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UPRITE Fall Prevention Education Program in our Care Communities

September 23, 2019

September 23 is Fall Prevention Awareness Day!

Learn more about our fall prevention efforts in our care communities.

Every community that serves the older population is looking for ways to reduce falls. There is no one concrete way to prevent falls. "Knowing this, we take special precaution to keep our residents as safe as possible while they are in our care, and one way we do that is through the UPRITE Fall Prevention Education Program,” says Ginny Burke, director of clinical education and quality.

The main focus on the UPRITE Fall Prevention Education is that everyone in the community, from nursing to housekeeping to maintenance, can help prevent falls. In fact, UPRITE stands for YoU help Prevent Resident Incidents with Team Effort!

“All team members who work in the neighborhoods in our skilled nursing and personal care communities know the residents just as well as a nurse does, so we have trained different disciplines to be looking, watching, and pointing out any potential fall risks,” says Ginny.

“UPRITE really focuses on the importance of being aware of what’s going on around you. If a team member is passing through a neighborhood and notices someone is trying to get up alone, they assist them or get a team member that can. If they notice a call light is on, they will pop their head in – a resident may need something that is just out of reach such as the television remote or a tissue. It’s the little things like this that can prevent bigger things from happening,” Ginny says.

In our care communities, we have a larger number of residents who are wheelchair bound, or who use walkers to get around. Because the mobility of some of our residents is limited, they often experience weakened legs and muscles due to inactivity. Ginny says, “In order to assist those residents who have limited mobility, we encourage our team members to frequently ask if there is anything the resident needs, even if they have just helped them or are just checking in. We have found that rounding consistently has improved resident satisfaction and safety.”

Interested in learning more about fall prevention? Check out this article for stats and other facts about fall prevention.

How to Successfully Adopt a New Healthy Habit

September 20, 2019

Experts offer tips to increase your chances of sticking to it
By Patricia Corrigan

Tell my massage therapist you’re struggling to stick with a healthy habit of any kind and her reply sounds like something your dental hygienist would say: “Only floss the teeth you want to keep.”

That’s a spin, of course, on “use it or lose it.” If you want a strong body, a calm mind and an elastic brain — not to mention clean teeth — you’ll want to tend to them all in turn. Plus, remember to eat your vegetables, work on your balance and go to bed at the same time every night, too.

Bernice Brandmeyer, 86, of Creve Coeur, Mo., admits that sticking with healthy habits isn’t easy. “Right now I’m out of the habit of going to my water exercise class,” she says. “I’m gradually forcing myself back into it by having my pool bag ready at the door. When it’s time to leave for class, I don’t think about it, or I’ll stay home. I just go.”

Deciding to Change and Following Through

Forming new habits or reinstating ones we’ve let slide is tricky, according to Wendy Wood, a social psychologist and provost professor of psychology and business at the University of Southern California. “We underestimate how complicated the change process is,” she says. “We’re impressed when we just make an initial decision to establish a new habit, but then we have to follow through — and that’s hard.”

“Once you make a decision to form a new habit, figure out a way to make it fun, because the initial motivation is hard to maintain.”

Wood has a few tips for establishing healthy habits that stick:

Assess your environment. “Our actions are closely tied to our environment, so explore opportunities to make desired changes easier,” Wood says. “Having a TV or laptop in the bedroom makes it harder to turn off the screen and stick to your plan of going to bed earlier.” If your goal is to incorporate more exercise into your day, place some of the equipment in plain sight, such as dumbbells or a yoga mat, so they become part of your environment and remind you to do it.

Some years ago, a Weight Watchers leader told me that you don’t need will power to establish healthy eating habits — you need a strategy. My friend, Susan French, 69, of San Francisco, applied that wisdom to her exercise routine.

“I decided I was done going to the gym,” she says. “I’ve been going a long time, and I’m tired of putting on my sports bra and my yoga pants and going out the door. It’s a long walk there and back.”

Now she exercises at home, working out for an hour six days a week with an aerobics class on the computer. “I really, really like this,” French says, “and I’ve been doing it for over two months.” How confident is she that she will keep it up? She laughs and replies, “Yesterday, I canceled my gym membership.”

Make change fun. “People are likely to repeat behaviors they find rewarding, so once you make a decision to form a new habit, figure out a way to make it fun, because the initial motivation is hard to maintain,” Wood says.

Gail Pennington, 70, of University City, Mo., finds learning new languages fun. “I’m on my two hundred and ninety-ninth day of learning Italian,” she says. “I have no plans to go to Italy, but this entertains me, and it’s good exercise for my brain.”

