Trends show that older adults are becoming more and more ‘tech savvy’! In fact, plenty of older adults are using iPhones and iPads as they are perceived as simple and ‘clean.’ A large body of research now understands what the technology needs of older adults are, as well as how they should be best addressed. Universities and teaching hospitals are offering courses on iPads and smartphones; as the population continues to age, tech will be increasingly applied to aging processes and care! Not to fear for we are here!
I recently spoke with a lovely couple from my community. Paul, newly diagnosed with dementia, published a number of best-selling Canadian novels. His wife, Beverly—now transitioning into ‘caregiver’—fears that her husband may be bored as he is no longer able to read. Beverly still enjoys her morning paper and afternoon novel but feels guilt when Paul ‘just sits’ as she reads. This guilt is exacerbated as reading was an activity they enjoyed together.
As a social gerontologist, I immediately mentioned the effectiveness of music and the calming effect of photographs. As the lovely couple mentioned that they have tried (and tired) both options, my mind trailed off onto the topic of podcasts. Podcasts are like radio shows, pre-recorded for your listening pleasure. I commute for almost seven hours every week, and I myself am tired of music. Recently, I have been listening to podcasts (thank you, Electric Runway)! The time I spend listening is not only entertaining, but keeps me up-to-date with current technology, events, and politics.
The Podcasts App is featured on all iPads and iPhones. This app features podcasts for any and every topic—from history to fashion, and cooking to dogs. The purple icon opens a whole world of information that only requires your ears! Podcasts last anywhere from 15 minutes to an hour… And beyond! I, therefore, explained that there has to be a history podcast applicable to his interests. You can search a keyword and download to listen.
To support listening, I recommend large headphones that comfortably fit over the ear like the white ones featured on this post (Walmart, $11.15). iPhones and iPads come with complimentary ‘ear pods.’ These ear pods, however, are unusable (and uncomfortable) with hearing aids.
We cannot fear technology, nor aging and dementia. We must continue to be resilient, adapt, and learn how to best deal with our realities. It is evident that caregivers require more support, resources, and assistance. Together we can revolutionize the way we age, and the way in which we perceive aging.
Andrea is a second year Masters of Science Student (in eHealth) at McMaster University in Hamilton, Ontario. Throughout her undergrad, Andrea worked in Therapeutic Recreation in long-term care. Andrea’s research focus surrounds technology needs for informal/formal caregivers, as well as technology needs in long-term care. Andrea’s mission is to normalize aging through fashion, technology, and awareness.
It’s hard not to talk about falls when we speak about the care of older adults. Falls are a frequent topic of concern for both family and professional caregivers. And for a good reason, they can cause serious injury, render a person immobile, and will often leave the individual fearful that they will fall again. In addition to the safety concerns of the individual, fall prevention has become a top priority in almost all care communities. Because of severe consequences and even law suits that are taken against professional caregivers when an older adult falls while in their care.
And yet, with so much attention on the topic and so many preventative measures in place, falls of older adults still occur both in and out of the professional care setting. So is it possible to ever really eliminate this issue? On September 11, 2017, I had the pleasure of attending an event that worked towards offering answers to this question. Entitled the Unintended Consequences of Good Intentions: Balancing Improved Mobility with the Risk of Falls, this workshop was organized by the Advancing Excellence in Long-Term Care Collaborative and hosted by Forest Hill of D.C., and it was truly a meeting of the minds.
Facilitator Anna Ortigara, RN, MS, FAAN, Organizational Change Consultant, PHI, started us off with a question, how many of us in the room had shown up to learn about fall prevention? Almost all of us raised our hand. She then asked, what if I told you we aren’t going to talk about fall prevention but rather increased mobility? Although it may sound like just another name for the same issue, the thoughtful discussion that took place through this new lens reflects how critical attention to language is while creating programs and policies for our older adults.
