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Some of the hardest working, most loving staff members in long-term care are Certified Nursing Assistants. These employees are the ones working most closely with the residents. Residents often shared with me who was the best at assisting them in bathing, helping them to look extra nice for an outing, who made them laugh, whose shoulder was the best for a cry. The Nursing Assistants are very important in the lives of residents and the working of a facility.
June 16-23, 2011 is Nursing Assistant Week. If you know one of these people, please take a minute to thank them for their work.
- What is a CNA nurse (wiki.answers.com)
When I was employed as an Activity Director in long-term care, it took a lot of effort and time to arrange my vacations. At first, I found taking a vacation more stressful than not having a break. I had to be sure all my charting was completed, all the activities were covered, materials were in place…it was a lot of work! In my many years in the position at a variety of facilities, I did learn a few things that made it easier. And, I became a much healthier, happier person.
- Plan your vacation before you plan your calendar. This allows you to be sure you don’t schedule events you must be there in order for them to succeed.
- Identify coverage with your supervisor. Knowing who will provide coverage allows you to play to that person’s strengths, schedule events according to available coverage, etc. Sometimes my Administrator would hold a Resident Council meeting while I was away or another conversation based event.
- Contact your volunteers for extra assistance. Increasing the volunteer coverage provided for more one on one attention while I was away. Also, some of my volunteers were great at leading specific groups but not others. So, if chasing bowling balls & pins (this was pre Wii days) was something outside their physical contort but doing a group crossword was a strength, we would schedule accordingly.
- Set aside time prior to leaving to complete charting, purchase materials, leave plans. Leaving with your charting complete is key. I would create daily plan sheets of what was to happen when, who would lead the event, who generally attended these groups, and materials needed for the event. While it sounds like a lot, much of it was easy once I completed two days. It became more of a copy and paste. Then, if the covering person or volunteer was ill, there was sufficient information for the event to occur. And, I had a complete list of supplies to purchase if necessary as well as to leave. I tried to provide a little extra time in my schedule the last five days leading up to vacation to accomplish this.
- Plan for some easy to implement events while you are gone. Generally, my residents loved certain events that didn’t need much explaining like bingo. I also had materials from resources like Creative Forecasting, Activity Connections, and A New Day which were already set up for use. You can also use materials from newsletters like SPARKS (available for FREE here on the right), materials from your corporate office, or other resources. I general made copies and attached them to the sheets for each day or placed them in a three-ring binder organized by day.
- Schedule time for key staff to update you on what happened while you were away on your first day back. I found it helpful to sit with the Administrator, Social Service Director, or DON/ADON for 20 minutes the morning I returned to be up to date on everyone’s status. It let me prioritize my charting, resident visits, and alerted me to special needs that had developed in my absence.
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During the recent Midwest Regional Music Therapy Conference in Overland Park, Kansas I heard a wonderful case study using music to assist with bathing which I shared in my post “Reflections on Music Therapy Conference”. That has spurred me to think about how I have used music over the years in long-term care both as an activity staff member and as a music therapist . I have injected music into lots of events from horse racing to exercise to facility scabies scrub downs. As a music therapist, I know a ton of songs. That has worked to my advantage.
Having the staff involved in the music improved the response by the residents. Staff musically interacting with residents can make for a home like atmosphere, a sense of genuine compassion, and an energized facility. It can make everyday duties like ADLs or waiting for a meal less taxing. Singing favorite songs for or with a resident dealing with a dementing diagnosis can sometimes increase responsiveness. Given the limited number of long-term care facilities which employ a music therapist or contract music therapy services, I thought it would be nice to share songs the staff could join residents in singing. Know that song preferences change with resident, locale and facility. With that in mind here is my Top Ten Songs to Know in Long-Term Care.
- Amazing Grace – An old church hymn many people know & sing
- Clementine – Folk song with chorus & verses. Songs with choruses allow for easier participation even if residents don’t remember the verses.
- Five Foot Two – This flapper song seems to get toes tapping and lots of facial expression whenever I use it. It is a great one for starting a talk about fashion.
- God Bless America – A patriotic number many older adults know well.
- Happy Birthday – Self explanatory, I hope!
- Let Me Call You Sweetheart – Old love song which can bring out waltzing type moves. You can also ask residents about other nicknames to substitute in the lyrics for sweetheart.
- Pack Up Your Troubles – While this WWI song seems too old, I find most people know it.
- She’ll Be Coming Round the Mountain – Another folk song that can easily be changed up.
- Take Me Out to the Ball Game – Men & women alike know this song.
