Picture6Restorative care is a term that is often misunderstood or incorrectly defined as rehabilitation therapy. And while therapy and restorative nursing complement each other, they are not one and the same.

The purpose of restorative care is to maintain a person’s highest level of physical, mental, and psychosocial function in order to prevent declines that impact quality of life. In the Smith Care Center (SCC), restorative care is a part of every aspect of a resident’s daily life. Care includes, but is not limited to: range of motion (active or passive), ambulation, dining assistance, locomotion or wheelchair use, fall prevention, our Sit-to- Stand program, and more.

In addition to therapies, the restorative team also addresses residents’ many adaptive devices, such as skin protectors, night lights, chair pad alarms, and pendants. While not every SCC resident receives this service, since January 2016, an average of 58 percent of our residents benefitted from restorative care.

How exactly does the process work?

There is no set path that leads to restorative care. However, most residents receive it after therapy determines that they have reached their maximum potential. Following this determination, the therapist develops a resident’s restorative care plan and shares it with the Restorative Nurse, Lauren Krause, who ultimately implements the program. From there, it is the restorative care team’s job to retain the resident’s ability level. Restorative aides help to provide the care, follow through on programs, and track and report any changes.

How is SCC’s Restorative Care Team different?

Most skilled nursing facilities teach their staff some form of restorative care, and all employees on the floor are tasked with providing this care. However, SCC is unique in that we have a dedicated team that specializes in restorative care and works closely with the therapy department. “The communication between our department and therapy is really amazing,” Lauren says.

Additionally, while Medicare specifies that restorative care programs run at least six days per week, the Smith Care Center offers its residents seven days per week. Lauren leads the program alongside her team of restorative aides — Dennis Ortiz, Sheila Strahorn, and Nancy Chan (not pictured). When you visit SCC, you’ll be sure to see Lauren and her team in action. If you have questions regarding restorative care, contact Lauren at 941-361-7361.

 

Grindal 4x5 300 dpi (4) CropOn February 16th, Alan B. Grindal, M.D. gave a Health Matters presentation, entitled “The Aging Brain: Realities and Opportunities.” Dr. Grindal is a Board Certified Neurologist and Fellow of the American Academy of Neurology. In January 2016, he joined the Plymouth Harbor, Inc. Board of Trustees. Below is a summary of Dr. Grindal’s presentation.

REALITIES

By the age of 65, two percent of the population will have dementia, and after that, the number doubles every five years. Today, there are 7 million people with dementia. By 2050, that number is estimated to be at 14 million. The reasoning is two-fold: 1.) People are living longer; 2.) Baby boomers will move into the 85 and over age group.

As we age, our brain gets smaller, we lose connectivity, and experience neuron loss in certain areas of the brain. In normal aging, we see a decline in autobiographical memory — for instance, memories about yourself, such as what you did on a certain day or where you were. However, semantic memories, including facts and ingrained skills, such as the first president, tend to be well-retained. Also in normal aging, there is a decline in fluid intelligence, which results in slower responses, a decrease in multi-tasking, and diminished creativity.

In general, there are three stages of decline in the aging brain:

  1. Age Associated Memory Impairment – compared to younger people. As we age, we are not as sharp as we were when we were at our peak (at 30-35 years old). Our ability to remember and absorb knowledge tends to slow down. However, this particular stage suggests that we’re aging at the same level as our peers.
  2. Mild Cognitive Impairment (MCI) – compared to peers. This stage identifies individuals whose level of function is slightly impaired. When compared to their peers, these individuals are not functioning at the same level, but they are still able to live independently.
  3. Dementia – loss of Activities of Daily Living (ADL) skills. This stage identifies those with Dementia — an impairment of higher cognitive mental skills that prevents people from being able to live independently. How does Alzheimer’s disease fit in? While the above are levels of function, Alzheimer’s disease is a pathology that can cause any or all of these stages.

OPPORTUNITIES

While the reality of the aging brain is not always encouraging, there are several opportunities under our control that may help delay certain effects of aging, including:

  • Educational Attainment and Intellectual Challenges. The more educated you are, the less risk you have. In addition, continuing to challenge yourself educationally is extremely beneficial — particularly when you get engaged in something you enjoy doing, such as Sudoku, reading, crossword puzzles, etc.
  • Physical Activity. Aerobic exercise is proven to lead to an increase in brain volume.
  • Engaged Lifestyle/Social Environment. It has been shown that people can deteriorate quickly if they become socially isolated. Humans are social beings, and it is important to continue this attribute as we age.

