An Elder Care Conversation About Senior Activities Done Right

November 28, 2011 By Leave a Comment

During my research on assisted living communities and elder care, I met a woman whom I consider to be the model activities director. Her name is Terri Glimcher and she is the Life Enrichment Coordinator for Emeritus Senior Living. In addition to her duties at Oak Park Assisted Living in Clermont, Florida, she also serves as a trainer for many other local communities. If her techniques were universally adopted, this chapter would be completely unnecessary.

I’ve spoken to Terri several times during the course of my research, as she is a true expert in her field. She gets it!

To reword our discussion would not serve her great work justice, so I’ve included the entire transcript of our discussion.

RYAN: Thanks for spending the time with me, Terri. The work you’ve done at Emeritus has been amazing.
TERRI: Thanks for the kind words.
RYAN: Let’s go ahead and get started. What is your role at the company?
TERRI: I am the Life Enrichment Coordinator for Summerville at Oak Park Assisted Living, an Emeritus Senior Living property in Clermont Florida. I am also on the marketing team here at Oak Park.
RYAN: Sounds like a lot of hats! Being a marketing guy from a previous life I know what you’re going through. I’d like to focus on the activities portion of your responsibilities. Would that be okay?
TERRI: Sure.

RYAN: What is the role of “activities” in an assisted living environment?
TERRI: Great question! Activities play a very important role in assisted living. It is very important to keep the mind and body challenged and stimulated throughout the day. More importantly, however, is the socialization that comes with activities. It is very important for your loved one to feel connected in their new residence. Activities will help to do this. Activities also help the resident continue to enjoy many things they used to do. This consistency helps with the overall transition to assisted living.

RYAN: That makes a lot of sense. I know it was tough for my mom to transition to assisted living, because she was so active before.
TERRI: What did she do?
RYAN: She was involved in women’s club, some charities and card parties with her lady friends. She missed all that when she got into assisted living, as she remembered what is was like before her stroke.
TERRI: That sounds tough.

RYAN: It was. Anyway, let me ask you another question. What do most assisted living communities do wrong with regard to activities?
TERRI: I only know from many that I have observed that they do not meet the needs of ALL residents. They focus on the mainstream population and often have activities that people with special needs such as physical, visual or hearing cannot participate in. In my community, we make sure that adaptive equipment is in place so that all residents can participate in any activity.
RYAN: That great to hear…
TERRI: I also firmly believe that the residents should have choices in their schedule, which is why a resident council should be in place. This is their home and activities should be available at all times for residents to participate in as a group or individually. That piece lacks in many communities. Another important factor is that the assisted living community should be connected to the local community. Many times residents feel isolated because their whole world revolves around the community. The community is very open to seniors and it is a great way to keep them connected.

RYAN: Your approach sounds really unique. What have you planned that is unique?
TERRI: I really believe that most of my activities are unique in that age never plays a role in what I plan. We are always involved in a community service project of some kind. My knitting class made baby hats for the neonatal unit at our local hospital. We donated 150 hats. They were also involved in the Give a Kid a Backpack Program here. The residents hand-craft a beautiful teddy bear to go in each backpack received by the children. We have made soldier caps that were sent to Iraq, we raised money for breast cancer awareness and many more. Seniors enjoy giving back. They feel a part of a bigger picture.

RYAN: That’s really amazing. This is the kind of thing that probably makes a big difference to the residents. It seems like having a purpose is often missing for many of the assisted living residents I’ve met.
TERRI: Absolutely. In talking with the residents, I learned that not working and not having responsibilities was the hardest part for them. In hearing that, I came up with a list of jobs within our building and held a huge job fair for the residents. Each resident who wanted a job came down dressed up, filled out an application for the position, and was interviewed by me. This gave them a chance to tell me about their former careers and what it was like to work when they were growing up. It was wonderful. They all got the jobs they applied for — floral committee, taking statistics, welcome committee, sending get well cards, watering plants etc. I can tell you that for three years, every one of them has taken their job very seriously. We are a family here, and it takes a family to make it work. They receive $100.00 a week funny money and shop at our General Store.

