Category: Tips for gifts, visits
Posted by Dr. El - February 24, 2010 - Engaging with families, Tips for gifts, visits
In my years as a psychologist in long-term care, I find it’s normal for new residents to be feeling some depression or anxiety. Most of us would take time to adjust if we were away from home, feeling poorly, not able to get around like we used to, and living among strangers. With a few simple interventions, family members can help ease this adjustment process and reduce the likelihood the depression or anxiety will be long-lasting.
Call or visit regularly – It helps residents to know that Junior will call or visit every Sunday, or the first Monday of the month, rather than wondering when their next visitor will arrive. If schedules need to be more flexible, calling in advance of a visit will provide days of looking forward to your arrival.
Attend activities together – One of the best features of nursing homes is the opportunity to try new things and meet new people. Check the recreation calendar to find events of interest to your loved one, attend them together, and point out other activities that might be enjoyed in your absence.
Facilitate friendships with other residents – Ask the social worker or recreation therapist if they know other residents with similar interests, and bring them together to talk about baseball, their hometown, music, etc.
Bring photos or other mementoes – Even if the stay will be a brief one, it can be comforting to have a family photo or other sentimental object in the room. Bring items that are important but not irreplaceable.
Throw a room-warming party – For residents who enjoy company, invite friends and relatives to an open house to encourage visitors. For more on this, see my blog post
Throw Me A Party.
Enjoy some home-cooked food – Sharing a home-cooked meal, or some take-out, within dietary guidelines, is a great way of bonding and of bringing the comforts of home into the nursing facility.
Request an evaluation by the psychologist – If you’re worried about your loved one, ask the team for a psychological evaluation. Most psychologists schedule weekly sessions, if needed, to discuss concerns, but don’t prescribe medication. (That’s the job of the psychiatrist.)
Develop your own supports – Residents often worry about the burden they’re placing on their family members. Help them by helping yourself. There are tons of support options out there, from online resources to in-person support groups, with some of them listed in the Resources for Family Members section in the sidebar of my blog.
Posted by Dr. El - December 4, 2009 - Communication, Customer service, Resident care, Tips for gifts, visits
In a staff meeting the other day, the social worker mentioned her new resident was having difficulty because he didn’t speak any English. It was arranged that the director of the Dietary Department would go up to act as translator.
“I know a website where you can get language cue cards with health-related words on them,” I told the team.
“What language do you need?” I asked her, looking at a list of over 60 languages ranging from Italian, Spanish, and German to Ukranian, Farsi, Swahili, and Japanese.
“Punjabi.”
A few seconds later the pages printed out, and were at the 4th floor nursing station within the hour.
Each sheet contained pictures of important social and medical issues, with the English and Punjabi words for them below. The selection included “husband,” “wife,” “sit down,” “shower chair,” “diabetes,” “pain,” and “hospital.” Nestled between “audiologist” and “psychiatrist” was the Punjabi word for “psychologist.”
Posted by Dr. El - November 29, 2009 - Tips for gifts, visits
With Hanukkah and Christmas just around the corner, you may be wondering what would make a good present for a relative in a nursing home. If you check my sidebar under Products of Note, you’ll see some possibilities, a few of which I’ve blogged about earlier in the year. (Try using the Search tool in the sidebar to find a post on a particular item.) In my efforts to banish the barren nursing home room, photos are still my number one pick for holiday gifts, but here are other suggestions (be sure to label everything!):
- Nice lotions, soaps, and grooming products
- A special bedspread
- A “lap” blanket to wear while sitting in a wheelchair
- Wheelchair accessories (Google it) like cup holders, side pockets, wheel lights, etc.