An Interdisciplinary Panel
Physical Therapist, Hilary G. Forman PT, RAC-CTSVP of Clinical Strategies Division, Healthpro-Heritage
Risk Manager, Paul A. Greve Jr. JD RPLU Executive Vice President, Willis Towers Watson Health Care Practice
CNA, Iye Jalloh, Fores Hills of DC
Executive Director/Administrator, Mary Savoy MS, LNHA, Executive Director/Administrator, Forest Hill of DC
Family Member, Janice Dabney
The expert panelist assembled for the facilitated discussion represented all sectors of health care. And each viewed the concept of increased mobility through a different lens and shared the opportunities and challenges in embracing this new model of care.
Obstacles to Maintaining Mobility
There was overwhelming agreement that the Culture in skilled nursing slows the move towards increased mobility. Mary Savoy notes that there is a culture of protectionism among care workers many who are concerned with the repercussions of a fall. Often over protecting to keep their residents safe. Hilary Forman furthered this idea by making a note of the reactive culture in care homes often handling issues as they occur rather than proactively seeking solutions before they arise.
There was also a consensus that federal regulations can sometimes hinder the process. Established to protect residents from harm, rules take very few situational details into consideration. And to meet the documentation and statistical ratings to keep care homes in good standing takes time away from an organizations ability to concentrate on much else.
What change can we make? “Accept falls,” says Forman. The more time we spend preventing falls means, the less time we can devote to keeping the resident mobile and physically active. It’s only when we accept falls that we can move forward and create systems that support mobility.
The Family’s Role, How do you Talk to Families about Mobility and Falls?
Paul Greve referred to the need for care homes to prioritize conversations with family members. Noting that if family members were offered more information and awareness on the benefits of mobility, they could be more accepting of the risks of falls and less likely to pursue a law suit.
Janice Dabney agreed that communication with staff and building relationships with her mom’s care workers made a world of difference in her perception of the home and her understanding of fall risks. But also noted the importance of the physical lay out of the facility, low staff to resident ratios, and a culture of teamwork were all excellent ways to promote mobility.
Savoy noted that breaching this topic is difficult because we want families to feel confident in the care that we are providing for their loved ones. But Iye Jalloh believes relationships with the resident and consistency in staff assignments are the best way to care for residents, promote their mobility, but also develop relationships with families.
Accepting Falls and Mitigating Risks
The conversations that occurred by both the panel and the attendees offers hope that a future of increased mobility for our residents in care homes is possible. As a field, we should all start having open conversations about the realities of falls and ways we can mitigate risk. Involving family members, as well as federal and state regulatory bodies, are essential to this conversation. We all have the same end goal, to keep residents safe while increasing and maintaining their mobility.
With a background working in Activities, I am always a bit (a lot!) partial to stories, people, and businesses that support and expand the scope of the Recreation Department. A Recreational Therapist has a unique opportunity to get to know older adults living in a skilled nursing center not only by their diagnosis but also by their hobbies and life stories.
The American Therapeutic Recreation Association defines Recreational Therapy as a systematic process that utilizes recreation and other activity-based interventions to address the assessed needs of individuals with illnesses and/or disabling conditions, as a means to psychological and physical health, recovery, and well-being. However, close ties to Bingo and ball bouncing often limit the perception of the job description.
Just like those in the medical profession, a Recreational Therapist is trained and certified to provide care and are also required to maintain Continuing Education Units or CEU’s to retain their certification. Busy schedules, limited budgets, and even a lack of awareness of the profession often create barriers for professionals to obtain the necessary number of CEU’s, which can be both frustrating and detrimental to their career. In steps, SMART CEUs Hub.
Nathan and Nikki Lamaster started SMART CEUs Hub because they saw a need for accessible educational resources for recreational therapist all over the country. I learned about SMART Hub through their active social media presence on Instagram and after speaking with founder Nathan Lamaster quickly realized that this married duo have the innovative and entrepreneurial spirit that is just what the aging services needs!
With a profound respect and understanding for the needs of older adults and the desire to help others, this dynamic pair is expanding their reach in the aging services and helping Recreational Therapist all over the country stay current and productive within their profession. I had the chance to ask Nathan and Nikki about how they got started in the field and why they believe the work is so important.
SMART CEUs Hub Explainer Video
How did you get your start in the aging services?
