Posted by Dr. El - May 17, 2010 - Boomers, Resident education/Support groups, Technology, Tips for gifts, visits
I recently saw a video showing a 99-year old woman reading and composing poetry on her new iPad, which brightened and enlarged the typeface enough that she could read again despite limited vision due to glaucoma. It got me thinking about apps our elders could use in the nursing home and upon discharge. Please add your ElderApp suggestions in the comments section.
- Kindle, for a treasure trove of books
- A Diabetes app (there are many), to track blood sugar and help plan meals upon discharge
- A Medication Tracker
- Pandora, for instant access to favorite music (for inspiration in Rehab, or to drown out the buzzers and overhead pages)
- Games, to keep the mind sharp and to play while waiting for all the things residents have to wait for
- A Voice Memo Recorder, to easily capture thoughts before they escape
- The 12 Step Companion, which includes the Alcoholics Anonymous Big Book and a meeting locator, to keep close to your program until all nursing home host AA meetings (for more on this, see Why Every Nursing Home Should Host AA Meetings)
Posted by Dr. El - April 25, 2010 - Anecdotes, Boomers, Dementia, Role of psychologists, Technology, Tips for gifts, visits
Now that I know I’m not going against State regulations (see Dr. El Goes Undercover with the NYS Department of Health), I’ll confess I love to use my iPhone with the residents. In nursing homes that don’t yet have computer access, the iPhone and other web-enabled mobile devices bring the world right to the residents. (For more on the subject, see Therapeutic Use of the Internet in Nursing Homes.)
Here are some therapeutic interventions I’ve used during my psychology sessions. Please add your experiences in the Comments section.
- When I arrived at the door of his room, Jim was sitting with his head in his hands. He looked up and I saw the worry in his eyes. “What’s up?” I asked him. He said, “I put all my stuff in storage before I got here, but now I can’t remember the name of the place. I’m worried I’m gonna lose my things.” Pulling out my iPhone, I Googled the storage center based on the general location, and handed him the phone number. Relieved, he was able to discuss his other concerns. When I ran into him later in the day, he’d phoned, made arrangements for his belongings, and was now smiling and relaxed.
- “My old doctor gave me different medication,” Ms. Garcia told me. “I never had this problem before.” “Do you have your doctor’s phone number? Maybe your old physician could talk to your doctor here.” “I don’t have the number. But I know her name.” After a quick search and a couple of phone calls, Ms. Garcia was on the phone with the MD she’d had for the last fifteen years. “Hey!!! How you doing??? Listen, can you call my doctor here and tell him about me?” Two days later, the MDs had conversed, the meds had been changed, and the problem was solved.
- Ana’s usually energetic demeanor had faded and my attempts to engage her were met with glum, monosyllabic replies. I switched gears. “Would you like to listen to music? We could play some of your native Romanian songs.” She was unenthusiastic until my YouTube search came up with the Romanian Ballad of Ciprian Porumbescu. Her face lit up and she listened intently, eyes closed, appearing to drink in the music. “He is very famous in my country,” she told me, and when the ballad concluded, she reminisced about her past, revealing more about her youth than she had in our previous three months of psychotherapy.
- Once I worked briefly with a man who was new to the nursing home and appeared lost. Trying to anchor him, I asked if he had any hobbies. “Irish dancing,” he told me. I searched for Irish dance music in YouTube and found a video of some Riverdance-type performers. His eyes brightened and, from his wheelchair, his feet jumped and pranced with remarkable skill. From the knees down, he was a Riverdancer; from his neck up, he was a happy man. After this intervention, I spoke to his children and asked them to bring him a CD player and some Irish music, and also shared the information with his recreation therapist so she could play his music on the unit.
Posted by Dr. El - October 20, 2009 - Boomers, Business Strategies, Communication, Customer service, Resident care, Resident education/Support groups, Technology
A recent study by the Phoenix Center looked at adults 55 and over, but not employed or in nursing homes, and found that Internet use decreased their level of depression by 20%. I’m not at all surprised by this, and I believe a similar decrease in depression levels would be observed in nursing home residents as well.
