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The Power of Music

May 22, 2019

May is Older Americans Month! Communities that encourage the contributions of older adults are stronger! By engaging and supporting all community members, we recognize that older adults play a key role in the vitality of our neighborhoods, networks, and lives.

This year’s theme, Connect, Create, Contribute, encourages older adults and their communities to: 

  • Connect with friends, family, and services that support participation.
  • Create by engaging in activities that promote learning, health, and personal enrichment.
  • Contribute time, talent, and life experience to benefit others.

One awesome example of how we "connect" with our residents, is through the use of an iPod Shuffle. It is said that "music holds a special place in the heart and mind that time can’t erase, even when almost everything else is gone." We believe this, which is why we utilize the Music and Memory Program.

Music Enhances the Lives of Individuals Living with Dementia

Gina Iuliucci, MT-BC, CDP, lifestyle engagement coordinator at the Presbyterian SeniorCare Network Washington campus loves music. In fact, she is a music therapist and shares her love of music with our residents living with dementia to enhance their lives with their favorite tunes.

“We utilize Music and Memory, a non-profit organization that provides personalized digital music to older adults,” says Gina. She, as well as 20 certified team members on our Washington campus, use music technology to comfort our residents living with dementia at times when they could benefit from this type of engagement.  

“We have a resident who has aphasia. It is heartbreaking to watch the emotions on her face as she tries to verbalize what she is feeling. To help relieve some of her nervousness, we’ve used Music and Memory; once she begins listening, her anxiety melts away. She is often more relaxed long after the music stops playing,” says Gina.

Music and Memory Executive Director, Dan Cohen founded Music and Memory with a simple idea: if he needed nursing care, he wanted to be able to listen to his favorite ‘60s music. With the popularity of iPods, he brought music into nursing communities. Music and Memory also offers certification for organizations to incorporate therapeutic music as a standard of care; Presbyterian SeniorCare Network is a certified organization.

iPods are provided through Music and Memory, as well as through donations from community members. “Our iPods are programmed to include personalized playlists for each of our residents,” says Gina. To get an idea of the music preferences of each resident, Gina and team will inquire with family members, as well as residents. “Often, a resident may not remember the name of an artist, but can tell you if they like country or big band music. That helps us to narrow the genre and program a list that includes their preferred music,” says Gina.  

Music and Memory is offered in the dementia care communities around our Network. Through the program, we are able to give pleasure to persons living with advanced dementia, reduce frustration and late-day confusion, as well as offer an alternative or a reduction to the use of anti-psychotic medications.

When asked if she sees a benefit to Music and Memory, Gina instantly answers, “yes!” “It is an honor to be able to provide personalized music to our residents. When a resident is feeling anxious, as soon as the headphones are placed on their ears, you can see a change in their demeanor. When they are happy, I am happy. It gives me the chills to know that music has made their worries melt away.”

To learn more about the living and care options around Presbyterian SeniorCare Network, visit SrCare.org. 

Pictured above, Aggie, enjoying the Music and Memory Program.

Sue Mazur, Aggie’s daughter, says "The special songs from Aggie's past make an immediate connection and allow my mom to connect with family and friends in a way that she wouldn't be able to otherwise." Aggie is a resident in the Woodside Neighborhood at Southminster Place of Presbyterian SeniorCare Network. The Woodside Neighborhood specializes in dementia-specific personal care. 

Dementia Care Reimagined: A Q&A With Dr. Tia Powell

May 21, 2019

The author calls for more research on developing compassionate care model
By Edie Grossfield

As so many medical professionals, policymakers and nonprofits continue to sound the alarm about the impending tsunami of Americans with Alzheimer’s disease and other dementias, the U.S. still has no affordable long-term care system to handle the situation.

In her new book Dementia Reimagined: Building a Life of Joy and Dignity from Beginning to End, Dr. Tia Powell joins those sounding the alarm, but she calls for a much greater focus on developing care programs and facilities for people with dementia that preserve their dignity and ability to experience joy in life.

The professor of psychiatry and bioethics at the Albert Einstein College of Medicine in New York says it’s time to stop focusing only on finding a cure for dementia, as if that will save us from having to pay for care. It’s too late for that, she says. No magic pill or other preventative intervention is anywhere on the horizon that would be available in time to make a difference for the 10,000 boomers turning 65 every day.

Powell’s book, released this month, blends a fascinating history of how dementia has been viewed in the U.S. with her thoughts on what compassionate care for people with dementia might look like. She also includes her own experience helping to care for her mother who had dementia and died a few years ago.

