Blog

Opening the door for ombudsmen

Here’s my latest article on McKnight’s Long-Term Care News:

Opening the door for ombudsmen

Last week during a talk at the Pennsylvania Department of Aging 2017 Ombudsman Conference, audience members told me that they’re having difficulty speaking to administrators and other senior staff when they visit the facilities. In fact, some people reported that the administrators close their office doors when they find out the ombudsman is in the building!

While I can imagine from an administrator’s point of view that an unexpected interruption from someone complaining about problems is not exactly a welcome visit, perhaps there’s a way to shift the relationship to mutual advantage.

In fact, ombudsmen may be able to use their resources to help you solve problems within your facility.

Their role

Long-term care ombudsmen act as advocates for residents to address problems and to facilitate quality care. According to The National Long-Term Care Ombudsman Resource Center, ombudsmen promote “the development of citizen organizations, family councils and resident councils.” Ombudsmen and the councils can identify areas of potential improvement and, if properly guided, can offer solutions and assistance.

Local ombudsman’s offices have, for example, sponsored training programs on culture change and invited facility staff free of charge. Ombudsmen have arranged trips for staff to visit nearby Green Houses and provided free staff training on various resident care matters.

Pennsylvania’s Ombudsman Program is very active in promoting resident participation. Their ombudsman-trained PEERs (Pennsylvania’s Empowered Expert Residents) focus on improving the quality of life for residents. PEER efforts include initiating activities in which elders have the opportunity to assist others, such as a program making blankets for the homeless. That would make a nice mention during the prospective resident tour, don’t you think?

Ombudsman contact tips

While it’s likely that your ombudsman will be sharing resident complaints with you, it’s better to hear about these problems from them than from a state surveyor. Consider the following methods to improve your working relationship and to enhance resident care:

For the entire article, visit:

Opening the door for ombudsmen

Insights on family-friendly care from Dr. El — the daughter of a new resident

Here’s my latest article on McKnight’s Long-Term Care News:

Insights on family-friendly care from Dr. El — the daughter of a new resident

Due to a series of unfortunate events, both of my previously independent parents were recently injured over the course of five weeks. In the past, I’d been the granddaughter, the niece and the daughter-in-law of someone in long-term care, but I’ve now taken on the very different role of daughter of a resident.

In between errands, trips to medical appointments and calls to the facility, I’ve been making mental notes of insights afforded me by my new perspective and that of my family members.

Here are some thoughts from someone who’s seen the long-term care world from both sides now:

• It’s worthwhile to have a pleasant and efficient receptionist. I don’t often call the facilities in which I work so it hasn’t affected me personally if the automated telephone system sends callers into a netherworld of options and hang-ups or if the receptionist is curt or bumbling.

As a family member, however, it’s tremendously reassuring to have a calm, competent individual answering questions and guiding me to the appropriate staff member.

• Visitor areas are scrutinized. While my general philosophy is that I’d much rather be in a place that focuses on emotional and physical comfort than on outward appearances, my visiting family members are definitely aware of disrepair, cleanliness levels and shabbiness.

For the entire article, visit:

Insights on family-friendly care from Dr. El — the daughter of a new resident

On power, teamwork and communication

Here’s my latest article on McKnight’s Long-Term Care News:

On power, teamwork and communication

Having enough of it at work, I tend to avoid drama in my entertainment choices unless it involves aliens or post-apocalyptic nonsense. My family and I are currently enjoying the creative spectacle of Project Runway “Teams” version from a few seasons ago. In it, the judges of the clothing design competition repeatedly make the point that “teams are only as strong as their weakest link.”

A significant part of the Project Runway teamwork challenges involve communication. Collaborators who take over the project and those don’t speak up can both get penalized by the judges. Similarly, teamwork within the long-term care setting heavily relies on communication. For the best healthcare outcomes, it’s essential for all team members to contribute their expertise.

