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By Camrin Nettey, MS, CCC-SLP, DOR, The Healthcare Resort of Leawood, KS
The Occupational Therapy team at The Healthcare Resort of Leawood is passionate about implementing the Abilities Care Approach to improve the quality of life for our residents with dementia. In doing so, they recognize the importance of collaborating with and providing education to other staffing departments within our facility to maximize the ongoing success of this program.

The team recently created a Powerpoint presentation, along with pocket-size strategy reminders to provide at an all-staff in-service. Through collaborating with other staff, we have seen countless success stories for the residents that we serve here at The Healthcare Resort of Leawood.

A recent celebration included a resident, Lee, who was having difficulty participating in bathing/showering tasks. Nursing staff voiced these concerns to the Therapy team, and our OTs identified strategies based on her Allen Cognitive Level that created opportunities to improve Lee’s active participation with showering/bathing. By integrating what they knew about the Allen Cognitive Levels, along with individualized information, the OTs successfully identified strategies to reduce Lee’s level of anxiety, provide dignity, and improve her quality of life.

“Using the Abilities Care Approach with Lee has not only helped her ability to participate more in her ADLs, but her overall demeanor has changed. Throughout the day after her therapy sessions, you can see a change in how she holds herself and interacts with others.” — Erin Mallory, COTA

By Gary McGiven, Milestone Therapy Resource, Utah
Milestone’s HR Resource Brandon Lane has rolled out a retention plan with most of our facilities to better live our culture and show our new-hires our Love One Another culture. As a visual for the whole department head team to see and be a part of, this plan includes a retention board. This board has weekly tasks for the department head team to complete, following the employee from new-hire through their first 12 weeks. Some of the weekly tasks include:
● Assign a mentor
● Phone check in
● Non-work connection (i.e., off-site activity with mentor and/or other facility employee)
● Thank-you treats
● Empower them to recognize and reward a peer
● Send a text

With the retention boards being a department head focus, the Therapy leaders and their teams decided they wanted to partner with the department heads to take part in the retention process. To coincide with the facility’s retention plan, the Therapy departments each came up with a plan. Some of those ideas include:
● Therapy involvement in orientation process (transfer, gait belt, and body mechanics training)
● “Therapy Moment” in each all-staff meeting
● Therapy leader identifies new facility hires and relays to the team; each team member is encouraged to introduce themselves and get acquainted with the new-hires
● Discuss facility hires in weekly Therapy meeting and find out what was learned about new-hires
● Therapy “Open Door Friday” new-hires are encouraged to stop by Therapy for a treat and some therapy education

These are just a few of the ideas for the retention boards and the Therapy team retention plans. Our Therapy teams take loss of employees very seriously and want to be part of the solution to making a work environment where we are the facility’s workplace of choice.

By Whitney Wilding, DOR Rosewood Rehabilitation, Reno, NV
We have started a Falls Team at Rosewood that includes two of my PTs and I meeting monthly to discuss issues and trends. We do our meeting following the monthly QA meeting and look at trend data as well as personal experience from those on the floor regarding issues, patterns, etc. I feel it has been very successful at this point! Here are a few of the things we have put together:

We started a screen form specific to falls as we felt the UDA in PCC did not gather the information we really needed to intervene properly after a fall. This screener is filled out by a therapist and includes time-of-day information, fall predictor information such as patient’s history of falls, and qualitative information such as fear of falling to complete our analysis. This also includes what Nursing interventions are currently in place and any referrals to Therapy following the incident. I have attached a copy of that for your perusal. After implementing this form, we began to take note of some patterns that were happening with falls that we could address. After implementing some additional safety measures to address the patterns we noted, our falls declined 18% month over month.

Next, Melinda — who is one of my all star PTs — put together a list of falls predictors that increase someone’s likelihood for falls. These include dementia/cognitive impairment, polypharmacy, DM/neuropathy, incontinence, prior falls, assist with ADLs, ambulation with an assistive device, and fear of falls per self-report. Next, we rolled this out to the entire Therapy team, who are including it and a rating score (i.e., 3/8) on their initial evaluations. This allowed us to prospectively look at those who are at risk for falls prior to the incident for our skilled patients. The idea is to see how we can support them by adding interventions aimed at decreasing fall risk within our treatments to prevent falls. We have just started rolling this part out, but l am very excited about the prospect of having this focus on our initial evaluations for all disciplines. Eventually, all disciplines will be included in a monthly falls meeting, and we are getting them thinking about this now.