View Dr. Grindal’s full presentation here: https://www.youtube.com/watch?v=ykdfRPl0f0c

 

In the latter part of 2013, Plymouth Harbor elected to provide a wider array of services to our residents. We wanted to emphasize the availability of private duty home care, with the thought that many residents have both short- and long-term needs for these services. We surmised that residents would appreciate the opportunity to receive these services from Plymouth Harbor staff who have been screened, hired, trained, and supervised by onsite staff. Gradually, with time and dedication, we hoped to win over residents who had relied on outside agencies for these services.

Today, Plymouth Harbor is pleased to report that we have made some headway. Shown below is the Home Health revenue for the past three years:

2013                             2014                         2015

$131,000               $411,000               $827,000

Additionally, for January 2016, we billed for approximately $103,000. We are thrilled to see residents taking advantage of the services we offer, and we truly appreciate the opportunity to serve you. Home Health is available whether you are in an apartment, the Callahan Center, or the Smith Care Center. We customize our services to meet your needs, from 24 hours per day to just one or two hours per day. And we are always staffed by your Plymouth Harbor team!

“The care that I get from the Home Care staff is always first rate! I have assistance both in the morning and evening, and everything goes well. Thank you so much.” Betsy Bagby

“The HOME is the key! I have had several unexpected ‘events’ in the last 10 months, and Home Care was right there when I needed them. The last event was critical enough to warrant an EMS call. The action by the team was professional, fast, and caring.”  — Weta Cannon

 

Picture7“My position as Admissions Coordinator often times allows me first contact with potential residents desiring short-term rehab, long-term care, or a respite stay. I strive to ensure and coordinate a smooth transition into SCC. By working closely with all parties, including the resident, their family, physicians, and hospital representatives, a solid foundation for the excellent care our residents receive upon admission and throughout their entire stay is established. Attention to detail and a thorough education about our community and care standards help residents adjust appropriately to their new environment.”

 

Plymouth Harbor is excited to announce Mary VanSant as our new Admissions Coordinator. Mary came to Plymouth Harbor in October 2015.

In her role as Admissions Coordinator, Mary is the first point of contact for those interested in coming to the Smith Care Center (SCC), whether it be for short-term rehabilitation, long-term care, or respite stay. Specifically, she is responsible for the admission process and the coordination of a smooth transition for residents (and their support network) into SCC. This includes maintaining a positive professional relationship with members of Sarasota’s medical community, and serving as an effective facilitator in guiding family members and decision-makers to reach a mutually beneficial agreement on behalf of incoming residents.

Mary has extensive experience in the marketing and admissions field. Prior to joining Plymouth Harbor, she served as the Admissions Director at Sarasota Point Rehabilitation Center, as the Marketing and Admissions Director at The Inn at Sarasota Bay Club, and as Manager for Dr. Joseph R. Lowe, D.M.D., P. A.

Most recently, Mary served as Sales and Business Development Director at AutoXotic. In each of these roles, she was responsible for the planning, development, and implementation of marketing strategies to increase community awareness. Mary attended Florida State University and received a bachelor’s degree in psychology, with a minor in child development.

Plymouth Harbor is thrilled to have Mary join our team, and we look forward to the continued growth of Smith Care Center admissions.

 

 

fkjahskdhf'adIn October 2015, we reported that the Smith Care Center (SCC) began a new pilot program called the Personalized Music Therapy Program. This program includes the use of iPods and personalized music playlists as an enjoyable therapeutic activity. The purpose is to calm unwanted behaviors frequently associated with Alzheimer’s and dementia-related conditions, thus creating an alternative to the use of pharmaceuticals. For this reason, the initial target population included SCC residents who have experienced behavior and personality changes, such as agitation and restlessness.

SCC Activities Director Judy Sarnowski headed the program, modeling it after Music & Memory, a non-profit organization that created its own personalized music program. Judy says that Music & Memory got her thinking more about how she could modify certain aspects of their program to fit needs that were specific to Smith Care Center residents. So, before launching the three-month program in October 2015, Judy did her homework.

