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Pet Therapy Brings Smiles!

November 21, 2018

When the pets visit, our residents light up and smile from ear to ear! Who doesn’t love doggie kisses, soft fur and a few barks? Pet therapy happens about once a week at Woodside Place of Oakmont, and the residents sure look forward to it.

We have many pets that visit Woodside Place, but some of our furry friends are registered therapy dogs. As soon as one of our therapy dogs enter the building, the residents begin interacting; approaching the dogs to pet them and talk to them. Residents who are quiet often begin speaking, sharing stories of a pet they once had. And let’s not forget our team members—they love pet interactions as well. Visits have helped start conversation and create special bonds and good memories.

Also, the pet therapy sessions have physical and therapeutic benefits for our residents. If a resident needs more exercise in their day, they will get it by walking a dog; we’ve found that residents are much more willing to move around if they are walking with a furry friend! 

If a resident needs help with fine motor movements, we give the resident a small brush and have them brush a dog.

Plus, therapy animals offer stress relief! Residents enjoy relaxing in their favorite chair with an animal on their lap to pet.

Pet therapy has had a positive impact on the residents and team members at Woodside Place, and we look forward to having more pets visit in the future.

Committing to Memory

November 21, 2018

More than 5 million Americans are living with Alzheimer’s disease. Is it time for you to talk to your doctor about Alzheimer’s?

If there’s one thing that worries seniors, it’s the prospect of developing signs of dementia. These fears prompt many to visit websites that claim to provide online tests for Alzheimer’s disease.

While these Internet tests may do a good job of presenting their material in an understandable and usable way, research reveals them to be ineffective for diagnosing Alzheimer’s. According to a study presented at a recent Alzheimer’s Association International Conference, online Alzheimer tests are inaccurate, unscientific and unethical.  Don’t waste your time or money on online tests that may only make you more anxious about your memory issues!

A battery of tests and expert interpretation are required to make an accurate diagnosis. If you have concerns about your memory, it may be time to talk to your doctor about Alzheimer’s testing. Your doctor can tell you for sure whether your memory issues are related to Alzheimer’s or dementia.  And if you do have Alzheimer’s, there may be medications that can slow the progression of the disease. 

For more information about Alzheimer’s, visit the Alzheimer’s Association website  or tap into our additional Senior Experience here.  

An Employee Pipeline That Starts With Schooling

November 20, 2018

Presbyterian SeniorCare Network, a full-continuum provider serving 10 counties in western Pennsylvania, has accepted that challenge by creating a program that not only recruits young people as employees, but actively partners with schools to educate and train them for the purpose.

Click here to read more of this LeadingAge Magazine article about how Presbyterian SeniorCare Network is building an employee pipeline. 

Are you a Caregiver? Take time to caring for yourself!

November 20, 2018

Caring for a loved one with dementia can include helping with chores, medication, bathing and grooming. As the disease progresses, your loved one relies on you even more. This hard work can take a toll on care partners.

According to the Alzheimer’s Association, about three out of four people report feeling concerned about maintaining their own health, and their work and social lives are usually also affected. Being an effective care partner for your loved one means also taking better care of yourself.

Fortunately, there are national and community resources available to find support and advice:

Person-Centered Care Focuses on Patients' Needs

November 19, 2018

What person-centered care means and how you can get it

By Patricia Corrigan

The way patients and health care providers think about health care delivery is changing, with an increasing desire to involve patients in decisions and planning. Today, many providers also work to meet patients’ needs that go beyond medical treatments. This philosophy is known as person-centered care.

The SCAN Foundation, an independent public charity (and funder of Next Avenue), defines that philosophy as putting older adults “at the center of the decision-making process” by making use of a care team “that considers the full range of needs of individuals and their families.”

Rebecca Kirch, executive vice president of health care quality and value at the nonprofit National Patient Advocate Foundation in Washington, D.C., is a proponent of the philosophy. “So often in our health care system, when we are asked what’s the matter, the provider’s response to our answer doesn’t always align with what matters in our lives to us or to our families,” Kirch says.

