Trouble Areas

[Guest Guest_Tricia]

Hello All,

I've just read all of your problem areas, and was just wondering if anyone was having trouble with "younger residents"? You know those that are between the ages of 30 to 50. I have 396 residents, and about 50 of them are under the age of 50. They just don't want to participate in the typical nursing home activities.

So what I try to do is send them out 3 to 4x per month. But now I'm having a hard time getting them to go out on trips. Any suggestions? :-o

[Guest Pat8231]

Hi Tricia - My experience working in a 290 bed SNF, only 3 were younger. I tried everything but nothing worked. They felt sorry for themselves being in a SNF to start with and I couldn't change their minds. I offered cards, checkers, books nothing worked. I would just talk to them about anything in general. Just getting them to open up was an accomplishment. The three use to sit together and chat. From my prospective there isn't much you can do. I just relaxed a little and stopped worrying over them. Eventually, the three got to be friends and stuck to themselves. Hope this helps a little.

[mamachapparra 0]

My problem area is the sensory stimulation groups any ideas that really work for anyone?? Please I could use any and all ideas that work. Thank you, Ann Ortiz

[Guest KathyA]

I have both younger residents and 52% male population. So the challenges that we have may help you. First you have to really find out what the folks are interested in, hobbies, dreams, favorite sports programs, favorite teams, favorite snack foods, favorite drinks, carpentry projects they have done, fish that they have caught, wild game that they have hunted, places they have been, Military services, favorite movies, favorite memories and what exactly they did for a lving. So if they name the company they worked for, you have to find out what they did for that company.

For my younger ladies the same stuff applies. The more information that you can get from them and their family the better.

Then you have to do some research on Baby Boomers (those brought up in the 40's and 50's). There is a ton of informaiton on the Internet. A simple search will help you find out their lifestyle. They are a sedentary group right now (not like the folks that you will get soon) and enjoy movies, old TV shows, educational programs on fishing, cooking, gardening, self improvement. They joined groups and played cards. They had TV and radio, they saw a Man walk on the moon and went to the 1964 Worlds Fair with their kids and saw the future.

So take a step back, get rid of the Bingo and get out the Trivial Pursuit. Stop the crafty projects and hire a retired professor to come and teach a class on the history of TV. Go to tag sales and buy the knick knacks that date from the 40's and 50's for a Sensory Program. Research favorite foods, forget the Smoothies and go for the real Milkshakes. Forget the home made chicken and get s Swanson Frozen Dinner with a real TV Table.

For the guys, go to a Custom Car Show, get sons and nephews to come in for a Super Bowl Party complete with wings and beer. Watch old war movies, sit around a campfire and just talk. Listen to Talk Radio and talk to the radio! Have a political discussion! Old radio shows...nope......old TV shows absolutely!

[mamaweg 0]

We just had a mock survey where the ED, DON and ACU director from another facility spent the day with us and wrote out tags they found. I got my first tag ever. It seems my more cognitive residents complained that I wasn't offering activities at their higher cognitive level. I ask them at Resident Council all the time what they want and I get nothing. The last meeting the president said she would like to see more bible study. They agreed they would like to hear about St. Valentine. I did my research and not a one of them would come. For SuperBowl we have a large screen tv, I bought NA beer, chip, popcorn, peanuts etc. I put the sign out using a 'higher cognitive' resident's name as the host. No one showed up. I'm at a loss as what to do. They won't tell me or what they do tell me they don't come to. Any ideas???? I'd love copies of other facilities calendars to get new ideas or show my ED that I'm not that out of line from what other places do.

Dianne_Wegner@beverlycares.com

Thanks for any help!!!

[Pennie 26]

hey all

if you have not become a member on the activitydirector.com area you should think about it. The cost is reasonable and it address many of these troubled area like bedbound, men's activities, CP's and much more. I hope to see you as a member soon Pennie

[martiniques_mommy 1]

I think the hardest for me is not on the list. It is the progress note. I am not 100% sure if I am documenting enough or too much. What to add, what not to add! Is there a template out there somewhere?! :-?

[Guest Guest_Dajuan]

:cry: Hello everyone, My problem is the new population.

 

In my facility Iam faced with the problem of having a population that is 70% 55 and under. It is so hard to come up with activities for such a population. Its like if I dont offer anything that is of personal benefit like food, prizes, or socials I can't get any participation. I can only document so much Independent leisure, GUYS I NEED HELP :cry: :cry: :cry: :cry:

[Guest Guest_Judy]

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.

Hey

Try a Men's club to have unique ideas and activities just for them.

Gardening

[sandylou 0]

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!

 

Hi,

I use it at least once every two weeks, with men and women alike. It works very well. How can I help you?

