News

By Mahta Mirhosseini, Therapy Resource

I recently had a chance to interview Lana Mathis about her experience with Clinisign. Lana is an OTA who has been with Ensign since 2012 as a DOR at Granite Mesa and now at Legend Oaks Kyle in Texas. When she is not “DORing,” she loves archery, and likes to travel, fish, take long motorcycle trips, and read. Her favorite ice cream flavor is Haagen-Dazs® Caramel Cone.

How long have you been using Clinisign?

LM: I have been using CliniSign since 2017

Did you have any challenges in getting started and how did you overcome them?

LM: The main challenge that I had was getting the Physicians to sign. Once I explained how it works and gave them a copy of the CliniSign for Physicians they were more open to it. I think the key words here are “time saving” and “it’s as easy as punching a button.” It is a lot easier to get Nurse Practitioners to sign up. I signed on a Nurse Practitioner here at Legend Oaks Kyle. She stated, “Oh that was really easy and very convenient.”

How does Clinisign impact your therapy program?

LM: CliniSign has a tremendous impact on the therapy program. It affects productivity/time. It saves so much time and chance for errors. It helps with compliance and especially with MSCA audits. The amount of time saved is enormous. I changed buildings recently and I had forgotten how cumbersome and outdated it was to have to chase signed papers.

How does Clinisign impact your therapists?

LM: The therapists love Clinisign because it saves them time from having to complete clarification orders. It also saves time from having to rewrite clarification orders because the through dates were different from the evaluation dates. They also don’t have to print their evals and recerts anymore.

Did your IDT have to do anything different to adapt to Clinisign?

LM: All of the IDT related information is on the portal and very user friendly. I recently had a Nurse Practitioner out on vacation for a week, and the covering Nurse Practitioner was not in Clinisign. It felt like going back in time to life before electronic health records. The amount of time chasing pieces of paper and making sure they were scanned into PCC was ridiculous.

Any advice for therapy programs who are thinking of getting started with Clinisign?

LM: To all programs that are thinking about getting started with Clinisign, I say…

Just Do It!

What are you waiting for?

It’s a life changer for the therapy department!

You will be amazed at how much time you save!

It’s much easier than you think!

Give yourself an early Holiday present and do it now!

You deserve it!

Remember, if you have any questions about getting started with Clinisign, please reach out to Mahta Mirhosseini (mmirhosseini@ensignservices.net) or your local therapy resource.

By Angela Ambrose, contributing writer

The hectic holiday season is in full swing and chances are your to-do list has more than doubled in length. When you’re feeling harried and overwhelmed, this is the best time to hit the pause button and find a few minutes to just sit and breathe.

Meditation involves bringing your full attention to a single point, such as following your breath as it flows in and out, repeating a soothing word or phrase to yourself, gazing at an object such as a candle flame or listening to an inspirational song.

“We live in the 21st century where the fast-paced world we’ve built is inundating us with floods of energy constantly, if we allow it. A 10-minute break from that can be very beneficial,” says Benjamin Decker, meditation teacher and author of Practical Meditation: a Holistic Three-fold Approach to Meditation.

Hundreds of research studies show that meditating regularly can help reduce stress, sharpen your focus and memory, manage depression, lower your blood pressure and improve the quality of your sleep. Studies also prove that regular meditation can create positive changes in the physical structure of your brain that may lead to better decision-making, increased empathy and better emotional control.

“The biggest challenge that I find with clients who have resistance to learning meditation is their lack of understanding of what it really is and what the benefits actually are,” says Decker. “The only way to really understand the benefits of meditation is to ‘take the leap,’ so to speak, and begin the experiment of engaging in the practice.”