In a recent interview with Next Avenue, Powell talked about what she learned from researching and writing her book:

Edie Grossfield: You wrote that you expect some people will take issue with your suggestion that we need to shift more research funding from finding a cure for dementia to developing compassionate care for people with the disease. Can you elaborate?

Dr. Tia Powell: I don’t want people to stop looking for a cure. Dementia is a serious illness, it is a fatal illness and we don’t have a cure, so I’m all for finding a cure. But that has been the overwhelming majority of the research we’ve done.

If we find a cure, it’s not going to be in time for the baby boomer generation. We will have millions and millions of people who need care. And although I think there are good people working on that, there has been pretty modest funding for thinking about what would good care look like? How can we pay for that? How can we make it accessible to people all across the country? What are the things that people with dementia and their caregivers really say they need and want?

You also expressed concern about some researchers and pharmaceutical companies focused on a preventative drug for people who have high levels of amyloid plaque in their brains — that being one theory about the cause of Alzheimer’s. You said that since research has shown high levels of amyloid doesn’t mean a person will get Alzheimer’s, such a drug would mean big bucks for ‘Big Pharma’ with little benefit for most of the people who take it. What are your thoughts on this research today?

I hope that particular dream is fading. We just had in the last couple of weeks another major failure of a big, hundreds-of-millions-of-dollars clinical trial trying to decrease amyloid as a way of preventing and treating dementia, and it failed again, just like the ones I’ve described in the book. I’m hoping it’s going to be the nail in the coffin for looking just at amyloid. It’s not that amyloid is good for you, but there’s something really important that we don’t understand, and it really looks like just decreasing amyloid or even preventing its buildup — I don’t think that’s going to be the ticket.

What are your hopes for developing care for people with Alzheimer’s and other dementias?

A lot of people who don’t even have dementia yet are absolutely terrified. They think that this is more frightening than cancer, than AIDS. And that’s partly because we haven’t done enough to reassure them. I think we can reassure people. I think you can have a life with dementia that has joy in it, and we need to make sure that’s not an empty promise, but an actual one. I think it can be. And since a lot of us are going to have dementia, and probably me, too … I think we should do more to make sure that people with dementia don’t have to be so terrified of it.

What is one example of the kind of care you hope we’ll see more of?

A lot of older buildings that are nursing homes had no easy access to the outdoors. In some cases, people might go literally years without ever feeling the outside air. And now, there are places that think we can do better than that. They’ve said even if somebody is in a wheelchair, why don’t we get one that they can operate by themselves? Why don’t we set up our facility so that the access is easy so the person can just present themselves at the door, the door will open automatically and they will be in, basically, a kind of walled garden? They can walk or roll about as much as they want, and end up back at the door. You can’t get lost. So, it’s that simple freedom that can make an enormous difference in somebody’s life.

Toward the end of the book, you wrote that you think you have a good chance of getting dementia when you’re older because both your mother and grandmother had it. Is that one of the reasons why you wanted to write the book?

The book is, in a sense, an enormous thought experiment for me to figure out: Can I make my peace with that? And if I’m going to have dementia, I’d like to have some joy in that life. I would like to be happy, because that’s really the point of life. So, I better think about how to be happy with dementia — and what would that look like and how would I do that.

What was it like for you to do that exercise?

I think it was very useful. It was very comforting to try and think about that. So, I thought that I would offer it as a suggestion (to readers of the book) because, as we know, a lot of people in middle age and up are really worried about ‘Oh man, what if I get dementia? It’s just the most horrible thing in the world.’

I’d like to at least tease them with the idea that maybe it doesn’t have to be so horrible. What could you think about, what could you bring with you into the stage of dementia that might make you happy? How could you remodel the world around you? So, if you wish there was a community garden where little kids come and plant bulbs, it may be great for older people with dementia to maybe sit and watch the little kids putting in the bulbs. Maybe you could work on that. It would be a great thing to do.

Hope for Simple Joy

In the last paragraph of her book, Powell described what she hopes she could still enjoy as a person with dementia.

She wrote: Even toward the end, I hope still to have some joy. I may not get there, but I’d like to see again one of my familiar places: the dancing world of Central Park on a perfect day. Leaves shimmer overhead in a light breeze. Midair Frisbees fly while dogs and people arc gracefully up to seize them for the ether. On the ground, a young couple on a picnic blanket, Motown on their boombox. Their wobbly first child stands, resplendent in a dinosaur-print onesie, his small hands in the large ones of his seated father. He cannot walk yet, but he dances, bobbing his padded bottom up and down. His face is the portrait of happiness, with the sun, his parents’ love, the breeze, the music all radiating through him. If I could be there again, trees, breeze, flying dogs and dancing babies, that would be enough. I’ll be seeing you.

