ADVANCE Perspective: LTC : CCRC

Hospice in long-term care

Maureen Salera — Fri, 05 Jun 2009 17:31:00 GMT

A little more than a year ago, I wrote an article about integrating palliative care into nursing homes. My research and my sources seemed to agree that end-of-life care wasn't anywhere near where it needed to be in long-term care. In fact, in some long-term care organizations, palliative care had no place at all. Others were trying, but there was still a lot of work to be done.

I'm now writing another story on hospice for an upcoming issue of ADVANCE so I was eager to see if this has changed. I started out by looking for long-term care providers who have somehow integrated hospice services into their continuums of care. My preliminary research indicates that an increasing number of senior living providers across the country are somehow getting involved in hospice.

I have a lot of questions for these providers so keep your eyes out for their answers in an upcoming issue of ADVANCE. In the meantime, feel free to comment on your experience with hospice.

Mice-on-Resident Violence

Adkins-Ali Carrie — Fri, 01 May 2009 13:11:00 GMT

A news item about a mouse-on-resident attack in an Australian nursing home is hitting the U.S. media. Tales of mice chewing off residents' ears are, we can only hope, extremely rare, but certainly stir up a lot of attention and fear.

Do you think the U.S. long-term care community should respond to this news report on a national level? How about a local level? Have you heard from any of your residents' families inquiring about your rodent control program?

Active Aging Week 2008

Liz Rosto — Wed, 10 Sep 2008 19:10:00 GMT

The International Council on Active Aging (ICAA) is sponsoring Active Aging Week September 22 - 28. The theme is "Choose an Active Life!" This annual health promotion event is dedicated to introducing older adults to a healthy and active lifestyle.

Get in on the fun by planning some events in your community that encourage physical, intellectual and social well-being. Some of the plans other facilities have in the works include:

Dances
Wii tournaments
Games for physical and mental agility
Open houses, free classes and demonstrations
Fitness classes, yoga, tai chi, bicycling, walks and hikes
Bowling, billiards and paddle ball
Treasure hunts, tournaments
Health fairs, seminars on health topics, screenings

For more resources, see the Active Aging Week site.

The Move to Retirement Living

Maureen McAndrews — Tue, 13 May 2008 16:35:00 GMT

The Washington Post puts an interesting spin on an article about the decision to move into a retirement community. Instead of telling the story from the oft-used angle of those who work in the retirement living industry, the article is written by a 79-year-old woman who recently made the move from her home into retirement living. She explores the way her and her husband came to terms with their idea of "aging in place." She concludes that this decision was best made on their own terms, when they were ready. She talks about timing being everything.

In an accompanying article, the writer's daughter shares her thoughts on coming to terms with her parents' move to a retirement community. While she originally felt some guilt, she says it was assuaged by witnessing her mother making many new friends and starting a new phase of life.

Is this general feeling shared by most people who move into retirement living? In your experiences of dealing with residents, what do you find? Are most ready? If they're not ready, are they glad once they've made the move? What role do adult children play in the process?

These two unique perspectives can give you some idea of just exactly what's going through the minds of your potential residents.

Connecting With Residents Who Have Dementia

Maureen McAndrews — Thu, 17 Apr 2008 18:27:00 GMT

A recent article in the Washington Post explores how certain games and other activities can help family members form more meaningful connections with loved ones who have dementia.

Researchers conducted a study on 33 families, and found that satisfaction was higher after playing one of the new board games with a relative with dementia than after a visit that involved no game-playing.

The article also indicates that memory books and scrapbooks can be helpful for those who live in nursing homes and similar settings, providing a method for staff and volunteers to get to know residents.

Look for more on this in the future: The National Institute on Aging supported the study and the researchers have submitted it for publication in a peer-reviewed journal.

Presidential Candidates Health Care Plans

Adkins-Ali Carrie — Fri, 11 Apr 2008 14:18:00 GMT

I recently heard a comment that when the Clintons tried to reform health care, it had an unforseen negative impact on nursing. Hospitals, my source noted, were laying off nurses because they did not think they were going to have enough money to pay them because of the cuts. Many nurses left the profession and others decided against nursing careers.

How do you think the presidential candidates stated plans will affect the industry? Which candidate's plan, of any, do you support?

The Value of an Apology

Maureen McAndrews — Fri, 01 Feb 2008 15:49:00 GMT

Over the summer I made a major purchase at a home improvement retailer. To make a long story short, the vendor: lost my order data due to a computer power failure, delayed product delivery, ordered the wrong size product, forgot to collect payment from me while I was in the store (which meant I had to make an extra trip to the store), allowed the product installer to cancel several appointments that I’d rearranged my schedule to accommodate and ultimately sent me a product that was drastically different from the one I’d seen in the store and ordered.

