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Battling depression: Advice on how to make seniors feel valued by others (McKnight’s LTC News)
Here’s my latest article on McKnight’s Long-Term Care News:
Battling depression: Advice on how to make seniors feel valued by others
Research shows that the rate of depression among elders in senior residences is 24% to 27%. It’s not that every fourth resident you greet in the hallway is depressed.
It’s that we should be more concerned about the people who aren’t in the hallway to greet.
“Depressive symptoms are expected to become a leading cause of the global burden of disease, second only to cardiovascular disease, by the year 2020,” according to Tracy Chippendale, PhD, OTR/L in her 2013 Clinical Gerontologist study.”
Depressed residents are less independent in their activities of daily living, have a decreased quality of life, and tend to use more medical services than peers who aren’t depressed.
Factors reducing depression
According to Chippendale, elders with more education, better self-rated health and more social support are less likely to be depressed. While we can’t necessarily change a person’s health or the level of education they’ve achieved, as senior care providers we can certainly offer opportunities for social support.
An important component of social support — beyond the number of connections in a person’s life — is how much the individual feels valued by others. For a retired elder who has completed raising her children and lost the value of a job and its contacts and income, mattering to others can come from family relationships, friendships, community service, and owning a pet, for example. Studies suggest that moving to a senior residence can reduce some of these opportunities to connect and to be of service.
Creating opportunities to ‘matter’
For the entire article, visit:
Battling depression: Advice on how to make seniors feel valued by others
Savvy Resident’s Guide nominated for Best Books for Aging and Caregiving! Please vote!
I’m pleased to announce that The Savvy Resident’s Guide has been nominated as one of the Best Books for Aging and Caregiving in the Senior Homes 2014 Best Senior Living Awards contest.
Your vote is needed!
Please click on the yellow badge link below and vote for The Savvy Resident’s Guide on the Senior Homes page. Thank you!
Click on the badge to get to the Senior Homes page and vote for The Savvy Resident’s Guide!
The Eldercare Method: Using psychology for positive outcomes (McKnight’s LTC News)
Here’s my latest article on McKnight’s Long-Term Care News:
The Eldercare Method: Using psychology for positive outcomes
I watched with dismay as the nurse abruptly moved a table in front of a confused and agitated resident trying to leave the dining room. “Sit down!” she told him in a stern voice. “Dinner will be here in an hour!”
Those of us in long-term care have undoubtedly witnessed similar incidents where residents become agitated and staff members don’t have the tools to prevent or manage their distress. Psychologists — who could offer such tools — are largely limited in the current reimbursement model to providing individual services to cognitively intact residents.
Using mental health expertise
The Eldercare Method, developed by psychologist Kelly O’Shea Carney, PhD, CMC, executive director at the Phoebe Center for Excellence in Dementia Care in Pennsylvania, harnesses the training of mental health professionals to successfully address the gap between what’s known in the mental health world about how to handle challenging behaviors and how they’re often managed in long-term care.
The method uses interdisciplinary teams facilitated by mental health professionals (psychologists and licensed clinical social workers) to examine the causes of resident distress and to identify ways to prevent it. Team members include representatives from the nursing department and other direct care staff such as dietary, housekeeping, and aides.
Needs assessment
The first step in the Eldercare Method is to assess the overall behavioral health needs of the facility and to establish training programs and annual service goals. This dramatically increases the focus on behavioral health as compared to facilities that provide behavioral health training sporadically, often after an incident occurs, missing the opportunity to prevent problems on an ongoing basis.
For the entire article, visit:
The Eldercare Method: Using psychology for positive outcomes
Kelly O’Shea Carney, PhD, CMC
Amazon Review #4 of The Savvy Resident’s Guide
I finally visit a Green House — and it blows my mind! (McKnight’s LTC News)
Here’s my latest article on McKnight’s Long-Term Care News:
I finally visit a Green House (and it blows my mind!)
In my last post, I discussed culture change and its positive impact on the mental health of the residents, particularly at Eden Alternative facilities. I recently also had the opportunity to tour a Green House, which I’d heard about but had never seen. While Eden Alternative homes change the culture of care within existing facilities, The Green House Project creates the “ideal” setting from the ground up.
The template of a Green House is a small building that is home to 10 to 12 residents, or “elders,” and two caregiving “Shahbaz,” which is the plural of Shahbazim. A Shahbazim is an aide trained to do almost everything that needs to be done within the house – providing care for the elders, laundering the clothes and bedding, performing light housekeeping, planning meals, cooking, serving the food, engaging the elders in activities, etc.
The house itself is designed to be more like a home, with private rooms off a large common area that includes a living room, dining area and kitchen.
I found this model turned everything I’d known about nursing homes upside down.