The last paragraph of your book is beautiful, but also sad, as you talk about what you hope to be able to still enjoy if you have dementia.

It is a little sad, but it’s also about gratitude and feeling happy for the things that you have loved in life, and really hoping to find at least some of those things that you can still be happy about as you go forward and step into the future. What could you take with you that would still be a happy thing?

By Edie Grossfield

Edie has been a journalist for more than 20 years, reporting and editing for newspapers and magazines. She also worked in communications for a large health care organization. She holds a bachelor’s degree in communications and media and a master’s degree in journalism, both from the University of Wisconsin in Madison. Reach her by email at egrossfield@nextavenue.org.

Should All People 65+ Get Cognitive Assessments?

May 20, 2019

Experts agree it's crucial for early detection of dementia, but some have concerns
By Edie Grossfield

A special section in the recently released Alzheimer’s Association’s 2019 Alzheimer’s Disease Facts and Figures report focuses on the role primary care physicians can play in early detection of the disease. The association says all people 65 and older should receive some kind of assessment of their thinking and memory functions and that the primary care setting is the best place to do it. It should be a part of routine exams, said Joanne Pike, the association’s chief program officer.

“We hope the report will encourage seniors and physicians both to be more proactive in discussing cognitive health during the Medicare Annual Wellness Visit and other routine exams,” she said in the press release about the new report.

According to the report’s survey of 1,954 health care consumers age 65 and older, only half have received a cognitive assessment, and even fewer receive routine cognitive assessments.

Experts say early detection of mild cognitive impairment, which can lead to dementia and Alzheimer’s disease, is important in terms of treatment and other factors. But some see problems with assessing all people who are asymptomatic — that is, showing no signs of impairment and not complaining of thinking and memory problems.

The main concern is the lack of information regarding the accuracy of the tools commonly used to detect cognitive impairment. Those are structured tests such as the “Mini-Cog,” the “Mini-Mental State Examination” and the “General Practitioner Assessment of Cognition,” or GPCOG.

The Alzheimer’s Association’s survey of 1,000 primary care physicians found that nine out of 10 sometimes use one or more of these types of tests, along with their own observations, during office visits. If some indication of impairment is found, most of these doctors refer their patients to a specialist, according to the survey.

Concerns About ‘Mini’ Cognitive Assessments

Dr. Terry Quinn, a geriatrician, researcher at the University of Glasgow and editor with the Cochrane Dementia and Cognitive Improvement Group, has written and been involved in articles investigating the accuracy of several brief cognitive assessments. Quinn is concerned about cognitive screening for all asymptomatic people 65 and older, not only because there’s lack of evidence to show the tests are accurate, but because there’s lack of information about the emotional and practical impacts they can have on people when the tests miss problems or falsely find problems.

“For example, we don’t know whether asymptomatic older adults want screening, we don’t know the effects of an erroneous label of cognitive impairment, we don’t know if screening tests predict future cognitive change, we don’t know the health economics of screening, we don’t even know what to do with a positive screening result,” Quinn says. “There are many examples of screening tests that do more harm than good. I am not against cognitive screening per se, but I would, at least, like to see small-scale pilots before we introduce it at scale.”

One of the most commonly used brief cognitive assessments is the Mini-Cog, a three-minute test in which the patient is asked to remember three words, then draw a clock with the hands set to a certain time. After the patient completes the clock, he or she is asked to recall the three words given at the beginning of the test.

A Cochrane review of studies measuring the accuracy of the Mini-Cog to detect dementia stated that the highest-quality study found the Mini-Cog “failed to detect up to 24 percent of individuals who have dementia,” according to Cochrane. In addition, the same study found that “up to 27 percent of individuals may be incorrectly identified as having dementia.”

Most of the primary care physicians surveyed by the Alzheimer’s Association (94 percent) said it’s important to screen all people 65 and older for cognitive impairment, and 82 percent of the consumers surveyed said it’s important to have their thinking and memory functions checked.

However, the report also found a significant minority of consumer respondents who are concerned about assessment and testing. About one-third believe the tests are unreliable, and 24 percent agreed that “the idea of all seniors being tested for thinking or memory problems is insulting,” according to the report. Also, 19 percent believe that since there’s no cure or treatment for thinking or memory problems, “why bother testing for them.”

‘Is Something Better Than Nothing?’

Neurologist Dr. Ronald Petersen, director of the Mayo Clinic Alzheimer’s Disease Research Center in Rochester, Minn., agrees that there are significant problems with brief cognitive tests, like the Mini-Cog, but still believes regular cognitive assessments should begin at age 65.