TERRI: I also started the Bridging the Generations program with all the local high schools. This is ongoing for three years now. The high school kids come to Oak Park and are paired up with the residents. They do projects together, cook together, etc. We celebrate holidays with the students. I bring the residents into the high school so that students learn about the aging process. The students play their instruments for the residents and work on their science fair projects with them. The residents are truly mentors for these students. We have been recognized by the Orlando Sentinel many times for outstanding programs here. One of our greatest activities was “Biker Day” at Oak Park. A local merchant brought their Harley’s to Oak Park. Each resident dressed up in leathers with headbands and posed for pictures on the bikes. We sent pictures to the families saying “And you thought your loved one was at home knitting!” We got a huge response of laughter from all involved. It was a blast!

RYAN: (Laughs) That sounds incredible. You really owe yourself a pat on the back for such great work! Can you please send me a picture of Biker Day? That sounds awesome!
TERRI: Sure, no problem.
RYAN: So, in your opinion, how have the residents benefited from those unique activities?
TERRI: The residents feel a part of the community. They truly see that they make a difference. They are loved and respected by so many people in this community. The merchants come here to do activities with them. The local florist does flower arranging, Home Depot does workshops with them, Ritters Frozen Custard makes sundaes here, and we have a merchant that sets up a fruit stand in our lobby with fresh fruits and veggies that the residents can choose at no charge. They feel very connected. It’s not just being part of their residence, but still maintaining a sense of community. That is important factor in maintaining good emotional health.

RYAN: Very cool. How do you mix physical and cognitive activities?
TERRI: I do a lot of physical and cognitive activities. I run a cooking class. We have measuring, kneading, peeling, cutting, those are all good ways to combined both physical and cognitive. We bowl and golf both in the community and out. The residents keep the score. We play twister with word games. Scavenger hunts, walking club, following a map to the destination. Most of the activities have both components as a part of it.
RYAN: I really appreciate your spending so much time with me. I am learning so much. I have a couple more questions if that is okay?
TERRI: Sure, happy to spend the time with someone who’s so passionate about it.

RYAN: Thanks! Ok, so what would you recommend from an activities perspective to readers evaluating assisted living communities?
TERRI: I think it’s very important to ask a lot of questions. You want to make sure that there are activities going on all day that include, physical activities, crafts that include a product that the residents can take to their rooms, outings, and cognitive activities. You want your loved one to be able to make choices in his or her schedule. A big component is to find out how they will help your family member connect when they first come in to the community. “What can you do to help my mom or dad connect if they do not want to come out of their room?” You should also make sure that there are outings outside of the community and that there is community involvement consistently. If people are sitting in the lobby with no activity, chances are that is the way it will be when your loved one lives there. Look for resident participation – talk to the residents. They are the best indicators of what truly goes on in the assisted living community. They will tell you if they are active or not. Stimulation is very important. If you don’t use all your faculties, you begin to lose them. Make sure each and every part of your loved one is being challenged daily.

RYAN: Last question. Do you have any other advice for the readers?
TERRI: Take the time to look around at different communities. Talk to residents; request a report from the Department on Aging for the state survey of the community. You can request it from the community as well. They have to show it to you. That is the law. This will give you the information on any violations the community has had. It covers resident care as well as dietary issues. This is an important piece of information to have. There are agencies that are able to help with the cost of assisted living. If you are a spouse of a veteran or a veteran yourself, there are ways to receive help. Look in to all options before making your decision. Remember, this is your family member’s home. It should not have a community feel but the feel of being home.

Terri’s activities plan is not the norm, although I wish it were. However, it should serve as an example of the kinds of things available to your loved one.

Unfortunately, many assisted living communities follow our typical day example rather than the fine example Terri has described. Do not be lazy about finding a community with good activities. It is a major social and emotional outlet for your loved one.

Photo credit: visual.dichotomy

Filed Under: Assisted Living, Quality of Care Tagged With: , , ,

Senior Care and The Importance of Staying Physically and Mentally Active

November 21, 2011 By 9 Comments

Before Mom got sick, she was an active lady. By active, I don’t mean she walked every morning. Rather, she was involved in almost every woman’s club in town, dedicated time to fundraising and countless local charities and took a deep level of interest in her family’s lives.

I vividly recall the first community I visited. As the admissions director walked me through the amenities during the tour, I drifted thinking about whether my mom would be bored there. I asked the admissions director what their most unique activity was. She responded: “armchair exercises.”