In addition to identifying three program participants and speaking with their family members for permission, Judy made the following modifications to the program:

  • She set a 30-minute time limit. Music & Memory has no limit, but due to short attention spans, Judy decided to limit the exposure for our residents.
  • She used the iPod Mini. Music & Memory uses an iPod Shuffle. However, SCC used the iPod Mini for greater programming capabilities, which ultimately helped to increase  personalization.
  • She used over-the-ear headphones. Music & Memory uses “ear buds,” but Judy went with over-the-ear headphones for greater comfort and compatibility with hearing aids.
  • She used a personalized questionnaire to help create each playlist. Judy compiled a questionnaire for each resident’s family member to complete. This questionnaire helped to elicit different memories by asking questions, such as “What is your favorite movie?” and “What is a song that was played at your wedding?”

Judy and her team have been compiling data throughout the program, and have already seen a noticeable difference. The pilot program ends on December 31, 2015, and at that time, Judy will compare data from the three month-period to data that was produced before the program started. Stay tuned for an update in early 2016 regarding the final results.

 

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Plymouth Harbor is excited to announce Eva Duerr as our new Staff Development Coordinator. Eva came to Plymouth Harbor in June 2015.

In her role as Staff Development Coordinator, Eva is responsible for providing and overseeing the necessary educational training for all Plymouth Harbor staff members, particularly in the Smith Care Center. Her specific responsibilities include assessing, planning, and implementing organized educational programs for staff according to federal, state, and local requirements. Additionally, Eva helps to provide wound care to Smith Care Center residents and oversees nurses providing this care on a daily basis.

Prior to joining Plymouth Harbor, Eva served as the Resident Care Coordinator at the Memory Support Center for Evangelical Homes of Michigan in Saline, Michigan. Here, she was responsible for overseeing resident admission, developing and directing operational and support services, and recruitment, selection, and performance evaluation of staff.

87637+In addition, Eva previously worked for many years as a Home Care Nurse in Berglen, Germany. Eva received her associate degree in nursing from the RMK School of Nursing in Backnang, Germany in 1991. In 2012, she was certified as a Registered Nurse by the Michigan Board of Nursing. Eva is also knowledgeable in memory care and has earned her Best Friends Approach to Dementia Care Certificate.

Over the next year, a major focus of Eva’s will be to enhance Plymouth Harbor’s community-wide education. This will include annual training for each Plymouth Harbor employee, occurring during the month of each employee’s anniversary date. Additionally, beginning in February of 2016, Eva will begin her training to become certified in Teepa Snow’s Positive Approach To Care (PAC). Plymouth Harbor is lucky to have Eva on our team, and we look forward to the continued enhancement of our staff education.

 

SCCThe name of Plymouth Harbor reveals much about the values on which it rests. Like our historic counterpart far to the north in the 17th century, Plymouth Harbor is committed to a life in fellowship one with another — which explains why we call our community neighborhoods “colonies.”

Colonies were established at Plymouth Harbor when our doors first opened in 1966. However, when our Smith Care Center (SCC) was completed in 1988, it didn’t quite follow suit. Back in the 1980s, Dinah Stamp, then Activity/Social Services Director (now VP Residential Services), began facilitating monthly meetings for SCC residents. However, these meetings were only referred to as resident meetings and SCC wasn’t considered its own colony at the time. Years later, our Social Worker, Brandi Burgess, was hired and began leading the monthly meetings.

It wasn’t until about five years ago, however, that Brandi decided to start calling the meeting the “SCC Colony Meeting” to help drive attendance and assign the significance it deserved. Two years ago, the Residents Association became aware of the SCC “colony” meeting, and began investigating a by-law change in order to include SCC as an official colony of Plymouth Harbor. Terry Aldrich, President of the Residents Association, was instrumental in making this change take place. He worked hard to inform existing colonies of the need for the change, and collaborated with the Residents Association Board of Directors.

At the April 2015 Annual Meeting of the Residents Association Board of Directors, Smith Care Center was officially approved and written into the Residents Association by-laws as its own colony. The change has been hugely successful, and residents have become more interested and engaged in participation. Prior to this, long-term residents would retain membership in their previous colonies rather than participate as actively in SCC.

Today, there are 11 official paying members, as only permanent, original Plymouth Harbor residents pay dues. However, all SCC residents – and their family members – are invited and encouraged to attend meetings and voice their opinions. Additionally, any voting SCC colony member is eligible to be a representative. SCC currently has two resident representatives as well as one staff representative — Brandi Burgess. The now-official SCC colony meeting is held on the fourth Thursday of each month at 4:00pm in the SCC Living Room.