Sandylou

[faithbygrace 0]

Hi everyone! It sounds like everyone has their share od AD blues. Since I am new in the field I can only give advice from my old career field. Which was Early Childhood Development. Owning and Directing for 13 years and being in the business for 22. The one thing I found out was Time Management plays an important role in how successful you do your job. I took many classes on Time Management and still take them when I find them. Everyone has their techniques on Time Management. I have learn from all the ones that I have taken.

 

How I use to get my teachers to do what I needed them to do. I would make a contest out of it or award them. Have each Nurse Station compete with each other in who gets the most residents down to activities. The one who wins gets pizza for lunch, a cake or something. I made my teachers feel important. AD need to make the CNAs feel important. I have found out that alot of CNAs do not think their job is important, they are "just" a CNA. I would make sure I compliment the ones that DO help. Treat them to a little gift. I get alot of chapstick, lotions, etc. from Avon when it is on sale. It saves me from burning up gas looking for stuff. Invest a little time, praise or monies in the CNAs and you might get more help than you need. Hope this helps...

[lemark 0]

My company also requires special forms for activity attendance which do not list all the activities we have at our long term care facility. Like you, I have complained to Corporate; they listened to my reasons and I have heard nothing back (3-4 months ago!). My solution is not the best, but here is what I do: I cross out several activities on the form and write in activities we do use. For example, I cross out "Computer" and write "Cognitive." There are several blank lines at the bottom of the form; I use one to document 1:1 visits, and the other we use to initial each days' documentation. (Is it weird that the form would not have a place for staff to sign? Shouldn't every piece in the resident's chart be signed by the staffperson responsible for the information therein?) This is not a perfect solution and probably breaks some corporate policy, but right now it's what I'm doing. I definitely want every activity to be accounted for and documented. As they say, "if it's not documented, it didn't happen."

[Jen 0]

I also have a corporate form for attendance that I have to use, but I have doctored it so it fits our programming better, but I also circle a claendar for each resident. State wants to know from our progress notes what exactly the resident is engaging in, not some general stuff, & I need to know what programs are successful by if residents are attending them. It's double work, but I don't think there's an alternative.

[faithbygrace 0]

Hi I am new at this and I was wondering if anyone could fax me a mock budget for a year, a quality assurance form,a policy/procedure for the activity department and how you carry it out. I am going to school and these are some of the things I need for class. I hav eno ideal what these are or how to do them. Can anyone help me with this? Thanks!!

[turtle 0]

Hi I am new at this and I was wondering if anyone could fax me a mock budget for a year, a quality assurance form,a policy/procedure for the activity department and how you carry it out. I am going to school and these are some of the things I need for class. I hav eno ideal what these are or how to do them. Can anyone help me with this? Thanks!!

Hi faithbygrace. I would be willing to share what we use with you. I could fax it or send it via e-mail, whichever works best for you. Let me know. Have a wonderful day, Heather

[soduspoint 0]

Hi faithbygrace. I would be willing to share what we use with you. I could fax it or send it via e-mail, whichever works best for you. Let me know. Have a wonderful day, Heather

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

[SaHarris 0]

Help!!! Its my third week on the job and state walked in!! I am used to state surveys as being an assistant but not as an AD. The lady that worked here befor me was gone for a month befor I started. NOBODY was doing the asssesments, CP, or notes. So I started off behind. Does anyone know what kind of questions they will be asking me???

[Largesse 0]

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.

 

Idea!!!!

Next time you have a small group activity provide each nurses station and DON and ADON with whom you would like to attend. Post it in the nurse book and for the CNA'S to see the day before.

Choose two Resident's from each wing. Give out a small prize and post a group photo of the staff and tell why they are be honored. Encourage postive

Team work. One on Ones are hard. The state will write your department up for not meeting their needs. Provide a In-service on One on One

activities. The staff is always short and we must remeber communication and always treat all staff with the up most respect. Try this for three

months. The Don and Adon should be aware of how many In-rooms from your MDS and care plans. No one should be "Bed bound" Yes, Resident have skin breakdown It is very rare for A resident to be in bed all day. I have only know of Two per family request. Read all the charts and

Doctor's orders when resident return from the Hospital and during care plan meetings. You can get them while they are waitng for bath or before they get weighed.Finding the time is hard.

 

Build a volunteer program and choose the right person for each Resident for One on One Activities. You do not want to loose a Volunteer

becuase you did not match the right person for your One On ONe Resident

This will be hard if you do not have the man power outside your home. Good Luck. I know what you are dealing with.

[Largesse 0]

Help!!! Its my third week on the job and state walked in!! I am used to state surveys as being an assistant but not as an AD. The lady that worked here befor me was gone for a month befor I started. NOBODY was doing the asssesments, CP, or notes. So I started off behind. Does anyone know what kind of questions they will be asking me???

