Posted by Dr. El - November 29, 2010 - Boomers, Business Strategies, Communication, Customer service, Engaging with families, Technology, Younger residents
Looking for a great, inexpensive way to create some good will and holiday cheer at the nursing home this year? Why not set up a call center using Skype? Residents, families, and staff members can sign up to call loved ones around the globe, conversing with them via video call.
What it would take:
- A laptop or desk-top computer set up with FREE Skype
- A semi-quiet, semi-private area for conversations
- Tech support, or volunteers who know how to use Skype (for example. high school students or tech-savvy residents)
- A pre-call information sheet for families so they can set up Skype on the computers of those they plan to call.
- A sign-up sheet to maintain order in what is likely to be a wildly popular service
Posted by Dr. El - May 24, 2010 - Business Strategies, Communication, Customer service, Engaging with families, Technology
For families with hectic schedules, trying to attend Care Plan Meetings, which occur during daytime work hours, can be a major challenge. Of course they don’t want to miss the opportunity to meet with the whole treatment team to provide and gather information, and to advocate for their loved one. On the other hand, taking time from work and other obligations may prevent even the most dedicated family member from being able to show up for this very important meeting. Using the free Skype or another video call option would allow family members to be present from almost anywhere — even halfway across the world.
For nursing homes, offering families the option to Skype into Care Plan Meetings shows their understanding of the challenges faced by family members and their dedication to customer service. It highlights their commitment to providing the best possible care for the residents, which includes facilitating the ability of families to be part of the treatment team. And did I mention it’s free?
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 - May 10, 2010 - Business Strategies, Communication, Customer service, Engaging with families, Technology
My hip 80-something mother-in-law uses
Skype’s free video calls to view the family as she talks with them over the computer. I’d like to see video calls in nursing homes, either via a video phone or over the Internet in the resident computer room (what, your facility doesn’t have a computer room yet?).
- Families could literally see how their loved ones are doing, relieving anxiety and contributing valuable information to the treatment team. (Who knows better than her family that Mother isn’t quite right today?)
- It would allow long-distance family members to participate more actively in the lives of their loved ones.
- A laptop could be put on a movable cart in a wifi hotspot nursing home to bring to the rooms of residents who are unable to get to the computer room, reducing isolation.
- It’s a great marketing tool for families and residents alike.
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 - April 13, 2009 - Business Strategies, Customer service, Resident education/Support groups, Something Good About Nursing Homes, Technology
At the Center for Nursing and Rehabilitation (CNR) in Brooklyn, New York, Recreation Director Brenda Torres, has established computer stations with Internet connection in all the “neighborhoods,” as they call their units, and has several groups currently being run by the residents themselves. I believe both of these steps are essential for the emotional health of residents, but as they are all too rare in nursing homes, I asked Brenda if she’d share with us how she managed these accomplishments. She graciously agreed, and what follows is my interview with one of the most talented, dynamic, and creative people in the field. You can visit her at technohealer.com for more information about her work.
How long have you been a recreation therapist and why did you choose to work in nursing homes? I’ve been in Recreation over 19 years. I was a psych major and had been gifted in the arts and when I started working in adult day care, I was able to use my art and my psych background, as well as an exercise component. I work with both young and old folks through the intergenerational program at CNR. I don’t focus on age, I focus on abilities.
You’re a big advocate of the use of technology with the residents. What do you see as the benefits and how did you go about getting the administrative support and financial backing for this? Walking through the nursing home halls, I noticed there were a lot of bed-bound residents, and I wished there was a way to get the activities to the residents because they couldn’t get out to them. I had a vision of having a mobile computer unit, so I started Googling it. At the time, they only had a unit that was used for hospital paperwork, so I started to research adaptive devices. At about this time, you and I started talking about a particular young resident and how he would benefit from Internet access. Using your testimony about the need, and other paperwork such as photos of the computer unit and information about the cost, I put out a request for funding. Two and a half years later, the funding came through the CNR community advisory board, which had collected the money through community fundraisers. Now CNR has a mobile unit, which we call R2D2, that brings games and activities as well as Internet access to bed-bound residents, in addition to multiple computer stations throughout the nursing home.
Some of your residents run their own groups. Do you think this has been beneficial for the residents and group leaders? Currently I have a poetry group, a bible group, a collage art group, and a crochet group run by the residents. The President of the Resident Council is in charge of games. Another resident is in charge of R2D2’s “wife” Techno, whom we were able to purchase through additional funding, and other residents come to her to gain use of it. One of the main benefits of having the residents run their own groups is empowerment. It gives them self-worth, a sense of being part of a community, and it gives them purpose. Being empowered prolongs their life and makes them feel needed. Traditionally in a nursing home, people tend to feel like they don’t have a life, that they’re just there until the end, but it’s not true. These are individuals who are survivors, they planted the soil for the new leaders. If it wasn’t for them, we wouldn’t have Obama. They are the blueprints to our society.
How would you suggest a resident who wanted to start a group within their facility go about doing this? [I thought the residents were coming to Brenda to ask if they could run a group, but I learned it was Brenda who was approaching and encouraging the residents.] Before you start a group, look at the needs and skills of the residents and assess the skills of the potential leader. The challenge is how to address a possible leader. I share with them the notion that leisure should not be work, it should be a fulfillment of purpose. It can take time to nurture a potential leader. Display their gifts, show them they still have the ability, invite them to teach others. Help them to visually see the group. We have to take away the barriers, using visual guided imagery. It can be a process taking up to a year, highlighting abilities, and providing reassurance.
What kind of practical support do you offer them in terms of set-up, supplies, etc? We do help with supplies and bringing the residents to the group. A staff member stays with the group as needed, puts up fliers for recruitment, reminders of the group, etc. It can start out at 100% support and eventually over time it moves to 30% support.
Are there any changes you would like to see in long term care in general, from your perspective as a recreation therapist? Yes, many. There has to be change in all long term, because life is changing. The changes have to match our lives, like technology and aging baby boomers. We have to make society paint a picture of long term care in the future, because then it will be more acceptable to be in a nursing home and they will be ready for people like you and me. All the work I am doing is part of building my own home for the future.
Posted by Dr. El - December 18, 2008 - McKnight's Long-Term Care News, Technology
http://www.mcknights.com/Long-term-care-residents-can-benefit-from-the-Internet-too/article/123005
The Internet as Therapeutic Tool in LTC
On November 4th, 2008, McKnight’s reported on a study that Internet use stimulates the elderly brain. Perhaps you’re wondering what your residents would do on the Internet and whether or not it’s worth your time and investment to establish access for them. As a psychologist who has used the Internet extensively with LTC residents of all ages, I’ve found that every resident I’ve taken to the computer room has been thrilled to see what all the fuss is about and amazed at the possibilities offered to them. Below are a half dozen ways I’ve used the Internet with my residents. Given proper instruction, these interventions can be carried out by staff members, a resident’s family, volunteers, and/or the residents themselves.
1. Psychoeducation Regarding Illness
Often residents are given diagnoses, but little information about them, leaving them confused or upset, which sometimes results in noncompliance with medication and care. I often 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 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.
With access, instruction, assistance, and encouragement, I foresee residents of the future getting high school and college degrees on-line, learning languages, and participating more actively in the political process. To continue to the discussion, visit me at mybetternursinghome.blogspot.com or reach me at efeldmanbarbera@nyc.rr.com.
