Intergenerational Programs - Getting Our Youth Involved

The Sparks of Life Program More Evidence of the Healing Power of Music

Thanks to reader Laura Bramly who alerted us to this program in Australia. It is called the Sparks of Life program and uses music therapy, along with leaders trained as facilitators. Here is a link to a video. It shows two people with dementia who were unresponsive prior to taking part in the program.

It very much supports this notion of music as therapy and even more so supports the fact that you need to approach and accept the dementia or Alzheimer’s patients where they are. In other words whatever world they are in on a particular day that is the world you acknowledge and occupy. That is their reality.

If you should visit a nursing home be aware of the world that residents occupy and step into it. You will enrich their life and yours.

Study Reports Nursing Home Satisfaction at Its Highest Level

The 2008 National Survey of Consumer and Workforce Satisfaction in Nursing Homes released today by independent research firm My InnerView shows a majority (85%) of consumers report their nursing home satisfaction as either "excellent" or "good." Sixty-six (66) percent of employees recommend their facility as a place to work as either "excellent" or "good."

According to the pollster, these satisfaction levels are at their highest levels since they began this research in 2005, and have increased by three percentage points since 2007. One in every three facilities in the United States participated in the survey, with responses from 223,449 employees, 54,711 residents and 146,949 family members in 5,075 nursing facilities across the United States.

Keep in mind that the company administering the survey is a company that sells its satisfaction measurement services to long term care facilities so they naturally will put the best spin on the data. And that data may eventually affect pay for performance reimbursement.

Indeed the levels of satisfaction may have gone up but to think that 85% of consumers reporting their satisfaction as excellent or good is a great number is misleading. First of all, their press release does not define consumers. If you are grouping residents and family members together that is misleading because families may see a whole different care perspective when they drop in versus the resident who experiences the care full time. And at the end of the day only the “excellent” responses count.

And the report shows that the workers most directly involved in patient care are the least satisfied employees and notes that job stress is a significant opportunity for leaders to address in order to improve nurse and nursing assistants' satisfaction, while meeting resident choices and preferences. If only 66% of your employees would recommend you as a place to work then that is not a good score. And eliminate the “good” responses and keep the “excellent” and you will probably find an even worse score.

Here’s the thing. This data does not jive with public opinion and perception. So even if it is accurate the industry has a long way to go to prove it.

I believe that a great resident experience starts with a great employee experience and it is not about a one and done let’s all smile and be nice to each other program. It is about creating a culture around the resident. When this happens satisfaction improves, word of mouth marketing improves and revenue increases.

Satisfaction surveys only skim the surface. Deeper probing reveals the truth. A long term care facility that is truly centered around the resident does all that it needs to do to make sure the resident is front and center. It does not just perform in those areas that affect a survey question and possible reimbursement. Facilities that do that are not those who have a culture revolving around the resident. They are simply manipulating data to make themselves look good.

When you center on the resident, the satisfaction scores will increase as a byproduct of that. So facilities need to ask themselves what their motives are at the end of the day – better scores or a culture of resident centered care. And they can not be satisfied with anything but “excellent” responses to any questions regarding the recommendation of the facility. The rest do not matter. And as the numbers indicate, while improved, there is a long long way to go.

After reading the survey in its entirety I will re-post my thoughts and give you an update.

More on Music Therapy and the Healing Effects of Music

This on CNN.com, a perfect reminder of the healing effects of music on hospital patients and the elderly.

AT&T Testing Technology to Aid Fall Prevention

AT&T is experimenting with telehealth devices and a communications network that might reduce falls in the home. One of three people over 65 fall each year. Almost a third of these accidents require medical treatment, and 10% result in serious injury or death. Nursing homes experience a fall a day among residents.

AT&T is testing shoe insoles with built-in sensors that take gate, stride, and pace measurements as patients walk. The measurements are beamed wirelessly to a modem-like gateway box that's connected to a health-care network via the Internet. AT&T's scientists are hoping that by catching changes in a patient's walking pattern, the software can alert doctors to a problem before they take a tumble.

Read more here.

Document Nursing Home Abuse In Order to Fight It

I came across a thoughtful blogger who documented his/her grandmother's alleged abuse at a Virginia nursing facility after years of otherwise wonderful care in an assisted living facility. It is a very thorough documentation of abuse and that struck me. Unfortunately there was a bad ending to the story and that haunted me and scared me.

Here was a family that was in the facility 25 hours a week advocating for their loved ones and they still could not get results. They lived in fear that the grandmother would be thrown out of the facility with each growing complaint. And that is a culture we must change. It needs to happen on several fronts. The nursing home staff have to be connected to a higher calling of helping their residents lead a quality life. No amount of legislation can change a bad culture.

Nonetheless this blogger has some thought particularly on Virginia legislation that would help curb abuse. I will list some of those here, many of which are applicable not just in Virginia but across the country.