What does person-centered care look like, and how can you get it? Here are some examples and advice to help you start a conversation with your doctor about a broader range of care for yourself or a loved one:

‘We Listen to What Patients Need’

Sharp Rees-Stealy Medical Group in San Diego has committed itself to person-centered care, with the goals of improving communication channels and offering more support services.

“Medical groups across the country are paying more attention to what patients need and want because patient involvement produces the best outcomes,” says Janet Appel, Sharp Rees-Stealy’s director of population health. The organization serves some 220,000 patients who make more than a million doctor visits each year.

Appel added, “If people are not engaged in how they receive care, their health goals will most likely not be met.” The medical group practices person-centered care in several ways, including:

  • Phone or video appointments
  • Webinars on topics such as diabetes education
  • Expanded evening and weekend hours
  • Case management services
  • Support programs
  • Nurse navigators to help with difficult diagnoses
  • Texting to receive reminders and health tips

“The texting program is especially popular,” Appel says. “Patients choose how often to receive texts with tips for healthy living, reminders about appointments or information on where and when flu shots are available. They can also text us with questions, and texting answers back to them helps us stay connected at the patients’ convenience.”

Appel noted that Sharp Rees-Stealy actively seeks feedback so it can make changes that will help communications and practices evolve based on what patients want. “We listen to what patients need in order to improve patient engagement to improve healthy outcomes,” she says.

Delivering Care Where Patients Are Is ‘Critical’

At Inland Empire Health Plan (IEHP), a not-for-profit Medi-Cal (California’s Medicaid program) and Medicare health plan, the focus on person-centered care extends to individuals who may need it the most. Based in Rancho Cucamonga, IEHP is a network of more than 6,000 providers and 2,000 team members who serve more than 1.2 million people.

Through the Affordable Care Act, a large pilot program called the Behavioral Health Integration and Complex Care Initiative allows IEHP to provide person-centered care for its low-income plan members at locations convenient to them.

Working with a dozen agencies, IEHP has staff at 30 sites. “We’ve put nurses, behavioral health specialists and care coordinators at primary care offices, behavioral health clinics, substance abuse treatment clinics, adult day care centers, assisted living centers and pain management clinics,” says Dr. Bradley P. Gilbert, IEHP’s chief executive officer.

“Many people we serve face many complicated issues, including with their health, housing, transportation and other challenges, so making sure they are part of the planning and then delivering care to them where they are is critical,” Gilbert says.

The project has made significant improvements in people’s health, based on measurements regarding depression, anxiety, blood pressure and more, Gilbert says. “We’ve had great feedback from members, and providers also say they like the structure of the health care delivery.”

Currently, the pilot program is in transition. The number of sites is increasing, and nurse care managers, social workers and community health workers are being added at each. Plus, IEHP is working to house high-risk members who are homeless.

Ask Your Doctor About Person-Centered Care

What about your needs?

Is it a hardship to arrange transportation for X-rays, screenings or blood tests done across town from your primary physician’s office? Maybe you see specialists in two separate health care systems and you want them to better coordinate your care. Could you benefit from a talk with a social worker about local agencies that help pay some living costs?

Speak up, the experts advise.

“Let your voice be heard,” Appel says. “Ask what patient-centered care means at your doctor’s office, and if it’s not available, ask how you can help get that started.” You may be surprised, she adds, at the doctor’s willingness to listen.

“The medical world has gotten into what retail has done all along — listening to the consumers and then drawing them in by offering what the consumers want,” she says. “Today, there is a lot of competition, with many places to go for health care.”

Person-centered care can be especially important when individuals are coping with serious illness. Kirch, at the National Patient Advocate Foundation, gave this example: “Palliative care, now part of mainstream medicine, presents a bullet-proof case for person-centered care that aligns treatment with the goals and the specific needs of the person and the family affected, rather than focusing only on the disease. Providers must ask about those goals, document them and honor them.”

‘What We Need Now is More Public Demand’

Like Appel, Kirch encourages speaking up for what you want from your provider. “Public demand makes medical practices change faster than any policy or payment incentive,” she says.

How would Kirch assess the status of person-centered care in the U.S. today? “We have more than a toehold, but not yet a foothold,” she says. “We have demonstration programs in place in some pockets of the country, but it’s not yet scaled to where it needs to be. Still, I’m optimistic. What we need now is more public demand.”