Pennington is going to Quebec later this year, so she’s also refreshing her French. “A shopkeeper in Paris once complimented my French, and speaking to a native speaker and being understood makes me happy,” she says.

That good feeling comes from a release of dopamine in the brain, Wood says. “If the brain responds to an activity with dopamine, that makes a stable memory trace and cements what you did to get that reward. That’s your brain enabling you to repeat what was rewarded in the past and makes it easier next time.”

Be patient. Experts say it takes two to nine months to establish a new behavior as a habit. “Many behaviors we try to make habitual have multiple steps to them — complicated steps that involve decision-making and some habitual response,” Wood says. “If you make a new behavior easy and fun, then it will be something you keep doing. As that practice accumulates, it becomes a habit.”

One mind trick that works for me is to put my qigong (a mind-body-spirit practice) sessions and aqua yoga classes on my calendar; I schedule them just as I would for lunch with a friend or an appointment. I consider these classes commitments, and when my phone “dings” to remind me it’s time to get ready, I do.

‘Prove to Your Brain That You’ve Got This’

Marcia Reynolds, a behavioral scientist based in Phoenix, recommends talking about changes you want to make. “Say it aloud, ask for help from family and friends; that makes you more accountable,” she says.

A leadership coach and author of the book Outsmart Your Brain, Reynolds also believes in posting quotes or pictures in places where you will regularly see them to remind you of your goal as you work to establish a new habit. She also cautions against beating yourself up when you don’t always live up to your new expectations.

“We often focus on where we lapsed, what we didn’t do,” she says. “As we move toward change, the brain needs evidence that we will be successful, so, remember to look at what you did well, even when it’s just one thing. Prove to your brain that you’ve got this.”

Whether you want to start meditating, stop smoking or practice random acts of kindness, Reynolds recommends making these or other changes for personal reasons. “If you’re doing it for a family member or for your doctor, that’s not good enough,” she says. “For the best end result, a strong emotional launch requires a deep personal desire.”

By Patricia Corrigan

Patricia Corrigan is a professional journalist, with decades of experience as a reporter and columnist at a metropolitan daily newspaper, and a book author. She now enjoys a lively freelance career, writing for numerous print and on-line publications. Read more from Patricia on her blog.

Balancing Your Career and Your Aging Parents

September 17, 2019

Advice for women from "Working Daughter" author Liz O'Donnell
By Richard Eisenberg

It often isn’t easy to balance holding down a paying job and being a part-time caregiver for a parent. In a new Home Instead survey of 1,100 employed people who also care for a parent or in-law, 59% felt they must choose between being a good employee and a good daughter or son; that’s up from 47% in 2017. Liz O’Donnell, author of the new book Working Daughter, knows the struggle well — personally and professionally.

A Boston-based marketing executive, in recent years O’Donnell helped manage care for her late mother with ovarian cancer and her late father with Alzheimer’s. In 2018, she became a caregiver for her husband, Kevin, who was diagnosed with pancreatic cancer; he died in March 2019. These experiences led O’Donnell to write the useful book and launch the supportive, content-heavy Workingdaughter.com site and 2,291-member Working Daughter Facebook community group.

“When you go to websites that say ‘It’s a blessing to be a caregiver,’ you feel like you are the only one having terrible thoughts.”

I interviewed O’Donnell to hear what she learned from the elder care attorneys, hospice nurses and working daughters she interviewed for the book and to get her guidance for women — and men — juggling care and career:

Next Avenue: Why did you write the book?

Liz O’Donnell, author of ‘Working Daughter’

Liz O’Donnell: I was seeking help because my parents needed more and more care. I had stress insomnia and was waking up at 3 in the morning, looking in Google to find how to balance career and care. The web sources were either sickly sweet — saying things like, ‘Just convene a family meeting,’ which is fine for the perfect family, but how many of us are in one? — and the government websites said: ‘Click here for assisted living.’ I couldn’t find what I needed.

So, I started to build a working daughter website and then a Facebook group for women to ask each other questions and vent and cry. And then I wrote the book.

I wanted caregivers to know they weren’t alone and that there was help available even for people whose families weren’t perfect. And I wanted caregivers to know that it was perfectly normal to have thoughts like, ‘I don’t want to do this anymore’ or ‘I can’t take it.’ When you go to websites that say ‘It’s a blessing to be a caregiver,’ you feel like you are the only one having terrible thoughts.

Why is the book called Working Daughters and not Working Daughters and Sons? Women aren’t the only one balancing jobs and caregiving.

I was working full-time and caring and had to focus on what I knew. And I’d always written to a female audience. Also, I wanted to focus on issues that women face, like not earning the same salary as men due to taking off time for raising kids or scaling back hours to care for parents.