1) Procedure by which residents and/or family members can voice concerns and file formal complaints/requests for correction of care without the fear of retribution, either by means of maltreatment or displacement from the facility.

2) Formal written procedures should be in place allowing each request that is made by a resident or family member to be documented and followed in order to avoid family requests for medicine, hydration treatment, special diets, and other standard routines being ignored or going unanswered.

3) Provision for the availability and use of in room cameras that can be installed and used by residents and residents’ family members to document and ensure proper care via internet access (viewing and recording), at the request of the resident or family members.

4) Requirements for the automatic reporting of incidents of deaths and subsequent investigation of deaths resulting from causes that suggest neglect such as dehydration and infections not associated with a preexisting medical condition.

And specific to Virginia -

5) Section VA 5-371-150 should be amended to require that a resident’s rights and complaint/grievance procedures be reviewed and explained to the resident and family members not just annually, but upon admission to the facility.

6) VAC 5-371-170 Quality Assessment and Assurance needs to be amended to require that internal quality assessment and assurance committees consist of at least two people who are current residents and of sound mind to actively participate or who are family members of current residents and should be attended by a representative of the state OLC (Office of Licensure and Certification).

For those in Virginia, support our blogger. And everyone else heed the warning. You can live in the facility with a loved one and that is still no guarantee they will get treated right. And do what this blogger did, keep a journal documenting care but act on it daily.

Joan Rivers Celebrity Apprentice Win Should Be Noticed

Love her or hate her just as do with The Donald you nonetheless have to admire Joan Rivers for her energy and for doing older people proud.

As she stated in this Larry King interview, "So many people in this country are counted out from the age of 60. When I walked in, I looked them all over, I thought: 'I can take you all with one behind my back at 75.'

And she did. Joan is intelligent, tells it like it is and is a successful businesswoman and she is a smart marketer. That gets my attention. You know my mom is 87 and she is very much like Joan, tireless, smart, says what's on her mind and has something intelligent to say.

Thanks Joan for calling attention to what "old" people can do.

Call Congress for Long Term Care Reform

AAHSA is hosting a Congressional Call-In Day tomorrow, May 13, 2009, from 8 a.m. to 6 p.m. Eastern in an effort to get long-term services and supports included in upcoming health-care reform legislation.

They believe health reform without long-term care services is not a comprehensive solution. I agree.

Please call their toll-free number: (800) 687-3813. You will be prompted to give your state name and will then be connected to one of your senators.

More information, including a sample phone script, can be found on the site.

Pet Therapy in Nursing Homes

I came across this "obituary" for Boo. Boo was a therapy dog who made 3,000 visits to nursing homes during his career. Pet therapy is just one of many ways to be of service not just this week, National Nursing Home Week, but all year round. Let's just hope that people's concern with infection control is balanced with the great work provided by pet therapy and pet therapists.

Music Therapy Aids Dementia and Alzheimer's Victims

My mission with seniors started when an avocation for singing turned into an advocacy for older adults. I still perform in facilities and use songs in my keynotes. I know firsthand the value of music therapy on dementia and Alzheimer's patients.

This NYT article validates it.

When looking at a care facility take time to participate and evaluate the activity programs. There are some facilities that still meet the stereotype of plopping people by a television and leaving them there. Then there are the progressive ones. Those that use progressive methods like intergenerational programming and music therapy are able to unlock something inside our elders and even halt some of the steady progress these conditions inflict on people.

New Bill Would Protect Senior Citizens from Scams, Fraud and Abuse

Three Congressional representatives have introduced a new bill to protect senior citizens from scams, fraud, and abuse. The bill would give state and local governments more resources to combat elder abuse.

Some measures included in the bill:

Establish an Elder Justice Coordinating Council to coordinate activities of the Federal, State, local and private agencies and entities relating to elder abuse, neglect and exploitation.

Improve the quality of information and research related to elder abuse.

Create new forensic expertise in elder abuse.

Establish penalties and prosecution for failure to promptly report crimes in long-term care facilities.

Provide a first-time direct funding stream for Adult Protective Services (APS).

Establish an advisory board to create a short- and long-term multidisciplinary strategic plan for the developing field of elder justice.

Authorize $72.5 million over four years for national organizations or states that represent or train long-term care ombudsman representatives to provide training, technical assistance, demonstration programs and research.

Authorize $67.5 million over four years in grants to enhance long-term care staffing through training and recruitment.

While the nursing home industry has and justly so been maligned, it should be noted that elder abuse in many cases and in all its forms is often instigated by family members. That said we need more dedicated staff in facilities and more ombudsman patrolling the corridors.

Senior citizen scams, fraud and abuse preys on our least vulnerable. They need to be protected.

Even Funeral Homes Understand the Experience

Did you catch the article about funeral home experiences in the NYT? Very interesting. Funeral directors are starting to understand that the experience even extends to the dead (and their love ones) as they customize the ultimate send off.