“I’m a neurologist, so I’m a specialist, and I sometimes cringe at those very, very coarse assessments of a complicated operation — namely cognitive function,” Petersen says. “But on the other hand, is something better than nothing?”

He says there’s plenty of debate about which brief assessments are better than others, “and studies show that ones that are a little more detailed and take a little longer to do, in fact, give you more information about the future outcome.”

But even at the simplest level, Petersen says, some kind of discussion of thinking and memory should happen during an annual physical exam for people 65 and older because early detection is important. So is having a baseline from which to compare future assessments, he adds.

“It could even be, ‘I asked Bill how his memory was and he said it was OK,’ and put that in the medical record. As incomplete as that might be, at least it shows that some attention has been paid to that issue. And I think that’s an important first step,” Petersen says.

The Alzheimer’s Association website lists these advantages to early detection of dementia:

  • Treatment that can lessen symptoms, such as memory loss and confusion, for a limited time
  • Opportunities to participate in clinical trials
  • A chance to prioritize other health issues, such as high blood pressure, smoking and fitness, which can help preserve cognitive function
  • Receiving emotional and social support as soon as possible
  • Planning for the future, including finances and care services

Petersen recommends that people 65 and older bring up the topic of cognitive function with their doctors. Not only can it lead to early detection of possible problems, he says, but peace of mind for those patients. He says studies by AARP and other organizations have found that Alzheimer’s disease is what most scares older people when it comes to medical issues.

“They’ve done surveys asking people, ‘What are you most concerned about?’ and you’d think [things like] heart disease or cancer, but it’s Alzheimer’s disease,” Petersen says. “They’re most concerned about losing their cognitive function, interactions with their family, losing their memory and things like that. So, if that’s the case, shouldn’t we at least open the door on this issue rather than waiting until something develops?”

By Edie Grossfield

Edie has been a journalist for more than 20 years, reporting and editing for newspapers and magazines. She also worked in communications for a large health care organization. She holds a bachelor’s degree in communications and media and a master’s degree in journalism, both from the University of Wisconsin in Madison. Reach her by email at egrossfield@nextavenue.org.

Plugging In

May 17, 2019

May is Older Americans Month! Communities that encourage the contributions of older adults are stronger! By engaging and supporting all community members, we recognize that older adults play a key role in the vitality of our neighborhoods, networks, and lives.

This year’s theme, Connect, Create, Contribute, encourages older adults and their communities to: 

  • Connect with friends, family, and services that support participation.
  • Create by engaging in activities that promote learning, health, and personal enrichment.
  • Contribute time, talent, and life experience to benefit others.

There is no greater example of this theme than our Longwood at Oakmont Technology Committee, led by Janis Ramey. Read on to learn more about how Janis connects Longwood residents, creates engaging and meaningful activities to help our residents use and understand technology, and contributes her technology expertise to benefit the lives of her fellow residents.

How Technology Enhances Connections at Longwood at Oakmont

I like to be involved wherever I live or in whatever I’m doing, and technology is one way for me to be a part of the community and to be able to not only contribute something, but meet people and create a network,” said Janis Ramey, a resident at Longwood at Oakmont. “I wouldn’t want to sit in my apartment and stare out the window.”

Janis brought her skills as a technical writer and teacher to Longwood about two years ago, and shared her knowledge with others after joining the Technology Interest Committee, helping to launch an app that Longwood residents fondly call the MyLAO app (LAO = Longwood at Oakmont).

The MyLAO app serves as a one-stop shop for the residents and team at Longwood at Oakmont. Users can look up names in the directory, read the resident handbook, view photos from events, see the daily activities and dining menus, play games, look at the weather forecasts and news, put in work requests and so much more.

To develop the app, Touchtown, an Oakmont-based resident engagement solutions company, teamed up with Janis and the committee in order to tailor the application to the needs and interests of the residents at Longwood. The app is heavily influenced by the Longwood at Oakmont Technology Interest Committee. Therefore, residents like Janis are able to help dictate the content and features included on the app, which enables the residents to make the most of their experience at Longwood.

Sean Porter, project manager at Touchtown, described the app as a way to “make it easier for residents to establish and maintain connections throughout their community, while taking advantage of all of the excellent resident engagement opportunities.”

Since joining the committee and helping to launch the MyLAO app, Janis has noticed how the introduction and integration of technology in the community has changed both her life and the lives of her fellow residents as they convert to a more digital world. “The MyLAO app has given me access to lots of information about what’s going on at Longwood, without the hassle of shuffling through paper announcements – which I consider an affront to our environment,” said Janis.