She proudly told me about the activity and suggested that I stay 30 minutes for the start of the next session. I was intrigued, so I stayed.

Slowly a few residents arrived, most of them with the help of a community caregiver and a wheelchair. Once seated in a semi-circle, the activities coordinator began walking the residents through a number of arm and leg motions.

The concept was solid. The problem: the activities director either didn’t notice or didn’t care that the residents weren’t participating. Many residents had a scowl on the face, evidence of the fact that they did not want to be there. Others went through the motions as best they could.

I remember thinking to myself when I left the community: armchair exercise is not an activity!

The point of my story is not to be sarcastic, but rather to illustrate something important. Activities represent an important part of your loved one’s day. They should be engaging both physically and mentally.

Being physically active can prevent and help treat many of the most common chronic medical conditions associated with old age. Physical activity is one of the most important steps older adults can take to maintain physical and mental health and quality of life. Yet today, more than 60% of older adults are inactive – and this number is probably much higher for residents of assisted living communities. Many are sedentary, physically unfit, and experience disability from chronic medical conditions as they age.

Community administration and staff members hear many reasons from residents as to why they are not active:

  • It’sboring.
  • It doesn’t feel good.
  • It makes my arthritic joints hurt.
  • It takes too much time.

However, they need physical activity more today than they care to admit. In fact, without physical exercise they will continue to suffer the loss of strength and stamina.

Walking groups and physical activity programs can help residents become and remain active.

Strength training is recommended for all adults, but it is a vital link to health for older adults. The reason is that strength training prevents sarcopenia, the muscle deterioration that comes with aging, and also helps maintain bone mass. “Stronger people have better health outcomes,” noted Dr. David Buchner, Chief of CDC’s Physical Activity and Health Branch and renowned Gerontologist. However, some elderly people avoid physical activity and become sedentary out of fear of falling and fracturing a bone. Dr. Buchner added that emerging data indicate that physical activity can prevent falls by improving strength, balance, and endurance.

Keeping Young at Heart aerobic activity, which is cardiorespiratory or cardiovascular endurance activity, is also important. It keeps the heart strong, lowers blood pressure, and relieves anxiety and depression. Even when the activities in a program such as this one are too strenuous, older adults can obtain significant health benefits with moderate physical activity, such as walking or gardening.

“We need to make physical activity part of the daily routine for older adults,” said Dr. Buchner. To that end, you should search for a community that has an active, diverse fitness program. Or, should the community you select have less-than-desirable physical activity programs, become instrumental in developing them.

What about Mental Fitness?

A large-scale study of women aged 65 and older found that cognitive decline was least common in those who were most physically active, while a large-scale study of men aged 71 and older found that those who walked less than a quarter of a mile a day were nearly twice as likely to develop dementia as those who walked more than two miles a day.

Basically then, aerobic exercise appears to improve higher cognitive functions (planning, organization and working memory) in the elderly. Another way physical training may help cognitive function in the elderly is by increasing their confidence in their abilities.

A small 14-day study found that those following a memory improvement plan that included memory training, a healthy diet, physical exercise, and stress reduction, showed a better performance on a cognitive measure controlled by this brain region, and participants reported that they felt their memory had improved.

The memory training involved doing brainteasers, crossword puzzles and memory exercises. Diet involved eating 5 small meals daily (to prevent fluctuations in blood glucose levels) that were rich in omega-3 fats, low-glycemic index carbohydrates (e.g., whole grains) and anti-oxidants. Physical exercise involved brisk walking and stretching, and stress reduction involved stretching and relaxation exercises.

Photo credit: brad montgomery

Filed Under: Assisted Living, Quality of Care Tagged With: , , , ,

3 At-A-Glance Guides for Assisted Living

November 14, 2011 By 1 Comment

There are many details involved in choosing an assisted living facility that will work for your loved one. The process involves navigating the terminology and verbiage of health insurance policies and also figuring out what a day-in-the-life would be like at a facility.

Here are three at-a-glance guides to help illustrate what long term care insurance is, clarify key insurance terms and show what a typical day at an assisted living facility should look like.

1. Long Term Care Insurance

You may hear a lot about long term care insurance, but how do you know if it is the right choice for your family? Below we’ll outline the target market indicators for long term care insurance, to help give you a better sense if these types of policies would be a good fit for you.

