Dr. El - February 26, 2013 - Business Strategies, Customer service, Long-Term Living Magazine
Here’s my latest article in Long-Term Living Magazine online:
What design features do LTC residents most want?
The psychologist walked into Mrs. Winters’ room and found her in the corner, muttering under her breath. “Is everything okay?” the psychologist asked, concerned. Mrs. Winters was usually a calm lady, but today her face was tight with anger.“Thank goodness you’re here!” Mrs. Winters cried. “I came over here to get a letter from my nightstand and now I can’t get out of this spot!” She tried to move her chair backward but the wheels jammed into the wall. She pushed the chair forward and ran into the bed. “I’ve been stuck like this for almost an hour and my call bell is on the other side of the bed. It’s a good thing I’m too angry to cry because I can’t reach my tissues either!”Renovations and redesigns large and small can breathe new life into a facility, especially when they’re focused on the needs of the people who live and work within them. The changes that are most important to the residents tend to be those that center on their psychological need to regain control. Most residents enter long-term care after a fall or other health crisis takes them from their home and thrusts them into an unfamiliar environment with rules not of their own making. Meals are served on schedule, toileting depends on staff availability, and discharge plans rely on a host of factors and players that can’t be managed by the resident. When the big things in life are spiraling out of control, being able to direct the small things can make a world of difference. Here are some design changes that matter most to the residents.
WITHIN RESIDENT ROOMS
To provide increased control within each room, consider that most nursing home residents have limited mobility and are often in wheelchairs that are difficult to maneuver in small spaces. Residents spend significant amounts of time in bed, unable to get out on their own. While most LTC facilities have mechanical beds that allow residents to adjust themselves as needed, there are many additional aspects of the environment that could be under resident control.
- Room temperature. Many times the call bell is ringing because a resident wants a window opened or closed or wants the air conditioning adjusted. Providing remote controls for the air conditioning and heating system allows the residents to take care of this function and frees staff time for other concerns. If the windows can be opened by remote (or easily opened manually) this improves quality of life, especially because getting outside for fresh air can be such a challenge.
- Large remote control for TV. Residents may have remote controls for their televisions, but have difficulty using them due to overly complicated designs with small buttons and tiny labels. The best remote controls are simple, with large well-labeled buttons, yet are not so heavy that frail elders have trouble holding them. Provide recommendations to family members as part of a good customer service program.
- User-friendly telephone. Similarly, the best telephones are the least complicated. They have large buttons, a loud ringer and speaker, are impervious to liquids and can withstand the inevitable falls that occur during use in long-term care. If families are providing phones, offer them these suggestions because you’re the experts and they’re probably going through this for the first time.
Dr. El - February 20, 2013 - For Fun, Inspiration, Nominations/Awards
I’m very pleased to announce that after several weeks of close competition, My Better Nursing Home was voted Best Industry Resource in the Senior Living Awards at SeniorHomes. Thanks for your votes and congratulations to all the winners and finalists!
Dr. El - February 13, 2013 - Nominations/Awards
Thanks to all of you who voted, My Better Nursing Home is now a finalist for Best Industry Resource! If you haven’t voted yet, please take a moment to click on the link below and move MBNH to first place. Thanks!
Dr. El - February 6, 2013 - Anecdotes, Personal Reflections
Over the years, I’ve spoken with hundreds and hundreds of people whose daily lives were interrupted by a health crisis that led them into long-term care. They’ve told me how challenging it can be and we’ve discussed the changes that have occurred and how to adapt to them. If they’re going back home, we talk about how to minimize the chances of another fall or how to make use of supports in the community. I understand it’s a stressful time and have a blog post that specifically addresses the stress of nursing home admission. I thought I “got” it.
Then last week I was called for jury duty, plucked out of my life in the middle of a hectic time. I’ve done it twice before, including a month of grand jury service, so it wasn’t that I was opposed to serving — it just wasn’t a good time. But since I’d already postponed once and I didn’t foresee a less hectic period in my life for, say, another 10 years, I showed up at the courthouse to await my fate. I was anxious, though, because I have my job to do and blog posts to write and then there’s the New York City school bus strike — another unpredictable, uncontrollable event taking me out of my routine for hours at a time.
