Celebrate

Check out some of the latest snapshots and video from the field, featuring the Therapy Team at Park Manor Rehab Center in Walla Walla, Washington. Thank you for sharing your accomplishments, Sonya Taylor, OTR/L, Director of Rehab!

Park Manor raised over $3,500 for the EEF (Ensign Emergency Fund) to help those affected by Hurricane Harvey. The son of a PTA brought his piggy bank to pour into the EEF collection jar that was eventually filled with $240 in loose change!

Park Manor Therapy Team was represented in the Walk to End Alzheimer’s. Lots of bright colors and smiles to share!

Preparing a meal with the Park Manor team at the Christian Aide Center. PT and ST and her family helped with the cooking and OT and his family helped with the serving along with other Park Manor staff.

Fiddle Mitt – For our lower level dementia patients to utilize when restless.

Surviving a Transition Through Use of the Energy Bus

By Jennifer Ybarra, OT, DOR, McAllen Transitional Center, McAllen, Texas

Last year brought on many changes for me and my team at McAllen Transitional Care Center. We were a part of the huge Legend acquisition that happened on May 1, 2016, and with that came many new, exciting and challenging times. We got through it with the help, support and guidance of way too many people to name individually, but among those are Maricela Garcia, Jon Anderson and Deb Bielek. Thank you, all!

Let’s sprint forward to October 2016. I had been so focused on learning new policies, documentation procedures and compliance standards, as well as tracking new metrics, that I was beginning to feel it was all a bit too robotic and that I was missing the personal connection with my staff, which includes 25 full-time therapy team members.

Thanks to social media, I was introduced to a book by Jon Gordon titled The Energy Bus. Wow! I read it in a day, and I immediately decided to inject positive energy and re-energize myself and my team! But how? We mobilized a plan, and over the next six weeks, I was determined to share my newfound excitement and energy! The following is an overview of the book and of the activities used to get my team on the bus.

You’re Invited to Come on Board!

Jon Gordon presents 10 Rules to fuel your life, your work and your team with positive energy, and that’s exactly what these rules did! I started this journey by sharing my vision and goals for our team. I am the driver of my bus! I laid out a roadmap of where we were headed and how they all play a vital role in that plan. I asked my team to also think about their own vision, not only for work, but for their life as well. After all, you can’t get to your destination if you don’t have a vision of where you want to go!

I used The 10 Rules as a guide for our journey. I jumped over Rules #1 to #5 and started with Rule #6.

Rule #6: No Energy Vampires Allowed!

An energy vampire is a person who literally sucks the positive energy out of a person, out of a situation and eventually out of the team. I thought that establishing this concept early on in our journey would set the tone for the rest of our trip.

There are many instances in life in which we feel like we don’t have a choice — such as paying taxes and adhering to work and family schedules. But we can always choose our attitude, and we can always choose our energy.

At the end of our first meeting, we broke up into small groups and had a little friendly competition with prizes awarded to the winning team. Then, I formally invited all my team to join me and climb aboard my bus. Each was handed a bus ticket and was asked to sign it as an acceptance to my invitation. All were returned signed, and everyone was on board my energy bus!

“Being a positive person doesn’t mean you won’t have negative thoughts. The key is not to listen to them. Just keep moving forward.” — JonGordon.com

It’s All About the Energy!

Our journey continued a couple of weeks later, and we all gathered again after lunch over some ice cream and started in with the next rules on the list. We explored the ways that thoughts are powerful and are loaded with energy. There is an energy to thought and we need to mobilize the energy to create the life we want.

Rule #2: Desire, Vision and Focus Move Your Bus in the Right Direction

We’re winners, not whiners! Positive energy will keep moving the bus forward: trust, faith, enthusiasm, purpose, joy and happiness. The positive energy will help inspire and lead others.

Rule #3: Fuel Your Ride with Positive Energy

Remember, where there is a negative charge, there is also a positive charge. Fuel up with positive thoughts! Toss the negative energy. Choose to think positive even in difficult situations. When work is piled sky-high, be thankful you have a job and are healthy enough to work. When family life is hectic, be blessed to have a family. When you’re stuck in traffic, be thankful that you have a car to drive. Choose to be positive.

The team-building activity chosen for this week’s bus ride was my favorite. Every team member was asked to write a positive comment about each of their colleagues. It could be personal or work-related. The sheets were not big enough for all the positivity that was bursting out! We don’t use compliments enough, and it was great to see the team acknowledging each other for great work or for personal attributes.

Let’s Keep Moving Along

The McAllen Transitional Bus was moving along! We wanted to keep moving and spread our message, bringing us to Rule #4.

Rule #4: Invite People on Your Bus and Share Your Vision for the Road Ahead.