Who needs long term care insurance?

  • People who have assets they want to protect
  • People who want to maintain their financial independence.
  • People who are concerned about having a choice in the quality of care they will receive in the future.
  • The average age of people who buy long- term care insurance is about 65.
  • Married people with assets of above $100,000 (not including a house).
  • Single people with assets above $ 50,000. Otherwise a client would probably deplete their assets before the insurance kicks in, making them eligible for Medicaid.
  • Since women live longer then men,they have a greater chance of ending up in a nursing home. According to a 1997 study by the Health Insurance Association of America, half of all women who live to age 65 will need a nursing home at least once during their life, compared to about one- third of men.

2. Key Health Insurance Terms

Insurance is a major factor in today’s eldercare system. I advise you to contact an insurance advisor who specializes in working with older adults and their families. Here are some basic terms you’ll need to be familiar with:

  • Medicare: A federally-funded health program administered by the Department of Health and Human Services. It is available to all Americans over the age of 65. It is made up of two parts.
  • Part A: This is available to everyone, and covers inpatient care and some aspects of in-home care.
  • Part B: This is optional and requires a monthly premium. It covers many outpatient services.
    Both Part A and B include deductibles and co- payments, and exclude certain services. You may choose to purchase Medigap insurance to cover the “gaps” in coverage by Medicare.
  • Medicaid: This is also known as Medical Assistance, and covers health care services for low-income Americans. Funded by federal, state and local governments; this program requires that applicants meet stringent income and asset requirements. While it covers some inpatient services in hospitals or certified institutions, it rarely covers in-home care.
  • Secondary Insurance: Purchased privately, these policies do not cover long-term health care costs, and rarely cover long-term in-home care. This insurance is designed to supplement Medicare.
  • Long-Term Care Insurance: Such a policy covers both in-home and residential services (including nursing homes) over an extended period of time. Often prohibitively expensive.

3.  A Typical Assisted Living Schedule

When you begin to tour assisted living communities, pay attention to the daily schedule of activities, as physical and mental stimulation will help keep your loved one happy and well.

Planned correctly, activities will become the cherished part of your loved one’s day. To set our frame of reference, let’s look at a typical assisted living day from the perspective of the resident:

  • 6:45 – 7:30am: Have breakfast and receive assistance for a shower from the aide that I’m already comfortable with
  • 7:30 – 9:00am: Make my way down to breakfast. An aide will assisted me to the dining room if necessary, and the medication technician will provide my medications for the day.
  • 9:30 – 10:30am: Morning exercises in the activity room include some stretches, leg lifts and rubber band exercises.
  • 10:30 – 11:30am: Choice of a scenic drive or reading a book by the fireplace. If I take the scenic drive, the van will be wheelchair-accessible.
  • 11:30 – 1:00pm: Lunch and return to my apartment to rest for a while.
  • 2:30 – 4:30pm: Different things happen on different days. During a week, I’ll usually see education presentation, musical performances or craft demonstrations. Nothing is required if I am tired.
  • 4:30 – 6:00pm: Dinner.
  • 6:00 – Bedtime: Evenings can bring visits from family and friends, outings in the community van, or quiet time at home.

Photo Credit: Jan Krömer

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Seniors and Caregivers Connect Online

June 20, 2010 By 8 Comments

There’s a pervasive notion out there that older people can’t, or don’t want to, use computers.  Facebook fan pages like I Hate Teaching Old People How To Use Computers, boasting over 200 members, Yahoo! chat forums, the Lifestyle section of some newspapers and guests at cocktail parties can all be counted on for stories of someone’s mother/grandfather/elderly neighbor messing up when it comes to computers and getting online.  These anecdotes spread and grow and eventually morph into a general perception that seniors and technology don’t mix.  The reality, however, isn’t so clear-cut.

Given the opportunity, seniors can and will use computer technology in much the same way their younger counterparts do.  A 2004 study, for example, found that older US Web users do product research (66%), purchase goods (47%), make travel reservations (41%), visit government Web sites (100%), look up religious and spiritual information (26%) and do online banking (20%).

What does set older and younger computer users apart, however, is their ability to get-online in the first place.  Seniors are much more likely to be grappling with vision loss, hearing loss, cognitive impairment and diminished motor skills, all of which create barriers to getting online.