© Next Avenue - 2018. All rights reserved.

Excellence in Dementia Care

November 19, 2018

As a leader in dementia care for more than 25 years, Presbyterian SeniorCare Network is recognized as a Dementia Care Center of Excellence. In 1991, we set the standard when we introduced our cutting-edge residential community, Woodside Place of Oakmont, which has been replicated more than 100 times nationally and internationally. From Woodside Place, we developed the Woodside model and philosophy of care—standards and best practices that solidify the specialized expertise and commitment to excellence in dementia care that we have across our Network.

Recognizing that a majority of older adults may experience some level of cognitive impairment over time, our organization invests consistently in training and education for all of our team members. In fact, each team member at every level of our organization is certified in dementia care through the National Alzheimer’s Association at the time of hire. Additional in-depth training is provided annually for team members who provide direct care for individuals living with Alzheimer’s and other dementias. We have more than 70 team members who are certified dementia care practitioners that our front-line team members can call upon for even greater support and expertise.

We continue to explore new ways to enhance the lives of persons living with dementia. We have spearheaded a unique collaboration to demonstrate the therapeutic benefits and positive outcomes that can be achieved through rehabilitation therapies for persons living with Alzheimer’s disease and related dementias. A world-renowned gerontology expert and one of our trusted advisors, Steven Zarit, PhD, will be overseeing this research project, which will be a joint effort between our Rehabilitation Center of Excellence and our Dementia Care Center of Excellence.

When You Are Shamed for Moving a Parent into a Care Center

November 16, 2018

How to cope when other realtives don't understand your decision

By Rachael Wonderlin

Beth came up to me, tears in her eyes.

“My cousins came into town,” she lamented. Normally this would not seem like a big deal, but Beth’s cousins were diametrically opposed to the idea of her moving her mother — their aunt — into a long-term dementia care community.

“They think I shouldn’t have moved Mom…they think I should have just kept taking care of her at home,” Beth sighed, dabbing at her eyes. “Maybe they’re right. Maybe I should just take Mom back home with me.”

More3 Surprising Things That Raise Your Dementia Risk

I would love to tell you that this was the first story of a family member getting shamed for moving their loved one into a care community, but it is not. I am the director of Memory Care at an assisted living community, and I’ve been working in dementia care for five years. I hear this kind of thing all the time.

Harsh Judgment

We’ve all heard of “shaming,” a phrase that seems to have picked up more popularity recently. We have seen everything from “body shaming” to “middle class shaming” in articles online. I’ve become very familiar with another type of shaming: shaming people for moving their loved ones into long-term care communities.

Although it would be very nice if everyone could take care of their aging loved ones at home forever, this is just not the case for many families. There are many factors involved: where the family lives, what jobs and responsibilities the family members have, what type of care the aging adult needs, financial concerns, nutrition and health concerns.

Most complicated are mental health concerns for the aging adult. Taking care of anyone at home is challenging. Taking care of an adult with dementia at home is particularly difficult. For example, if you are caring for someone with dementia in your three-story house, you cannot explain to that person that he or she should not attempt to use the stairs if they are home alone. People with dementia have trouble remembering facts, following directions, or understanding risks.

I cannot tell you how many people have had to move their loved ones with dementia into an assisted living or skilled nursing facility because of a major fall.

A Limited View

I explained all of this to Beth. I also reminded her that, no matter what her cousins from out of town had to say, they were not the ones caring for her mother. They didn’t come visit her every single day. They hadn’t been taking care of her at home for the past two years, watching her dementia progress and her falls become more frequent.

These cousins hadn’t retired early, just so they could help care for this aging woman in her own home. They weren’t taking time away from friends, other family, and vacations to bathe, clothe and feed this woman.

More3 Ways to Work From Home and Be a Caregiver, Too

Beth’s cousins had absolutely no idea what it was like to take care of another human being at home without much in the way of other help.

It’s Different With Kids

When you are raising children at home, there’s a community that rallies around you. You host big birthday parties, invite other parents and their children over to your house, plan nights out, call up babysitters, and, although you are probably exhausted, you feel joy in watching your children learn and grow.