Would your advice for men be any different than what you advise women?

Some of the issues that come up are universal, like making space for your life and figuring out what matters most to you and balancing your career with that.

How difficult is it for women with paying jobs to do their work and also provide caregiving for loved ones?

It’s really challenging. I hope the more we talk about it, the easier it might become.

When you have a child, you know roughly when you will be out of work and you can set up for that time with maternity and paternity leave. You know when your child will go to preschool and for how many hours. You know what time the bus is coming, and you know when summer vacations are. With elder care, the phone could ring at work at any moment.

And there are so many factors for elder care that are different from in the past. Families are often dispersed, and people are having fewer children, so the caregiving responsibility often falls on one person.

What are the biggest challenges?

The unpredictability, and learning how to exit with grace [during the day] with all your work covered.

Another thing I hear in the working-daughter community is the mentality that caregiving has interrupted their lives and put their lives on hold. I went through that myself. One of the messages I try to share with women is we have to accept our lives as they are.

It means staying networked even if we’re not at work, so when we’re ready to go back, we’re still connected to people who can help us. And it means staying relevant, so we’re up-to-date on technology and on what’s happening in our industry, even if we’re not active in it.

Your first chapter is called ‘Accept.’ What do you mean by that?

I’m the youngest of three daughters and didn’t feel suited to be a caregiver for my parents. I had this attitude of: ‘Why me?’ Eventually, I shifted from resisting. The only way to go through the caregiving experience is to deal with it.

Another chapter is ‘Prioritize.’ What do you mean and how should women do it?

One of the things that exists in abundance in the working-daughter world is guilt. I get it. There’s always more you can be doing.

It’s important to say to yourself: ‘What are the parts of my life that really matter to me?’

Which are you going to prioritize and where are you going to glide? Don’t feel bad about stuff that takes a back seat.

How well do you think employers deal with employees who have family caregiving duties?

They want to do the right thing. Where I see it break down sometimes is at the line manager perspective. It’s important for companies to make sure caregiving policies are part of their culture and that middle managers are trained to work with employees around their care lives.

Another thing is training employees to say things like: ‘I need to leave Wednesday at three and here’s how I’m going to cover and when you can expect me back.’ As opposed to: ‘My mother’s sick. Do you mind if I leave?’

Are employers getting better at this?

Elder care benefits are on the decline, which is alarming.

What I’m hearing anecdotally from the working-daughter community runs the gamut from ‘My employer is cold-hearted and doesn’t get it’ to “I have the most amazing boss and that’s what makes it possible for me to do the caregiving.’

Do you see any reason to think employers will do better in the future for employees who are also family caregivers?

I’m hopeful.

By Richard Eisenberg

Richard Eisenberg is the Senior Web Editor of the Money & Security and Work & Purpose channels of Next Avenue and Managing Editor for the site. He is the author of How to Avoid a Mid-Life Financial Crisis and has been a personal finance editor at Money, Yahoo, Good Housekeeping, and CBS MoneyWatch. Follow him on Twitter.

Share My Story: Going Above and Beyond

September 13, 2019

We love when our team members share their stories, especially when it shows the passion of our team towards their work.

Read about Carrie Karns and why she has stayed with us for over three years.

“This past Christmas Eve I was able to adjust the schedule to send one of my team members home early, knowing that she was behind on her Christmas preparations. Since we are a small department, that left me to complete the tasks for the day. After returning from a Walmart run for supplies, I had planned to deliver the mail for the day and start my vacation early. Planning to leave at 2 pm, after several interruptions and last minute things happening, it was quickly 4 pm and I had not delivered the mail yet. I went to the main office to discover several packages and 40+ holiday cards that needed delivered. With a small sigh, I began to separate the mail by neighborhoods and started my delivery. I helped several residents open packages and had nearly all of the cards delivered when I came to the last envelope. It was a larger envelope that I could tell had pictures in it. I asked the resident if she would like me to open it and help her read it. With excitement she said, “Yes, I’ve been expecting something from my brother in California.” Upon opening the envelope, I saw a folded up piece of paper, front and back, typed in small print. It was a “year in review” from her brother’s family. I have to be 100% honest, at this point I looked at my watch…’after 5 pm?!’ was what went through my mind. As I began to read I noticed right away how much this Christmas Eve package meant to her. The letter told of their travels abroad and updates on her grandchildren. There was also a hand written note from her brother. As I read the words, so elegantly written to his beloved sister we both began to tear up. She then asked to read it again herself. I sat 10 minutes before desperately wanting to run for my car to enjoy my own Christmas Eve. I now found myself at a loss for time, not worried about MY plans and what I was late for. As I rushed to make it to Christmas Eve service I thought about how I was called to stay late that night, and how much that resident needed me for those 20 minutes. It’s moments like that which define what we do at Presbyterian SeniorCare Network and I am blessed to share my story.”