- Sturdy clothes that can handle being washed in an industrial washing machine
- Colorful bangle bracelets to blend in with nursing home wrist bands
- Plants, or potted flowers, especially if you can come by to water them regularly
Great gifts from the heart:
- Make a commitment to visit once a week, or once a month
- Make a commitment to call once a week, or once a day
- Organize friends and family so that each person has a week to call or visit
- Bring a home-cooked meal
- Organize friends and family to bring a home-cooked meal on a regular basis
Posted by Dr. El - November 3, 2009 - Engaging with families, For Fun, Tips for gifts, visits
In my post, What I Want My Nursing Home Room to Look Like, I mention I’d like to have family pictures in my room. Actually, I’d like everyone to have family photos in their nursing home rooms, in addition to photos of themselves when they were young. Before I started in long-term care (I was working at the state psychiatric hospital at the time) and Grandma Lily was in a nursing home, I bought a multi-photo frame, inserted pictures of the family, and hung it on her wall. It transformed the previously anonymous space and I felt happy to see her surrounded by loved ones whenever I came to visit. Pictures and memorabilia tell the story of someone’s life and remind everyone who the person is. They’re the single most homey addition to a room and they last longer than flowers. I’ll be talking more about the holidays as they approach, but if you’re wondering what to get a nursing home resident, photos are an excellent gift.
My parents were thrilled with their 50th wedding anniversary gift of a photoscope created by the talented Sue Samek of Photoscope Gifts. Sue creates one-of-a-kind artwork from your photos.
Here’s a photoscope of Sue’s family, and a detail of the work. She also creates photoscopes for hobbyists (cat lovers, gardeners, etc), travel buffs (a great idea for vacation photos), and any series of photos you can imagine.
Posted by Dr. El - October 6, 2009 - Anecdotes, Tips for gifts, visits
I peered into Ms. Alford’s room and saw a visitor sitting in the chair next to her bed, where she was sitting with a stack of photos on her lap. Ms. Alford noticed me and waved me into the room with a broad smile.
“This here’s my son, Willie.”
“And you are?” His worried eyes met mine.
“The psychologist, Dr. Eleanor Barbera. I’ve been seeing your mother since just after she arrived. I’m glad to meet you.”
“Can I talk to you?” He was out of his seat even before I got Ms. Alford’s nod of assent. We stepped into the hallway and spoke in hushed tones. “How’s my mother been doing? She was so depressed the last time she was here.”
“Well, she was very withdrawn and not eating well or working with the staff when she got here a few weeks ago, but she’s doing better now. I only see her once a week and I’m not on the floor all the time, but it seems to me things improved after I took her upstairs to meet with an old coworker of hers who happens to live here too.”
“Really?” He looked at me with pleased surprise.
“I tried to get them to hook up at some activities afterwards, but it can be hard to arrange. Being on different floors can be as difficult to connect as being in different states. But here’s her friend’s name and room number,” I scribbled it on a sticky note, “If you could help them get together, that would be great.”
“I could definitely do that.”
I shifted my gaze to his mother, who was watching from her bed in her house dress, her hair flying in every direction. I waved and she smiled and waved back. “Your mom really needs to get her hair done.”
“I used to cut it for her. I could do that again. It would be a great bonding activity.” His mood was lighter and he sounded excited.
“That would be awesome. I’m sure she’d really appreciate that.”
We headed back into Ms. Alford’s room and the three of us talked for a while before I signaled it was time for me to leave.
“Thank you so much,” Willie Alford said to me, “you’ve given me more than I could have hoped for.”
“I’m glad,” I replied, happy Ms. Alford had a son who so obviously cared about her welfare.
Posted by Dr. El - August 20, 2009 - Business Strategies, Customer service, Tips for gifts, visits
I saw this great idea posted on McKnights this morning. My suggestion is, if needed, the residents address it in their Resident Council Meetings to see if they want to raise the funds themselves.
http://www.mcknights.com/Turning-on-the-lights-for-nursing-home-residents/article/146809/
Turning on the lights for nursing home residents
Eric Smith August 19, 2009
In 2004 I accepted a position at a skilled nursing facility (SNF) as a maintenance assistant. I was excited to have this new job as I felt the experience of being in an environment among senior citizens would be very rewarding. I had previously assisted the elderly and I remembered how enjoyable it was. The job however, was challenging, but I loved the work and it was a great job.