While residents are living together rather than isolated in their own homes, and therefore have more opportunities for socialization, there are still many people who don’t partake of the recreational activities offered for their enjoyment. Some residents never leave their rooms due to physical or psychological barriers, and some don’t like crowds. Other residents feel uncomfortable socializing because of the physical changes of illness, wish to pursue activities other than those available in the nursing home, or miss connecting with those outside the home. The Internet offers the opportunity for nursing home residents to transcend their physical illnesses, leave the boundaries of the facility, and connect with the world.
In an earlier post, I shared ways in which I use the Internet for therapeutic purposes, and I believe they’re worth repeating here:
1. Psychoeducation Regarding Illness:
Often residents are given diagnoses, but little information about them, leaving them confused or upset, which can result in noncompliance with medication and care. I search for a resident’s illness with them on the computer, and discuss the symptoms and treatment, which enhances cooperation with medical staff. Some residents are more receptive to information coming from a “neutral” source than from their own caregivers, and most residents appreciate a print-out of information they can refer to over time. Posting a list of illnesses and the Web addresses of important sites near the computer would facilitate this process (eg; The American Diabetes Association, the Amputee Coalition of America, etc).
2. Support Regarding Illness:
Most of the residents deal with their illnesses in isolation, when there are many avenues of support available to them on the Internet. Having the opportunity to “discuss” their concerns anonymously with peers can often be more effective than trying to generate a conversation between two or more residents at the nursing home, due to discomfort at revealing personal information. At strokenetwork.org, for example, stroke survivors can “meet” other survivors on-line and get information and emotional support, as can their caregivers. To find the appropriate support groups, enter the name of a particular illness and “support” into the browser window and look around from there. Another option: Look for a Yahoo group about the illness and sign up the resident after establishing a free email account through resources such as Yahoo or Google.
3. Connection with Family and Friends:
Why should residents have to limit themselves to family visits or phone calls when most of the rest of the country is communicating via email, Twitter, or a social networking site such as Facebook or MySpace? I’ve established email accounts for octogenarians to help them keep up with the grands, and a free Facebook page would accomplish the same thing with a bit more zing.
4. Reminiscence:
I once worked with a terminally ill 88-year old man who’d left Barbados in his thirties and had never realized his dream of seeing his country again. Imagine his expression as I entered “Barbados” into Google Images and up popped photos of the country he thought he’d never be able to see again. This intervention generated a flood of memories and a profound sense of relief and closure. Reminiscence could also be conducted in a group format, with connection to a large screen, so that residents should share with others information about their home countries or hometowns.
5. People Search:
One of my favorite things to do with residents on-line is to find their long-lost friends and relatives. For example, through the Internet white pages, I helped one extremely lonely and depressed resident find a friend with whom he lost touch sixty years ago. They are now enjoying an exchange of letters and photos, and my patient has something else upon which to focus besides his poor health and lack of visitors.
6. Fun & Miscellany:
Acting under the theory that doing something enjoyable will begin the upward spiral out of depression, I’ve occasionally brought a resident to the computer to listen to their kind of music (try shoutcast.com), to check out the latest fashions, or to see photos of famous movie stars (Google Images). Once a 97-year old Panamanian resident told me she’d felt unattractive all her life because she thought her lips were too big. “Oh, no,” I told her, “your lips are considered beautiful and the height of fashion.” She believed me after I clicked on Google Image photos of Angelina Jolie.
Do you have more therapeutic uses of the Internet? Please add them to the Comments section.
Posted by Dr. El - September 25, 2009 - Boomers
- Customer Service — Boomers will expect service more like a hotel than a hospital. For more on this, see my post Less Hospital, More Hospitality.
- Better food — They’ll want healthier food, with a greater selection, tastefully presented, in a pleasant atmosphere, and served by people who have the time and attitude to make meals a pleasurable experience.
- Computer Access — They’ll prefer a wireless facility, with computers adapted for disability.
- Outdoor Space — Boomers will expect to go outside in all sorts of weather, at all times of the day, onto an attractive patio. They’ll want to sign out of the facility AMA (against medical advice) rather than have to rely on others to go off-campus.
- Quiet Areas — A serene place within the facility to be away from the bells, buzzers, phones and alarms will be well-received.