Carrie has been working at the Oil City campus for over three years as the Director of Lifestyle Engagement. She has found that one of her favorite parts of her work is building connections with the residents at Oakwood Heights.

She says, “I got very close to a resident on our Gardens neighborhood who was withdrawn and spent most of her days reading in her room or sitting in the corner of the lounge doing a puzzle. I’m not sure how, or why, but I started sitting with her every day. Sometimes it was five minutes, sometimes thirty. If a day went by that I didn’t stop over she would send a team member to check on me and make sure that I was okay. She even said to me one day, “I don’t know how we became friends, but we are.” She passed away about 8 months after we became friends. The pastor who did her service spoke about her love of puzzles and made the statement, “It’s not about the puzzles, it’s about the people.” I couldn’t agree more.”

Carrie said that she enjoys making sure that each residents feels special and appreciated by the team members at Oakwood Heights.

Like Carrie, do you have a story about Presbyterian SeniorCare Network that you would like to share? Share My Story is a fun way for team members, residents, and family members to share their personal experience about a moment with our organization that has touched their heart.

To share your story, visit www.srcare.org/moments.

Ready, Set, Go – Starting an Exercise Routine Now May Extend Your Lifespan

September 12, 2019

Whether you’ve done it for years or are just getting started, a new study suggests that maintaining the recommended physical activity level may extend your lifespan.

We all know that getting a good workout in regularly is beneficial to your overall health. However, a recent study from The BMJ has concluded that it’s not too late for those who haven’t yet prescribed to the recommended two to five hours of moderate-intensity exercise.

The population-based study took a look at over 14,000 middle-aged and older people’s baseline physical activity. Then, over the course of approximately 12.5 years, it compared those who maintained, increased or decreased their physical activity level with causes of mortality, such as cardiovascular disease and cancer. 

The findings?

“Middle aged and older adults, including those with cardiovascular disease and cancer, stand to gain substantial longevity benefits by becoming more physically active, irrespective of past physical activity levels and established risk factors—including overall diet quality, body mass index, blood pressure, triglycerides, and cholesterol. Maintaining or increasing physical activity levels from a baseline equivalent to meeting the minimum public health recommendations has the greatest population health impact,” stated research program leader Soren Brage, Ph.D., the University of Cambridge.

At Longwood at Oakmont, our successful living retirement community, we help our residents thrive by offering a variety of wellness options to choose from. We are here to help keep your physical, intellectual, social and spiritual pillars active and growing. We offer many options for different levels of fitness and are always exploring new choices for our residents. To learn more about what Longwood at Oakmont offers, head here.

You can find the rest of The BMJ study and more details on the results here. 

Learning New Things: No Audience Required

September 10, 2019

For writer Elaine Soloway, improving on later-life skills is best done solo
By Elaine Soloway

As the instructor was assembling foam dumbbells for her upcoming water aerobics class, I was grateful her busyness kept her from looking my way.

Because I was wearing goggles instead of my eyeglasses, her image had a soft blur, as if she were a figure in an impressionist painting. But there was no mistaking the steel grey hair, her body as slim and muscled as someone decades younger, and her air of drill sergeant.

“Please don’t watch me,” I sent silently through the moist air of the indoor pool. For I knew if she did, my long-ago YMCA Beginning Swim teacher wouldn’t be able to resist striding over to tell me what I was doing wrong.

As I lowered myself into the pool, I was relieved the instructor had settled into a lounge chair far from my lane. “Surely, she can’t see me here,” I told myself as I took a calming breath and ducked under the water.

My reluctance to be viewed, to perform for others, moves out of water to my bench at the piano keyboard.

Without her eyes on me, I slid slowly through my lane, reminding myself to face the pool’s bottom as if it were a mirror, and pretend I was laying my head on my left arm as my face lifted out to the right. Then, I sent myself a REMEMBER to close your mouth after an intake of air, and once under water, blow out through mouth AND nose.

The Lecture I Hoped to Avoid

This was my inelegant stroke, taught to me by a coach I discovered two years ago who helped me learn to swim at age 78, after my many attempts with other coaches, including the taskmaster lounging nearby. After several lengths, I emerged and quickly wrapped myself in towels, grateful my iWatch had credited me for the 30-minute routine.

As I removed my cap, goggles and fins, I heard: “You’ve got to move your left arm more, Elaine.” It came from a sharp voice on a lounge chair. How had she seen me from that distance?

