According to a 2010 NPR report, young adults have been one of the fastest growing long-term care populations over the past 10 years, with 14% of nursing home residents under the age of 65. Some live in facilities that have specialized in the care of younger residents and others are in settings where almost all the other residents are seniors.
Both scenarios pose challenges in terms of accommodating the unique physical, emotional, and recreational needs of younger adults — and the reactions of staff members to their young charges.
Having spoken with many young residents and their bewildered staffers over the years, I know firsthand how challenging interactions can be. I wrote about some of the psychological issues and remedies in my 2008 McKnight’s guest column, Young adults in long-term care: the canaries in the coal mine, where I argued that the problems arising with young adults now are precursors to those that will be endemic when the assertive baby boomers arrive at our doors — unless we adapt as providers.
Recognizing the need for facilities to be better prepared, the American Medical Directors Association has released a toolkit on “The Younger Adult in the Long Term Care Setting” as part of its LTC Information Series. I had the pleasure of working on this project, which covers a wide range of matters affecting young adults and provides recommendations for addressing them.
The guide is one of the few sources of information on this understudied population. If your facility has even one young or boomer resident that staff members consider “demanding” or “a problem,” you’ll find this report invaluable.
I was on the plane home from the American Psychological Association conference last August when I noticed that the man across from me had the same APA conference tote I was carrying. My friendly inquiry led to a very pleasant 3-hour conversation on the flight with psychologist Dr. Jeffrey Zimmerman of The Practice Institute. The Practice Institute features educational resources for mental health practitioners, including interviews with authors of books on various aspects of building and maintaining a private practice. It’s a treasure trove for psychologists, with timely and essential information from well-established therapists.
On Tuesday, April 9, 2013 at 1pm ET, I’ll be talking with Dr. Zimmerman about
If you’re not able to listen to the call on Tuesday, the recorded interview will be available for members of The Practice Institute on their website.
You can register for this FREE event at The Practice Institute’s Event Registration page. I hope you’ll join us!
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:
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.
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.
Many nursing home residents have experienced an amputation, an issue that’s often under-addressed both in the facility and in the media. (Limb loss should, but doesn’t always, trigger a referral for psychological services or other support.) Grey’s Anatomy has been working with The Amputee Coalition to make their portrayal of a character with an above knee amputation as realistic as possible. Tonight, 11/29/12, they plan to air a public service announcement about The Amputee Coalition to raise awareness about the resources available to amputees and their families. For more information about the collaboration between the coalition and the show, click here. To read more about Grey’s Anatomy and its characters, click here. Watching or discussing the show with residents could be an opportunity to recognize their concerns about limb loss and to consider what other support they might need.
There’s a new dramatic series on aging parents and their adult children on YouTube. These brief vignettes, with 13 episodes in all, capture issues facing families as parents become less able to care for themselves and their children try to intervene/help. I saw the first one and thought it was very powerful.
Here’s a link to what Paula Span, of the New Old Age blog at the New York Times has to say about it: Drama of Aging and Caregiving, on YouTube
Here’s the first episode:
Maybe it’s because I live in the New York metropolitan area, but it seems every nursing home I’ve worked in is filled with residents and staff from all over the world. I find it an exciting environment with the opportunity to learn about different cultures at every turn. Somehow, despite our differences, we make it work and provide top-notch care for our residents. Unless they’re gay. Or lesbian, bisexual, or transgendered (LGBT). Then many LGBT residents, no matter what country they hail from, feel they need to go back into the closet and hide who they are from those caring for them. They fear the prejudice of staff members and rightly so, based on a number of conversations I’ve had with co-workers about the issue. According to The Aging and Health Report released by The National LGBT Health and Aging Center, 21% of LGBT seniors do not disclose their sexual or gender identity to their physician. Their physician.
If you’re looking for resources to address LGBT issues in LTC, consider showing your staff the award-winning hour-long documentary Gen Silent or using one of their training programs. I had the opportunity to view the film at the American Psychological Association conference last month and think it would make an excellent tool for addressing sexual diversity. Given the strong feelings many staff members have on homosexuality, a training program is likely to be more helpful than an open discussion of the issues. As a psychologist privy to the private concerns of residents, I can tell you that you do have LGBT residents within your facilities — you just might not know who they are.
This month’s Caring for the Ages magazine features an article by Joanne Kaldy on reducing the emotional distress of resident through disaster preparedness. Here’s my contribution:
During a disaster, staff might be surprised at how calm many residents actually are. “A lot of residents aren’t as upset as we think. We need to be careful not to think that everyone is distressed,” said Eleanor Feldman Barbera, PhD, a psychologist who consults in long-term care facilities in the New York City area. For some residents, a hurricane or a snowstorm isn’t as significant as a personal disaster such as a roommate’s death, Dr. Barbera said.
Other residents may not display their significant concern. “People might be in their rooms quietly freaking out,” Dr. Barbera said. Some cultures think it is inappropriate to express feelings, and men may feel that they should act strong and not show their emotions. “Count on aides who know the residents better than anyone,” she advised. “Have regular in-service programs about signs of trauma, and make sure [staff] know who to report their concerns to.”
For the full article, click this headline:
I’m lucky enough to hear the private perspective of nursing home residents every day, but for those of you wondering what residents really think about living in long-term care, here are some blogs that generously offer their often surprising, sometimes shocking, viewpoints.
Straw Flowers, “one woman’s 20+ year journey through the elder care system,” is 78-year old Marya Methven’s wise and engaging chronicle of her life and long-term care experience.
Kathleen Mears blogs for Long-Term Living Magazine about her 16 years of life in nursing homes as an incomplete quadriplegic. She is very attuned to the social dynamics of the nursing home and to the impact of rules and regulations on the residents.
Worthless Goddamn Cripple is the angry, profane, insightful blog written by a man who had a stroke at the age of 33 (see the synopsis page for details). He offers a youthful perspective well worth the read and, despite the fact that the blog mysteriously ended in 2008, it’s still relevant.
If you know of other nursing home resident blogs, please add the urls to the Comments section. Thanks!