6 Simple Steps to Meditating

Take a moment now to try this simple meditation technique of counting your breaths:

1. Find a quiet place free of distractions.
2. Sit comfortably in a chair with your feet flat on the floor and a straight spine. Avoid leaning against the back of the chair. You can also sit on the floor with your hips elevated on a cushion. If sitting upright is painful, lie on your back with a rolled up blanket or pillow under your head and neck.
3. Close your eyes, take three big, deep breaths and exhale out your mouth with a “ha” sound.
4. Bring your lips together and breathe naturally through your nose. Nostril breathing is more calming to the nervous system, but if this isn’t possible, breathe in whatever way is comfortable.
5. Start to count your breaths backwards from 10 to 1. As you inhale, say to yourself “10” and as you exhale, repeat “10” silently. Continue like this with the numbers 9, 8, 7, and so on, until you reach zero. Then return to 10 and begin again. If you lose the count, simply start over from 10. Aim to complete at least 3 cycles of counting.
6. When you’re done, slowly open your eyes and take a few moments to notice any thoughts and sensations in your body before moving back into your daily routine.

How to Stay Committed to Your Practice

Set a goal of meditating daily for five minutes, slowly increasing the duration each week. On days when you feel too busy to meditate, just take 10 slow, deep breaths anywhere you can find a few moments to yourself — in your car before you pull out of the driveway, at your desk or even in a bathroom stall.

Be patient with yourself and let go of any judgment about how your practice is going. It’s normal for thoughts to come up while you’re meditating. When they do, just observe them like clouds floating by in the sky. The true benefits of meditation come, not while you’re sitting there in stillness, but rather during times of high stress — when someone cuts you off in traffic, your toddler throws a tantrum in the middle of the grocery store or when you’re dealing with a serious health issue. With regular practice, the heightened sense of awareness and inner calm that you cultivate while meditating will start to spill over into other parts of your life.

“Every moment of our lives can become a meditation. How are you driving? How are you speaking to loved ones and strangers? What kinds of thoughts, feelings and emotions come up for you when you’re moving through life? Begin to bring your awareness into life as you are already living it,” says Decker. “Turn off the radio, turn off the TV, be with yourself and be more present with others.”

Meditation can transform your life by making you more patient, grounded and less reactive in all your relationships and with the unexpected challenges that inevitably come your way— at home, work and on the road.

Try a Free Meditation App on Your Mobile Phone

If you find it difficult to meditate on your own, download a meditation mobile app such as Insight Timer, Calm, Sattva, 10% Happier or Stop, Breathe & Think. These mobile apps track your progress and offer a myriad of meditation styles – from guided meditations and chanting to sounds of nature and relaxing music. The mobile apps are free, but premium content costs extra.

Incorporating a WELL Lifestyle can help to prevent or halt Diabetes! November is National Diabetes Month, a time when communities across the country team up to bring attention to diabetes.

By Angela Ambrose, contributing writer

Healthy Eating and Exercise to Slow or Reverse Diabetes?

Many diabetics view their diagnosis as a lifelong sentence of taking daily medications and dealing with the complications of chronically elevated blood sugar levels. However, numerous studies indicate that small lifestyle changes have the potential to prevent or halt the progression of this disease.

Over 30 million Americans have diabetes, and nearly one-quarter of these cases are undiagnosed, according to the 2017 National Diabetes Statistics Report from the Centers for Disease Control and Prevention (CDC).

Diabetes Cases Are Soaring

Diabetes is expected to dramatically increase from one in 10 Americans to one in three by the year 2050. Type 2 is the most common form of diabetes, in which the body’s cells develop insulin resistance.

The alarming rate of type 2 diabetes is fueled by unhealthy lifestyle trends such as obesity, physical inactivity and poor eating habits. A growing aging population may push this rate even higher in the coming years. Other risk factors include smoking, high blood pressure, high cholesterol and high blood glucose.

More than one-third of Americans have prediabetes, which puts them at high risk of developing full-blown type 2 diabetes, stroke and heart disease.

Adopt a Healthy Whole Food Diet

Many people rely heavily on medications to manage their diabetes and overlook the single most important factor in controlling diabetes — eating healthy foods and limiting portion sizes.

“In many cases, diabetes can be completely reversed, particularly in the early stages, if we start with the dietary treatment of diabetes early enough after the diagnosis,” says Dr. Hana Kahleova, director of clinical research for Physicians Committee for Responsible Medicine and author of Vegetarian Diet in the Treatment of Diabetes. “Oftentimes, after switching to a predominantly plant-based diet, people start losing weight, their blood sugar normalizes, and they may even be able to reduce or completely drop off their medications.”

