Category: Books/media of note
Posted by Dr. El - June 20, 2011 - Books/media of note, Common Nursing Home Problems and How Psychologists Can Solve Them, Stress/Crisis management
When nursing home residents are evacuated from their facilities after any type of disaster, they typically move to another nursing home rather than to a public shelter. They therefore miss the opportunity to speak with trained first responders who can help them address their emotional reactions to the experience.
Developed by psychologist Lisa M. Brown, PhD, and colleagues, the guidebook is based on the idea that, like medical first aid, anyone can be trained in psychological first aid techniques. The Psychological First Aid: Field Operations Guide for Nursing Homes provides training information specific to the needs of nursing home residents, including those with dementia.
The guidebook is an incredibly valuable resource, generously made available for FREE, and worth the click. A quick perusal of the table of contents will give you a sense of whether or not you and your staff members are prepared to help the residents in the event of a disaster.
Posted by Dr. El - May 31, 2011 - Books/media of note, Communication
I just finished reading A Bittersweet Season: Caring for Our Aging Parents — and Ourselves, by Jane Gross, founder of the New York Times’ New Old Age blog. A chronicle of her mother’s last years, the book is part love story, part cautionary tale. Jane Gross bravely shares intimate details of her family’s journey down this path while providing essential information about the late life health care system and how to negotiate each step of the way.
Having worked for years in nursing homes, I thought I knew a lot about what lies ahead in later years. Upon reading this book, however, I realize I know a lot about nursing homes, and not so much about what life might be like before one gets there. As someone with seven close relatives between the ages of 74 and 92, I found the book a wake-up call. It provides a good jumping off point to start to one of those difficult, but necessary, conversations with elders who have read it too — and for elders to open the dialogue with reluctant adult children. Beautifully written, with wit and intelligence, it passes a New York City reader’s highest standard: I was so engrossed in the book, I missed my subway stop.
Posted by Dr. El - April 18, 2011 - Books/media of note, Depression/Mental illness/Substance Abuse, Resident care
I once heard a family member complain at the nursing station about a parent being on antidepressants.
“She can’t remember a thing. How can she be depressed?”
The nurse replied, “I know.”
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| Marc E. Agronin, MD |
We tend to associate Alzheimer’s disease (AD) and other forms of dementia primarily with memory problems, but as a geriatric psychiatrist who specializes in dementia, most of my consults are for mood and behavioral problems. In fact, rates of depression approach 40% in AD sufferers over the course of their illness. Depression may look differently, however, in the context of dementia. Irritability, agitation, and resistance to care might be seen as prominently as a sad mood. Loss of appetite and poor sleep are common manifestations of both dementia and depression, and can make it difficult to tease them apart. In clinical practice, we look primarily for a rapid decline from one’s baseline when depression strikes.
The cause of depression in AD likely has less to do with a psychological reaction to cognitive and functional loss and more to the damage the disease causes to brain nuclei that regulate moods and produce key neurotransmitters. As a result, antidepressants that we use to treat depression in younger and nondemented individuals can be used with similar efficacy and safety. In early stages of illness, talk therapy can also play a key role, and in all stages there may be benefit to therapeutic programming involving music, pets, and exercise.
As I make clear in my book “How We Age: A Doctor’s Journey into the Heart of Growing Old
,” we cannot adopt a fatalistic attitude or even give up when depression or other mental illnesses afflict AD patients. Not only is there much we can do to treat these symptoms, but there are always underlying strengths that can be tapped, including humor, creativity, sensory enjoyment, and the ability to interact in socially meaningful ways.
Posted by Dr. El - November 22, 2010 - Books/media of note
Guest Post by Kitty Holman:
Nursing home staff are a tireless group of professionals and medical personnel striving to care and advocate for Americans elderly. From administrators and nurses to social workers and therapists, the number of people needed to keep nursing homes running smoothly is great. To help these professionals stay abreast of relevant news and information in their fields, many turn to blogs written specifically for nursing home staff. Below, is a list and brief descriptions of just a sampling of these resources.
Hospice and Nursing Homes Blog is useful blog and is written by Frances Shani Parker, author of “Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes.” She provides all interested readers with news, practices, and insight into the field of hospice, eldercare, and nursing homes. She also often includes research, images, and related videos.
Nursing Home Talk is a blog written by a nursing home administrator for the all members of nursing home staff. She provides information on field exams, tips and information on nursing home services, and other thoughtful insights. This blog aims to a “nursing home information source” for all interested readers.