We noted that quite a few falls were happening due to the patient’s need to toilet. The PTs again jumped on board and decided to start a day shift toileting program whereby we scheduled time daily for the skilled patients who had the above-mentioned risk factors. One therapist would have those patients scheduled for regular therapy and then follow-up during the second half of their day to work on functional mobility and transfers in a toileting program. They were successfully able to incorporate functional training with toileting to reduce fall risk. . The two weeks we were able to run the program so far evidenced no falls on shift (and high patient satisfaction 😊). Our next step is to include all PTs and OTs on a rotating basis to perform toileting rounds on day shift and see how this impacts our falls. Lastly, this ties in nicely with PIVOT for Nursing and strengthens our Therapy and Nursing partnership.

Submitted by Dominic DeLaquil, Therapy Resource, ID/NV
Like all of the Summit Markets, Meadowview Nursing and Rehabilitation in Nampa, Idaho, is intently focused on building its Therapy-Nursing collaboration into something truly transformative.

Director of Rehab and CTO Kristen Bailey acknowledges that while they have only begun to scratch the surface of the various ways Therapy and Nursing can collaborate to improve quality metrics, increase staff retention throughout the facility, and improve the lives of the residents, she has already seen a significant change in the atmosphere at Meadowview.

“If you’re not in the building every day, you probably won’t see it. Our Nursing and Therapy have always gotten along, but it’s different now. I see the therapists and nurses having a different energy to their conversations in the hallways. I see them laughing with each other much more and in a way that’s different,” Kristen said. “It’s joyful! And it spreads and you can see it in the demeanor of the residents! It’s really fantastic.”

Thank you, Meadowview, for exemplifying two of our core values, Customer Second and Love One Another, as you work on your Nursing-Therapy collaboration. You are demonstrating how these two core values in action improve the day-to-day lives of your residents.

Submitted by Aaron De La Torre, Therapy Resource, Keystone Borderstone Market, TX
Providing therapy services during the COVID-19 pandemic has been more essential than ever to improve the outcomes of the residents we serve. With all the social distancing mandates that have been implemented to keep our residents safe, our interdisciplinary teams have been hard at work to ensure that therapy is provided in a safe and efficient manner. However, with social distancing also comes more time alone, which can lead to unwanted consequences.

If you were to visit Veranda Rehabilitation & Healthcare in Harlingen, Texas, on Thursday morning at approximately 10 a.m., you would witness the amazing way they encourage safe socialization while improving residents’ functional skills. You would find several groups of residents playing an adapted version of volleyball, where residents are holding pool noodles and working on their dynamic reaching and core strengthening as they hit a balloon over the net. Do not be surprised if you see some friendly competition between residents and therapists! You will likely also see another group of residents with ankle weights kicking balls of different sizes and playing a makeshift version of soccer, all the while strengthening their lower extremities. Music that ranges from oldies to reggaeton will be playing as patients enjoy their group activity.

Fun group Thursday is possible thanks to a collaborative team approach. Vanessa Munoz, DOR, helps identify the patients who would benefit from group therapy and creates a master list on Wednesday. She then emails the master list to Jason Hess, ED, and the rest of the IDT team. Each team member ensures that every patient is up and ready for the fun group activities after they have had a delicious breakfast. The CNAs, nurses, Activities, and of course every therapist who is available plays a crucial role in helping fun group Thursday occur. Pictured are some of the equipment that is used and the amazing Rehab team at Veranda Rehabilitation & Healthcare.

Submitted by Aaron De La Torre, Therapy Resource, Keystone Borderstone Market, TX
Having a decline in health can be an extremely challenging time for the individual and their family members. Typically, individuals who are admitted to the hospital can expect to be discharged to a skilled nursing facility, where they will receive therapy and nursing care and then be discharged home, where they will be serviced by a new set of therapists at home. At McAllen Transitional Care Center, the team has specialized in helping individuals receive an excellent continuity of care to assist them in their journey to return to their prior level of function. Jennifer Ybarra, DOR, and Ediel Barrera, ED, have worked hard to create a culture where patients are cared for from the time they are referred to McAllen Transitional Care Center until they have returned to their desired environment.

Upon admission into the facility, the evaluating therapists start discharge planning from day one. Once the patient has met all of the inpatient goals and is ready to go home, the physician and team determine the need for continued services. If outpatient services are indicated, the team starts the planning to ensure continuity of care.

Every individual who serves the patient at the facility plays an important role in ensuring that the patient receives the highest continuity of care possible. The patients are excited to discharge home and continue services with the therapists they have made strides with to return to their prior functional level. Below are pictures of the amazing team at McAllen Transitional Care Center that goes above and beyond to make the outpatient dream work!

