Download Staff Education and Engagement

Technology As An Intervention for
Dementia
Bryan Allen-White
Household Coordinator
Jack York
President / Co-Founder
Josh Hansen
Technology Director
Jack York
President / Co-Founder
Story of iN2L
• US Based Organization Founded in 1999
• Mission to improve quality of life for older adults through adaptive
computer technology
• Systems in 2000 + communities, 50 states, 4 countries
What are the system options?
1. Resident Package: includes adaptive keyboard,
speakers and microphone
2. Mobile Flex & Mobile Flex Lite: Includes;
flying, bike simulator, adaptive keyboard, speakers
and microphone, flip video camera
3. Shuttle: 11.6” 1.8lb slate
There is a problem – do you hide it or
embrace it?
Common Sense – If you enjoy
it, you’ll do it…..
The Orchestra is Only as
Good as the Conductor –
meet Western Homes
Josh Hansen
Technology Director
Western Home Communities
“Western Home Communities is a charitable
Christian service organization that assertively
creates fulfilling lifestyles for seniors, their
families, and our employees”
Our communities currently encompass two
campuses:
Western Home Communities
– Downtown Campus
• The Stanard Family Assisted Living Center
• Martin Health Center (Nursing)
• Willowwood (IL)
Western Home Communities
South Main Street Campus
Windgrace, Windermere, Windcove, Windridge (IL)
Windcrest Villas and Townhomes (Active Lifestyle)
Windhaven Assisted Living Center
Thalman Square (Memory Care AL)
Last June We Opened two (2) 16-room Chronic Confusion and
Dementing Illness (CCDI) cottages utilizing a “neighborhood model”
to meet the demands for dementia support
Project Description
Goals
– Improve care and quality of life for all our
residents
– Address the behavioral and psychological
symptoms of dementia (BPSD) for residents living
with dementia in a non-pharmacological manner
– Implement technology-driven engagement and
activities
– Reduce the use of as needed or PRN antipsychotics
• fewer side effects
• savings to Medicare and beneficiaries
Project Description
Expected outcomes
– Reduce PRN antipsychotic use by at least 35
percent
– Enhance relationship-centered interactions
between staff and residents
– Empower staff – they provide guidance as to
which programs are most effective for each
resident
Project Community
Site - Martin Health Center
Two-story building
100 living units, 2 community rooms, 2 dining rooms, lounges &
therapy gym
11 of the 48 residents had a dementia diagnosis and were
receiving PRN antipsychotics to treat their (BPSD)
Implementation Approach
Evaluated several options
Opted for iN2L systems to provide person-centered
recreational and leisure activities (RLAs)
– Four (4) mobile units
• Electric, height adjustable stand
• Articulating arm for flexible screen positioning
• Peripherals
Implementation Approach
• Project leads - directors of leisure services, technology,
and nursing & the Center’s administrator
• Leadership team procured funding through the Iowa
Department of Human Services, Iowa Medicaid
Enterprise (IME) 2013 Civil Money Penalty Quality
Improvement Initiative Grant (CMPQII):
1. support quality of life improvement for nursing facility
residents, such as the reduction of off-label use of antipsychotic medications;
2. have direct measurable outcomes; and
3. provide staff education or training opportunities
Implementation Plan
• Measurable Outcomes Baseline
– Nurse managers compile three months of data on each resident
receiving PRN antipsychotic medication
– Identify areas where the systems could be utilized to replace or
supplement current activities
• Staff Education and Engagement
– Initial on-site training for staff utilizing the iN2L systems
– Identify volunteer opportunities
– Nurse managers and leisure services staff make recommendations for
each resident receiving PRN antipsychotic meds
– Caregivers make recommendations on programming that best supports
the resident
– Collect resident success stories whenever possible
– Subsequent quarterly trainings provided to new staff
Implementation Plan
•
Roll Out Activities / Family and Volunteer Engagement
•
Project Sustainability
– Send letters to families about the iN2L systems being purchased
– Hold a family member meeting to provide a demonstration and describe the abilities
of the program
– Provide training on Skype, email and other Internet services is provided to
encourage family to stay connected with their loved ones
– Introduce the iN2L system at Family Tree Meetings
– Use marketing handout in brochure material.& Incorporate program information
into tours
– Nurse managers conduct monthly evaluations of antipsychotic use episodes
– Nurse managers meet with leisure services staff and assist in making further
recommendations to the caregivers
– Quarterly reports are sent to IME by the administrator regarding progress,
expenditures made and program details
– Staff provide iN2L trainings to new residents in small groups, as well as one-on-one
interactions
Outcomes (so far)
• 50% less residents requiring PRN antipsychotics
• 20% reduction in the total number of doses given to all
residents with PRN antipsychotic medications
Quarter
# of Residents with PRN
Psychotropic Medications
4Q 2013 (Baseline)
1Q 2014
15
13
Total # of Doses of PRN
Psychotropic Medications
Dispensed
51
87
2Q 2014
10
64
3Q 2014
7
41
4Q 2014
6
24
NOTE: 2Q 2015 # of Residents receiving PRN Psychotropic Meds was 32%
Estimated to be 16% at end of Q4 2015
Caregiver Observations
Bryan Allen-White
Household Coordinator
Training
Day!
