Monday, June 21, 2010

Narrative care, narrative medicine, tools for building relationships and biographies

LifeBio is honored to have become familiar with the work of Dr. Bill Randall and Dr. Gary Kenyon, both professors of gerontology at St. Thomas University in New Brunswick, Canada. There definition of narrative care is as follows:

"'Narrative care' begins and ends by honouring the lived experience, or the story, of the person receiving help. Narrative care is therefore "core care". In conjunction with St. Thomas University, LifeBio's autobiography tools have been employed at York Manor, a nursing home in Fredericton, New Brunswick to support the community's efforts to employ narrative care.

Another leading expert in the field of narrative is Dr. Rita Charon at Columbia University. In the fall of 2009, Columbia University launched their new and innovative program in narrative medicine. According to the New York Times, "Through literature, she learned how stories are built and told, and translated that to listening to, and better understanding, patients. She could let them tell their own stories without interruptions and see how people described their symptoms as part of the larger story of their life."


http://www.nytimes.com/2010/01/03/education/edlife/03narrative.html?emc=eta1
http://www.nytimes.com/2010/01/03/education/edlife/03intro-t.html?ref=edlife

With LifeBio's work with the Mayo Clinic, York Manor, and dozens of nursing homes and long term care facilities, we see huge growth ahead in the field of narrative medicine and narrative care. LifeBio has the tools to accomplish the goal of knowing the patient and the people -- this can only improve the delivery of service and care.

Friday, June 18, 2010

Justifying the Cost of LifeBio in Senior Living or Active Aging Communities

What does it cost you…
1) When someone moves out because they never felt connected and didn’t build any new friendships.
2) When someone moves out because the family didn’t feel you really knew their loved one as well as you could or should.
3) When someone is depressed because the family doesn’t visit as often as he or she wishes or the family members only stay only briefly when they come to visit.
4) When you don’t have the latest, greatest innovative programming for brain fitness, lifelong learning, technology innovation, and memory care that other communities have – so the competition wins.
5) When your efforts to promote person-centered care still aren’t helping you individualize service and care as much as you would like. How will you take it to the next level?
6) When your outreach/marketing efforts are the “same old, same old” approaches that may be losing their advantage.
7) When volunteers are coming to you but you can’t engage them or keep them involved as much as you would like.
8) When employee turnover happens because people don’t feel a meaningful and strong connection to the people and this place.

LifeBio can help in ALL of the above areas! Call 1-866-LIFEBIO or email info@lifebio.com.

Saturday, June 12, 2010

Reinventing activity programs in long term care

How do we keep "activities" REAL? What are some next generation activities that aren't the "same old, same old"? How do we excel at life enrichment? Is it possible to help people achieve happiness and wellness--even when the physical body doesn't want to cooperate anymore? Here are four things I suggest activity directors, life enrichment directors, or therapeutic recreation directors focus on. What are your thoughts?

1. Keep normalcy in everyday life.  Guard and prevent institutional, medical approaches from encroaching on normal life. I was in a community recently and I participated in a poetry group in the memory care area of the building. This poetry class happens only once a week--everyone looks forward to it. During the one hour of class, two out of eight people were taken out of class for a podiatrist to check their feet. This special time was interrupted unnecessarily by the medical team. Frankly, if the community's focus is on wellness, the poetry class is probably more important than foot care. Stand up and protect these special social, emotional, spiritual, and intellectual experiences from medical interruptions. They can wait.

2. Walk in people's shoes. One-on-one visits are a chance for two friends to talk with one another...to learn from each other and to really listen to each other. It's important to ensure that family, staff, volunteers, and you are seeing the whole person (not a patient, a person). We can't judge a book by its cover. We can't let ageism creap into life in the community. We need to really open the book and read the whole, fascinating life story. Embrace the journey--walk in people's unique shoes, understand who they are and where they've come from. Celebrate life everyday.

3. Concentrate on what people CAN do. For example, I think that people who have lived a long life but now find themselves in long term care have MUCH to give. For example, many older people understand the power of prayer and they use it--they don't need to have legs or eyes that work to pray for those around them. I've been in communities where I can really feel that power around me and it makes a positive difference. Realize that some people may be spending time alone intentionally to pray, to meditate, to read and remember their favorite scriptures or songs. Also, while physical possessions might be fading in importance, older people are carrying with them wisdom and values that are essential to pass on to the next generation. Unfortunately, in too many communities, younger generations are not connected to receive the wisdom that's sitting there or standing there waiting for them (even grandchildren and great-grandchildren don't really have the chance to truly know their grandparents deeply). Activities directors and life enrichment directors have the distinct privilege to bridge the generations together as much as possible.