Submitted by Kai Williams, Therapy Resource, Keystone East, TX
The Copperfield team is at it again! They continue to create a bridge between Therapy and Nursing by having dedicated activities for all to enjoy together. The Therapy Department spearheaded this most recent event. Loretta Johnson provided a beautiful description of the event and why it was so very much needed.

Bridging the Gap represents a means for the Nursing and Rehab departments to bring together diverse individuals with different skills and areas of expertise to develop and generate new ideas and unique solutions to enhance team performances.

At Copperfield, we believe in the tower of strength and togetherness as we withstand many obstacles on a daily basis. By combining our physical energy, knowledge, proficiencies and skills, we take charge in maintaining consistent communication. This allows us to truly appreciate and maintain the respect we have for one another.

Our Bridging the Gap program has created a warm and supportive environment for our Nursing and Rehab team. The Therapy department presented a Hot Cocoa Bar for our Nursing department. The Rehab team was ready and served up hot cocoa, tea, apple cider and with a variety of toppings and sweets. Just as these drinks and toppings blend together in unique flavor combinations, we see Nursing and Rehab working together to develop new ideas and solutions for success.

We have a truly great Rehab team at Copperfield. We work tirelessly to support the needs of our residents and our team members. We know team building takes work, and we take great pride in our commitment to remain the best team ever!

By Jon Anderson, DPT, Senior Therapy Resource

We truly have heroes working in every department, making miracles happen each day despite tremendous odds. Here in Keystone our Therapy Resources decided that one way to give back is to spread joy with our Happy Bar!

Happy Bar Concept
As healthcare experts, we give a “prescription” for health and happiness along with sweet treats, coffee, tea, or any other goodies.

On the prescription, we can have 10 things:

1. Take a few deep breaths. We all know that a deep breath helps us relax. No surprise, then, that decades of research have demonstrated that by taking slow, deep breaths, we calm the body and mind by activating the parasympathetic nervous system; when this happens, stress markers, heart rate, and blood pressure all decrease. That’s why taking deep breaths throughout the day can help keep us calmer and more balanced.
2. Call an old friend. Research suggests that social connections’ impact on mortality is on par with blood pressure, cholesterol and obesity. The benefits likely come from the immediate activation of prosocial emotions and the long-term benefits of social support. This might be particularly helpful for my patients who are facing challenges with their physical health.
3. Give someone a hug. Hugging releases oxytocin that helps build social bonds and lowers levels of the stress hormone cortisol. When hugging, we also release endorphins that lead to a sense of well-being and relaxation. But does anyone really need a scientist to tell us that hugs are good?
4. Help a friend in need. Helping others allows us to meet some important psychological needs, such as developing our senses of agency and competence as we strengthen social relationships. When we act on our values by being a good friend and helping those in need, we foster a sense of purpose, which is foundational to a meaningful life. In fact, recent research suggests that those providing help may get more benefits than those receiving it.
5. Write a thank-you note. Many studies over the last two decades have found that people who express gratitude are happier and less depressed. While one thank-you note is not the kind of gratitude practice that leads to lasting, positive cognitive change, I tell my patients that their notes should be the beginning of a habit of counting their blessings in writing.
6. Sing in the shower … or anywhere. Making music, and in particular singing, just makes us feel better. And this happens through several mechanisms. We release endorphins when we sing; given this, it is not surprising that singing reduces pain. Stress hormone levels fall, leading to improved immune function. We make meaning as we embody the lyrics. I often add that people should join a choir, as singing surrounded by others greatly magnifies the benefits of singing.
7. Dance to your favorite song. We all know that moving our bodies improves our health, but moving to music has additional benefits. The mood boost from dancing lasts much longer than from exercise alone. And dancing often has social benefits. There is even data suggesting dancing prevents cognitive impairment in the elderly.
8. Go on an awe walk in a beautiful place. Awe is the feeling we get in the presence of something vast or beautiful that challenges our understanding of the world. It is something we depend on to keep life fresh. Awe makes us feel more alive, but, importantly, it also makes us more humble, more generous, and less self-centered. The purpose of an awe walk is to move more slowly and look carefully at the surroundings for wonder and beauty.
9. Forgive someone. First off, forgiving someone doesn’t mean denying we were wronged; it means we let go of our anger and other unhealthy cognitive processes. Forgiveness requires some hard work, but the benefits are profound: Those who have learned to forgive live longer. This occurs from less stress, less depression, and better sleep and relationships.
10. Talk to yourself in a kinder voice. We are often our own worst critic, and when our health goes bad, we can cast an unhealthy amount of blame upon ourselves. Self-compassion helps us heal ourselves rather than hurt ourselves. Talking to ourselves in a kinder voice is the key to this practice.