The Hospice Foundation Blog is a wonderful, frequently-updated blog that looks at a host of current issues affecting palliative care. It’s a great resource for workers in the field who want to get a better idea of what’s happening in hospices across the nation.
Hold My Hand: A Social Worker’s Blog is written by Doris Plaster, MSW, LCSW. As a social worker in a nursing home, this blogger offers readers interesting and moving insights into the world of eldercare. This blog is readable for all nursing home staff, but other social workers might find inspiration in the blogger’s thoughts, stories, and reflections relating to this profession.
K. Tree, CNA is a personal blog written by Ms. Tree. It features her daily insights into her life as a CNA. Nurses looking for motivation and inspiration should stop by at this wonderful site.
Transforming Long-Term Health Care is a blog created by an administrator that offers fresh perspectives on nursing and health care. It’s great for those who are looking for words of wisdom from an angle of leadership and management.
My Better Nursing Home is a blog about long-term health care from the perspective of a psychologist. Dr. Eleanor Barbera delves into mental health issues that are a very important part of developing better nursing homes.
Obviously there are more blogs dedicated to nursing homes and eldercare than can be described in this post. But all nursing home professionals are encouraged to read and review blogs that can help them along their professional journey in these facilities.
By-line:
This guest post is contributed by Kitty Holman, who writes on the topics of nursing schools. She welcomes your comments at her email Id: kitty.holman20@gmail.com.
Posted by Dr. El - September 14, 2010 - Books/media of note, Tips for gifts, visits
With many families scattered around the country, it is a challenge to visit our aging parents as often as we would like. And, once our parents need nursing home care and move there, it becomes even more of a priority (to us and them) to be in touch.
A good friend shared, “One of my brothers moved to Houston a year before my mother died. He continues to apologize for not being there, not helping more, not visiting more. He missed out on the bingo games, the home videos, the photo albums and all the great stories that went with the memories. Grief gets mixed with guilt, and soon you are fighting a double edged sword. I know he is over the grief but will he ever get past the guilt?”
In this post, I am going to share some simple and easy strategies every family member can use to stay in touch with their loved ones in a nursing home. Distance does not have to be an impediment to communication nor does it need to result in guilt.
Here are some low-tech and high-tech ways to communicate directly with your loved ones from a distance.
1. Establish a contact (staff member) at the nursing home, someone you can connect with and call on a regular basis to ask how your parent is doing. Be sure you keep the relationship professional, and thank this person for their help.
2. Set up a schedule for when you’ll call your parent and stick to it. If he/she can’t answer the phone, talk with your established contact to set a schedule so the phone can be taken to your loved one.
3. Ask if the nursing home has a portable laptop with Skype (no-cost video and voice calls) that could be taken to your parent’s room.
4. If the nursing home doesn’t provide a portable laptop & Skype, ask if you can take the issue to the Residents Council. I bet the other residents would also really like such a service.
5. Another suggestion would be one of the newer technologies. With site installations offered by tech companies such as Grandcare, family members can send “virtual” communications to a resident’s TV.
Also, even when you can’t be with your family member in person, by voice or video, there are other ways to share with them in a meaningful way. It may take some thought, reflection and creativity, but the effort is well worth it!
1. Send photos of family and trips. I have a dear friend, “Mary”, in a nursing home who loves to receive photos in the mail. I help her fill albums, and she has a wonderful time reminiscing about the people and places.
2. Send postcards. Same type of thing. Mary keeps albums of these as well.
3. Send wedding and graduation announcements. Keep your loved one involved. Although they may not be able to attend, they will appreciate being included in your thoughts.
4. Know that birthdays are a very special occasion to someone in a nursing home. Mary received several pretty and funny cards, and a few flower arrangements. She especially loved the one with her favorite flowers, daisies, in a bright yellow dish with a Smiley face on it. The person who sent it took great care to select her favorite things.
5. Send special gifts such as audio and videos that have special meaning for your parent.
6. If your loved ones collects something, that’s a great way to pick out a meaningful gift. Mary loves flamingoes. She has quite the collection of stuffed flamingoes. It really makes her room personal and cheery.
Don’t forget about utilizing volunteers to spend time with your loved one when you can’t be there. Is the nursing home lacking a structured volunteer program? Share your desire for a volunteer with the administrators. I volunteer at a nursing home with no structured program. When I first inquired into opportunities, the administrator I met with saw a match between me and Mary, and I have been visiting her weekly for almost 2 years now. I have become her pseudo-family.
Finally, do not forget about your own personal needs. Find a support group for long-distance caregivers. Such a group, whether online or in-person, can provide you a place to meet others who are in a similar situation. You’ll be able to share your issues and feelings, and learn from others. The more positive action you take, the less guilt you will feel.