I sat in the holding room until late in the morning before I was called for a medical malpractice trial. A group of us filed into the courtroom and the judge proudly announced that he runs the longest trials of anyone in the district and we could expect to be there for 2-3 weeks. (What!????) We broke for lunch and I rushed to run a job-related errand, making it back to the courthouse in the nick of time. The judge allowed those who thought they couldn’t provide 2-3 weeks of jury duty service to make their case. I waited on line for my chance to speak to him privately and watched him send potential jurors back to their seats, saying “That’s not an excuse” or “We can work with that. Sit down.” Nervously, I approached the bench with three reasons I couldn’t be out of my life for that length of time. I began with the school bus strike and the judge interrupted me. “Your first reason is good enough.” He sent me back to the jury pool where I sat for an hour and half before being given notice that I’d served my time and wouldn’t be called for another four years.
The next day I spoke with a man who’d been in the nursing home since before the holidays and was wondering when he’d be going home. He’d been referred for psychological services because he’d been irritable with the staff. I explained the discharge process as I have so often in the past, but this time I felt his anxiety in a whole new way. I’d only been called for jury duty and still I’d felt for a few days like my life was out of my control. This man had fallen, been taken to the hospital, and then to the nursing home for rehab. He’d missed Christmas, New Year’s, and his wife’s birthday, and was waiting on a host of other people to tell him when he could go back to his life. I was humbled. He was handling things so well.
Dr. El - January 28, 2013 - Business Strategies, Long-Term Living Magazine, Motivating staff
Here’s my latest article in Long-Term Living magazine online:
3 small changes promise big impact in motivating your LTC staff
The new year has just begun and even without an official resolution, January holds the promise of a fresh start. This could be the year to address perennial problems plaguing your organization. It can be a challenge, though, to know where to begin on the mountain of tasks needing attention. Perhaps you have neither the time nor the budget for major changes. The good news is that
psychological research suggests small goals tend to be more successful than great ambitions. With that in mind, make use of the new year’s momentum by making minor adjustments in three areas for a big impact: appreciation, repair and organization.
1. APPRECIATION
Studies show that long-term care staff members aren’t in it for the money. Because workers tend to be more motivated by recognition of their efforts than by remuneration, showing appreciation will reap great rewards.
- Start small by simply thanking the people around you for their efforts. Recognize triumphs, commitment to the team and attempts even if they don’t result in success. As leaders within the organization, your attention to appreciation can create a ripple effect as others model their behavior after you and start thanking their coworkers and subordinates.
- Make it a habit to recognize one person, unit or action in each morning report or department head meeting. By calling attention to positive behaviors, you provide a roadmap for your employees or coworkers regarding the kind of work you’d like to see. Ask coworkers to “tell on” their peers, and vary who receives acknowledgement so that the unsung heroes shine as much as the obvious go-getters. Use this powerful tool, for example, if you sense a new employee might be feeling anxious, commending their work in front of colleagues to generate a feeling of inclusion and welcome.
- Take appreciation a step further by establishing an official recognition program such as “Employee of the Month.” Rewards can be as simple as a good parking spot, a plaque on the wall or a gift certificate to a local restaurant.
2. REPAIR
In any establishment there are things that break down. The New York City subway system, for example, is over 100 years old and in constant need of repair. The Metropolitan Transit Authority moves station to station with complete renovations that transform the location from dingy and crumbling to bright and freshly tiled. A recent sign in a subway car, however, announced a change in its repair program: instead of complete overhauls while most stations languished in disrepair, they’d now be attending to the most urgent needs of all stations. If the MTA can use this triage approach, so can long-term care.
Dr. El - January 22, 2013 - Books/media of note, Inspiration
I’ve been reading Marya Methven’s Straw Flowers blog for some time now, imagining her typing away at a laptop perched on her tray table in a Wi-Fi enabled nursing home. I was surprised to discover how far from the truth my imagination had taken me. When I heard how the blog was actually maintained, I thought it might inspire people to help more seniors get their thoughts and experiences out into the world. Imagine your elders transcending the walls of their LTC facility and reaching out to the larger community with their wisdom. My suggestions, if you decide to move ahead with this:
- Keep it positive and instructive — be the change you want to see in this world.
- Keep it going — it’s easy to start a blog, hard to continue. Make a frequency commitment you can handle.
- Be aware of privacy and interpersonal issues — consider the impact of what you write on the people around you.
- Be creative — a blog is fun!