For the first 18 months I worked under a maintenance director whose favorite answer to almost all issues was “fix it,” and he would further go on to add, “I don’t care how long you take just fix it.” Well, one of those issues happened to be me constantly replacing the over-the-bed light switches. The problem was that the residents would tie the string that activated the light switch to their bed rails, electrical cords, bed sheets, stuffed animals or to anything they could reach easily due to their limited dexterity. Whenever these items were moved by the staff or sometimes by the residents themselves, they would inadvertently rip the string from the light switch damaging the switch, making it inoperable. Now the maintenance director had a problem with not just me spending the time to replace the switch but also incurring the cost to replace the damaged switches.
I did not like his solution to the problem. My boss had made a decision that all strings that were tied to bed rails, etc., be cut loose immediately. Unfortunately for me, I was instructed to carry out this unpleasant task. To this day, it remains among one of the most difficult things I have had to do. Residents begged and pleaded to me, used vulgarity, cursed me and even tried to bribe me not to cut their strings loose.
Then the company promoted me and moved me to another facility. I was now the maintenance director and the “string problem” existed here too. The strings were tied to call cords, bed rails, stuffed animals and even towels. I have further come to recognize that not only do the residents have limited physical dexterity; they also have a problem gripping the very thin strings that come with these light fittings. This is a common problem I have seen it in every SNF I have visited. Some buildings were new and the residents had those silly strings tied to anything they could reach.
I had an idea and a friend of mine and I fabricated a bracket. We installed the bracket to the reading light in the nursing home and it WORKED!!!!. We then had a tooling company build 10 of the brackets and I installed some of them in my building. The residents loved them. The first resident that got a bracket for her light was Mrs. Pittman. I asked Mrs. Pittman to tell me in her own words what she thinks about the bracket. These are her words:
The new overhead light switch is great. It is easy to reach from my bed and to locate. The chain is a whole lot better than the string as it is clean and doesn’t wrap around anything. Just pull the chain and the light is there. Sure looks nice the way it is put up. Thanks so much.
Frances Pittman
I installed five more brackets after that and everyone thought they were great. When a resident would move to another room that didn’t have a bracket they would ask me to move the bracket to the new room. Family members would ask me if I could put one in their loved ones room. I even had a resident that intentionally kept breaking her light string in the hopes of us putting a bracket in her room. Unfortunately, my resources were limited. We only had 10 units. The residents that had a bracket in their room told me there is no way they could reach their light string without it. I’ve also been told by the residents how nice and clean they are.
I have since talked to nursing home owners, CEOs, administrators, designers, architects, builders and even the Department of Aging and Disability. Everyone thinks it is a great idea, but nobody wants to do anything about it. In the four years I have worked in SNFs, I have come to understand how things work or how the “game is played.” Things change only if the guidelines, rules or the code dictates it. The phrase, “we will wait for the state to write it up then we will fix it,” is commonplace in our business. In other words, we’re not going to spend any money until we have too. I think that is exactly the same mindset I’m seeing with this problem. Nobody wants to spend the money to address the problem until they have to. In the meantime the residents are the ones that are doing without.
The Texas Administrative Code, Title 40 Part 1 Ch. 19 Subch D Rule 19.334(a)(6) states:
Each room must have general lighting, bed reading light, and night light. …. A durable nonglare (opaque front panel) reading light securely ancored to the wall, integtrally wired, must be provided for each resident bed. The switch must be within reach of the resident in the bed.
I would venture to say that more than 80% of SNF residents cannot reach their switch from their bed.
Eric E. Smith is director of maintenance at the Winters Park Assisted Living and Memory Care in Garland, TX. Smith can be reached at Eric2960@gmail.com.
**The EasyReach Bracket is available for sale. For ordering information and sample requests, contact Niven Padachy at (800) 641-2345. Check out the Web site at http://txerich.com/
Posted by Dr. El - June 11, 2009 - Dementia, Tips for gifts, visits
My Grandma Lily lived for several years in a nursing home, and toward the end of her life she became quite confused. While this was disturbing to me and the rest of the family, I found when I changed my approach and expectations of our time together, our visits were more successful. Between that experience, my training as a psychologist, and my work in nursing homes, I’d like to offer some suggestions of what might be helpful to others in their visits with residents with dementia. If you have additional tips that have worked for you, please add them to the comments section.