An article in the American Psychological Association Monitor, however, suggests that people who feel powerful are more likely than those who don’t feel powerful to share “opinions that differed from the norm,” a important element of team interactions.

Further, the authors cite research that describes how “people who feel powerless are more likely to…behave in inhibited ways. People in positions of greater power, on the other hand, are more likely to…act in uninhibited ways.” A care team member who feels inhibited is less likely to speak up and contribute to a group discussion.

In the hierarchical world of LTC, administrators, nursing directors and medical directors have more perceived power than, say, charge nurses or recreation therapists, despite whatever layers of upper management and accountability exist.

In my conversations with aides and residents, there is consistent disagreement among them regarding who has the power. Aides will argue that the “Resident’s Bill of Rights” gives the residents control, while residents, waiting on aides for intimate care, feel that the aides are in charge. Both struggle to deal with the moods and behaviors of the other.

Family members can be considered a part of the team that wields power in the form of potential phone calls to senior staff, the ability to transfer their loved one to a different facility, a negative social media review or a lawsuit. At the same time, relatives are often overwhelmed by the new and unfamiliar situation and the shifting dynamics within their families and many feel powerless in relation to the staff members upon whom they depend for good care for their loved one.

The challenge for LTC is to empower all team members to overcome their “inhibitions,” so that they offer their expertise despite the imbalance of power and in perceptions of power.

For the entire article, visit:

On power, teamwork and communication

Enthusiasm and ingenious inventions at the NYC Aging2.0 Global Startup Pitch Event

Here’s my latest article on McKnight’s Long-Term Care News:

Enthusiasm and ingenious inventions at the NYC Aging2.0 Global Startup Pitch Event

Perhaps, like me, you’ve heard of Aging2.0 but hadn’t had the opportunity to attend one of their events. When I discovered that they were holding a pitch session a subway ride away from my home, I jumped at the chance to be there. I was curious to see if any of the startups were promoting products to benefit elders in long-term care.

Here’s what I learned:

What’s Aging2.0?

According to their website, “Aging2.0 is a global innovation network on a mission to accelerate innovation to improve the lives of older adults around the world.” Moving beyond the development of medical products for seniors, Aging2.0 seeks to facilitate collaborations between senior care providers and entrepreneurs to create products and services that can be integrated into their businesses.

The scene

The event was held at the modern, tech-oriented community space of SeniorPlanet.org in Manhattan. (The tagline for SeniorPlanet.org is “Aging with Attitude.” One of their recent articles is titled, “Is it time for #OscarsSoYoung?”)
The large, windowed, ground floor room on West 25th Street was filled with the animated clamor of innovators munching on crudité and discussing products to better the lives of elders. The youngest attendees appeared to be twenty-somethings and the oldest participant was octogenarian and aging activist Muriel Beach, Chief Elder Officer and a judge for the event.

The format

Each inventor had several minutes to pitch their product and take questions from the four judges, who also included the CEO of 1-800-Wheelchair Joseph Piekarski, HealthTech Angel Investor Sacha Levy, and AARP’s Director of Market Innovation Jeffrey Makowka.

Aging2.0’s host Crispin Baynes kept things moving along swiftly and explained that the winner of the event would receive cash, mentorship and an international spotlight, going on to pitch at Aging2.0’s inaugural Americas Summit in Toronto on June 21, 2017.

The inventions

Nine people pitched their products, which were designed to assist elders with a wide variety of challenges.

For the entire article, visit:

Enthusiasm and ingenious inventions at the NYC Aging2.0 Global Startup Pitch Event

Remember to breathe

Here’s my latest article on McKnight’s Long-Term Care News:

Remember to breathe

I was putting the finishing touches on my article for this week’s column when I paused to consider the headlines on McKnight’s right now.

“Don’t be worried about Medicaid funding, be very afraid,” advises Editorial Director John O’Connor.

