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Distress and Aging

No single principle of mental health can guarantee that a person will pass through the challenges and perils of a long life without experiencing distress, loss, suffering, and human error that are part of most lives. However, it is within our abilities to reduce the depth and frequency of suffering and to help each other when our own resources are temporarily overrun.

In old age, distress can be more acute since immediate problems bring to mind earlier difficulties. The old person may be haunted by memories of stressful events and relationships as far back as early childhood. Tormented by both past and present, they may feel helpless. At the same time, there may be fewer resources available to cope with problems in the immediate situation, fewer people to share experiences with, less physical and financial control over the environment and so on.

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Key Implementation Concepts for Drug Regimen Review

Three new items have been added to Section N of the MDS, that will have a major impact on the policies and processes you have used in the past regarding medication reconciliation and administration.

  • N2001: Drug Regimen Review (Assessed on Admission)
  • N2003: Medication Follow-up (Assessed on Admission)
  • N2005: Medication Intervention (Assessed on Discharge)

Although this new item may seem to be commonplace in your facility already, there are scenarios which frequently arise, that may interfere and render your processes inadequate. These fundamental concepts will be required for Medicare Part A covered residents but are considered a best practice for any payer source.

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At a Slower Pace and Aging (i.e.: an opportunity to contemplate)

There is another common change in us as we grow older: we slow down. This change is probably most obvious in our physical activity. But it is part of our mental life as well. Psychomotor speed, as psychologists often call it, is required by many activities. This is the pace at which we carry out all steps of an action, from sizing up the situation, figuring out what we want to do about it, and finally doing it.

Activities and tests that place a premium upon speed often show the old person at a marked disadvantage. He does however perform as well as younger people. But does performance in those circumstances reflect intelligence? When activities or mental tests are designed so that speed is not a significant factor, then the difference between old and young becomes much slighter. The old person reveals his ability to learn, think, remember and solve problems when not being rushed and when allowed to proceed at his own pace.

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SNF MARKETING 101: Tell a Story

Do you often ask yourself what gives your skilled nursing facility its identity or what makes it stand out amongst competitors? If your patients, residents, and staff come to mind, you’re on the right track. But, now what?

Your facility is a story unfolding across all customer touch points.

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Communication and the AD Person (AD = Alzheimer's Disease)

In spite of language losses suffered by an individual with Alzheimer’s, many skills that support communication are remarkably preserved and remain for a long time. When working with the AD individual, the caregiver should keep in mind six abilities that are nearly always preserved.

1) The Use of Procedural Memories
Individuals with AD begin to lose memory for words, information and events quite rapidly, but procedural memory, or the knowledge of how to perform familiar tasks remain relatively intact until the later stages of dementia. The research suggests that this is because procedural memory is the most elemental of human memory systems and is the only memory system capable of operating independently. This system can sustain some very complex human activity such as walking, washing hands, or even driving a car. Procedural memory is like a computer program whereas other types of memory are like data stored in the computer. Alzheimer patients begin to lose data rapidly but still function. They may forget where they are going, but they still know how to walk. They may forget what they are saying, but they still know how to talk.

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Taking Leave and Aging

      • The look on the face of the five-year-old as he boards a school bus for the first time and the look of apprehension on the face of his mother.
      • The last lingering touches of two lovers who cannot bear to let each other go.
      • The moment when one must board that jet and fly off to a new life elsewhere.
      • The apprehension that this could be the last time they shall see each other and that chill of final separation.

The following is an excerpt of a discussion I had several years ago with the daughter of a man (her father) who had recently passed away.

“The last time I saw my father I guess I knew it might be the last time. We talked a little about this and that…nothing important. It was as if we both had agreed to keep it that way because we both knew, and we knew that we knew.

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Perspective and Aging

Definition: Perspective “a view of things (as events) in their true relationship or relative importance” (The Merriam Webster Dictionary)

Some years ago I had a conversation with a resident in a facility where I was the head of the Nursing department. She was close to her 100th birthday. I asked her what she made of her life in general. She promptly replied: “Can’t tell yet! I am still making my life!”

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The Effects of Anxiety and Aging

A person who appears demented may be tormented by grief and anxiety. His demented behavior may have been brought about by emotional pain. A grieving person at any age is less able to pay close attention to everything that happens around him. He takes less care in grooming and dress. He has less emotional energy to welcome new opportunities or to respond to challenges. He feels uncomfortable with his body. His mind may be constantly uneasy or tortured.

Loss and grief are common in old age as death removes loved ones. An old person may have suffered other significant losses, of occupation, residence, physical mobility, belonging, or usefulness – all of which produce a grief response.

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Emotional Intelligence and Long Term Care

Without question, working in long term care is demanding and stressful. In addition to the intrinsic stressors staff must face daily in nursing homes, often they must also struggle with managers who add to the stress. It takes only one thoughtless supervisor to create a work environment that goes from bad to worse in an instant.

Unfortunately, there are managers and supervisors in long term care who may lack self-awareness or the desire to evolve into better leaders. They may intentionally create “power distances” between themselves and their employees. This distance may also signal that they may be unapproachable.

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Strategies for Success in Senior Living in 2018

The new year brings new opportunities and challenges to the senior living industry. With all the changes in process, it’s a good time to revisit your strategy and evaluate what decisions can make you successful in 2018.

Investment in Senior Living

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