4. Help people realize their dreams. I concentrate on people's life stories because I think the past and present holds the keys to the future. Recently an 80-year-old man finished his LifeBio with the help of his daughter and he shared that he's always felt there was music inside of him but it has never been expressed. It's like he should have taken piano or guitar lessons and it just never happened. The time has come for those lessons to happen NOW. Authentic activity directors could also be called "wish granters" or "dream makers" or "happiness coaches" in my opinion. The genuine heart-to-heart conversations are going to reveal the dream that still needs to be fulfilled. Has Betty always wanted to start her own business and sell her quilts on the internet?  Has Joy wanted to raise $10,000 for her favorite charity, a homeless shelter in town? Has Glen longed to see the World War II Memorial in Washington? With the power of community connecting residents, staff, family, and volunteers, there is no telling what BIG dreams could happen together.

So tell me what you think the future is for community life, life enrichment, therapeutic recreation, or activity programming? If we're brainstorming, it just might happen!

Beth Sanders, Founder & CEO, LifeBio.com 1-866-LIFEBIO, bsanders@lifebio.com

Tuesday, June 08, 2010

Memory Care Program Tips

Senior living communities, retirement communities, assisted living, skilled nursing, adult day programs, and other organizations have a growing interest and need to enhance or add memory care programs to their offerings. Here are four tips to consider for your memory care program of the future...

1) RE-THINK your memory care program and "RE-INVENT" without delay - Beyond meeting the physical needs of a person with Alzheimer's or another form of dementia, the community must look at the robustness and effectiveness of the memory care program. Some communities have a wealth of activities but are the activities really engaging for someone with dementia? Weekly entertainers, BINGO groups, and a Connect 4 or checkers board just don't cut it. How are you connecting eye-to-eye, face-to-face, hand-to-hand to be a true friend? How is the community addressing all the dimensions of wellness in the life of a person who is having difficulty remembering? How can the community stimulate the brain and try to build cognitive reserve or try to lessen memory loss? One good idea is to ensure that reminiscence programming is in place that will be engaging, address all dimensions of wellness, and stimulate the brain. Using all the senses and touching memories, looking at pictures that stimulate discussions, and asking people to share their own personal life experiences. Ensure that conversations in the community aren't just "chit chat" about weather, health, sports, and food. Instead ask, "Do you remember your first bike?" or "Did you have a paper route when you were a kid?" Take the conversation to a whole new level that isn't in the present moment.

2. RECORD the life story. Reminiscence works to promote interesting conversations but RECORDING the life stories is crucial too--especially for someone with memory loss.  This information will be like gold in the pursuit to deliver quality service and care in the short term and in the long run. And it's not the standard social history that is going to be all that's necessary. The details of family relationships from the person's youth, childhood memories, young adulthood, historical events,  love, marriage, children, grandchildren, pets, life lessons, values, and more are all part of this rich story. For example, it would make more sense if staff members knew that Betty's beloved horse from her childhood was named "Slippers" when someone mentions slippers (on someone's feet) and it causes Betty to shed a few tears.

Curriculum for memory care is a growing trend. For example, LifeBio has developed a tool called MemoryBio that provides a universal photo album with over 200 pictures that will stimulate discussion on 35 major themes of life such as "Travel & Vacations" "Cooking, Baking, & Canning" "Jobs and Careers" etc. Along with every picture, MemoryBio includes a personal history question (yes or no, multiple choice, or a few open-ended questions) that will help generate a fun and interesting conversation. Even if a person with mid to late stage dementia cannot answer, the pictures and questions could help the leader to talk about something more interesting--from his or her own life. It's key that the programming not be childish, but stimulating and fun for both the staff member and the resident. The themes in MemoryBio are also used by communities as a "theme of the week" -- so weekly life enrichment doesn't revolve around holidays all the time (how many people really celebrate all the holidays anyway).