From what I have seen, caring for an aging parent is the complete opposite. There is no sense of community. There is no joy in watching them grow and learn. There is only guilt, sadness and panic as you watch them descend deeper into physical and mental disability. There aren’t birthday parties, family gatherings and babysitters to lend you a hand.

A Common Theme

I offer a phone call service for caregivers who have questions about dementia care. While I always help these caregivers troubleshoot their dementia-related issues and provide advice about care communities or care at home, we always end up talking about guilt. All of these caregivers feel guilty, even the ones who are taking care of their loved ones at home.

They don’t give themselves time off, they don’t get paid, and they certainly don’t let themselves off the hook about mistakes they feel that they have made.

“Mom fell the other day,” one told me. “I left the room for 20 minutes to do her laundry, and I should have put the phone next to her — she could have called me for help! This was all my fault.”

‘Clean, State-of-the-Art’

Choosing to move a loved one into a care community is a personal decision. Care communities are also not the awful places we read about decades ago. “Putting someone in a home” does not carry the painful weight it used to carry.

Many of the care communities I’ve visited are clean, state-of-the-art buildings that offer social activities and outings. Sure, care communities are not perfect, but caring for people is an imperfect science. Choosing to move a loved one into assisted living or skilled nursing should not be a worst-case scenario. Sometimes it’s the best-case scenario for aging adults and their families.

My hope is that, as our population continues to age, our society will begin to understand the need for all types of care. The U.S. prides itself on being made up of many types of people and families. Yet we lack the progress and understanding that comes with accommodating different types of caregiving. You can care for a loved one from across the country and still be a fantastic caregiver. There is no shame in choosing the best possible care situation for you and your loved ones.

Woodside Place: The Capstone of a Tradition of Innovation

November 16, 2018

Presbyterian SeniorCare Network has had many pioneering moments in the 27 years since it established Woodside Place of Oakmont, a groundbreaking new model of dementia care.  Not only was Woodside Place one of the nation’s first residential care communities designed specifically to meet the needs of older adults living with Alzheimer’s and related dementias, but it was the foundation of the person-centered culture and care model that is part of the fabric of Presbyterian SeniorCare Network today.

When the original leadership team visited a unique residential Alzheimer’s facility in England in the late 1980s, they returned to the United States even more determined to create a compassionate environment that would be in complete contrast with the regimented institutional models prevalent at the time. With grant support from several local foundations, we enlisted the help of Pittsburgh dementia expert Judith Saxton, PhD.

“Dr. Saxton became a trusted adviser right from the start and her input was invaluable to our programming, design and evaluation of the original resident population,” says Jim Pieffer, senior vice president of Presbyterian SeniorCare Network and a member of the leadership team that made the trip to England 30 years ago. “We were really breaking new ground in dementia care, so we relied heavily on Dr. Saxton’s expertise.”

Dr. Saxton had made a name for herself in the cognitive disorders of aging field while on staff at the University of Pittsburgh and later at the Alzheimer’s Disease Research Center (ADRC). Her career-defining achievement occurred while working with us on the design of Woodside Place.  Dr. Saxton developed the Severe Impairment Battery (SIB), a group of tests that made it possible to evaluate dementia patients as their skills declined. It was significant not only in its use as an evaluation tool in the clinical setting, but also as a pharmaceutical measurement in the development of one of the earliest drugs used to treat Alzheimer’s disease.

According to Francois Boller, MD, PhD, former director of the ADRC and Dr. Saxton’s supervisor and collaborator, “Judy led a team that devised a battery of tests for people who are much more severely impaired. Until then, there was no way of quantifying people with severe dementia. Her test was very simple. You talk to the person, see if the person pays attention to you, and show them some simple items, such as a cup, a knife. You see if the person can use them, can recognize colors. The beauty is that it is universal—every culture has these items—so the test can be used in any country. The SIB test has been translated into many languages and is still in use today worldwide.”