“Um, I have arthritis in that shoulder,” I said, as apologetic as a student who had once again forgotten homework.

By now, she had risen from her chair and delivered the lecture I had hoped to avoid: How that pained arm would only get worse if I didn’t activate it, how uneven my stroke would be without a powerful left arm, how awkward….

“Oh, okay, sure,” I mumbled as I gathered my gear and waved goodbye.

Expertise Was Never My Zenith

Back home, after playing the film of our morning’s encounter in my head, I realized I loathe anyone watching me when I perform any of my lifetime goals, which are: to swim and breathe on one side, play Rodgers and Hart on the piano and speak Spanish in the first tense.

As long as I can remember, I envied those who could perform that trio of tasks and wondered why they didn’t crow about their achievements — that’s how glorious I thought these talents are.

Of course, those individuals had skills that were much more proficient than the basement level targets I set. But I never aspired to reach their levels. Expertise was never my zenith. Mediocrity would satisfy me, just as much as a slim slice of my favorite pecan pie.

My reluctance to be viewed, to perform for others, moves out of water to the bench at my piano keyboard. I AM playing Rodgers and Hart, but likely quite differently than they envisioned when the lyrics and notes danced through their talented heads. Often, although the sheet music calls for F Major 7, I may decide to have only the A and C link hands. And sometimes, just to see if I can hear a difference, I’ll allow the F to stand alone.

Not as Shy as You Might Think

As for Spanish language, I’ve come up with the ideal way to practice and improve — sans teacher or classmates swiveling their heads to signal errors. Every evening, seated with a glass of wine, a spiral notebook and a pen, and my Apple device open to Google Translate, I record my daily activities in Spanish. Because I tend to do the same things most days, I learn how to write and read vocabulary that applies to me.  Desperté a las 4 am después de un buen sueño.  (“I woke up at 4 a.m. after a good sleep.”) You get the idea.

Based on my seeming embarrassment to be viewed as I splash, tap and roll my R’s, you might tag me as shy. But you’d be wrong. Read my close-to-the- bone writing, or listen to me at an event where I’m a saucy, but comfortable, speaker.

The difference between those scenarios and my undercover endeavors is that my late-in-life trio was hard-won and too precious to risk abandonment if critiqued. I won’t take that chance.

By Elaine Soloway

Elaine Soloway is a PR consultant, writing coach and tech tutor, and the author of Bad Grandma and Other Chapters in a Life Lived Out Loud and Green Nails and Other Acts of Rebellion: Life After Loss. The Emmy Award-winning television series 'Transparent' was created by Elaine Soloway's daughter Jill and inspired by their family. Follow Elaine on Facebook, Twitter @elainesoloway and Instagram.

Memory Café: Savoring Special Moments

September 6, 2019

Respect for our elders is a canon we all try to be mindful of, but in today’s society, older adults with Alzheimer’s disease and related dementias often find themselves isolated from mainstream society as they lose their ability to follow “customary” social rules.

This often results in loneliness. Trips outside the home go from fun shopping trips and visits to a favorite restaurant, to only a trip to the doctor to address their disease. The fun seems to disappear and the individual living with the disease, and their caregiver, do not get enough interactions with others who genuinely understand their journey.

The good news is that there are places created specifically for these older adults and their caregivers to connect with other people who are on the same path. Where? At a Memory Café. These Memory Cafés provide important social interaction in an environment that everyone can enjoy.

Coming Together

In 1997, Dutch psychiatrist Bere Miesen introduced the idea of a place where those with Alzheimer’s and related dementias can intermingle and enjoy life in a warm and safe environment. The concept of Memory Cafés spread throughout Europe and were so well received that they eventually made their way to the U.S. In 2008, nationally renowned Alzheimer’s specialist Dr. Jytte Fogh Lokvig opened the first Alzheimer’s Café in Santa Fe, NM.

What is a Memory Café?

Those affected by memory loss and their care partners gather to talk, share and take a much needed break from the disease in an accepting, casual environment. Cafes are made up of a group of like-minded individuals run by compassionate volunteers and/or those who work in the field of dementia care. As of 2013, more than 85 Cafés are helping people enjoy more special moments together throughout the U.S., and that number continues to grow.

Although these Cafes all share the same fundamental goal of providing a fulfilling, enjoyable experience, no two Memory Cafés are exactly alike. That’s because each Café is a grassroots effort organized, operated and maintained by the people who attend them, giving every Cafe its own personality and flavor!

For instance, Memory Cafés offer a variety of fun, stimulating activities, from singing to crafting. Laughter, camaraderie and relaxation are mainstays, all to provide support for both caregivers and those who are cared for.