Kahleova recommends a diet that emphasizes plant-based whole foods such as vegetables, fruits, legumes and whole grains. While no single eating pattern is right for everyone, the American Diabetes Association suggests the Mediterranean, DASH and vegetarian diets as healthy options to consider.

Exercise Regularly in Short Spurts

Exercise not only strengthens the body and burns calories, but also helps release tension and reduce cortisol stress hormones, which may have a positive impact on glucose levels. When you exercise, your cells become more responsive to insulin, which allows more glucose from your blood into your cells to use as fuel when you work out.

All physical activity offers benefits, but for most people brisk walking is the simplest way to get started. Aim for 30 minutes daily with short bursts of exercise spread out throughout the day.

“For people with diabetes, it’s better to go on a brisk walk after each meal for 10 minutes,” says Kahleova. “That helps with glycemic control better than just one workout session for 30 minutes.”

Get More Sleep, Sunshine and Vitamin D

Getting enough sleep and going to bed early can increase the secretion of the hormone melatonin, which in turn, promotes insulin sensitivity. Kahleova recommends going to bed no later than 10 p.m. and getting seven to eight hours of sleep each night. Reducing your exposure to blue light from digital devices two hours before bed can also improve sleep.

To up your production of melatonin at night, spend time outdoors in the sunlight. This also helps your body produce more vitamin D.

“Many people with diabetes are vitamin D deficient,” says Kahleova. “Vitamin D is important, not only for bone density and calcium, but also for our immune system and increasing insulin sensitivity.

Shedding a Few Pounds Can Make a Big Difference

About 88 percent of adults with diagnosed diabetes are either overweight or obese. Losing as little as 5 to 10 percent of your body weight and exercising for 20 to 30 minutes daily may help prevent or slow the progression of type 2 diabetes, according to the CDC’s latest Consensus Report.

For a person weighing 200 pounds, that means losing 10 to 20 pounds.

Be Open to Change

We can’t change our genetics, but we do have the ability to change our eating, exercise and sleep habits.

“If we all made these small changes, the rate of diabetes would go down dramatically,” says Kahleova. “These are things that are doable. We just need to do them consistently.”

WELL Challenge! Share your own stories about nutrition, exercise and sleep habits that work for you! Here are two simple ways to share. Choose the one that works best for you:

1. From your smartphone, visit EnsignTherapy.com, click “WELL” at the top of the page, then click “Share your Story” from the top of the WELL Site. There you’ll find room to share a short story and upload a picture from your phone.
2. From your Instagram account, share a picture and caption and remember to hashtag both #CAPLICOwell and #CAPLICOnation.

We look forward to seeing your inspiring stories as a collaborator to our WELL Project.

By Cheri Prince, Therapy Resource

Have you heard about it? There’s a spark, and it’s starting to catch fire! Last week’s workshops had over 30 participants in total — and this is just the beginning!

PDWELL came from a desire to do more to meet the needs of the Parkinson’s community in the Omaha metro area. As a Physical Therapist and Rehabilitation Director at a skilled nursing facility, I had the opportunity to develop a Parkinson’s program over the last six years. Through this experience, we identified a need for a place for Persons with Parkinson’s Disease (PwPD) to go for Parkinson’s-specific therapy, exercise classes, education and resources.

While there are Parkinson’s offerings in town, the services are fragmented, with most people attending classes at many different locations in the area in order to meet their needs and/or interests. The same issue exists for support groups. Many PwPD attend multiple groups in order to obtain all of the education and support they and their care partners are looking for.

In addition, many people don’t know where to go to obtain Parkinson’s-specific therapy services. They get an MD order for therapy but are frustrated by the non-specific services they may receive at a typical outpatient clinic. Based on the feedback from physicians and the PwPD in the community, the concept of PDWELL was born.

The three pillars of PDWELL include Exercise (skilled therapy and exercise classes), Education (patient, caregiver and professional) and Community (fostering a sense of community among the members). We are establishing PDWELL initially with a focus on the pillars of education and community.

