Our assisted living activities have been upgraded to more of a recuperation-oriented department, to respond to the changing resident mix we observed last year and anticipate will continue.
We’re seeing more complex but higher functioning neuropsychiatric syndromes with medical, neurological and psychiatric components. Many of the residents are coming from other facilities where there is not enough support along one or several dimensions.
Others have been home with private duty care and their illnesses are further along by the time they come to assisted living. Finally, medications to slow down, much less reverse, any dementia syndromes continue to fail in the drug development process.
To increase the clinical skills in the activities departments, we’ll bring a new staff that is trained in complex recuperation teamwork. Traditionally, they go to work in skilled rehab centers or head injury/spinal cord injury treatment settings. We want them to see dementia as a number of diseases which will benefit from the same approaches but with different outcomes.
Our outcome measures are improved quality of life, decreased disability during the end of life care and smooth transitions from acute care to end-stage care (hospice) for residents and families. The indicators of improvement include active participation in group activities, selective involvement in cognitive preservation activities (see activities program details) and satisfaction reports from family and/or significant others.
Activity department’s staffing and approaches
Three categories of staff work in the departments:
- Activity aides
- Activity therapists
- Licensed/certified Recreational therapists
The licensed/certified staff will work with the owner and administrators to revise the programming, maintaining some activities, eliminating some and adding others.
The overall goal is a cohesive, research and practice-based approach to memory, mood, movement, and medical syndromes. There will be individualized activities, small group, and large group opportunities.
Initial assessments by the Licensed/Certified staff will be included in the comprehensive treatment plan and coordinated with other therapists (PT, OT, and Speech). Meaningful documentation and feedback to other staff at team meetings will be done, proportional to the complexity of the residents.
New residents will have the first month of focused attention (four weekly interdisciplinary reports). Assessment and monitoring instruments will be field tested for reliability, validity and practical applications.
Activity plans and general treatment plans will thereafter be reviewed quarterly or as a result of a change in condition.