While each Café is different, they all serve an important role in our society today. Alzheimer’s diagnoses are multiplying annually, according to the Alzheimer’s Association. In the U.S., there are already more than 5.4 million people living with the disease today. While it can severely affect the individual with the diagnosis, memory loss also touches the lives of their caregivers and all of those who love them.

Find out if there is a Memory Café near you!

Presbyterian SeniorCare Network hosts free monthly Memory Cafes in three locations. These Cafes are designed exclusively for individuals with dementia and their caregivers and feature a casual, supportive environment full of conversation and meaningful connections.

Washington area

  • Where: Eat’n Park, 320 Oak Spring Rd, Washington, PA 15301 (reserved room)
  • When: Held on the 3rd Saturday of each month starting May 20
  • Time: 10:00 a.m. – 11:30 a.m.
  • RSVP not required – just pop on in! Coffee and cookies provided.

Oakmont area

  • Where: Somma Pizza, 380 Route 909, Verona, PA 15147 (private area)
  • When: Held on the 2nd Wednesday of each month starting June 14
  • Time: 11:30 a.m. to 1 p.m.
  • RSVP not required – just pop on in! Snacks provided.

Erie area

  • Where: Lincoln Community Center Library, 1255 Manchester Road, Erie, PA 16505
  • When: Held on the 2nd and 4th Tuesday of each month (hosted in collaboration with the Alzheimer's Association)  
  • Time: 10 a.m. to 12 p.m.
  • RSVP not required – just pop on in! Snacks provided

For more information, visit www.SrCare.org/cafe.

This Activities Program Engages and Calms People With Dementia

September 5, 2019

It tailors activities to each individual's abilities and interests
By Melba Newsome

For people with dementia, having nothing to do can contribute to agitation, frustration and a feeling of loss of control and well-being. It is a situation family caregivers often encounter.

Laura Gitlin, distinguished professor and dean of the College of Nursing and Health Professions at Drexel University in Philadelphia, has spent more than three decades developing non-pharmacological behavioral approaches to helping adults with dementia age in place.

“It’s important to assess not just what the person can’t do, but also what they can do.”

Gitlin’s most recent approach, the Tailored Activity Program (TAP), has been shown to help manage critical behavioral symptoms in people with dementia while reducing the caregiver’s burden.

Assessing Abilities and Interests

TAP is an individualized, family-centric program that provides people with dementia activities tailored to their abilities and interests. TAP also includes training for both formal and informal caregivers on how to use activities as part of daily care routines.

“Engagement is an enduring need throughout the disease process, but there hasn’t been a protocol for using an activity-based approach before,” says Gitlin. “TAP is very oriented and focused on how we can improve engagement and meaningful activities at any stage of dementia.”

In randomized clinical trials, TAP improved quality of life for people with dementia by reducing behavioral symptoms, improving their engagement in activities, and providing caregivers with an effective tool. TAP can help with behavior issues, such as agitation, aggressiveness, irritability, restlessness and apathy.

Activities for Different Disease Stages

As dementia patients decline in mental abilities, they often experience challenges in cognitive function that increase negative reactions to their environment.

Many times, family caregivers overestimate or underestimate the capability of their loved ones with dementia. When this happens, they may prescribe activities or communicate in a way that falls below or above their loved ones’ abilities, which can lead to frustration and upset for both parties.

“It’s important to assess not just what the person can’t do but also what they can do, as well as their interests, and set up the environment to support that person,” Gitlin says.

TAP identifies patient interests and evaluates their abilities to perform activities tailored specifically for them. This provides a way for them to positively re-engage with their environment.

The program is delivered or supervised by occupational therapists and can be integrated into home care, or used as part of other caregiver support programs in care settings. The program involves three phases:

  • Identify the capabilities, physical functioning and previous and current interests of the person with dementia
  • Develop “activity prescriptions” for the person’s capabilities, an activity schedule and specifications for setting up and effectively engaging the person in the activity
  • Train caregivers to use these prescribed activities

The activities could be physical — such as balloon toss, chair aerobics or a walk with a companion — crafts or games, but they should be of interest to the person.

“We have a protocol to help determine what could be most meaningful to that person and how to set that up,” explains Gitlin. “We use the same approach regardless of the type of dementia for those who have challenges with executive function when interacting with their physical and social environment.”

Success Stories Using TAP

Gitlin gave an example of how TAP worked well for one woman with dementia who lives in a memory care facility. Because the woman was frequently agitated, it led to some disruption at the facility.