Innovations in memory care can mean emphasizing narrative care in your community. The focus should be on both reminiscing and RECORDING life stories. This isn't just a "nice to have" activity but an essential component of delivering quality long term service and care.
3. INVOLVE the family and volunteers more. In many cases I've seen, the family is happy to be engaged in the memory gathering process. They are glad to have a focus for their visits and some way to help. For example, family members can be asked to help create a LifeBio Storyboard, help fill in the Life Story Journal, or attend a LifeBio class with their parent or grandparent. Some family members even want to gain access to LifeBio.com to work online to help build the life story.
Joe has vascular dementia to the point that he cannot speak. His family accessed LifeBio.com's online autobiography template as a group and worked on building Joe's story from their own perspectives. "If dad could answer this question, he would say......." Joe's wife or his four children would do their best to answer the question for their husband and father. It was a beautiful experience for everyone. They were reminded of the many, many good times they had experienced together--despite the challenges of the present time.

Sharing life stories can be a joyful time and a way to involve youth groups, middle or high school students, or college students in writing down what older adults have to share. Be sure to encourage volunteerism in memory care more than ever. An 80-year-old Texan in a memory care unit commented, "There's nothing better you can do for me than bring these young people in to visit with me."

4. SEE the connection betweeen reminiscence and wellness. Reminiscence does touch all dimensions of wellness so working on life stories will help people feel more purposeful and useful, while meeting their physical, emotional, social, intellectual, and vocational needs. When many things are out of control, one thing that many people with dementia can do is express their life stories (especially from their earliest childhood). Most people enjoy reminiscing about their own experiences, and it leads to validation of a life well lived. The goal is to help people with dementia experience more love, more hope, and more peace--that can be accomplished through focusing on the person's life more than ever before.

Please contact LifeBio at 937-303-4574 or email info@lifebio.com to learn more about LifeBio's memory care programming for senior living communities, retirement communities, assisted living, skilled nursing, adult day programs, hospice, or other senior service agencies. MemoryBio provides over 200 pictures and questions to stimulate engagement and recording of life stories.

Wednesday, June 02, 2010

What's stopping retirement communities from telling life stories?

Here are 3 reasons why some retirement communities may hold back from beginning a reminiscence program.

1. Reminiscing is so “old fashioned” – shouldn’t we just focus on the future?

The power of story helps people to build authentic relationships. When they have just moved in to a community or even if they have lived there for a while, people benefit greatly if they can develop closer, more meaningful friendships. LifeBio’s Story Cards are a simple way for people to have conversations that don’t involve the weather, health, sports, and food. LifeBio opens a door to new conversations and people realize how fascinating and accomplished the people are around them. LifeBio 101 classes help residents get to know other residents, staff, family members, and even prospective residents. People realize what they have in common – they can enjoy their future together more if they actually KNOW each other at more than surface level. When people know each other, it helps them experience more genuine love, hope, and peace. It helps the staff deliver better service and care too.

2. Why reminisce—isn’t that just dredging up old losses and causing more grief and pain?

Everyone has “sweet and sour memories”. Everyone has had multiple losses in their lives. The problem comes when people have no way to express these emotions. If people are forced to retreat to their rooms when they feel sadness and anger, they will continue to harbor these feelings. We find that people in LifeBio group classes have a chance to recall many positive experiences, review many accomplishments (validating their lives), and they realize that they are not ALONE. Everyone has experienced plenty of joy but also periods of pain too. There is something comforting in knowing that you’re not the only one who is feeling these emotions.

3. Reminiscing has been and “old school” activity for many years. What’s different now?

Yes, shadowboxes have been in memory care areas and activity directors have used Reminisce Magazine for discussions for years. What’s different now is a focus on lifelong learning (LifeBio 101 classes), brain fitness (working the hippocampus of the brain where memory is stored), exploring new technology (www.lifebio.com), and achieving higher resident and family satisfaction(expectations are high—management is realizing they must really KNOW people to deliver the very best service and care). LifeBio helps people achieve the goal of creating a biography in their own words—enriching lives in the process. Every person is unique. Communities are focused on person-centered care now and individualizing what they do more is KEY. LifeBio helps them accomplish this BIG goal. This isn’t just a little activity anymore.

For more info, contact Beth Sanders at 937-303-4574 or email bsanders@lifebio.com