We are excited to see this change take place, and look forward to seeing more and more resident input and involvement in the Smith Care Center.

 

rehab imageEvery day, in every part of America, there are individuals facing similar challenges transferring from medically supervised rehabilitation care in a skilled nursing facility back to their “normal” routine at home.

Doctors suggest walking, swimming, low-impact exercise, and even returning to the gym, to regain strength and balance. However, doctors are not trained in exercise physiology and cannot offer the practical advice needed for each individual’s recovery. For this reason, they prefer to send their patients to a supervised rehab facility. Too often, if there is no means of structured support to continue their recovery through exercise once rehab is over, people settle back into a more sedentary lifestyle, resulting in a less than optimal recovery.

Sarah Ross, Physical Therapist, PT, DPT, GCS, CEEAA, a certified expert on exercise for aging adults, works with many of our patients in the Smith Care Center (SCC) during supervised rehabilitation. Sarah says the ideal outcome is for every individual to safely mainstream into an exercise program suited to their body and condition. “Ongoing exercise provides the maintenance program for a happier, more active lifestyle which everyone deserves,” she adds.

“At Plymouth Harbor, our goal is to provide a continuum of care and communication to help residents safely transfer from supervised rehabilitation to ongoing use of the exercise equipment in our Wellness Center,” says Chris Valuck, M.S., ASCM-CES, CWWS Certified, Director of Wellness.

The Wellness Program at Plymouth Harbor, led by Chris Valuck, communicates routinely with SCC Rehab Services, led by Clinical Manager Gina Kanyha.  When a resident in rehab expresses an interest in actively pursuing their recovery by using the facilities in the Wellness Center, a connection is made with Chris Valuck to confer on individual rehab needs and requirements.

While the Wellness Center staff do not provide one-on-one physical training, they are on hand to monitor and attend to resident needs in the strength-training area.  They have found the communication with SCC Rehab Services goes both ways. “It is not uncommon for a resident to share their concern about an observed pain or decreased mobility,” shares Chris. “I can then refer them to Sarah or the other physical therapists in the Smith Care Center where they can receive out-patient rehab services.”

“I like to bring patients over to the Wellness Center before we release them so that I can encourage their use of the Wellness Center and provide an initial orientation to the equipment best suited to their rehab and medical issues,” says Sarah.

One resident shared, “In rehab, I liked the security of knowing that someone (a physical therapist) was there to push me to do things that I didn’t realize I was even capable of doing.  Things (exercises) I would not have dreamed of trying.”  She went on to say that she was encouraged and challenged throughout the process and considered it a great opportunity to learn and continue her exercise program in the Wellness Center once her physical therapy ended.  Her ‘transition’ experience from Rehab Services to the Wellness Center?  “It all just fits together!” she exclaimed.

That’s what it is all about: one smooth transition of care with the goal of optimal health for all residents.

Teepa Snow TeachingIt starts with the touch of your hand.  One of the hallmarks of the Positive Approach to Care™ taught by Teepa Snow, one of America’s leading educators on dementia, is the Hand-Under-Hand™ technique of connecting physically with an individual living with dementia. With thumbs interlocked, established nerve pathways in the hand are engaged, and by holding hands in this manner while helping to dress or feed, or guide the individual, the caregiver allows him or her to still feel in control and subtly connect eye-hand skills.

As yet another step is taken down the path of developing world-class memory care services at Plymouth Harbor, Brandi Burgess, the Smith Care Center’s social services coordinator, has undergone extensive training in the Positive Approach to Care™ (PAC) toward certification as a PAC trainer.  The rigorous process included hours of online classes, training videos, periodic testing to pass on to upper level learning modules.

At one critical point in her training during an 8-hour intensive on site at the Pines of Sarasota, Teepa Snow herself was coaching Brandi on how to hold a resident’s hand using the Hand-Under-Hand technique to help them stand up.

“It was inspiring,” Brandi said about learning from this pioneering advocate for those living with dementia. Teepa has made it her personal mission to help families and professionals better understand how it feels to be living with the challenges and changes that accompany various forms of dementia so that life can be lived fully and well.

Her philosophy is reflective of her education, work experience, available medical research, and first hand caregiving interactions. Working as a Registered Occupational Therapist for over 30 years, Teepa’s wealth of experience has led her to develop  Positive Approach™ to Care (PAC) techniques and training models that now are used by families and professionals working or living with dementia throughout the world.