Why Is It So Important That Seniors Get Online?

When Cora McCune’s husband passed away, her family became worried about her being on her own.  Phone conversations were beginning to get difficult for Cora yet her children needed an easy way to check in with her everyday.  The solution was to set Cora up with a computer and email account.

Connected individuals are healthier and happier than their non-Internet using counterparts.  The evidence is compelling.  Those who connect with family, friends and the wider community via email and the Internet are less likely to suffer from depression.  Age-related dementia can be slowed, and possibly reversed, when seniors take advantage of computer-based brain-fitness games.  Self-esteem goes up when individuals learn something new.  And some studies suggest that those who take advantage of what the Internet has to offer stay independent longer.  The list goes on and on.

Cora’s computer became her link to the outside world.  It was both a source of entertainment and communication.  When Cora wasn’t using it to play games, do puzzles or read the online version of the local paper, she was emailing her children and grandchildren.  And her grandchildren, who were more comfortable connecting online than picking up the phone, emailed back.  Cora’s computer was like a friend in her room.

Caregivers Benefit When Their Loved One Is Online

Cora’s daughter Sheila was a two-hour drive from her mom.  Being able to check in with her mom every day, even when she couldn’t physically be there, was a godsend.  Being able to videophone her mom using Skype™ technology was especially useful.  “It let me monitor the room,” says Sheila.  “I can listen in, for example, when the TV repair man visits.  And there’s something more intimate about being able to see her.  It’s one thing to talk to someone but being able to actually see how they look is even better.”

There’s also an economic benefit.  In a May 2010 study done by Volunteers of America, 48% of women surveyed say the recent economic downturn has made it harder for them to care for loved ones.   And nearly 80% of those same women believe people should receive paid leave-of-absence to care for an elderly family member.  In Canada, individuals providing four hours or more of care per week were more likely to reduce their work hours, change their work patterns or turn down a job offer or promotion. (From Balancing Career and Care.)

While email, video phone and Internet connections are no substitute for personal interaction, they can provide a cushion that allows caregivers to keep working a little longer while still caring for aging parents.

About the author: Karen Hamilton is a writer and blogger with PointerWare Innovations Ltd. PointerWare is an easy to use computer platform that helps anyone get online and stay connected with family and the wider world. Using PointerWare, anyone can send email messages to loved ones, play brain-fitness games, organize photos and see and talk to their children and grandchildren with voice and video conferencing.  For more information, visit their website at www.PointerWare.com

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Assisted Living Senior Prom: Behind the Scenes

March 16, 2009 By 2 Comments

On February 26, the high school students at Ocoee High School and East Ridge high school made the senior residents at Oak Park’s dream of having a ” Senior Prom” come true.

Every resident had a prom date from the high school. The residents were picked up at 5:30 p.m at their apartments, pinned with corsages and escorted to the photographer where prom pictures of the couples were taken. Following the photos the residents were escorted to the lobby where DJ Larry spun the tunes for the evening. I would like to share with you some of the ” behind-the-scenes-secrets” prior to and following the prom. [Read more...]

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Bridging the Generations: Assisted Living Senior Prom

March 9, 2009 By Leave a Comment

Terri Glimcher, our contributing writer and assisted living activities expert has out-done herself again.

As she has written about before, her “Bridging the Generations” program has for years sought to connect the generations, sharing the unique lessons people learn and carry throughout their lives.

In late February, she added another wonderful event to what I believe is one of the most amazing activities programs in the country.  On February 27, The “Chinese New Year”-themed senior prom was held at Emeritus’ Summerville Oak Park in Clermont, Florida.

The Orlando Sentinel covered the event live.  I’d like to share that story and congratulate Terri for another fantastic job.  She’ll be back next week to share the “behind-the-scenes” details and photos with everyone.

Read the article

Note: I have been trying to convince Terri to start teaching her activity-planning techniques.  If you are at a community and would like more information, please contact me directly and I’ll make an introduction.

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Reader Q&A: What Activities Prior to Assisted Living Move-In?