I hope these ideas help spark ideas for family members with a loved one in a nursing home a distance away. Just because you can’t be there in person does not mean you cannot “be with” your loved one.
Dale Carter, MBA
Posted by Dr. El - March 2, 2010 - Books/media of note, Depression/Mental illness/Substance Abuse, Medication issues
I saw an article yesterday in the Health section of the New York Times describing the difficulty of younger people to imagine what life might be like in later years, particularly in nursing homes. I thought readers would appreciate it.
The old woman had drawn down the shade in her room — hoping, I imagined, to stop the midday Miami sun from penetrating her grief. But the sun still hit the window full force and illuminated the shade like a Chinese lantern.
She sat silently in a wheelchair, her 93-year-old silhouette stooped in the bathing light. I entered, held her hand for a moment and introduced myself. “Sit down, doctor,” she said politely.
Click
HERE to read the entire article.
Posted by Dr. El - February 26, 2010 - Books/media of note, Talks/Radio shows, Transitions in care
Listen to me and David Solie, MS, PA, author of How To Say It To Seniors: Closing the Communication Gap with Our Elders, in the program, What Do Nursing Home Residents Discuss with their Shrinks? You can hear the free half-hour BlogTalkRadio show, recorded on February 27, 2010, by clicking HERE.
Posted by Dr. El - November 17, 2009 - Books/media of note
Today’s guest post is from Denise Tyler, PhD, of Brown University’s Center for Gerontology & Health Care Research. The LTCfocUS website she writes about contains an invaluable tool that allows the user to input variables such as resident demographics and facility staffing, and creates maps and tables of nursing homes in the US based on these factors. While the main purpose is to provide vital information for shaping healthcare policy, I can see other uses as well. For example, perhaps a family is looking for a nursing home with a good record in preventing urinary tract infections, to which their elderly mother is prone. The answer is a few mouse clicks away.
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Millions of Americans live in nursing homes and millions more receive short-term care from one after a hospital stay. But the current healthcare reform debate has largely ignored nursing home care.
This is due, in part, to a lack of data about how and why that care is given.
As we move ahead with health care reform, we must understand how nursing homes are being utilized, what kinds of patients live in them, and what the outcomes are for the people who rely on them for care.
This matters because healthcare reform will likely be paid for in large part, by reductions in current healthcare spending. And the majority of these reductions will come from the Medicare program and nursing homes will likely be the target of these spending reductions.
Until now, there has been no resource for accessing information about nursing homes and those they care for. A new Web site that provides this information for the first time,
www.LTCfocUS.org, has been developed by the Center for Gerontology and Healthcare Research at Brown University.
LTCfocUS.org hosts data regarding the health and status of nursing home residents, characteristics of care facilities, and state policies relevant to long term care services and financing. The Web site allows policy makers and researchers to trace clear relationships between state policies and local market forces and the quality of nursing home care. What’s more,
www.LTCfocUS.org also provides information gathered from a variety of sources, which makes it useful to answer research and policy relevant questions that could not previously have been answered. For example, the Web site can be used to determine which nursing homes are providing greater proportions of Medicare services or examine the growth in Medicare services in nursing homes over time.
The Web site contains data about nursing home resident health, with specific information covering areas including incontinence, or the number of patients who are on anti-depressants or have high blood pressure. Users can also learn about the size of nursing home facilities, whether they are for profit or non-profit or affiliated with a chain. Do you want to know how full these facilities are? Our Web site can also help with this information.
The system now in place can also inform about local market condition and competition, the Medicare Managed Care market penetration rate, and state policies regarding Medicaid spending on nursing homes.
In addition, because the Web site provides several years of data, it is possible to examine trends over time and determine how changes in nursing home policy or financing have affected nursing homes and their residents from year to year. This information will be important for deciding which policies and financing schemes improve care and save money, some of the primary goals of healthcare reform.
Why is this information necessary? It matters in the bigger picture, for both health care and health care reform.
Health care reform will spur many changes and it is critical that these changes be evidence-based, and not dependent on politics. LTCfocUS.org is a new resource that will be vital to building this evidence base regarding nursing home care.
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The author, Denise Tyler, Ph.D., is an Investigator in the Center for Gerontology & Health Care Research at Brown University. She’s project manager for the Shaping Long-Term Care in America Project, a five-year, $10 million project funded by the National Institute on Aging that aims to improve nursing home care in the US by examining how market factors and state policies affect the quality of care delivered in the country’s 15,000+ nursing homes.
LTCfocUS.org is a product of this project.