- Mobility — Boomers will take the risk of falls in order to maintain their mobility and independence as long as possible. They won’t care about the facility’s falls policy.
- Motorized Wheelchairs and other adaptive devices — Knowing how much technology is out there, boomers will seek devices that improve their lives, and they’ll create what they need if it doesn’t already exist.
Have something to add? Comments are welcome.
Posted by Dr. El - August 24, 2009 - Anecdotes, Boomers, Customer service, Resident care
Here’s an interesting article on a brief nursing home stay by a medical student as part of her training.
Experiencing Life, Briefly, Inside a Nursing Home
By Katie Zezima
Published: August 23, 2009
MAMARONECK, N.Y. — For 10 days in June, Kristen Murphy chose to live somewhere she and many others fear: a nursing home.
Ms. Murphy, who is in perfect health, had to learn the best way to navigate a wheelchair around her small room, endure the humiliation that comes with being helped in the bathroom, try to sleep through night checks and become attuned to the emotions of her fellow residents.
And Ms. Murphy, 38, had to explain to friends, family and fellow patients why she was there.
Ms. Murphy, a medical student at the University of New England in Biddeford, Me., who is interested in geriatric medicine, came to New York for a novel program that allowed her to experience life as a nursing home patient.
To read the full article, click on the link below:
Posted by Dr. El - August 11, 2009 - Boomers, Business Strategies, Customer service
As Father Bart pointed out in his July 28, 2009 blog interview, one of the greatest challenges facing the residents of nursing homes is their dependence upon others to meet their needs. I often work with them on coming to terms with this unavoidable fact of life, and to find ways in which they can retain control over their situation. After numerous discussions about the frustrations of relying on busy staff or family members to purchase items for them, I began to consider the merits of an Independence Cart.
An Independence Cart is a roving store on wheels. Imagine if twice a week the residents could buy stationery, pens, stamps, phone cards, eyeglass repair kits, personal care items, or order a birthday present for a grandchild. It would give them some means of accessing the goods available in the outside world, and free up time that good-hearted staff and family members spend on burnout-inducing errands.
I once worked in a nursing home with a candy and soda cart that traveled from floor to floor. Items purchased in bulk were sold at discounted prices, and the money from the venture funded resident activities. Residents helped the recreation department leaders stock and staff the cart. It was a dietary disaster, but a practical and financial success. I believe that this concept, taken in the right direction, could be successful in every way.
Posted by Dr. El - April 24, 2009 - Boomers, Business Strategies, Customer service, Tips for gifts, visits
Dale Carter, of Transition Aging Parents, sent me the following question after reading my last post about caregiving for family members in nursing homes.
“Eleanor, when I went to check in to volunteer today at our local nursing home, I was chatting with a lady and she said the thing she missed most was not being able to get outside in the beautiful springtime. She was in a wheelchair. How do you respond when you hear that? Any suggestions on something the nursing home or a volunteer could do?”
As someone who plans to spend the spring, summer, and fall of my nursing home years out on the patio, it saddens me to see how difficult it is for many nursing home residents to get outside. Sometimes people tell me they haven’t been out for months, and occasionally years, or only for clinic appointments. I have several suggestions to help nursing home residents get some fresh air.
- If getting outside is important to you, pick a nursing home with accessible outdoor space. Be aware that some nursing homes limit the times of year the patio can be used.
- Try to get a room on the ground floor of the building, so it’s easier to get outside.
- Attend activities such as barbecues and outdoor games provided by the recreation department.
- If you’re unable to wheel your own chair, encourage family members to go with you to the patio, or off-campus, if there’s no patio, even if it’s just wheeling around the block.
- Enlist a volunteer to bring you outside, either through the volunteer directly, the volunteer coordinator, the social worker, or another advocate.
- Recruit staff members to take you out. If you’re able to stay outside by yourself, or with another resident, ask one staff member to bring you out, and another to pick you up at a certain time, such as before lunch. Try to make it convenient for their work schedule.
- If you can’t wheel your chair, but have private funds, and the nursing home permits it, buy an electric wheelchair and get out there on your own.
- If there are nursing home-wide difficulties accessing outdoor space, this can be addressed in Resident Council Meetings or with the nursing home administration.
