers, or a free public service announcement on local radios. It is worth the leg work and hours spent training and directing. Have volunteers tell you what they like and put them in the right role, they can save you hours of work every week. Their varied personalities also make for wonderful one on ones for the residents.


Men's Group, get men in your facility to lead these, our men do not want our female staff. Administrators, Environmental services, local VFW, Local Fire department, Local churches (put it in their bulletins). Let them meet with the man leading te men's group and discuss what they want to do, if they want munchies, etc. then at the next men's group the same male leader does it with them. All it takes is for one man to love it and lead it weekly!



Documentation Attendance

Copy your monthly calendar onto a word document (make font smaller), with a space at the bottom of each day paste in that space; One on one TV self/ Lounge Supplies_______ Visitor Socialized Music Read

Every resident has a calendar with their name on it in the attenance book, (tabbed by last name, one book for each unit). My staff must HIGHLIGHT what activities the resident attended and next to it write a code for participation (A V= active verbal. this usually is for discussions, trivia, etc. O=Observed others, etc).

Sounds strange but I have used every attendance form I could find, until I started doing this. It is easier for your progress note documentation, especially if you set weekly group participation goals. They highlight One on ones and know they must turn the page over and write the date and brief note of what they did. Showing that a resident constructively occupied themself also is important so they higlight if they read or watched TV, etc. I type up these Attendance records, I make copies, My staff puts them in the attendance books and thins the books (leaving the 3 past months for my progress notes).


Hope some of this helps someone.


Hugs, tam

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  • 3 weeks later...
Guest Tinki

Please don't forget to vote, I want to submit this statistical poll into the Activity Director's Quarterly!



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  • 2 weeks later...

My trouble area is Sensory Stimulation for my 3 residents who have a DX of Semi-vegetative state from Closed Head Trauma. They range in age from 22 to 53. I have been using the same programs for several years and have run out of ideas and resources in my area are quite limite. We are located in South Central Oregon and do not have access to alot of the materials available in the bigger cities. I would appreciate any ideas for either Sensory Stim. sessions or materials. Thanks, Salgal

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You probably have used some of these things but just in case here are a few:

Tapes are a good way to stimulate them here are a couple of companys you may want to check in to

Resource: Tapes, music of all kinds

Recording for Recovery

413 Cherry Street

Midland, MI. 48640



Our Daily Bread

Radio Bible Class

Grand Rapids, MI 49555


Also use ice chips to rub on their lips and other body parts, watch for a reaction. Lotion on the hands, legs etc. use different oils for therapy:

Camomile: relaxing the mind & body. Sedative for anxiety & muscle tenderness

Benzoin Tincture: Warm, soothing, comforting oil. Add to a cream for protecting skin against chapping or cracking.

Camomile Roman: Strong soothing effect on the body & mind. Calms nerve, soothe headaches, and relieve insomnia & relives menstrual disorders. It can be used on inflamed skin conditions.

Coriander: Good massage oil blend to relive stiffness & muscle ache. In the bath refreshing & stimulating.

Geranium: Balancing oil for mind & body. Relaxes, restores & maintains stability of the emotions. Good for massages, treating eczema (itching skin inflammation with oozing & crusted lesions) & psoriasis (red patchy skin disease covered with white scales). It blends well with floral oils & mixed with lavender & bergamot produces a good room freshener.


Sitting and reading to them helps

hang up mobils and pics in the room

Brush their hair

I know their is alot of other things that you can do but maybe some of these will be new for you & them.

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Halmark has these neat ornaments that shine like stars and other shapes on the ceiling. These are good for the residents in gerry chairs to watch while they are reclining. They move around and create a very relaxing scene. You might have seen the comercial for them?


Pet therapy is good for all levels. There is a nice lady here that does not respond to much at all...but everytime we have animals around her, we get a reaction.


Laughter therapy is good for all levels, as well.



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