Green Hill visit
The first thing I noticed when I pulled up to Green Hill in West Orange, NJ, aside from the impressive entrance to this former hotel, was that there were parking spots reserved for visitors. By contrast, most of the nursing homes I’ve encountered have reserved spaces for upper level staff. This easily replicable idea offers a person-centered approach even before guests enter the facility.
Green Hill has four Green Houses in addition to its other levels of care. Ten elders reside in each of these small buildings in the back of the campus.
Walking into the Green House was very much like entering someone’s home. As I came through the entryway, there was a small, bright room on my left where I later interviewed one of the elders. On my right was a large, open kitchen. A computer monitor was discreetly tucked in the corner next to a glass cake stand holding a freshly baked cake.
For the entire article, visit:
I finally visit a Green House (and it blows my mind!)
For more on The Green House Project, visit their website.
Green Hill dining area and kitchen
“Dementia Village” in the Netherlands (video)
Many readers are familiar with people with dementia who want to “go home” when staff members leave at the end of their shifts or who “shop” for belongings in the drawers of other residents. It can be challenging for staff to redirect individuals intent upon leaving and upsetting for the people who are being prevented from going where they want to. “Shopping” is likely to irritate those whose dressers are being ransacked, creating ill will between neighbors on the floor.
In the Netherlands, a facility called Hogewey or “Dementia Village,” has created an entire town set up for residents with severe dementia. They’re encouraged to wander and shop and can spend the afternoon outside, coming home at the end of the day. Their homes have different lifestyle themes, such as culture or crafts or religion, increasing the chances that elders will be living with others that share their interests.
Below is a video from CNN about Dementia Village:
Dementia Village
Reducing depression through person-centered care (McKnight’s LTC News)
Here’s my latest article on McKnight’s Long-Term Care News:
Reducing depression through person-centered care
I was speaking about leadership to a group of administrators recently when the discussion turned to person-centered care. “Culture change, the Eden Alternative, whatever you call it,” I said, “things are moving in that direction. MDS 3.0 has the team asking residents questions that staff members would have answered in the past, such as whether or not residents feel depressed.”
We talked about the impact of this and I continued, “In my experience, the nursing home I worked in that was most attentive to the psychosocial needs of the residents was the one that was in the process of becoming an Eden Alternative home.”
I’m not in any way affiliated with the culture change movement, but I certainly noticed the difference in the atmosphere in the Eden facility and its impact on the residents’ mental health. In traditional facilities, an enormous amount of the residents’ psychotherapy time is devoted to addressing how to work in or around the nursing home system if possible, and how to maintain their equanimity and sense of humor if not. This was less of a focus for residents in the Eden home.
When I work with the staff in a traditional nursing home, I’m often an emissary of the residents, delivering their messages in a way that can be heard by the staff. In the Eden facility, there are more emissaries and more people listening to what the residents have to say in the first place. Being heard is essential for good mental health.
For the entire article, visit:
Reducing depression through person-centered care
How to better foster community among long-term care residents (McKnight’s LTC News)
Here’s my latest article on McKnight’s Long-Term Care News:
How to better foster community among long-term care residents
Mr. Cooper was staring out the window when I came by to see him for his weekly psychotherapy session. “There’s no one here to talk to except you,” he said despondently.
“You’re the fourth resident who told me that this week, Mr. Cooper!” I replied. “We need to get all of you together so you can talk to each other!”
Our strength is community
Many, if not most, of the services offered in the nursing home can be provided through home-based care. What sets nursing homes and other long-term care sites apart is the opportunity for residents to socialize with each other with ease.
The community atmosphere can be one of our most appealing aspects and biggest selling points to potential residents. Savvy facilities will make the most of this through developing and promoting their recreation programs and facilitating connections among residents and their families.
Benefits of social connections
According to Anna Miller in her January 2014 article in the American Psychological Association Monitor, having strong social connections has been “linked with such benefits as a greater pain tolerance, a stronger immune system, and a lower risk of depression and early death … [Loneliness causes] physiological processes to activate that are directly bad for your health.” This suggests we can actually improve the physical health of our residents by increasing their involvement in meaningful social activities.
Creating a stronger sense of community
Here are some suggestions to help develop positive connections between residents in long-term care:
1. Facilitate interactions between residents upon their admission.
As I wrote in The Critical Period, the arrival in LTC is a time when new behaviors — such as attending activities — are easiest to establish. Don’t wait until a resident is in the habit of staying alone in his or her room all day; instead, send a welcoming committee to engage the resident immediately. Find out new residents’ interests and connect them to others in the facility who share their passion for gardening or baseball, for instance.
2. Create opportunities to share secrets.
For the entire article, visit:
How to better foster community among long-term care residents
Tip #1 for families new to LTC (video)
In this video, Dr. El offers a suggestion for families who are new to long-term care:
http://youtu.be/4hSX3h3v2Ak