The more people we pick up along the way, the more positive energy that we create during the ride. The idea is to share what we have learned and to ask others to join. The worst they can say is no, but if you don’t even ask them, they won’t know to get on board. Negativity is the enemy. Negativity not only kills productivity, but also kills teams, companies and people.

Rule #5: Don’t Waste Your Time on Those That Don’t Want to get on Your Bus

Some will get on and others won’t. If you want to succeed, you need to be careful about who is on your bus. Some people will increase your energy while others will drain it. These Energy Vampires (previously discussed) will suck the life out of you and your goals. They will cause an engine leak, make your ride miserable or, even worse, slash your tires.

You have to be firm enough to say that negativity is not allowed on your bus. You give people a chance to change, and if they don’t get it, then you need to kick them off your bus or they will ruin your ride and the ride of all your passengers as well.

Trust That Great Things Are Happening

For our last meeting, I made a promise to my team: My positive energy and vision will be greater than anyone’s negativity. My certainty must be and will be greater than anyone’s doubt.

Drive your bus with heart. The heart is your power center. It is where contagious, positive leadership and attitude come from.

Rule #7: Enthusiasm Attracts More Passengers and Energizes Them During the Ride

The simple truth is that when you’re excited, people get excited about where your bus is going and that makes them want to get on and stay on your bus.

The most successful teams have enthusiasm. Every team wants it, but very few have it. It starts with you and me. When you have it, everyone else will see it and want it, too.

Rule #8: Love Your Passengers

Love is a process, not a goal. We are all valuable. Let’s help each other find and recognize the value in ourselves. Enthusiasm and positive energy will get people on your bus, but love will keep them on. (Side note: Rule #8 fits nicely in with our Core Values of CAPLICO!)

Rule #9: Drive With Purpose

Purpose is the ultimate fuel for our journey through life. When we drive with purpose, we don’t get tired or bored and our engines don’t burn out. Burnout is something that I think we have all had to deal with at some point, either with our staff or with ourselves.

Drive with purpose today, and cultivate that in our team every day. Everyone stays on the bus when it’s cruising along, but I also need everyone to get off and push when the bus breaks down.

Rule #10: Have Fun and Enjoy the Ride

Simple. Today, the Energy Bus is still moving forward, and it’s filled with positive and energetic passengers. Each one is excited about the future, and are willing to work together to achieve the goals and the vision laid out.

Many other facility staff members have asked and inquired about all the fun that the therapy department seems to have every couple of weeks. I have gifted several books to other members of our McAllen Transitional Team with hopes that they, too, will get on The Energy Bus!

Leave a legacy. Leave a world that has been impacted and touched by your presence, your joy and your positive actions.

 

“Music is the art which is most near to tears and memory.” — Oscar Wilde
One of the reasons the link between music and memory is so powerful is that it activates so many portions of the brain at the same time. For example:

• Tonality processes in the pre-frontal cortex, the cerebellum and the temporal lobe.
• Lyrics process in the Wernicke’s and Broca’s area, as well as the visual cortex and the motor cortex.
• Rhythm processes in the left frontal cortex, the right cerebellum and the left parietal cortex.
• The medial pre-frontal cortex is responsible for music processing and music memories. Most importantly, the prefrontal cortex is among the last regions of the brain to atrophy.

Neurological research clearly shows that the Music & Memory program provides many therapeutic benefits for individuals with cognitive impairment or physical health decline, including:

• Boosts cognitive function by reaching into the deep recesses of memory
• Reduces the need for anti-psychotic medications
• Provides an enjoyable, fulfilling and individualized musical experience
• Triggers musical memories
• Stimulates recognition abilities
• Enhances engagement and socialization with family, friends, staff and peers
• Reduces falls by decreasing restlessness and agitation
• Provides person-centered care
• Improves the quality of life for our residents

Getting Started

This program needs a Champion, as it is time-consuming to start and maintain. The Champion in Park Manor Rehabilitation Facility is our Social Services Director and one of her SS students who is doing an internship with us. They went to the Music & Memory course and became certified in the program. However, you can do the program without being certified; you just can’t use their name and logo.

You can start with your most agitated residents first to get the program up and running slower, so it won’t be so daunting. The SS student did an iPod (new or used), headphone and iTunes card drive at the university where she was a student and helped with all the initial setup. Park Manor employees also donated, as well as brought in CDs or flash drives with music to download. Our SSD orders used iPods, headphones and iTunes cards from Amazon periodically.

We also sent out letters to our family members letting them know that we were implementing the Music & Memory program. We asked them to let us know what their loved ones’ favorite music was and/or bring in any music they thought they would like.

To help prepare our staff, we had a facility viewing of the movie “Alive Inside,” a documentary about music and its effects on dementia (the start of the Music & Memory foundation), currently available on Netflix or at Amazon.com.