“We’re helping to save trees!” Sarah Kuhns, lifestyle engagement team leader and staff liaison at Longwood, works behind the scenes on the MyLAO app, uploading documents, information and reorganizing any features to keep them up to date. According to her, this surge of interest in technology from the residents has opened the doors to modern technology like social media and texting, which has allowed them to easily connect with friends and family members and heightening the camaraderie among the Longwood community.

To help residents struggling with the app or any of their devices in general, technical support sessions are held every Friday, where Janis and other residents on the committee help troubleshoot issues. The committee also holds the occasional “fireside chat,” which teaches residents how to perform certain tasks regarding technology, like sending photos from their iPhone.

Thanks to the efforts of Janis and the rest of the Technology Interest Committee, the MyLAO app has enriched its users’ lives and the Longwood community in the process.

Doing your homework before joint replacement leads to a better recovery

May 16, 2019

Meeting with a physical therapist and educating yourself before you have joint replacement surgery can help you to have a quicker, less stressful recovery.

Patients who meet one-on-one with a physical therapist (PT) and educate themselves prior to knee or hip replacement surgery feel better prepared to leave the hospital and report less pain and joint stiffness during recovery compared to those who did not, according to a study by Hospital for Special Surgery (HSS). The study evaluated the effect of a face-to-face counseling session coupled with web-based education on patient satisfaction and functional outcomes.

The goal of the education session was to manage patient expectations of the surgery and recovery before undergoing the surgery—rather than after the surgery, when they might be dealing with fatigue, pain or anxiety—so they were able to better absorb and retain the information. Researchers followed 126 patients who underwent knee or hip replacement for osteoarthritis.

All patients attended a group education class before surgery—the standard of care for those scheduled for joint replacement at HSS. They were then randomized into two separate groups. In group one, 63 patients attended the one-on-one education session with a physical therapist in addition to the group class and were granted access to an informational web portal featuring videos. The control group of 63 patients attended the standard group class and received a booklet about what to expect after joint replacement—with no further education.

Using patient satisfaction and patient-reported scores to measure pain, joint stiffness and function both before and after surgery, researchers determined that the patients who attended the extra one-on-one PT counseling session indicated they were better prepared to leave the hospital after surgery and were overall more satisfied with the preoperative education they received. Almost 97 percent of these patients accessed the informational web portal, and all of them said they would recommend it for patients undergoing the same procedure.

Almost 70 percent of patients from the group that did not receive the supplemental educational session or web portal access believed they could have benefited from additional education before surgery. Patients who received one-on-one counseling also needed fewer physical therapy sessions in the hospital before discharge and met PT discharge measures sooner, including being able to get out of bed, walk with or without an assistive device and go up and down stairs independently.

The upshot of this research is that, if you are considering joint replacement surgery, ask to meet one-on-one with a physical therapist BEFORE your surgery if that is not your doctor’s standard approach. And take advantage of any and all learning materials your doctor may give you—specifically online videos and information.

The more you know, the better your recovery may be.

My Neighborhood

May 15, 2019

“My time with Presbyterian SeniorCare Network has been ever evolving. I remember the day I interviewed to work here! I sat across from Kathy Hammar, who is now the Administrator here at Westminster Place. I remember how scared I was! She asked me why I wanted to work here, and I thought long and hard about my reasoning. I was inspired by my own mother who has been an RN for over 40 years! Growing up, I lived in a primarily elderly neighborhood. My parents took it upon themselves to give my brother and I exposure to our wonderful aging neighbors. I remember each of them fondly.

Here is where I gave my reasoning: I told her that I loved seniors and found them to be inspirational! My neighbor, Mr. Johnny next door, would have us over to sit on his porch until we were exhausted talking about the “good days” and when times were different. He was the kindest soul, he always called me “sweetheart.” My brother, Jonathan and I, had special permission to go into his garage and get out the extra lawn mower wheels from the shelf and race them down his hilly sidewalk on the side of his house, whenever we wanted! His neighbor, Mrs. Betty, was a lovely woman with white hair who lived alone. She was a joy and delight to talk with. She attended my birthday parties as a child. We didn’t sit too much on her porch, but she did invite me in and played piano for me. We also sat in her kitchen and talked for hours about her grandchildren and her kids. I loved listening to her speak about “the old days.” Across the street lived Mr. and Mrs. Jim and Cres. Two spunky individuals who I remember fondly. They drove a giant purple Cadillac and I don’t think she ever cooked a meal because they would invite us into their house and she always said “Let’s get you something special from the oven.” The oven was full of Lance sandwich crackers. On certain nights of the week they would be dressed in matching outfits to go square dancing! I loved seeing what outfit they would be wearing. These folks taught me a lot about life in general. And finally the last person who was the biggest influence in life, my Grammie. She played the biggest roll in raising me and I know that I wouldn’t be the person I am today without her.