Well, this is funny actually. My aunt Karen works as the Director Of Social Services at a Skilled Nursing Facility (SNF) in California, and when I was a young kid, I got the chance to sing and entertain the residents. I even got the opportunity to dress up as Santa Clause one year and help bring the Christmas spirit to the people living there. As for jobs in the field, I got my first job in aging services at the age of 16 working as a server for a 5 star Assisted Living Facility (ALF). Then when I graduated College with my undergraduate degree, I worked as the Director Of Activities for a few SNFs in California and now part of my job in Texas is working on specifically the behavioral health portion of geriatrics.
Why do you think recreation is so important for our elders?
I believe what we do helps give purpose to our lives whether that be entertainment, hobbies, volunteering, our faith, or anything that gains our focus. One of the biggest issues I have seen affecting the senior population is feeling like their best days are behind them and that they have a hard time seeing their purpose. As a Recreational Therapist, we get to help people in all areas of their lives including physical, mental, emotional, social, and spiritual. I believe God has given me this mission field to work in.
Where did the idea for SMART Hub come from?
SMART CEUs Hub came from seeing a need in the Recreational Therapy field for quality, affordable, online, educational presence specifically designed for Recreational Therapists, as well as giving job opportunities to Recreational Therapists through our SMART Instructor Program.
How does your business enhance the field of aging?
Our SMART Instructors are all considered experts in their specific areas of Recreational Therapy. The knowledge that they bring to the table helps other Recreational Therapists to be the best at serving their clients like a ripple effect.
Are you interested in becoming a SMART Instructor? You can sign up here for more information.
How do you for see SMART Hub expanding in the future?
SMART CEUs Hub has some big plans scheduled to be happening in October this year which is our 2 year anniversary of being in business. Our goals are to reach as many Recreational Therapists throughout the country as possible to help spread the knowledge of best practices in Recreational Therapy and gain more online exposure for our field. Who knows? Maybe traveling conferences are in the future for us!
Founder Bio: Nathan and his wife Nikki relocated from California to Tyler, Texas in 2013 right after they were married for his wife’s Christian radio career. While living in Texas Nathan found that very little people knew what Recreational Therapy was as compared to in California. A lack of awareness of the profession meant that positions were limited. As many Recreational Therapist across the country were in the same situation, Nathan began to think of ways to help his profession gain more exposure through a greater online presence. This was when he decided to create a quality, affordable, online, educational presence specifically designed for Recreational Therapists and taught by Recreational Therapy Experts (known as SMART Instructors) throughout the country. Thus in 2015 SMART CEUs Hub was born and continues to grow its influence.
Individuals living with dementia or Alzheimers will often speak of their younger years as if it was their current reality. They tell stories of their childhood home, their parents, and will even feel the need to go home and make dinner for their young children.
Sometimes the need for this reality is so great that they become anxious and even angry when they can’t find what in their mind should be there.
How trapped and powerless they must feel in these moments! Imagine if we woke up one day and everyone we know and loved were no longer there or if our once routine and purposeful lives were now only a distant memory.
If you’ve cared for someone with dementia you’ve most likely had to “fib” at one time or another. When asked where their mother or father was, you may have said they were at the store; When asked to go home, you may have said it’s too cold to go outside; Or when asked when their kids will be here, you may have replied they are at school today.
These types of answers may not always work as well as we hope they do, but more often than not these responses offer them comfort and a peace of mind in knowing that their mother is still alive and will soon return.
I’ve had many people ask about the ethical implications of lying to someone with dementia or Alzheimers. However, there are multiple benefits from the practice of being in their reality for both them and us. Because when we engage them in their stories of the past, we learn and connect on their terms, not ours.
First, I want to mention the practice of Reality orientation, which is the method of reminding the person with dementia or Alzheimer’s the facts of their current situation. If they wonder where their parents are we tell them that their parents are no longer living or that they can’t go home because they no longer live in their childhood home. We will also remind them of the actual date and time and their current living situation.
In my experience, reality orientation causes anxiety and can even scare the person with dementia or Alzheimers. Arguing with someone who has dementia is futile and will often exasperate the situation. Whether we think they are making up these stories or not when we attempt to correct them we are essentially calling them a liar and taking away any sense of control they may have in telling these stories.