Education:

PDWELL is offering an educational workshop based on the book Every Victory Counts, developed by the Davis Phinney Foundation. This is a nine-week workshop that focuses on living well with Parkinson’s. It’s being offered two times per week and is open to anyone with Parkinson’s, their caregivers or any other person who provides care to persons with PD.

We are getting the word out about PDWELL and the workshop through support groups, visiting PD-specific exercise classes in Omaha, as well as informing health care providers in the Parkinson’s community. Participants will be going through the interactive lessons on topics such as Parkinson’s symptoms, exercise and nutrition, assembling a wellness team, and navigating your Parkinson’s with your care partner.

Other educational workshops are being developed and will be both ongoing, like Every Victory Counts, as well as specific “boot camp” sessions for the newly diagnosed. We are planning other special events such as physician presentations and special topics of interest, such as Nutrition, Current Research in PD and pharmacology considerations.

Another component of education that PDWELL will provide is professional-level education. Currently, we have two CEU courses that have been developed and will be held in October and November in Omaha, Nebraska: Gait impairments and Parkinson’s Disease for PTs and PTAs, and Dual Tasking and Parkinson’s Disease for PTs, OTs and SLPs. In November, Practical Approaches to the Assessment and Treatment of Parkinson’s Disease will be offered in San Antonio, Texas, for PTs, PTAs, OTs and COTAs.

Community:

PDWELL is developing community in multiple ways. First of all, our educational offerings will bring a sense of community through learning and sharing experiences. The Omaha-area Parkinson’s community will be invited to “Give a Gift to Themselves” in December as we gather together to prepare Aware in Care kits from the Parkinson’s Foundation. These kits are designed to help ensure preparation in the event of a medical need. We are currently planning social outings and non-educational gatherings such as a ping-pong tournament as well as intergenerational offerings based around exercise and healthy living, such as cooking foods that are “brain rich” for Parkinson’s. We are reaching out into the community to bring in resources that will enrich their lives while they share the knowledge and passion they have for their hobbies/recreational activities.

PDWELL is sponsoring local Parkinson’s events. On Sept. 29, we sponsored Walk the Park for Parkinson’s, which is a 5K and fun run/walk for Parkinson’s Nebraska. We also provided educational support during the recent Nebraska Medicine 2019 Patient and Caregiver Symposium held on Oct. 14.

PDWELL is also participating nationally with Parkinson’s Foundation through hosting viewing parties for their 2019-2020 Expert Briefing series on topics such as “Coping with Dementia for Care Partners” as well as “Optimal Exercise Strategies for Stability, Stamina and Strength.” As an “Aware in Care Kit Ambassador,” I will be educating the Parkinson’s community in Nebraska on the benefit of utilizing an Aware in Care Kit for every inpatient stay. We are on the planning committee both for Moving Day Omaha — a walk for Parkinson’s through the Parkinson’s Foundation — and the 2020 Victory Summit from the Davis Phinney Foundation.

In addition to these PD-focused events, I have had the opportunity to work closely with some of our local post-acute care facilities to further develop Parkinson’s programs and provide input and support with patients.

I could not be more excited to be a part of an organization that supports building programs like PDWELL, which can lead to life-changing impact! I am so blessed to have the opportunity to serve the Parkinson’s community here in the Omaha metro and beyond!

Note: If you would like more information on interrupting the course of Parkinson’s disease in your community, please reach out to Cheri Prince, Therapy Resource, at ChePrince@ensignservices.net. Cheri is also offering upcoming courses through www.EnsignTherapy.com.