Challenged to describe the Positive Approach to Care (PAC) in one sentence, Brandi gamely responded, “The core philosophy of PAC is to recognize and celebrate the strengths that remain at each stage of dementia and learn how we can continue to connect with the individual in a meaningful way.”

Of course, there are many layers of understanding in the Positive Approach to Care (PAC) and Brandi was challenged in many other ways as she worked to earn her certification. Guided by a PAC mentor, she proved her proficiency with various techniques by videotaping herself working directly with residents. At the end of the full day intensive she had to develop and present an in-service training. On another occasion, she videotaped a training session she conducted for colleagues in the Smith Care Center in order to satisfy the program requirements.

On December 4, Teepa Snow’s team at Positive Approach officially notified Brandi that she has passed all program requirements and was now a certified PAC™ trainer.

Now it’s time for the real work to begin!  Brandi is now responsible for the ambitious goal of providing Positive Approach training for all staff at Plymouth Harbor.  All clinical staff, between 60 and 70 individuals, will receive two full, 8 hour days of training which will start in March 2015.  Limiting the classes to 24 students, Brandi will be conducting three separate waves of the two-class series. That’s six full days of teaching!

Next, Brandi will train all staff that have direct contact with residents in the Smith Care Center and the Callahan Center. Direct contact staff will receive one full day of Positive Approach Care™ training.

Finally, all other employees, from dining staff to security and all levels of management, will benefit from a two-hour introduction and basic skills training in Positive Approach Care™.

It sounds exhaustive, but we are developing a culture of world-class care for our residents of all cognitive abilities. Teepa Snow will be visiting Plymouth Harbor on Wednesday, January 28, 2015.

Residents are invited to an afternoon session with Teepa from 1:00 — 2:30 pm in Pilgrim Hall. The program is titled, It’s All in the Approach: Learning to Care, Live, and Laugh During the Stages of Dementia.  

Registration is required. Please call (941) 361-7252 to register. If you care to bring your loved one, please register them, as we will also host a separate supervised interactive Drum Circle for persons with dementia during the presentation, followed by refreshments.

 

 

Wellness Florida Retirement Community

Staff work with residents Jeanne Manser and Geri Johnson to assess gait and balance functionality.

The Health Services Team hosted an open house recently at Plymouth Harbor to highlight the wide breadth of Therapy Services available to residents and community members in this continuing care retirement community.

The Open House provided residents with a glimpse of both the therapy and nursing services offered to them. Physical, Occupational and Speech therapies showcased a diverse and energetic approach to rehabilitation and the spectrum they have to offer the residents. Nursing services from the skilled nursing center, assisted living, and home care  provided blood pressure screenings and insight to the total package of caring individuals within their building. The focus of this Open House was to address the “One Stop Shopping” for meeting their healthcare needs at Plymouth Harbor.

“We decided to do this in a fun, expo-like format, so that our residents would have a good time while getting to know the breadth of services that are available to them here,” says Joe Devore, Vice President of Health Services.  “Some of our residents are not aware that full therapy services are right here at Plymouth Harbor for their convenience.”

The entire room was buzzing during the afternoon as residents visited station after station to assess their own functional levels in balance, cognitive memory recall, endurance, and even blood pressure.  Residents could also sign up to volunteer in the Smith Care Center if they have interest.

Many residents came out to the Open House to learn more about the therapy services offered.  Visitors could register to win the drawing for a gift basket.

Many residents came out to the Open House to learn more about the therapy services offered. Visitors could register to win the drawing for a gift basket.

Staff in occupational, speech, and physical therapy led the balance, endurance, and memory cognition assessments.  Greg Carvajal, who works with our therapists and led part of the assessments, added, “We are looking for fall risks and functional deficits during these assessments. If we detect any here, we can recommend that they follow up with the staff at a later date, and hopefully avoid serious injury.”

Gina Kanyha, Director of Rehabilitation Services at the Smith Care Center, hopes to introduce the residents to the therapy staff.  “Our goal was to bring the faces of the team to all residents and let them know who we are and that we are there for them.  This also gives us an opportunity to showcase the services we can offer.”

Also available during the open house was staff from the Smith Care Center, Home Health Services, and Assisted Living.  “We are here to provide services for our residents and building that relationship early, even before they ever need our health services makes it so much more comfortable for all of us when and if the need arises,” said Stacy Baker, Director of Nursing Home Health.