The Alzheimers Association also stresses the importance of communication with those living with dementia and Alzheimer’s and notes that communication requires patience, understanding, and good listening skills.
There are several names we can give to the practice of staying in someone else’s reality: therapeutic Lying, embracing the reality, or empathy. No matter what you feel comfortable calling it, the practice itself has multiple uses and benefits for those living with dementia or Alzheimer’s.
People with Dementia Do Not Need to Be Grounded in Reality.
“When someone has memory loss, he often forgets important things, e.g., that his mother is deceased. When we remind him of this loss, we remind him about the pain of that loss also. When someone wants to go home, reassuring him that he is at home often leads to an argument. Redirecting and asking someone to tell you about the person he has asked about or about his home is a better way to calm a person with dementia.”
No matter what strategy or answer we find works best for our loved one staying within their reality rather than bringing them into our own will make them feel more safe and secure at this moment. This practice has a beautiful way of redirecting them so they are no longer concerned about the safety and whereabouts of their loved ones and they can then, in turn, enjoy the moment with you.
Guest Post Author: Bailey Chauner | Content Marketing Coordinator for Redfin
Having a memorial for a loved one after their passing is an important part of the grieving process. It’s a time to honor them, share memories with family and friends, and say goodbye. Some families find that there’s no better place to hold this personal event than at home, but knowing exactly where to start the planning process — especially amid the grief of a loss — can feel overwhelming.
This guide will help you plan a beautiful, meaningful home memorial service for a recently departed loved one. Proceed with patience and plenty of support. With a little time and the right planning, you can hold a service that will allow your family to come together and say goodbye.
Choosing a kind of service: Memorials vs. Funerals
The services and items you’ll need in planning a home memorial will vary depending on the kind of service you’ll have. Your loved one may have left instruction on their final arrangements, but if not there are two main options: memorials and funerals.
Memorials usually involve a group of family and friends coming together to mourn the loss of a loved one. There may be photos of the departed, flowers, and at least one eulogy, often from a surviving spouse, parent, or sibling. Some families also choose to have a religious or spiritual figure speak. The loved one is typically represented by a large photo, a collection of photos, wreath, or if they’ve been cremated, their urn.
Food and drink are often incorporated into memorials and can be organized in just about any format that works for you and your loved ones. Some memorials will offer light refreshments like water, coffee, crackers, cheese, and mini sandwiches. In other cases, the memorial is a potluck where family and friends are invited to bring a dish to share. Alcohol isn’t required, but it’s commonly offered — typically a basic wine selection is sufficient. Leftovers stay with the host or are given to the immediate family of the deceased (if the memorial is held at someone else’s home). For large memorials, it might be worth the expense to hire a caterer to provide finger foods, utensils, and drinks.
The location of the memorial within the house is entirely up to you; one convenience of a home memorial is that you can tailor it to be exactly how you want. Some families even choose to have a backyard service if the weather permits. The living room, den, or formal dining room are all good options, but ultimately it will depend on the space available in the house. You’ll need adequate room for your guests to chat amongst themselves before and after the service, seating for the formal eulogy or service, and places for people to set their food and drinks. Finally, there should be some kind of a dedicated space where the speakers will be clearly seen and heard, usually close to the visual representation of the deceased loved one.
Seating doesn’t necessarily have to be anything formal — though you can rent extra chairs if you have space and finances to do so — and many people manage by bringing all the chairs in the home to the memorial space. Neighbors and other nearby family and friends will likely be able to bring over extra chairs if needed. Arrange them facing the speakers’ area, and do your best to leave clear pathways for guests.
Flowers are somewhat traditional for memorials but can be quite expensive. A floral wreath with your loved one’s photo is often more than enough to create a beautiful and personal tribute and won’t cost too much, especially if multiple family members pitch in. If you do choose to buy additional floral displays, don’t be afraid to deviate from the normal white arrangements. A home Memorial allows you to really personalize the experience, so consider choosing types and colors of flowers that will bring happy memories of your loved one: the peonies your mother carried on her wedding day, tulips the color of your brother’s prized ’67 Mustang, or the roses your grandmother grew in her garden, for example. Keep in mind that though they make a lovely addition to a home memorial, flowers are completely optional — often those that are sent by loved ones with condolences are enough to create the desired effect.