I have stayed at Presbyterian SeniorCare Network for 10 years because of all of the people! Fellow team members, residents and family members have made a huge impact in my life. We have a resident who I care for currently, whose daughters hug me every time they see me! That is heartwarming to me! It makes it easier to get out of bed to come to work. This is my neighborhood and these are my neighbors. I must say my most cherished memory is getting to know all of the residents who I have had the pleasure of knowing and they will meet me again one day.

Like Emily, do you have a story about Presbyterian SeniorCare Network that you would like to share? We would love to hear it! Click here to visit our web page. Once there, please click on the button, Share My Story.

Once you have submitted your story, you will automatically be entered into a random drawing to win a $50 Visa gift card! Winners will be pulled the first Monday of every month.

Can A Caregiver Be Too Devoted?

May 10, 2019

How to know when caregiving crosses the line to self-neglect
By Randi Mazzella

Stacey G.’s (she asked that we use her last name initial only due to the personal details in the story) parents had a storybook romance. Married for over 60 years, her father still called her mother “sweetheart.”

Stacey’s mother developed dementia. As it progressed, her father tried for several months to take care of his wife at home with the help of health care aides. But then her behavior become explosive and irrational. Stacey, who lives in Voorhees, N.J., was faced with the painful decision of placing her mother in a nursing home.

“It was an extremely difficult decision and I still struggle with it, even though I am certain it was the right decision for everyone — especially my dad,” she says.

Her father’s devotion did not waver. He visited his wife twice daily, with just brief midday respites. “He would call at the same time every day to give me an update me on how my mother was doing,” Stacey says. “He rarely deviated from his routine.”

It didn’t matter that his wife’s dementia made it impossible for her to know if he was there or not. He continued to visit his sweetheart daily for more than three years, until she passed away.

While Stacey found her father’s devotion to her mother admirable, it was also concerning. Her father was in his mid-80s and had given up doing any of his traditional leisure activities, including playing poker and twice-per-week trips to Atlantic City with friends.

“He worried about my mother constantly,” Stacey says. “I was sad for my mother, but I didn’t worry because I knew she was being well cared for by the staff and by him. But I worried about my father. He wasn’t taking care of himself, he was driving exhausted and he didn’t spend time with anyone but my mother.”

Is it possible to be too devoted as a caregiver? And if so, how can a loved one’s help caregivers understand that they need to think about themselves?

The Physical Demands of Caregiving

“Can a vehicle continue to run without regular fill-ups and service? No!” says Rick Lauber, and author of the book, The Successful Caregiver’s Guide. Lauber, who lives in Alberta, Canada, helped care for his parents until they passed away. “Caregivers are no different. Caregivers helping and supporting aging loved ones routinely give too much of themselves while overlooking their own health and wellness.”

Clinical gerontologist David J. Demko adds, “Caregivers tend to get reduced sleep, including much-needed REM sleep. They have muscular aches from the physical demands of caregiving and neglect their personal nutritional needs.”

Stacey’s father eventually wound up hospitalized for five days with pneumonia. “The thing that really troubled me was that he still went to the care facility disregarding the fact that he was starting to feel pretty sick,” she says. “But his needs were unimportant to him.”

Some care partners actually become ill and die before the person they are caring for, says Rachael Wonderlin, a gerontologist and founder of a consulting business called Dementia By Day in Pittsburgh. “And it’s no wonder — they are highly stressed and consumed in their newfound role,” she says.

Strain On Relationships

Caregivers have decreased time for social outings and become emotionally drained. Even when they do take a break, they experience guilt. “When my father came to my house for holidays, he tried to enjoy himself, but I could tell he felt guilty that my mother was alone,” Stacey says. “He seemed lost and sad. He was much happier when I would bring my kids to him at the nursing home, but this was a hard environment for my young son. It was stressful for me to balance my father’s needs with my son’s.”

What Stacey’s father experienced is common, says Katie Ziskind, a family therapist at Wisdom Within Counseling in Niantic, Conn. “The (caregiver) often can develop codependency and depression as a result of caring so much for their loved one, even with the best intentions,” she says.

Stacey says her father is a very warm and kind man, but when he was away from the nursing home, he was usually distracted and anxious due to worrying so much about her mother.

“When we spoke, he would tell the same stories over and over again and was not really focusing on what was going on with me, my kids,” she says. It wasn’t until after her mother died that her father said, “I just realized, you lost your mother.”