By Mahta Mirhosseini, Therapy Resource

Projections 2.0 screen is loaded with helpful features and functionality to help make projecting and tracking minutes more simple. Let’s have a look:

Launching Projections 2.0

Projections 2.0 was created especially for PDPM. To launch Projections 2.0, follow these steps:

Optima Update

 

By Angela Ambrose, Contributing Writer

When you’re tired of doing the same old exercise routine, it’s easy to make excuses and skip workouts. Only 23 percent of adults meet the 2018 Physical Activity Guidelines set forth by the U.S Department of Health and Human Services. They strongly recommend:

• At least 150 to 300 minutes of moderate aerobic activity or 75-150 minutes of vigorous-intensity aerobic activity weekly
• Strength training of all major muscle groups two or more days per week
• Stretching and mindfulness activities such as yoga, tai chi or qigong
• Balance training to prevent falls

Adding more variety to your workouts can help you meet all of these important exercise guidelines each week. Not only will you find more enjoyment, but you will also be more likely to exercise longer and more consistently. Spice up your exercise routine by trying two or three of the following options:

1. Find a workout buddy — After a long, exhausting day at work, a supportive friend can give you that little nudge you need to get off the couch and get moving. Because you will need to coordinate schedules with your partner, your exercise time will be plugged in to your calendar ahead of time, making it a higher priority. Doing an aerobic workout with a motivating partner has the potential to double your performance, according to a study by the Society of Behavioral Medicine.

2. Try a group fitness class — Even if you’re exercising in a crowded gym, you can still feel lost and lonely if you’re climbing on the stair stepper in a dark corner or lifting weights by yourself. Most health clubs offer group fitness classes taught by nationally certified instructors. The group energy is contagious and can help you push through an especially challenging workout. From barbell and kickboxing to dance and yoga classes, you’ll find a wide range of options to build aerobic endurance, muscular strength and flexibility.

3. Get outdoors — Numerous studies show that exercising in the fresh air and sunshine elevates your mood, reduces tension and motivates you to work out longer and harder than exercising inside.

4. Join a team sport — When you were a kid, you never worried about counting steps or calories. You played catch, kickball or Frisbee simply because you enjoyed being with friends. Make exercise fun again by joining a recreational sports league such as softball, soccer or basketball or by taking up tennis or racquetball. Team sports are particularly beneficial because they create social connections and friendly competition. A study published in Mayo Clinic Proceedings shows that participating in partner and team sports is associated with longer lifespans than exercising alone because they combine the benefits of physical activity with stimulating social interaction.

5. Break it up into smaller portions —“I just don’t have time.” This is the No. 1 excuse for not (Insert Photo 5) working out regularly. Research shows that “exercise snacking” — engaging in small “snack-sized” portions of exercise throughout the day — can be an effective way to increase your physical activity, especially on days when your schedule is jam-packed. Taking the stairs instead of the elevator or walking to the corner restaurant for lunch all count as exercise. Too tired to hit the gym after work? Have an exercise “snack” of push-ups or sit-ups before dinner, instead of that plate of nachos.

6. Listen to upbeat, motivating music — When you listen to fast tempo music with a strong beat, your body naturally wants to follow the rhythm of the music. Energizing music can distract you from discomfort, increase your exercise intensity and increase your endurance as much as 15 percent, according to Costas Karageorghis, Ph.D., a leading expert on exercise and music research. Select music with the tempo or beats-per-minute (bpm) that correspond with the exercise you’re doing. The song’s bpm should mirror your target heart rate, according to the American Council on Exercise. (See chart for recommendations.)

7. Set SMART goals — Setting goals can help keep you motivated, but they work best when they’re clearly defined. For example, if your goal is to lose weight or build more upper body strength, use the SMART guidelines to make it specific, measurable, attainable, realistic and set within a defined time frame. Having trouble coming up with a motivating fitness goal? Sign up with a friend for a community walk, run or bike ride to support a charitable cause.

 

8. Track your progress — Download a free mobile fitness app to record your exercise progress, and wear a fitness tracking device such as a Fitbit or Apple watch to get instant feedback. Wearable technology may motivate you to increase your physical activity and serve as a daily reminder to keep moving.

9. Build up intensity slowly — If you’ve been sedentary for a while, gradually increase the exercise intensity and time you spend working out. Start with exercises like brisk walking, swimming or leisurely biking that pose minimal risk of injury. Enlist the help of a personal trainer, if you would like more guidance and a customized workout plan.

Variety adds more excitement and challenge to your exercise routine. If you’re having fun in your workouts, you’re more likely to log extra steps, burn more calories and go well beyond the U.S. Physical Activity recommendations, as well as your own personal fitness goals.