December 27, 2008 By 6 Comments

A reader named Denise asked a great question about activities while preparing to move into an assisted living community.  She asked:

I  would like to hear more about activities that can be done with my mom while she is in my home awaiting the transition to assisted living. I loved the articles by the activity director. I used her suggestions and found a wonderful facility for my mom for Feb. 1. I interviewed the activity director and she was very helpful. Thank you for the help. Denise and family

Some good suggestions are to keep your mom involved in activities of daily living (ADLs) like food preparation and laundry.  Start preparing her for the transition by shopping for items that she may want to put in her new home.

[Read more...]

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Bridging the Generations

December 3, 2008 By 15 Comments

It has always fascinated me how children in schools are taught history, but have never really met face-to-face with those who experienced or contributed to it. The older generation has not been exposed to modern technology, such as computers, cell phones or  iPods. They remember the old Victrola, entertainment through radio, the milkman delivering products, and the terrible depression we’ve only heard about on the news.

I thought it would be a great idea to somehow bring the two generations together.

The seniors would learn about life, the way it is for the children of today. And the children would learn about what life was like when the seniors were growing up 80-100 years ago.

About four years ago, I started the Bridging the Generations program with the local schools in my city. I’ve worked with several teachers on an ongoing basis over the years to bring the two generations together.

The children came to Oak Park to “Meet and Greet” my residents for the first visit. They were paired up with the residents, and prepared to ask questions and listen to the wonderful stories the residents had to tell. They children were amazed! “Wow, you rode in a horse and buggy to school? “, one child asked.

They kids began to look at the residents as individuals. Often times, children are afraid of seniors and view them as old, frail and vulnerable. This program really brings them inside the lives of seniors. They begin to see that aging is something to look forward to, not something to be afraid of.  It is a part of life that we all experience. It’s what you make of it that counts.

The next visit I have with the children is when I bring my residents into their high school. The children cook and serve breakfast to my residents. Last year, East Ridge High School students cooked a huge Thanksgiving dinner for the residents. The student band came in and played for them.  And the drama club, which consisted of the students that are in our program, performed a musical for them. The residents spent time listening to the students read speeches on what they were thankful for, and the students listened intently to what the seniors were thankful for.

The seniors saw first hand the art of text messaging, clothing that wasn’t tailored and multiple piercings. At first, I think they were shocked as to why a mother would let their children go out looking like that!

As the students sat down with my residents, the residents began to look past their outer appearance. They began to have a deep appreciation for the students and understood it was a struggle for independence. The residents gave the kids advice about the importance of education, following their dreams and to not judge a book by its cover. High school kids usually don’t listen to adults.  But for some reason, the children listened to the seniors.

The students learned firsthand about segregation.  They learned it both from seniors who had to be at the back of the bus, and from the ones that could only play with friends who were white. The students were amazed that segregation was really a part of history. It was a very moving experience for both generations.

The relationship between the residents and the students is continuing to grow. We are involved with them once a week and many other times during the month.  New schools continually want to be a part of this program. The kids also come and visit my residents all the time outside of school. They bake for them, pen-pal with them and come to all of our dances.

The hugs and kisses are never ending.

My residents’ faces light up when they see the kids. And the kids cannot run fast enough through the door to hug and kiss my residents. This program will continue for years to come for a simple reason: as much as the kids brighten the residents’ days, the residents have enriched the lives of the children in the very same way. It is very important for children to step back in time and learn about life before the comforts of today. We want to teach them to not be afraid of growing old but to appreciate the lessons they’ve learned.  We want them to understand that life as we know it now was pioneered by those who lived before us.

It is our responsibility to teach children to respect and appreciate the elderly, and I will continue to do my part to bring the generations together.

About the Author: Terri Glimcher is a Contributing Writer at Inside Assisted Living and the Activity Director for Summerville at Oak Park Assisted Living, an Emeritus Senior Living property in Clermont, Florida.

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What is Life Enrichment?

November 24, 2008 By 9 Comments

Regardless of your age, it is important know that you’re part of a larger picture.  Seniors often live with their family members, and during this time, we observe certain behaviors that lead us to encourage our loved one to seek assisted living.  More often than not, we do this for safety reasons, because our loved one has become a danger to themselves or others.

But in the minds of our loved ones, our move to protect their safety may be perceived as the “end of life the way we know it.” Take driving as an example. Many times, our loved one’s right to drive has been taken away because their vision or hearing has changed.  Cognitively, they are aware that they cannot do or remember the things they used to. Thus, their connection to the community, favorite eateries, and shopping has been weakened.

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