Staff Writer Emily Mongan alerts readers with these articles: “Access to nursing homes would dim under Republican proposal, AGS warns” and “Medicare could be next on Trump’s chopping block, experts say.”

In “The LTC industry should be ashamed,” guest columnist Buffy Howard admonishes long-term care leadership because their treatment of nursing staff is leading caring professionals to leave the field.

Reduced funding, departing staff members, widespread uncertainty in the industry … even the most stalwart individuals might feel uneasy. I’ve postponed my earlier topic to consider what I could say as a psychologist to help.

Perhaps you’ve heard the tale about the boss who yells at the worker, who comes home and grouses at his wife, who is short-tempered with her child, who kicks the dog. Anxiety can spread like that too, from CEO to administrator to supervisor to charge nurse to aide to resident.

In order to better face whatever is ahead — and to avoid causing panic in those around us — we can make an effort to be serene and centered. Below are some tried and true calming techniques to help you remain levelheaded despite unnerving times.

For the entire article, visit:
Remember to breathe

Join me for the ‘Relaxed Lane’ challenge!

Here’s my latest article on McKnight’s Long-Term Care News:

Join me for the ‘Relaxed Lane’ challenge!

Denise B. Scott, president of Drive Consulting, posted an intriguing story on LinkedIn the other day about a Scottish supermarket that partners with Alzheimer Scotland to help those with memory loss.

The workers are trained to understand how to help people with dementia, and the supermarket offers a “relaxed checkout lane” for seniors and others who might need a little extra time when paying for goods at the register.

On senior citizen discount day, the store posts a sign at the entry to the cashier’s line designating it as the “relaxed checkout lane,” allowing customers in a rush to go elsewhere. Those on the relaxed lane can check out slowly, without the pressure of worrying that someone behind them will get irritated.

The concept is so simple, easy and kind that I decided to ask my local supermarket if they’d join in.

For the entire article, visit:

Join me for the ‘Relaxed Lane’ challenge!

For more info on how to set up a “Relaxed Lane” in your neighborhood, click HERE and see the video below.

McKnight’s Free Online Expo 3/14 & 3/15

Once again, McKnight’s will host its annual online expo, which is a chance to attend a conference without leaving your desk. Register for the conference in advance, and then log in to hear the talks, visit the vendors, and chat with the reps and attendees.

This year’s topics are:

PAYMENT: ​Medicare compliance update: Are you up to speed? ​March 14th, ​10 a.m. ET
​CAPITAL: ​Following the money in 2017 ​March 14th, ​12 p.m. ET
​QUALITY: ​Strategies for surviving the survey ​March 14th, ​1:30 p.m. ET
​WOUND CARE: ​Accident or Intentional? Assessing patient injuries in long-term care ​March 15th, ​11:30 a.m. ET
​TECHNOLOGY: ​Your data always tell you what to do…are you listening? ​March 15th, ​1 p.m. ET

To register, go to:
​www.mcknights.com/Expo2017

Correcting long-term care’s image problem

Here’s my latest article on McKnight’s Long-Term Care News:

Correcting long-term care’s image problem

Long-term care has an image problem. For a variety of reasons, we aren’t associated with good times. There are things we can do to turn this around, though, starting with the perceptions of our residents.

Most people who come to live in a long-term care facility struggle with a sense of failure. This isn’t because of anything that occurred in their lives prior to placement, but because many people view living in a nursing home as a sign of a failed life.

The most common comment I’ve heard from new long-term residents over the years is, “I never thought I’d end up in a place like this.” Some add, “Where did I go wrong?”

There are good reasons for providers to address the inherent sense of failure many residents feel in LTC placement: It can increase customer satisfaction, improve morale among residents and staff, and reduce depression among residents, thereby lessening the need for antidepressants.

The role of the psychologist

Part of my job as a psychologist is to help residents recognize that living in a long-term care facility isn’t a failure. It’s not a reflection of a life poorly lived or necessarily indicative of difficulties in their relationships with their children or other loved ones.