Another option instead of flowers is to collect money and donate to a charity that was near and dear to the deceased one’s heart. This donation can be made in the memory of the person who died to honor a cause that was meaningful to them.
Large memorials may require a more advanced sound system. Some families like to play their loved one’s favorite songs (the volume level really depends on the tone of your memorial, but usually you’ll opt for the quiet side) or other calming music to soothe their guests before the service. Having a microphone and speaker set-up will make it easier for your eulogists to be heard, and even better if you have some kind of podium or raised step for them to stand on.
If finances are tight, you’ll likely be able to find a neighbor, family member, or friend who will have access to equipment you can borrow. Don’t be afraid to ask around; your loved ones will be hoping to lend a hand at this difficult time, so let them.
Bailey, Redfin’s Content Marketing Coordinator, loves writing about all topics related to home ownership from data to dogs and décor. Bailey’s dream home would have an oversize walk in closet and overlook Lake Washington. Redfin is a full-service real estate brokerage that uses modern technology to make clients smarter and faster.
Babydolls. Traditionally, a toy for little girls to play with, hold, and take comfort in has become a popular therapy tool for some individuals living with Dementia. Although this device should not be used for everyone, a baby doll does bring great comfort to those who have had an affinity to caring in their earlier years.
One particular memory care unit I worked on had a whole nursery set up in a quiet room at the end of the hall fixed with two cribs, a diaper bag, and a rocking chair. These Items, of course, you would not ordinarily expect to see when the average resident was age 92. And yet, two women, in particular, would frequently come in throughout the day to lay the baby doll down for a nap, sing him a lullaby, or like any good mother would show him off to all the other staff and residents.
Sweet and endearing as it may seem the site of an older adult holding a baby doll and “pretending” that it is real can be alarming. I’ve had several family members come up to me over the years questioning the practice partly out of concern for the persons well-being and partly because a women holding a baby doll is a visible reminder of dementia.
Dolls with Dignity
While caring for someone living with Dementia and Alzheimer’s we have a duty to uphold their dignity. Dignity is so important that the Right to Dignity is an actual federal mandate in nursing homes. This right is particularly important while using Doll therapy. Like most treatments in Dementia care, while addressing or interacting with the individual and the baby doll, we must always treat the doll as if it were a real baby. And never correct the way in which the individual cares for the baby doll.
It is not uncommon for someone to swaddle and swoon over the doll in one moment only to drop them on the floor (by accident) the next. They may leave the baby doll lying around, spill food on the doll, or even hold them upside down by the foot. But this doesn’t mean that WE can do this. Even if we think that the person isn’t watching we should always hold and treat the baby doll as if it were an actual baby. Otherwise, they will probably perceive us as negligent, and they won’t be afraid to tell us this either.
There are several common questions people want to ask when they see doll therapy in use, but these questions are often the ones that we should avoid. For instance, we shouldn’t ask what the baby’s name is, how old the baby is, or who the father is. Most likely they won’t be able to tell you and realizing that they have forgotten such important information can be quite upsetting. Instead, statements like “oh look at those cheeks” or singing a lullaby, are more engaging and empowering ways to enhance the therapeutic nature of baby dolls and will make the individual feel secure and even a bit prideful in that moment.
We don’t have to be ashamed or embarrassed by doll therapy. It brings great joy and comfort to care for a baby in this stage of their life and your support enhances their quality of life.
Does this Mean I should Buy Mom a Baby Doll?
No. As mentioned above, doll therapy is not for everyone, but if you notice that your loved one is feeling a bit more anxious laying a swaddled baby out where they can find them is a good way to see if they are interested. Even placing the swaddled baby in their arms to see if they attach to them is okay. However, it should not be a forced process, and if uninterested you will surely know. But, if their face lights up and a big smile appears you will know you’ve just given them a great gift of comfort.
The use of robotics and other AI Technology in Long Term Care is a highly debated topic, and there are fair arguments both for and against. Their use, however, seeks to solve a grave concern in the field. The number of adults 65+ by 2050 is expected to rise to 88 million. At such large numbers, resources are essential to the ability to provide and care for our older populations.