 

 

Congradulations on the new job!

Only give them what they ask for. Have these copied and ready to give Monthly calendar, Resident's council notes and all forms that you use, new ones. The Resident log should never be grouped with other Resident for keeping track of daily involment in grp participation.

The state will ask you about CP, Asssesment, MDS and Daily logs of Resident's Activities. The daily log is how we measure a care plan to see if we have accomplished the goal or will continue the approach another 90 day period. HIPPA Laws. Policy and Procedures in your Home

They will ask about "what is Abuse and Neglect" Resident's council notes, where are the state signs located for the Family and Resdient's if wanting to contact the State Department, who are your "bed bound" Resident's, Who is diabetic and on thick-it. If you do not know the answer or question from

previous state visit go ask the Department Heads. The state will realize you are new and will give

advice durning the exit meeting of what needs to take palce, if your Department is sited. You should be at the exit when full book is done. You can only change what is in your control at this time. You can do nothing from the past except correct it. I have worked as the AD, Abuse COR. Plan of corrections, Fire safety and Adm staff all at the same time. You will learn as you go and already know a lot when you where the Assistant AD. Read the chart, not just your section.

Care plans have time limits and sometime Department heads can only share so much information. If you do not know all the family members

call them, Have a meeting for the famlies to introduce your self without the Residents.

 

I stay at home. I soon will be going back to work when my daughter is 5.

I love working as a AD. I worked at the same place for almost 12 years. If you have any question e-mail me.

Good Luck,

Shelly Turman

mturman@austin.rr.com

[HirschmC 0]

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.

 

One of my favorite ideas for bed bound is hand massage with lotion. It really seems to relax the resident and they open up and talk. It is also a good intervention for depression or just giving comfort. Also depending on cognitive ability, oral crossword puzzle at bedside. They are so proud when they know the right answers. Crosswords come in varying difficulty.

[January08 0]

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

 

I definitely say it's the newsletter and calendar. I know I'll be expecting my AD to ask me to write a newsletter and prepare the monthly calendar one day now that I'll be finishing my this course. That will be my test from my boss. If I were to be asked to do such thing, this will be my first time. I know she will be guiding me but I am sure it will work out after sometime. I know she is a good boss but I don't feel comfortable about it. Well, there is a saying that "if at first you don't succeed, try and try again” or "if there's a will, there's a way. Benilda

[chrystal 0]

:unsure:Hi, my name is Chrystal Hoyle...I am having troubles with care plans and what steps to take...If there is anyone out there that can guide me through this...I appreciate it a lot...God Bless You and Thanks, Chrystal Hoyle

Edited May 8, 2008 by chrystal

[susieq 0]

I started out at a nursing home leading a Christian Bible Study. There was a Jewish lady who could not get out of the room fast enough when I would arrive. Often, I would wheel her out myself. I have always tried to be friendly and respectful, but she wants nothing to do with me. There are two other Jewish ladies who often stay for by Bible Study and we are friends.

Now I am doing a practicum in that nursing home. I would like to at least to be on friendly terms with her. She still remains very distant. I wonder if you might have some suggestions to begin a friendship with her. She seems to stay in her room always. I have noticed that she does work some crossword puzzles but I have not observed her mingling with other residents.

Any suggestions?

Thanks,

SusieQ

[turtle 0]

I started out at a nursing home leading a Christian Bible Study. There was a Jewish lady who could not get out of the room fast enough when I would arrive. Often, I would wheel her out myself. I have always tried to be friendly and respectful, but she wants nothing to do with me. There are two other Jewish ladies who often stay for by Bible Study and we are friends.

Now I am doing a practicum in that nursing home. I would like to at least to be on friendly terms with her. She still remains very distant. I wonder if you might have some suggestions to begin a friendship with her. She seems to stay in her room always. I have noticed that she does work some crossword puzzles but I have not observed her mingling with other residents.

Any suggestions?

Thanks,

SusieQ

 

 

Perhaps you cound invite her to share some of her Jewish culture with you and the other residents. Asking her about what is obviously very important to her may be a great way to get her involved in interacting with the other residents.

[spartans 0]

I started out at a nursing home leading a Christian Bible Study. There was a Jewish lady who could not get out of the room fast enough when I would arrive. Often, I would wheel her out myself. I have always tried to be friendly and respectful, but she wants nothing to do with me. There are two other Jewish ladies who often stay for by Bible Study and we are friends.

Now I am doing a practicum in that nursing home. I would like to at least to be on friendly terms with her. She still remains very distant. I wonder if you might have some suggestions to begin a friendship with her. She seems to stay in her room always. I have noticed that she does work some crossword puzzles but I have not observed her mingling with other residents.

Any suggestions?

Thanks,

SusieQ