Bike lovers pay an extra $200 or so to take their last ride in a special hearse towed by a Harley motorcycle. Gardeners select wildflower seed packets to include with their funeral programs. One gentleman wanted to be remembered for comforting his grandchildren with ice cream, so, after the funeral, mourners were greeted by a man in a Good Humor truck, handing out frozen treats.

With cremations on the rise, rental coffins available, even home funerals, it is easy to see that the industry has to adapt to survive.

Many funeral directors are compensating for lost revenue by offering new services like video tributes, grief counseling referrals and memorial items including ceremonial urns, keepsake jewelry, wind chimes and sundials that hold a portion of cremated remains.

So if the darn funeral industry gets the experience, how come many hospitals and long term facilities still don't understand this concept?

Price Transparency and Hospitals

Here is a guest post written for Health Leaders on price transparency in health care.

4 Secrets of Aging in a Healthy Way

This guest blog is written by Kat Sanders, who regularly blogs on the topic of phlebotomy technician salary at her blog Health Zone Blog. She welcomes your comments and questions at her email address: katsanders25@gmail.com. Kat supports many of the things we contend on a daily basis in this blog and the fact the aging in a healthy way starts with you and I taking self responsibility for our lives. Thanks Kat.

My maternal grandparents are still alive –my grandpa is now 83 and grandma is touching the octogenarian mark. They’re both in relatively good health considering their age, and except for the normal aches and pains and complaints associated with geriatrics, they’re able to cope on their own. Although they live with my uncle and his family, they’re able to take care of their own needs and don’t need nurses or helpers to babysit them. In my opinion, my grandparents have aged gracefully and healthily, and the reasons for this are:

· They were busy people with lives of their own until five years ago: If I had one wish, it’s that I’m as active as my granddad was when he was 80. He’s pushing 85 now, and up until five years ago, was active in the business he set up as a teenager and built into the successful operation that it is today. He was a dynamo who could not be stopped by any amount of discouragement because of his age or frail condition. Only the onset of an enlarged prostate gland and the ensuing surgery reduced him to a life of leisure (although he’s still on the phone and taking care of business when he’s not sleeping). Grandma had her own life which included the kids, grandkids and her social engagements. Staying busy helps you forget that you’re aging, and when you’re fully occupied, you don’t have the time to dwell on disappointments or failures.

· They’re surrounded by family: We visit often, but my uncle’s family is always there with them. The grandkids and great grandkids keep my grandparents’ spirits alive, and they’re never lonely, not with all the cacophony that surrounds them. In my experience, people tend to age faster when they’re lonely because they’re depressed when they don’t see and interact with other human beings who love them.

· They’re still independent: There’s a great deal to be said about independence, the feeling that you’re able to look after yourself and not have to depend on someone for the simplest of things. A balanced diet, regular exercise and a low level of stress all through your life allow you to age in a healthy manner and thus retain your independence. Mental health is extremely important too, so stimulating your neurons with challenging activities keeps diseases like Alzheimer’s and dementia at bay.

· They’re resilient: My grandma suffered a collapse 10 years ago and doctors said she would never walk again. But she proved them all wrong by walking just 6 months after the diagnosis. A good physiotherapist and a large amount of resilience and determination was all it took for her to be back on her feet again. When you’re resilient, you can postpone the negative effects of aging as long as possible and so lead a more fulfilling life.

Co-housing Yet Another Alternative for Senior Living

Came across this article in U.S. News on a novel but not new form of senior housing, sort of communal living where everyone in the community takes care of the other.

Actually we have friends who are talking about this very concept. Who can we bring together to live with as we grow older that will complement our life and make us all better as a result of being together. So boomers are already talking about co-housing without needing someone formally to build a community for them.

What I found interesting were the comments. Some were uneducated like older folks are living off the public dole so implementing these communities might be less expensive and therefore lower taxes. Don't people realize that our elders contributed to the very systems that are aiding them when they age? They paid into social security and Medicare. And besides neither have anything to do with the discussion.

Another person wished that more Americans were like Asians who bring their families together and take care of their elderly. Sadly that is changing in the Asian culture as there are more and more two earners in the family with no one home to give their parents the attention they need. So that is changing as well. Yes it's great that the Obama's took in Michelle's mother but frankly that was probably more to do with the grandkids than her own need for care.

The fact is we need to take better care of ourselves and avoid institutionalized care in the first place. And then we need to face the facts that most of the healthcare burden in our lives is eventually going to fall at our feet.

I think this co-housing idea has merit.

Eating Disorders on the Rise among Elderly

You don't often associate anorexia and bulimia with the elderly. Here is some alarming information in Advance for Long-Term Living from research by Remuda Ranch, an eating disorders program.

Eating disorders in elderly women have increased and the majority of deaths from anorexia nervosa occur in people over age 65. This is happening in your community. Are you watching out for the elders there?