WELL Challenge! Share your own stories about how you’re adding variety to your workout!

1. If you have Instagram: From your Instagram account, share a picture and caption and remember to hashtag both #CAPLICOwell #CAPLICOnation
2. Or, using your smartphone: Visit EnsignTherapy.com, click “WELL” at the top of the page, then click “Share your Story” from the top of the WELL Site. There you’ll find room to share a short story and upload a picture from your phone.

We look forward to seeing your inspiring stories as a collaborator to our WELL Project.

For more information on this topic or the latest health and fitness news, visit AngelaAmbrose.com or follow Angela on Facebook (@AmbroseHealthyLiving).

In Utah, we are fortunate enough to have a Recreational Therapy Resource, Kami Archibald. Kami is a great partner with our therapy teams to find ways to further enhance the lives of our residents. Through this partnership, our facility Rec Therapists are becoming an integral part of the therapy teams. This all started when they asked to be educated about our “therapy world,” productivity and how Rec Therapy can support us.

We started with Recreational Therapists and Therapy Teams coming together to find ways to partner for group treatments. The groups are then scheduled on the activities calendar. By partnering with recreational therapy, it was an easy “in” for our therapy teams to start integrating group treatment into clinical practice. Additionally, it allowed the therapists to screen participants who are not on therapy caseload for any declines or needs for therapy intervention.

It also created a way for our therapy teams to better understand the role of Rec Therapists and how they are critical to the success of our facilities. Once they understood what Rec Therapy was focused on, they quickly realized that the partnership and designing of tailored activities was a perfect functional maintenance program opportunity. This allowed our patients to maintain functional levels after being discharged from therapy and it gave our recreational therapists tools to have successful participation in groups. A specific example was integrating our Abilities Care Approach with Rec Therapy by being advocates of the life story boards during their activities and groups. It allowed the Rec Therapists to have very specific, meaningful information on each resident to enhance the experience.

As Kami conducts facility visits and training with the facility recreational therapists, she includes the therapy teams and shares best practices. Kami also supports MOCK surveys by doing both resident and resident council president interviews to follow up on the “hot topics” and make sure they are being addressed properly. Having this partnership has definitely improved the quality of life for our residents along with creating a greater appreciation of our recreational therapy partners.

By Mahta Mirhosseini, Therapy Resource

Last month, we talked about the exciting new revisions to our policy regarding Clarification orders. Facilities that are actively using Clinisign, Optima’s physician e-signature feature, do not have to write clarification orders for Part A payers when completing evals and recert if their documents are signed by the MD via Clinisign!

This can be a huge time-saving opportunity, especially since we already did not have to write clarification orders for our Part B payers. This is because Optima’s Clinisign product ensures timeliness of MD participation with therapy POCs/UPOCs. Here you will find some commonly asked questions that come when rolling out CliniSign:

Q: Can PAs/NPs sign our therapy documents via Clinisign?

A: Yes. By putting the PA/NP’s name in the “Clinisign signing Provider” area of the document, they will be alerted to sign the document. This is the signing on behalf of feature and will include the names and NPIs from both the physician and NP/PA on the document.

Q: Do I have to send the invite to a doctor who is already using Clinisign with another facility?

A: Yes, each facility needs to send out a separate invitation so the doctor can start to receive documents from your facility, but the doctor does NOT have to go through the enrollment process each time. Once enrolled, he/she will just get notifications that the facility will begin sending him documents.

Q: How often do physicians get notified?

A: Clinisign will send out a notification ONCE a day at 1 p.m. EST. This notification is sent via email and text (if mobile number has been provided). Physicians have the option to go into their account setting and change frequency and/or time of their notifications.

Q: Can the therapist edit the eval to correct a diagnosis if the doctor has already e-signed the document?

A: Yes, once the therapist goes into the document to make changes, the document will get re-sent to the physician for another e-signature.

Q: Will the MD e-signed document get sent into PCC?

A: Yes, the latest version of the document will get automatically sent over to PCC’s Therapy Clinical Document Report.