How to Help a Caregiver

“Self-care is absolutely essential to be a good (caregiver) because you can’t give from an empty bucket,” Ziskind says. Explaining this to devoted caregivers can be difficult, but try stressing that if they don’t care for themselves, they won’t be as helpful to their loved one or to the other people in their lives who love and worry about them.

Yoga, meditation, writing in a journal or going for a daily walk can all help to replenish a caregiver’s energy and mental well-being.

Socialization for caregivers is also crucial. Encourage them to spend time with friends, connect with family or attend support groups with other caregivers.

Looking back, Stacey says her one regret is that she didn’t insist her mother be placed in a facility closer to her home, instead of over an hour away. It was difficult for her to visit her mother more than once a week while balancing work and childcare responsibilities.

“My father didn’t have a lot of support in the area. If she were closer to me, I could have visited her more often and I could have tag-teamed with my dad instead of him going twice a day,” Stacey says. “He also could have spent more time with his grandchildren and me without feeling guilty that my mother was alone.”

During her mother’s illness, Stacey feared that her father would die from the pace and intensity of his devotion to her mother. She says her father was a beautiful role model to her and to her kids. She is thankful that he now appears to be doing more things for himself.

“He has no regrets about the time he spent taking care of my mother. Even though he is sad that she is gone, he is also calmer and less anxious knowing she is at peace. He is taking better care of himself and is back to his twice a week Atlantic City trips. We still talk daily about my mother, but about other things too,” she says.

By Randi Mazzella

Randi Mazzella is a freelance writer specializing in a wide range of topics from parenting to pop culture to life after 50. She is a mother of three and lives in New Jersey with her husband and teenage son.  Read more of her work on randimazzella.com. 

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Take a Break

May 10, 2019

Are you a full-time caregiver for someone with Alzheimer’s or dementia? A little breather may be just what you need.

Alzheimer's disease is life-changing for both those who are diagnosed and those close to them. Having a helping hand when you need it is key to keeping yourself, and your loved one living with dementia, healthy and happy.

When you need a break, consider adult day services.Not only is it good for you, but it’s good for your loved one. Adult Day Services offer people living with Alzheimer's and other dementias the opportunity to be social and to participate in activities in a safe environment.

Adult Day Services may be for you if:

  • You are a full-time caregiver: Adult Day Services can provide a much needed break. While your loved one is at adult day, you'll have time to rest, run errands or finish other tasks.
  • You work during the day: Adult Day Services can help you to balance a job with caregiving duties.
  • You want a safe, caring environment for your loved one:  Adult Day Service is a chance for your loved one to share time with their peers. It provides a chance for them to be social and to participate in engaging activities such as music and exercise programs, as well as fun outings. 

Did you know that Woodside Place of Presbyterian SeniorCare Network offers Adult Day Services at its campuses in Oakmont (412-828-5600) and Manchester Commons (814-838-9191)? We are here to help!

HELP WANTED: Must Have a Passion for Serving Seniors

May 9, 2019

Long-term care is a clinically rich career for nurses

Long-term care, isn’t that boring?” Well, imagine this. It is 3 am, and the usually quiet night shift suddenly springs an emergency on you. As the nurse, you may be challenged to make decisions that provide the best possible outcome for all of those involved. If that sounds more like the ER than long-term care, you’d be wrong.

What makes nursing in long-term care so clinically rich? We sat down with Kristin Henderson, senior director of clinical services for Presbyterian SeniorCare Network, to ask the important questions about a nursing career in long-term care.

Q: Is long-term care different than say a hospital environment?

A: If you are expecting the overhead paging system directing you to a “code” or sirens and medical professionals running down the hall with a crash cart, then yes. But in terms of the care provided, we are pretty competitive. The landscape of hospital care has changed. Before, a patient would stay in the hospital for a week or more and get most of the care they needed while in the hospital. But now, that is totally different. A patient is in the hospital for one to three days and then they discharge to a skilled nursing community like ours for short-term care. So the care that was once provided at the hospital is now provided in a long-term care setting, specifically in a rehabilitation setting. The majority of the time, nurses in long-term care are utilizing the same skills as those in the hospital. The bottom line is the skill set required to be a successful long-term care nurse is very specialized and utilizes a hands-on approach.

I think one of the most obvious differences in a long-term care environment is the relationship that our nurses build with their residents and their families. That relationship is key to their care plan, not only for the medical needs, but for the care of the whole person. My nursing teams tell me that this is a rewarding environment because they are able to see the resident through their entire plan of care.

Q: What types of nursing jobs are available in long-term care?