The greatest resource is the caregivers themselves, and currently, there is a significant shortage in the United States. Recruitment of employees is hampered by negative stereotypes of nursing homes and the often deeply emotional realities of caring for someone at the end of their life.
The most common reason people choose to work in long-term care is that they had a good relationship with an older adult (commonly a grandparent) at some point in their lives. The lack of senior caregivers will become a national endemic if the issue is not addressed.
There are several different types of robotics for senior care, but the most commonly used are robotic caregivers, social robots, and teleconferencing robots. Their use has grown increasingly more popular over the years and can now be found in Japan, throughout Europe, and the US. As the number of older adults increases, their use could be the solution we are looking for. But can a robot actually replace the human connection and socialization we as humans need?
The Pros and Cons of Robotics in LTC
Designed and developed in Japan, the Robobear is a transfer and lift machine for people who have difficulties getting up and moving on their own. Traditionally, this is a job for Certified Nursing Assistants who assist in lifting and transferring individuals from the bed to their wheelchair or from the wheelchair to the bathroom.
Nowadays, there are Hoyer lifts and sit to stand lifts which help take some of the strenuous burdens off of the caregiver, but they are still in the room and able to talk or calm a resident during the transfer process.
The Robobear (as pictured above) is designed to make this process a bit less scary and jarring for seniors. However, the idea that a cute smiling bear is more inviting and more receptive to seniors is a bit unfounded, but it does offer a friendly alternative to the more sterile machine options on the market today. In their use, we should keep in mind the potential for confusion they may cause our residents with dementia or Alzheimer’s.
Prototypes of humanoid robots are still being developed. And one day we may find that robots that look like humans could replace our caregiving staff. Although this still seems like an idea of science fiction, Carebots are already developed and on the market and their use is specifically targeted to assist the elderly.
Social robots are developed to simulate real pets. Most common are dog and cat robots as seen in the video below. The company Hasbro’s found that their children’s toys were being used by a growing number of seniors and decided to create a line especially for older adults living in nursing homes.
These “pets” act and respond just as a real cat or dog would. The cats will purr and vibrate while being pet and meow in response to being held. Since pets aren’t allowed in many long-term care settings, this type of companionship is a welcome replacement. And especially for those living with Dementia or Alzheimer’s can offer a sense of comfort and purpose.
Hasbro is not the first to unroll a line of robotic pet companions. Japan has a line that was established in 2003, which was purposefully designed as a therapeutic intervention for seniors. Unfortunately, this line is a bit pricey and not as easily obtained whereas Hasbro’s Lifelike pets are much more reasonable at about $100.00.
The Cruciferous Vegetable Amplification episode of the Big Bang Theory parodies the idea of sending a virtual self out into the world through video conferencing. Funny or extreme as the concept of this was, this type of technology is available and for the medical field has great potential to allow physicians to be two places at once.
One such technology is the GiraffPlus, already on the market and providing In-Home help care to the elderly throughout Europe. The GiraffPlus is a vacuum cleaner, monitoring system, environment evaluator, and a telehealth conduit for seniors living in their home.
As the number of older adults remain in their home, these types of technologies make aging in place a sustainable living option even as care needs change. Alternatively, however, does the lack of a personal visit to the doctors or the now “traditional” form of health care offer something more than a teleconference can offer? Particularly to a more vulnerable population for isolation.
Can a robot console the way a human can?
Seven million Americans over the age of 65 suffer from depression. This number will continue to increase over the next several years, but without enough caregivers, it’s hard to care for the emotional and physical needs of our older adults.
And as many movie and TV representations show us, although some robotics are advanced with many capabilities true human connection is not one of them. Although robotics have become increasingly popular throughout Europe, Japan, and the US one French non-profit the Society of Saint-Vincent-De-Paul created a short clip that portrays the ill-effects this lack of human console can have on an individual.
The Future of Long Term Care
Technology has been incorporated in nearly every field so it is no surprise that we would find a way to advance our caregiving methods. Personally, I am still on the fence when it comes to robotics specifically and maybe only sold on the cute toy kittens and a bit weary of a giant smiling bear capable of lifting a person.