The Straw Flowers Example
Step One: From her LTC facility in Florida, Marya handwrites the blog post early in the morning when her vision is best. She’s never even seen a laptop!
Step Two: A friend reads back Marya’s handwritten posts and makes any needed corrections before sending them on to Marya’s daughter Laura in Seattle.
Step Three: Laura types them up and posts them to the blog.
Step Four: Another friend prints out the posts and reads them to Marya in Florida.
Dr. El - January 16, 2013 - Nominations/Awards
I’m pleased to report that for the third year in a row, I’ve been nominated in the Best Senior Living Awards contest at SeniorHomes.com! Last year with your help, I became a Social Media Rockstar (can you believe it’s been a year already?) This year I’m up for Best Industry Resource.
You can help me by voting with a click of your mouse and by sharing the contest page. Visit the orange “vote here” section on the
and click on the Facebook “Like” and/or Google “+1” to vote. There’s also an icon on the page to share and tweet.
Thanks for your vote!
Dr. El
Dr. El - January 11, 2013 - Books/media of note, Resident care
These days the recreation calendar of most long-term care facilities has moved way beyond the bingo-heavy schedule of yesteryear. Residents are likely to find live music, current events, religious programs, pet therapy, crafts, Wii sports, and trivia games among their options. This abundance of choices makes it likely that residents will find enjoyable ways to spend their time and some of these activities (including bingo) help to keep the mind sharp. Staff members interested in “kicking it up a notch” and creating programs specifically focused on enhancing cognitive capacity will find a roadmap in this resource, Enhancing Cognitive Fitness in Adults: A Guide to the Use and Development of Community-Based Programs, edited by psychologists Paula E. Hartman-Stein and Asenath LaRue. The book “will highlight the research foundations behind brain fitness interventions as well as showcase innovative community-based programs to maintain and promote mental fitness and intervene with adults with cognitive impairment. The emphasis is on illustrating the nuts and bolts of setting up and utilizing cognitive health programs in the community, not just the laboratory.” The book includes chapters on oral life review, intergenerational groups, incorporating the arts, and Montessori-based methods for engaging persons with dementia. Part Five of the book, Gaining Through Giving Back: Programs with a Positive Societal Impact, outlines ways of improving quality of life for residents by helping them give back to the community — a concept near and dear to my heart.
On another note, Editor Paula Hartman-Stein, below, is offering two workshops for psychologists and social workers interested in learning more about the Physician Quality Reporting System (PQRS). Visit her website at Center for Healthy Aging for more information.
Dr. El - December 31, 2012 - Personal Reflections
Dear Readers,
Thanks for joining me for another year at My Better Nursing Home. When I first began sharing my ideas online about my work as a nursing home psychologist, I considered 2009 The Year of the Blog — an experiment I committed to for one year to see what would happen. By the end of 2009, I had fallen in love with blogging and with the expanded opportunities to help elders and others in long-term care. MBNH continues to be an interesting journey that allows me to challenge myself daily (and hopefully create some new neural pathways to stave off cognitive decline!)
Much of my energy in 2012 went toward realizing my lifelong goal of publishing a book. The Savvy Resident’s Guide became available on Amazon just a few months ago, making 2012 The Year of the Book. I was also pleased to present on Social Media at the APA conference in August and on Mental Health in LTC at the NASRM conference in October, as well as to discuss The Savvy Resident’s Guide on several radio shows in the last few months. I’m now a monthly blogger at Long-Term Living Magazine and a regular contributor to McKnight’s Long-Term Care News, and I’ve been working on a project with the American Medical Directors Association.
It’s been a busy, exciting year and I thank you for reading, commenting, emailing, Liking, Sharing, Tweeting and otherwise encouraging me on my path. Your support means a lot to me!
Best Wishes for a Happy, Healthy New Year!
Dr. El
Dr. El - December 21, 2012 - Nominations/Awards, Resident education/Support groups
Exciting news! The Savvy Resident’s Guide is the book club selection for an assisted living facility in California! I’m thrilled to hear that residents will be discussing the book. It’s exactly what I hoped for when I wrote it — that the information would get to the people who need it most and that it will generate discussion about how to handle the many challenging situations that arise in long-term care. I hope the readers find The Savvy Resident’s Guide informative and empowering and I thank them for giving me such a wonderful holiday gift.