A: We hire at a variety of levels. Entry level team members are Certified Nurse's Aides (CNA) and they provide the direct day-to-day care. At mid-level, we hire Licensed Practical Nurses (LPN) and Registered Nurses (RN). We also hire experienced nurses directly into manager and supervisor roles. But even RNs and LPNs without manager or supervisor experience have room for career growth. We have had great success training and growing our nurses into team lead positions, supervisor positions, as well as nurse educator and nurse navigator positions. We really can accommodate a variety of skill sets and experience levels!

Q: You’ve been with us for 15 years. What characteristics do you see amongst the nurses across our Network?

A: All nurses get into the field because they want to care for others. Our nursing teams are passionate about caring for others, it is ingrained in their DNA. And they do this every day, even when the day is emotionally or physically demanding, the caring never stops.

Our nurses are critical thinkers. They spend a lot of time with our physician groups and absorb a great deal of knowledge that they can use when a doctor is not onsite. They are comfortable offering recommendations to the doctors since they know their residents so well. They do this because they have a strong desire to quickly and accurately have proper diagnoses and treatments developed for our residents; after all, that’s what our residents deserve.

Q: What’s your favorite memory of your 15 year tenure?

A: Let me take you back to my first day at Presbyterian SeniorCare Network working as a staff nurse. I was given a stack of lab results to interpret and then report any abnormal results back to my supervisor. I had previously worked in a hospital setting where a doctor was always there and someone else read the lab results, I had not used those skills in years! What I quickly learned is that nurses in long-term care are challenged in new ways each day to pull all of those skills they learned in nursing school from the backs of their brains. It’s a really exciting environment if you like using critical thinking skills and nursing judgment. To meet these needs, we are committed to providing relevant training to refresh skills.

Q: Is a career in long-term care for anyone?

A: No, just like a career in a hospital setting or doctor’s office is not for everyone. It’s all about knowing your career aspirations and finding the right fit for you.

Q: What do we do to ensure that those we are recruiting are a good fit?

A: We want consistency of care for our residents and want to avoid as much team member turnover as possible because that impedes on that continuity of care, so we work hard in the interview process to ensure that our candidates understand the environment, and also feel that we fit into their own unique career goals. We offer tours of our campuses to prospective team members, as well as, when possible, the opportunity to shadow a current nurse and interact with our current team members.

Our recruitment team has a great motto: Happy caregivers = happy residents/patients = positive outcomes. I believe in that motto.

Q: The unemployment rate is low right now, making the job market very competitive and nursing jobs are always in demand. What are we doing to reach out to prospective nurses at every level?

A: We know that recruiting nurses is not a one-stop-shop and that there are multiple things we need to do to engage prospective team members. Our clinical recruiters are out and about, visiting nursing schools and participating in community events to share our open positions, as well as answering any questions about working in long-term care. We also know that there is a benefit to talking with our current high school- and college-aged employees. They may already know our organization through an entry level position in housekeeping or dining services, so it’s important for us to educate them about other career paths that are available in our nursing departments. We know that not everyone wants to go to college, so we offer guidance on the positions available within our organization that do not require a degree, such as a CNA. In 2018, our recruiters Network-wide made more than 300 touchpoints with the public, so we are out there!

Q: Anything you’d like to say to a prospective nurse looking to work in long-term care?

A: I could go on for hours about long-term care nursing careers! For prospective nurses, I’d say that each day you come to work, you get to use not only your clinical judgment, but what’s in your heart. We have a culture of caring, not only for our residents, but for our coworkers. It is truly a privilege to care for our residents, and if you are looking for a place to work where you can make a profound difference, we’re the place for you.

Explore Careers: CareersAtSrCare.org

We love our nurses!

May 8, 2019

Nursing at Presbyterian SeniorCare Network

Your Path. Your Expertise. Your Impact.

In honor of National Nurses Week, we are proud to feature one of our many superstar nurses! Check out why Stefany loves her work!


“I have worked at Presbyterian SeniorCare Network for 14 years and I love my position as an RN. I have a flexible schedule that allows for a healthy work/life balance with good pay and benefits. 

I love being a part of a nonprofit organization that has strong faith-based values and truly places the residents first. I value the personal relationships I have been able to form with our residents and their families over the years. My residents and coworkers have become my second family. 

I honestly could not see myself working in any other field or community. I am truly blessed.”

Stefany Renner, RN
Presbyterian SeniorCare Network, Washington Campus


Nursing at Presbyterian SeniorCare Network: A job isn’t one size fits all—it should be unique to the person filling the role! Here, our person-centered approach rings true for our residents, patients and team members alike. Find more than just a job. Build lasting relationships while doing meaningful work in a home-like setting. It’s your path. Be Uniquely YOU at Presbyterian SeniorCare Network.

Apply now! Click here to browse the RN and LPN open positions around our Network.

 
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