Throughout this entire process, which went on for several months, no one from the store ever once apologized. In fact, during one of my visits to the store, after I learned from the representative that the product measurements were inaccurate, I became very exasperated and said something to the effect of "This entire process has been such a hassle. I don’t know if I can keep going like this." The rep simply stared back at me and offered no apology. At that point, that store should’ve lost my business, but I elected to keep going because I didn’t want to forfeit my deposit and start all over again with another retailer.

But it would’ve made a difference if someone had said just once that they were sorry. Since my experience was with a retailer, it was simply a hassle. But when facility managers make mistakes, there are often far greater consequences. Even though the stakes are higher, an apology can still make a difference. As Loretta G. LeBar, JD, CHC, writes in her September/October 2007 article "Saying You're Sorry," "Today's culture discourages apologizing to victims and their families for fear of it being seen as an admission of guilt. We need to change this."

If you’re concerned about the legal ramifications of an apology, ask your attorney for more information on how you can effectively communicate when something goes wrong. If nothing else, at least start a conversation about the value of an apology. If the "carefully planned apology can prevent litigation, restore trust and build stronger employee infrastructure centered on quality of care for the residents," as Le Bar writes, wouldn’t it be well worth it?

Is your keyboard making you sick?

Maureen McAndrews — Mon, 07 Jan 2008 21:21:00 GMT

Norovirus, often called the "stomach flu," often shows its face this time of year. Most people realize it's highly contagious but, for the first time, U.S. health officials report it can be spread from contact on computer keyboards and computer mice.

With several people sharing computers in long-term care facilities, and the push towards electronic charting, there's a heightened risk of spreading these types of germs. The best defense against the spread of this virus is still handwashing and disinfecting shared equipment.

It may be a good practice to keep some antibacterial wipe dispensers around keyboards and computer equipment in your facility. Come to think of it, I think I'll clean my keyboard right now.

Food for Thought

Maureen McAndrews — Thu, 13 Dec 2007 18:00:00 GMT

Research from the November 2007 issue of The American Journal of Clinical Nutrition shows that fish intake, in particular the intake of dietary omega-3 fatty acids in fish, may improve cognitive performance. And the more fish, the better. The subjects who consumed more fish scored better on cognitive performance tests than those whose ate less. No difference was shown between the consumption of lean versus fattier fish.

Most long-term care facilities are already serving fish on their menus. It would be interesting to see if residents choose to eat it regularly.

NIA Offers Training Guide to Help Navigate Online Health Information

Maureen McAndrews — Thu, 29 Nov 2007 19:37:00 GMT

To help older adults search for and find credible health information online, the National Institute on Aging (NIA) has developed a free training curriculum for people who teach and work with older adults.

The Toolkit for Trainers, which is now available on http://nihseniorhealth.gov/, can be an addition to computer training programs at public libraries, senior centers, community colleges and other learning centers. Instructors can use the curriculum to teach older adults how to find accurate and timely online health information on their own. To make sure the training curriculum meets the learning needs of older adults, NIA developers based its design on cognitive aging and vision research and field tested the materials with older adults and instructors in computer classes, according to a press release from the NIH.

The curriculum features health and wellness information from NIHSeniorHealth and MedlinePlus. Users can access NIHSeniorHealth for short, easy-to-read segments of information in various formats, including large-print type sizes, open-captioned videos and an audio version. MedlinePlus is NLM's more detailed site for consumer health information.

Trainers who download the toolkit will receive lesson plans, student handouts, Web searching exercises and illustrated glossaries. An introductory video provides a quick overview of the curriculum and a glimpse of Internet classes in action. The toolkit also provides tips on how to set up a senior-friendly computer classroom.

The Good News and the Not-So-Good...

Liz Rosto — Thu, 15 Nov 2007 14:34:00 GMT

The State of Seniors Housing 2007, an annual publication produced by The American Seniors Housing Association (ASHA), the American Association of Homes and Services for the Aging (AAHSA) and the National Investment Center for the Seniors Housing and Care Industry (NIC), reports that senior housing occupancy rates are up.

The publication summarizes survey data from 807 communities across the country comprised of 87,646 independent living units, assisted living units and nursing beds.

Independent living communities enjoying the highest median occupancy rate (95 %), followed by assisted living (93.3 %) and CCRCs (90.7 %), while skilled nursing continues to fall.

We have written about diversifying your business several times this year. Click here and here to read articles on the importance of this topic. Are you thinking about diversifying your business by adding assisted living, independent living or other additional services, if you haven't already?

Copies of The State of Seniors Housing 2007 are available through the NIC website.