I do this in several ways, depending on the person and the circumstances.

I start by telling residents that I regard it largely as a societal problem. We’ve made advances in healthcare that allow people to live longer with chronic illnesses, but we haven’t yet devoted the resources needed to help people manage successfully at home and to support their caregivers. Long-term care is often the best solution under the circumstances.

Sometimes offering that view is enough to make them feel better about the situation, but other times more is needed. For example, Marie was a new resident who’d worked as an aide in a psychiatric hospital. She was distressed about living in the nursing home and had become irritable and withdrawn. I took her to visit a well-adjusted resident, Linda, who’d been a coworker and a union representative at the same psych hospital. They talked about the old days for 20 minutes and never visited together again, but Marie had a new acceptance for placement — if the nursing home was good enough for Linda the union rep, it was good enough for her too.

As a neutral party, I can provide the perspective that families and facilities can’t, pointing out, for example, how hard family members have worked to keep them out of the facility for as long as they did, how their relationships can reset once someone else is in charge of hands-on caregiving, and the benefits of living in a communal environment with easy access to medical staff and activities.

Organizational component

Aside from referring residents for psychology services, facilities can address this aspect of their image problem in several ways:

For the entire article, visit:

Correcting long-term care’s image problem

10 ways to incorporate mood-boosting exercise into LTC

Here’s my latest article on McKnight’s Long-Term Care News:

10 ways to incorporate mood-boosting exercise into LTC

Cold weather. An uncertain world. Rogue shrinks making the rest of us caring, diligent professionals look bad. I don’t know about you, but I need a mood lifter.

I came across an article that suggests that exercise of all kinds, even small movements, can make us feel less depressed. In “Get up and move. It may make you happier,” New York Times health writer Gretchen Reynolds notes that people in a University at Cambridge study “turned out to feel happier when they had been moving in the past quarter-hour than when they had been sitting or lying down, even though most of the time they were not engaged in rigorous activity.”

How can we incorporate more movement into our days across the spectrum of long-term care?

Personally, I purposely forego my car so I can walk to and from the subway and I take the stairs instead of the elevator whenever possible. I encounter surprisingly few coworkers doing the same, so perhaps that can be number one on this list of get-moving ideas:

1. Take the stairs.

2. Use public transportation. Sign up for or offer workers a transit tax exemption if a program, such as TransitChek in New York City, is available in your area.

3. Kill two birds with one stone by walking around the facility on rounds and checking in with staff members and residents.

4. Join or begin a lunchtime walking program. Find a buddy to add fun and accountability.

For the entire article, visit:

10 ways to incorporate mood-boosting exercise into LTC

A ‘novel-la’ way to educate families about dementia

Here’s my latest article on McKnight’s Long-Term Care News:

A ‘novel-la’ way to educate families about dementia

As I’ve mentioned in past columns, delivering high quality care for residents and their families means accepting our role not only as care providers but also as educators throughout the process.

This often involves teaching family members about illnesses so that they can become strong members of the treatment team, rather than bringing sweets to someone with diabetes or inadvertently agitating a resident with dementia.

As anyone who’s visited a doctor knows, however, it’s easy to become overwhelmed and to have the information presented by the medical professional blur so that it sounds like a Charlie Brown cartoon teacher declaring, “Wa wa wa wa, wa wa wa wa wa wa.”

I recently learned of a promising program to teach families — particularly Hispanic families — about dementia in a manner that makes the information easier to hear: an audio-visual novella called “Forgotten Memories” (“Recuerdos Olvidados”), which is available on YouTube in English and in Spanish.

The novella, by the University of Southern California School of Pharmacy in association with USC Good Neighbors Campaign, USC Dornsife College of Letters, Arts and Sciences, and USC Alzheimer Disease Research Center, tells the story of a man whose forgetfulness begins to impact his daily life and to affect three generations of his family.

For the entire article, visit:

A ‘novel-la’ way to educate families about dementia