Post family photographs, with labels that indicate the names and relationships of those pictured. It will serve as a reminder for your family member, and enable the nursing home staff to reinforce connections. I filled an inexpensive multi-photo frame with pictures, wrote the names on the mat between the photos, and hung it in a spot my grandmother could see from her bed.
Put a calendar on the wall and log your visits to help your loved one remember when you were last there, and when you’re planning to return.
Create a sign in book for guests, so your relative can review it after you’ve left. Add details (“Shared a pizza.” “Talked about the time we went to the circus.”) to refresh memories and to allow other callers to pick up the thread of conversations.
Leave other visible reminders of your visit — flowers, balloons, cards, photos, etc.
Turn off the TV, close the door, and minimize background noises during your time together.
Sit in chairs and on the bed so that you’re at the eye level of your seated relative. One family I know brought in small folding chairs, labeled them, and tucked them in a corner when not in use.
Use visual cues such as photo albums and small keepsakes during conversations.
Sing songs, listen to music, and dance, if possible. I used to exercise with one lady in the nursing home, running an individualized stretch class with her following along. She was very good at it, and I believe it helped her stay on her feet longer than she might have otherwise.
Go outside and share the sunshine, the breeze, and the respite from bells and buzzers.
Ask questions you know your loved one can answer, and don’t ask those your relative cannot. The goal is to provide a “success experience.” Not being able to respond correctly to a question once easily answered can be frustrating and/or embarrassing for someone with dementia, and upsetting for those visiting.
Redirect, rather than contradict, if your relative insists that something is true when you know it’s not. For example, I once woke Grandma Lily up from a nap and she said, “Eleanor, what are you doing here in the middle of the night?”
“But Grandma, it’s the middle of the afternoon,” I told her as I opened her window curtains. “See, it’s still light outside.”
“Oh, it’s always like that this time of year!” she told me.
Seeing I wouldn’t win that argument, I shifted the discussion to another topic, and I’ve savored the humor of that moment for years.
Let go of expectations. While Grandma Lily wasn’t the same person she used to be, she still had a lot of the same general characteristics (for instance, all visits had to include food), and she was glad to see me, even if she didn’t always know who I was.
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.
Posted by Dr. El - April 20, 2009 - Tips for gifts, visits
I’ve read many blogs and websites out there for caregivers whose loved ones live at home, but I haven’t seen as much for those with family members in nursing homes. While the role of caregiver may shift considerably once someone enters long term care, there is still much caregiving to be done. What follows are some of the most helpful practices I’ve observed in families in my work as a psychologist in New York nursing homes.
- Visit regularly
- Call regularly
- Attend Care Plan meetings, where the nursing home team meets to discuss the resident’s care
- Provide information about pre-nursing home health and behavior
- Display family photos
- Send cards, which can be posted in the room
- Bring flowers, or preferably plants, and keep them watered
- Plan off-campus outings, if possible
- Make use of the nursing home patio or outdoor space
- Learn and use the names of team members, especially aides, nurses, and social workers
- Keep the closet filled with presentable clothing
- Attend activities together
- Work to resolve family conflicts so there is a clear “front man” and communication chain
- Keep a calendar or log of visits, especially for those with dementia
- Encourage and facilitate friendships with other residents
Posted by Dr. El - March 17, 2009 - Anecdotes, Communication, Engaging with families, Resident care, Tips for gifts, visits, Transitions in care
Please:
- Hang my psychology diplomas on my wall, so I’m reminded of my accomplishments.
- Display family photos, so I feel surrounded by my loved ones.
- If I have Dementia, label my photos so the staff can talk to me about my family and help me to remember.
- Put a quilt or bedspread on my bed from home so my room won’t look so institutional.
- Over my bed, put up the Halloween photo of me dressed as Wonder Woman, to remind everyone of my hip and glamorous past.
- Make sure I have some nice clothes in my closet (and some lipstick on my lips), so I can continue my hip and glamorous life.