- You Are My Sunshine
Here are some other big favorites from my visits that you could also consider adding to your repertoire:
- America the Beautiful
- April Showers
- Auld Lang Syne
- Beer Barrel Polka (Roll Out the Barrel)
- Home on the Range
- How Much is that Doggie in the Window
- I Want a Girl (Just Like the Girl)
- I’m Forever Blowing Bubbles
- I’m Looking Over a Four Leaf Clover
- I’ve Been Working on the Railroad
- In the Garden
- My Bonnie Lies Over the Ocean
- My Wild Irish Rose
- Oh What a Beautiful Morning
- Oh, When the Saints
- Oh Susanna
- School Days
- Shine On Harvest Moon
- Show Me the Way to Go Home
- Side by Side
- Singing in the Rain – A good one for showers and baths.
- Tennessee Waltz
- When You Wore a Tulip
- Your Cheating Heart
I encourage you to ask your residents about their favorite songs. You may be surprised by the answers. If you are interested in learning more about music therapy services in long-term care, I encourage you to look at these informative posts by Rachelle Norman, MA, MT-BC:
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May 14th is National Chicken Dance Day! Here in an area settled by Volga Germans it is a very common dance at community events. And, it is a great intergenerational dance!
I generally modify the circling portion to be hand clapping or simple movements to reduce the likelihood of an older person falling. When doing this in an intergenerational group, I often break out the egg shakers and lead into the dance with “I Know a Chicken”. With the children present, the action song becomes more chance for the older set to show their silly side.
Break out of your shell, get up! Get moving. Do the Chicken!
Image via Wikipedia
Bubbles seem to have a lifetime of uses. They are an affordable, relatively clean activity. I have used them with young children and with older adults. This past weekend, I read a post titled “Bubbles are more than meets the eye”. Many of the developmental uses for bubbles are outlined in the article. It includes a bubble solution recipe. So, my article is more focused toward older adults and intergenerational groups.
Saying bubbles brings the songs “I’m Forever Blowing Bubbles” and “Tiny Bubbles” to my mind. These are two songs many older adults know by heart. In particular, I find the lyrics of “I”m Forever Blowing Bubbles” a great discussion starter:
- What dreams have you seen in your life?
- Did they fade & die as the song suggests? Tell me more about that.
- What fortunes did you find hiding in your life?
- Why do you think the lyricist spoke of fortunes in a song about bubbles?
- Did you blow bubbles as a child? With your child?
- Rather than sending a bride & groom off with rice, people now blow bubbles. What significance may this have?
We could also discuss where we remembered seeing bubbles during Lawrence Welk shows. Often this is where the song “Tiny Bubbles” comes into the discussion. I loved using the room air handlers or a blow dryer and creating our own Welk type event.
As a nursing home activity staff member, I also found bubbles could be part of intergenerational programs with school aged children. Depending on the class age and the teacher, it could take on a science to a social approach.We would together explore making bubbles of different sizes, discuss expectations of various wand shapes, see who could blow the most bubbles or the largest bubble, and share bubble experiences. The group also would discuss the type of air stream needed to create bubbles. Often there were discussions on the rainbows found on the bubble surface.
Enjoy some bubbles with someone today and see if a song or a smile surfaces.
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The month of May is filled with holidays and events for many people. Here are some resources on this blog for a handful of them:
Cinco de Mayo:
Older American’s Month:
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Research indicates meditation can have positive effects on us mentally and physically. There are many forms and approaches to meditation. Today I led my first Singing Bowl meditation in an assisted living facility. It was present as part of this month’s Brookdale Senior Living Celebrations theme of Mount Everest, Tibet.
Now, I have led meditations before with this population in rooms I could close the doors. There are lots of challenges in group assisted living settings for meditation. Among them are hearing, diagnosis,orientation to place/situation, varying levels of trust and willingness to try new things. Today’s meditation was in the living room so people were passing through, the phone rang, and other noises were present. When we completed our experience, I asked the group for their impressions and received:
- It was relaxing.
- We created a beautiful melody.
- I liked listening.
Here’s how I set up our meditation. As most residents in northwestern Kansas find this place distant and unknown, we started singing a few folk and gospel songs about mountains while seated in a circle. This was followed by a scarf movement activity to “Ain’t No Mountain High Enough”. Laughter and smiles seems to be a comment response of the clients. I wanted to be sure everyone was awake, ready to do something different, and hopefully in a positive state of mind. Next we listened to a recording of John Denver singing “Rocky Mountain High” and discussed the lyrics including where mediation was mentioned. Different forms of mediation and benefits of mediating were discussed.
Next I brought out my Tibetan Singing bowl providing a little history and demonstrating how it can be sounded. A brief introduction to meditation is presented. Residents were then offered a choice of a tone bar or rhythm sticks. (Tone bars were from a pentatonic scale.) Then I stated:
We will begin our meditation with a few breaths. I will sound the bowl. As you feel ready, play your instrument as often as you wish, when you feel moved to do so. When I feel we have completed the process, I will sound the bowl to end our playing and meditation.
All in all, they seemed to enjoy and to benefit from the process as did I. It is something I’ll share again with them. Our meditation closed and we went on to sing other mountain songs. For people on the high plains, it was a mountain top sing!