Q: Do I still have to scan these MD e-signed documents into the misc tab of PCC?

A: No, because there is an electronic time-stamped record of physician signature both in Optima and PCC.

Q: My medical records director helps monitor therapy document signatures. How will they know which documents are being electronically signed by physicians?

A: Medical records directors have access to “Physician E-Signatures Report” in Optima. Please contact Ensign Support to set up your medical records partners with an Optima user account.

Q: Whom do I contact if I have a question?

A: Please contact your local therapy resource or myself (mmirhosseini@ensignservices.net). You may also contact our Optima Support Team (support@optimahcs.com).

By Keystone Therapy

What started with a team’s desire to find a better way to treat LTC patients, morphed into a two-year ongoing journey, implementing the most recent evidence-based practice for their residents with dementia, leading them to the implementation of the Abilities Care Approach (ACA). ACA is a program that focuses on maximizing caregiver knowledge in dementia care. By doing so, it created a culture change within the facility that sparked an interest from dementia care to dementia design.

Dementia design is essentially a way to create the best environment for maximizing independence for persons living with dementia. In an Intelligent Risk, Legend Oaks-New Braunfels funded several team leaders to study dementia design at the University of Scotland, a world-renowned dementia design university where companies and facilities from all over the world have sought their accreditation and guidance in best practice for dementia design.

The training course began by presenting the increasing prevalence of dementia and the responsibility for those in the field to provide design and practice in accordance with what research has taught us about dementia. Three different models of how facilities operate when providing care to dementia residents were presented: Basic Needs, where only the basic needs of the resident are met; Social Model, where safety and security are the primary concerns; and a Bio-Psychosocial Model, which is an ambitious approach to care in dementia that takes into account individual needs and preferences, best design and care practice, along with needs and security. As they took an honest look into the approach utilized by their building, they were even more motivated to learn and implement the knowledge gained as they realized their building probably falls somewhere between a Basic Needs and a Safety/Security model.

Dementia design was introduced by an interior designer with extensive expertise in the field of dementia. The five primary dementia design principles taught during this session included: supporting individual needs, maximizing independence, reinforcing personal identity, making design orientating and understandable, and providing control and balance. Design features included: familiarity, reduction in stress and anxiety, clear visibility and multiple cues, and minimizing distractions. Design modifications and examples of other facilities were provided that achieve the five dementia design principles and design features. Color, hue and tone were explained in relation to dementia care and how to contrast design within the building to accommodate the deficits that present in dementia residents.

An extensive interactive workshop with the Legend Oaks-New Braunfels team was conducted where the team had to design a room and bathroom with the appropriate colors, hues and tones in accordance with what we had learned about vision deficits and other physical and cognitive deficits present in dementia residents. Extensive education was provided about utilizing familiar designs with dementia care and the evidence surrounding this approach. “More familiar designs mean people with dementia are less likely to need help, that they make fewer mistakes and that they are more satisfied with the process than if the designs are unfamiliar.”

The interior designer was then followed by an architect who specializes in dementia design. It was here the team learned extensive knowledge regarding appropriate lighting in the morning, afternoon and evening hours in accordance with what we know about dementia and brain function during these times. Appropriate lighting for dementia residents provides better performance throughout the day and good sleep routines, which is often difficult to accomplish in residents with dementia. Education regarding flooring consistency and knowledge on how to contrast floors with seating areas in accordance with vision deficits associated with dementia was explained in great detail to significantly decrease residents’ risk for falls and promote independence.

On the last day of training, the Legend Oaks team was able to tour educational rooms designed in accordance with the principles taught in class. These rooms included: bedrooms, bathrooms, hallways, stairs and a hospital. The team was required to inspect each room and “tag” any errors found in accordance with knowledge gained during the courses.

Legend Oaks-New Braunfels is hoping to seek a partnership with the University of Stirling as they begin their next grant that will focus on dementia design and the knowledge gained during their training courses. The team is already laser-focused on next steps and is diligently working to pave the way for dementia design in the United States, as well as provide cutting-edge research and care for residents with dementia.