Through a TAP assessment of the woman, the caregivers discovered that she had worked in a laundry business before she developed dementia. Using that knowledge, the caregivers provide the woman with a basket of clean clothes or towels to fold when she becomes agitated. The prescribed activity calms her, puts her at ease and she seems happy.

Karyl Chase is the director of the Senior Companion Program funded by the Corporation of National Community Service in Ogden, Utah. Her agency first employed a version of the TAP program as a way to help their volunteer companions feel more comfortable visiting people with dementia. Once they were trained in the TAP practice, volunteers became more open to taking clients with dementia.

For example, before the training, one of the volunteers spent most of her visits with a dementia patient watching television, during which the patient would often doze off.

After an occupational therapist assessed the patients interests and abilities, the volunteer and patient began playing a dice game together. While this particular activity is not connected to anything the patient did in the past, it shows the value of engagement.

“The client lit up and became more engaged, especially when she won,” explains Chase. “The volunteer noticed how much more enjoyable the visits were for both of them. The client is more alert and active during the visit and their time together goes by fast.”

As the disease progresses, people living with dementia will require different kinds of support. Therefore, they should be reevaluated at each juncture to make sure they’re meaningfully engaged and that the activity fits their current mental status.

Dissemination of the Program

TAP continues to undergo trials in the U.S. and several other countries, including Australia, Brazil, Scotland and Chile. Some countries are further along than others in implementing it for dementia care for their particular health care systems.

Widespread dissemination of TAP throughout the U.S. remains a work in progress. While TAP merits further evaluation to establish efficacy with larger, more diverse populations, it shows a lot of promise as a nonpharmacological approach to manage behavioral symptoms, Gitlin says.

“Our mantra is that we can make life better for the person living with the disease and the family member caring for them,” she says.

By Melba Newsome

Melba Newsome is an award-winning freelance writer with feature credits in many prominent publications including the New York Times, Bloomberg Businessweek, Oprah, Playboy, Reader's Digest, Time, Good Housekeeping and Wired. Melba also is a frequent contributor to such online sites as NBCNews and Healthline.

Love What You Do

August 14, 2019

We love when our team members share their stories, especially when it shows how much their work means to them. Read about David Rearick and why he has stayed with us for over 5 years.

“Was it just answering an ad? Honestly, that’s how it all started. Was it perhaps the best ad I ever responded to? Most definitely! As a steel worker for 30 years, I finally retired and got the opportunity to become a licensed embalmer/funeral director. In truth that is all I ever wanted to do. For many, working with the deceased in not their idea of a dream job, but for me it was an honor to make the person look their very best for the last time. Working closely with families at the worst time of their lives was challenging, but rewarding knowing you had made the entire process just a bit easier for them. Unfortunately, I had no family in the “business” so the decision was made to move in another direction.

I had some knowledge in various maintenance aspects and SeniorCare Network needed a maintenance technician close to my home. While being a tech allows for some resident contact, I always envied the manager having a closer relationship with residents and their families. That is what I would strive for with SeniorCare Network. I was very fortunate that someone took that chance and promoted me to the assistant manager position where I not only learned the manager’s responsibilities, but had the opportunity to interact with the residents too. Now as a manager, resident interaction and satisfaction keep me coming back for more! I have made many new friends all of which have one common goal: to be a part of a resident’s life as they age in place.”

David started his career with us as a maintenance technician for one and a half years and worked his way up to becoming a property manager at Forward Shady apartments in Squirrel Hill.  

He has enjoyed his time as a property manager saying, “There have been many rewarding experiences while working here. Speaking one-on-one with a resident who knows they may need more help performing activities of daily living, and seeing their contentment and happiness when reassuring them they can continue living in their apartment. One of my favorite things is that there is a very diverse group of residents at Forward Shady. I learn something every day about Russia, which is where many of the residents are from, or the Jewish religion or the Holocaust. If you take the time to speak to the residents, they will amaze you with every story they relate to their lives.”

Like David, do you have a story about Presbyterian SeniorCare Network that you would like to share? Share My Story is a fun way for team members, residents, and family members to share their personal experience about a moment with our organization that has touched their heart. To share your story, visit www.srcare.org/moments.

When a Parent Dies: Ways to Help Yourself and Your Surviving Parent

August 13, 2019

A grief-support expert shares a letter she wrote to a grieving friend
By Amy Florian

Not too long ago, a dear friend’s dad suffered a major heart attack and died. At the funeral, there was little time for more than a brief exchange of words.