The SIB test also was used to evaluate the effectiveness of the Woodside Place model and confirmed that the model truly was improving the quality of care for the residents. “She also created a tool that allowed us to measure residents’ strengths as well as their limitations, because it was important for Woodside Place staff to know each resident’s capabilities and focus on preserving them as much as possible,” says Anna Scott, who was the original dementia services coordinator at Woodside Place. “It allowed us to give families some positive news and not just report their family member’s decline.”

We are grateful for the groundbreaking work that created Woodside Place.  It spawned a new person-centered care model, which set the standard for dementia care. In 2016, for the 25th anniversary of Woodside Place, we honored Dr. Saxton with the Samuel K. McCune Award for Distinguished Service.  Dr. Saxton has now retired from the University of Pittsburgh but continues to be involved in aging research as a consultant to a number of dementia studies around the world.

Enhancing Worship and Services for All

November 15, 2018

Worship and faith in our dementia communities is strong; just because memories are fading, that doesn’t mean that our residents cannot engage in worship.

At our Oakmont campus, Reverend Susan Blank, director of pastoral care, adapts worship for our residents living with Alzheimer’s disease or a related dementia. Susan says, “Many of the residents find the hymns familiar, and because music is one of the last things our residents living with dementia are able to hold onto, we do a lot of singing. For those who still like to follow along, I have created a color-coded hymnbook. Rather than asking them to turn to a certain page number, which is often difficult, I ask them to turn to the yellow page or the green page. Colors are easier, which makes worship more fulfilling.”

Read on to learn about Susan’s first-hand experience about how worship – and hymn – can enrich the aging experience. 

No Name, No Voice, But Always Full of Purpose
A reflection submitted by Reverend Susan Blank, director of pastoral care, Oakmont campus

I had a resident living with dementia who was no longer verbal. But when he attended my worship services at Woodside Place of Oakmont, he always greeted me with a huge smile and sparkling eyes. His smile and his eyes spoke eloquently. When we sang favorite hymns, he would mouth the words. He enjoyed worship, and my work was made richer by knowing him.

Upon his death, I was asked to officiate at his funeral. As I talked with his family in preparation, I found that this man was an opera fan, and had even appeared on stage as a supernumerary (someone who appears in crowd scenes or small non-speaking or -singing parts.) In order for the opera to be believable, the supernumerary must perform well, but has no name and no voice!

This is quite a metaphor for what sometimes happens in the late stages of dementia: the person loses so much, even their voice, so we sometimes have difficulty recognizing the person they once were. But this was a man of faith, and through our faith, we are known by name and called the beloved child of God. Through our faith, our voice is heard, and we are blessed.

God tells us, “I have called you by name, and you are mine.” This became the message as we honored the life of this dear man. It was a comfort to me, as it was to the family and friends gathered that day.

Alzheimer’s Disease and Dementia: What’s the Difference?

November 14, 2018

The Difference:

Truth is, the human mind is a notoriously complex organ that controls our thinking, language, memories and more. When a person’s cognitive abilities begin to decline, there are several different (or combinations of) disorders that may be the cause, including:

  • Dementia: This is a general term for memory loss caused by physical changes in the brain that affect memory, language, problem solving and other abilities, and interfere with daily life.
  • Alzheimer’s: The most common type of dementia, Alzheimer’s is a degenerative brain disease that accounts for 60-80 percent of cases. There is currently no cure for Alzheimer’s.
  • Vascular Dementia: Impaired judgement, decision making and motor function are often early symptoms. Brain changes of vascular dementia and Alzheimer’s commonly coexist.
  • Dementia with Lewy Bodies (DLB): When Lewy bodies (abnormal brain neurons) develop in the brain’s cortex, initial symptoms can be hallucinations, imbalance and sometimes, memory impairment. DLB and Alzheimer’s may also coexist.
  • Other Types of Dementia: These include frontotemporal lobar degeneration (FTLD), Parkinson’s disease and Creutzfeldt-Jakob disease. Unfortunately, most types of dementia are progressive, meaning they advance through various, worsening stages.

The Journey Ahead

No matter what stage of dementia your loved one is in, you may feel anxious about the future. It’s important to remember that every individual— and every journey—is different. Be prepared and remember to take time to enjoy life, too!

SOURCE: Alzheimer's Association

 

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