With the program up and running, we use the following process to personalize the experience for each resident:

• Each iPod is assigned a number for each resident.
• The iPods are then personalized with the resident’s playlist.
• The staff check the iPods in and out for the residents (to help prevent them from getting lost or stolen).
• When any staff member notices a resident appears restless or agitated, is yelling (but has no care needs), or even just appears bored or lonely, we ask them if they would like to listen to music.

Results

The Music & Memory program has enhanced the lives of our residents. Park Manor has one of the lowest rates in the state of Washington for psychotropic medication use. We have decreased our falls, and the program has decreased the noise level by reducing yelling and agitation.

Meanwhile, it has provided our staff with a powerful tool to care for our residents holistically. It has freed up staff time to assist with resident cares. Undoubtedly, the Music & Memory program is an essential tool to provide compassionate, patient care to our residents with dementia.

 

At Somerset Subacute Nursing and Rehab, it’s not just a job for our rehab team; we also enjoy each other’s company. We always find time to eat and celebrate!

At the same time, our therapists are always working diligently to find the best ways to support our patients through rehab. Below are some of the highlights of our rehab team’s efforts.

Physical Therapy

Our PTs work with all types of patients, including those who are developmentally disabled, deaf or mute. Our staff learned to communicate via sign language, and patients have progressed from total assist and unable to ambulate to Modified Indep without AD upon discharge.

In addition, our DOR, together with other PTs from various facilities, collaborated on PT Day of Service for Alzheimer’s and Brain Awareness Month and was featured on the APTA website.

Occupational Therapy

We celebrated OT month together with Earth Day through the use of fine motor movements. We incorporated psychosocial stimulation of planting their own flowers and personalized it with their own pot painting.

Speech Therapy

Speech-language pathologists make a difference by making effective communication, a human right, accessible and achievable for all.

Our STs also work with trach/vent patients to address dysphagia and to improve overall quality of life.

By reaching out to one another and finding ways to connect as a team, we have built a supportive, interconnected culture at Somerset Subacute Nursing and Rehab. Even as we celebrate each other’s company, our therapists continually work together for the benefit of patients.

By Michelle Worth, PT, DOR, Somerset Subacute Nursing and Rehab, El Cajon, CA

Medicine adds Days to Life. Physical Therapy adds Life to Days!
Happy PT Month from Carmel Mountain Rehabilitation & Healthcare!

Upon admission at La Villa Rehabilitation & Healthcare Center three years ago, one 92-year-old Spanish-speaking patient came to us with a history of dementia, heart disease and renal failure. She had undergone prior hospice care as well as multiple episodes of skilled therapy intervention.

On admission, she would walk a short distance of 20 to 30 feet with a flexed trunk and knees. Having experienced a recent decline in function secondary to a hospital stay, she avoided socializing and disliked therapy. She has a history of not participating in therapy and tends to leave her sessions if she feels she has to do too much activity.

Interventions

Therapy evaluation revealed decreased ROM to B knees secondary to arthritic changes and hamstring tightness. Due to her long periods of sitting and the fact that she keeps her knees flexed during WC mobility and primarily uses her UEs for propelling, she presents with tight hamstrings and hip flexors.

With skilled therapy services, the focus was to increase BLE ROM with hamstring stretches and hip flexor stretches. However, the patient was not interested in these interventions. Family then expressed that she would like a new WC. The therapy team discussed with her that if she would help more with transfers and other mobility and allow us to stretch her out, then a new WC would benefit her much more.

The patient worked on the Sci Fit to increase her ROM and strength, with a focus on sit-to-stands on the parallel bars with max A and transfers with max A. The patient would help to stand, but once in standing, she would flex her knees again and would not bear weight.

During this time, we brought in the Barihab Table and encouraged her to let us try using the table with her for transfers, with assistance from the L side bar. This allowed her to feel more secure after the first try. Within a couple of days, the patient was gradually able to utilize the table for hamstring stretches.

We also used the back support to progressively lower her from sitting to a more supine position to obtain a hip flexor stretch. The patient began to perform crutches to increase trunk control, and she was beginning to like the outcomes of the treatment sessions.

We then introduced her to the seat lift for lower body support to move into standing. She was able to gain strength and trust, and she allowed herself to stand with one-handed support and slowly progressed to releasing both hands. She will now play catch with the ball and is helping with transfers as she stands up taller and takes steps to stand and pivot.

Conclusion

We are amazed at the progress we’ve made with a patient who previously disliked therapy and now knows to come to therapy on her own. She has a new custom WC, and even though she still keeps her knees flexed, she is stretching them out on her own and performs stand-pivot transfers with mod A with nursing. The patient’s initial smile when she could stand was priceless, and we continue to gain her trust with each therapy session.