But, given my background in grieving support and education, I wanted to offer some advice to help her and her mom through the grieving process. So, that evening I wrote her a letter. I’m sharing it here because I believe it can be of help to anyone who has recently lost a parent and wants to help their surviving parent through the grief. Here is what I wrote:

Dear Katie,

The way-too-soon and totally unexpected death of your dad has hit you hard. It was clear at the services that your family is reeling, trying to comprehend what happened to you, to understand the enormity of this loss, and to figure out what to do now.

Leave behind the well-meaning compulsion to cheer each other up or keep looking on the bright side.

I’m glad I was able to attend the services to celebrate his life and mourn his death together, and I also know your grief has only begun.

I remember after my husband’s death, a few of the letters that people wrote were extremely helpful — not the ones telling me the writer’s own story of grief, as if I was supposed to experience the same thing and handle it in the same way, but those that contained hard-won wisdom from grieving people.

In that vein, I offer you some input that may be helpful to you and your mom, gleaned from my many years of providing grief education, facilitating grief support groups and counseling grieving people.

If any of this does not apply in your case or is not helpful, then set it aside. Everyone grieves uniquely and you don’t have to meet my (or anyone else’s) expectations.

Grief hurts. We don’t want to face the pain, the loneliness and the void that will never be filled in the same way again. But if we don’t, we won’t heal.

Grief that is suppressed, denied or ignored does not go away. It stays there, it festers and it will find a way to come back out and bite you in physical, psychological, spiritual and emotional ways.

But it also helps to try to set the grief aside sometimes, as if in a box on the shelf, and let yourself smile or enjoy life for a bit. Those times will sustain you.

Don’t be afraid of bringing up your dad, saying his name and telling the stories. Will it cause tears? Yes, sometimes, but that’s not because you brought it up. The tears are there anyway. It is healing to allow them to spill out, whether you are alone or especially when you share those tears with someone else who also loved him, whether it’s your mom or supportive friends who will let you cry with them.

Did you know that there are physiological chemicals in tears that relieve stress? Tears are our natural stress-relief mechanism when we are sad — that’s why we call it “having a good cry.” So, when you cry, you help yourself heal.

One final thing about tears. People often say they can’t start crying because if they do, they will never be able to stop. Do you know that has not happened in the history of humankind? No one has ever not been able to stop crying. Allow the healing to happen, facilitated by allowing tears when they are there.

As you support your mom, remember your job is not to “fix it” or to make her feel better. Your job is to be her companion, to be there for her whatever she is feeling.

Leave behind the well-meaning compulsion to cheer each other up or keep looking on the bright side. Instead, just keep checking in. Ask what kind of a day it is today — feeling up, down or all over the place?

Talk about when you miss your dad the most. Share your stories about things people say that are helpful, and the well-intentioned things people say that are not! Share what you each wish people knew about what you’re going through. Keep the lines of communication as open as possible, so you can pour your experience out to each other and gain comfort.

Keep in mind that grief takes a very long time. Expect to hit sad periods of time again weeks or months after the death. This is especially true when those “marker days” hit: his birthday (and yours), the wedding anniversary, Father’s Day, the holidays, the monthly and yearly anniversaries of his death.

You will be sad over and over again. You will be happy over and over again, and eventually the happiness will predominate. But expect a roller coaster of emotions — some hours and days will be better, and some will feel like disasters. Hang in there. As long as you continue doing the hard work of grief, you are healing, you will heal and you will get there.

Another word about those “marker days.” Your dad’s absence will be huge, and yet the tendency of most people around you will be to talk about anyone and everything except your dad.

The intention is good — they want to keep you from feeling sad. Yet, these are the times it is most important to say his name, share the memories and keep his legacy alive.

His life and the lessons he taught you are with you forever. His love is with you forever. You are a different person because of him, and no one can ever take that away from you. Keep his name, his stories and your memories alive, even as you let go of all the things that can no longer be.

These are just a few things that I hope can get you on the path to healing. My most fervent hope is that your family may heal, carrying memories and stories of your dad’s life with you even as you move into a future that will be different than you had planned.

I will check in regularly, just to see what’s happening and how you’re doing. I am here for you for the long haul, no matter what.

I hold you and your mom close to my heart. In these crazy, turbulent days, I wish you moments of peace, an occasional smile and continued healing.

Love and hugs,

Amy

By Amy Florian

Amy Florian is an educator, author, public speaker, and Founder/CEO of Corgenius, the first professional training firm to focus on life transition support. With a style that combines grace, good-natured humor and rock solid science, Amy travels the country teaching financial advisors and other business professionals how to better serve clients experiencing loss, grief, and transition. She also educates clergy, hospice staff and volunteers, social workers and others who work with the grieving. Amy serves on the advisory board of Soaring Spirits International, a nonprofit organization that provides support for widowed people around the globe.

 
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