Clinicians Who Inspire – April 2022 Alyssa Stead

Through the Clinicians Who Inspire series, we continue to share motivation, creativity, and inspiration from clinicians in the field. This month, we spoke with Alyssa Stead, COTA/DOR and Champion Level II therapist from Avalon Care Center Sonora. Alyssa shared that though there have been challenges over the past two years, a shifted mindset has allowed the therapy team and residents something to look forward to.

As residents within the dementia unit were isolated from typical routines and interactions during the pandemic per federal guidance, Alyssa and her team took the initiative to create opportunities for meaningful participation. They obtained information about their residents’ interests and created kits that included materials for activities according to those interests. Through participation in these activity kits, Alyssa saw not only satisfaction from the residents, but also a decrease in some of the potential challenging behaviors that presented on their dementia unit. This successful intervention was something that both the residents and therapists could be excited about.

Even as the residents begin to regain a sense of normalcy, these activity kits remain relevant and beneficial. Alyssa Stead, COTA/DOR shared a quote that has always stuck her, “People don’t care how much you know, until they know how much you care.” Taking the time to learn what is meaningful and motivating to a resident can go a long way in showing that you care.

Thank you, Alyssa and team at Avalon Care Center Sonora, for shifting your mindset and exemplifying Care Matters!

Quality of Life is Medically Necessary

Since the Omnibus Budget Reconciliation Act (OBRA), or the Nursing Home Reform Act of 1987, federal standards have been in place to regulate efforts to address a resident’s quality of life (QOL). These federal standards identify six principles of QOL, including: sense of well-being, satisfaction with life/oneself, self-worth/self-esteem, satisfaction with environment and care, goals, and control. New data gathered during the COVID-19 era highlights the necessity to prioritize QOL, revealing that adverse effects of isolation have resulted in cognitive, psychosocial, and physical decline for many in post-acute care settings.

Because QOL is a multi-dimensional concept, this essential component of health and wellbeing should be addressed through the comprehensive efforts of an IDT. Each member of the IDT plays a distinct role to promote a resident’s QOL. Consider implementation of some of the following interventions for improved QOL within your facility:

  • Identify resident-specific interests and provide opportunities for participation in these activities on a regular basis. Consider virtual leisure opportunities, as well.
  • Improve the resident’s health literacy to promote wellness and prevent future injury/illness.
  • Execute environmental modifications that promote greater participation for all residents in activity groups.
  • Implement a facility-wide screening process for identification of depressive symptoms in residents.
  • Offer scheduled check-ins to allow residents the opportunity to present questions/concerns.
  • Consult with key players to identify activity groups, community outings, events, speakers, and responsibilities that could serve as opportunities for resident participation.
  • Provide stress management and relaxation strategies for residents and healthcare workers in the facility.

As experts in analysis of performance and participation, PT, OT and SLP can assist in assessing the resident’s functional abilities and tailoring interventions, like those listed above, to achieve person-centered goals. With the unique lens and contribution of each additional member of the IDT, these interventions can become reality; ultimately maximizing QOL, functional outcomes, and patient satisfaction.

Care Matters Spotlight – Forest Haven Nursing and Rehabilitation

Mr. Freberthauser, a long-term care resident living with dementia at Forest Haven Nursing and Rehab, had been experiencing frequent falls within the facility for a while. With some guidance from Reliant’s Clinical Team, the amazing therapists at Forest Haven worked together to investigate and understand what would work best to engage Mr. Freberthauser and ultimately prevent or reduce falls from occurring. For Mr. Freberthauser, music was the key to improving participation in therapy. The team did some research and found the biggest hits of his generation. When the SLP tried the timeline with country music hits, they really scored. He was beaming with a face full of expression and articulated, “I like to hear Hank Williams music.” The team also found that he performed better with regularly scheduled visits and interactions. Colby Millen, DOR, reports that Mr. Freberthauser “went from stumbling around aimlessly with no affect to smiling when he would see us (the therapy team) and had nicknames for each member of the team.”

With Mr. Freterthauser’s improved attention skills, the therapy team was able to work on the goals they had established. After weeks of therapy, he is now ambulating throughout the facility independently with an improved stable gait and improved safety. He can get out and safely enjoy the activities he loves with as much independence possible. Although there will always be some risk, he has now been fall free for the last month!

In order to set him up for a successful discharge, the therapy team requested that the activities department see Mr. Freberthauser daily to continue to have one-on-one time engaging him in meaningful conversations and allow him a chance to enjoy his favorite music that has improved his quality of life so much.

Thank you to Colby and the Forest Haven therapy team for taking the extra steps necessary to facilitate Mr. Freberthauser’s success!

Discipline Snapshot:

PT: The PT team incorporated music to engage Mr. Freberthauser in meaningful interactions while also working on goals for improved strength, balance, transfer, and ambulation safety.

OT: The OT team also incorporated music and engaging conversation to encourage him in activities to improve his abilities to feed and dress himself.

ST: For ST, facilitating improved engagement has been paramount to the success he has seen. Goals included following directions, comprehension of simple messages, and expression of wants and needs.