Activities are held with the IN2L. IN2L helps brings Caregivers, and Residents together and
help create a bond by helping Residents open up as well as Caregivers, giving them that Home
feeling. IN2L is used for trivia games, Price is Right, History, My Stories, communicating, etc.
Caregiver Observations
A Gentleman at the Martin Center, suffering from
dysphasia of the right side of his body after a stroke
taught himself to write left handed on the IN2L
system. He used it as a means to communicate with
staff and family.
He was a pilot in the Korean War, and
spent many days on the Google Earth
Flight Simulator touring the world. He
found much joy in instructing and
teaching staff, family and other residents
how to fly!
Caregiver Observations
One resident, post stroke, usually kept to herself in her
apartment. The iN2l system was brought in, and she played the
bubble pop game using her non-dominant hand for extended
periods of time. This surprised staff and her family.
Staff realized that while she was playing
she would engage with those around her.
Staff suggested that she come to the
lounge to play, and she did. While she
played and others observed,
communication started; relationships
were built.
Caregiver Observations
Recently, a resident living with his wife, at our Thalman Square
residence (dementia-specific assisted living)needed to
temporarily transfer to our rehab unit. The household
coordinators set up Skype sessions for the couple. It was very
touching seeing them talk to each other when they couldn’t
physically be together.
When a Resident is feeling anxious , our Caregivers will sit with our Resident and give
that 1:1 attention that they need. With the IN2L, Caregivers have something that could
help the Resident focus on something else rather than the thought that was making
them feel anxious. This has reduced our anxiety medication input.
Games
Galore!
Lessons Learned
Don’t under estimate your residents
– Identify and try different approaches
• for some residents it’s playing games, for others, its
communicating with family or friends.
– The adaptability that technology provides offers residents
numerous opportunities to stay engaged
Lessons Learned
Find your champions at all levels
– Engagement is better established when staff throughout the
strata of the community are engaged
– Trying to drive a project like this purely from the top down
can present avoidable challenges and resistance
Advice To Share With Others
Technology is a means to an end—of providing residents
with a customized experience and engaging staff
– The project’s primary focus is the interaction of caregivers
and residents
– We strive to implement tools that allow us to continue
developing an organizational foundation that supports a
relationship-centered way of living and caring for all our
residents and staff
– Although a technological intervention is at the heart of the
project, this is so much more than just about bringing
hardware to the community
Advice To Share With Others
Involve all stakeholders to encourage better communication
and gain support for an empathetic approach
– The technology we’ve implemented stimulates and facilitates
new means of communication, interaction and care delivery
– The technology has enabled the creation of new connections and
strengthened existing relationships—between staff and
supervisors, staff and volunteers, and most importantly, between
caregivers and residents and their families
– The technology is not meant to replace caregivers, it was put in
place to help them find new ways of communication and
increase meaningful interactions
Advice To Share With Others
Ensure that staff and family understand the focus of
project
– We provide training opportunities to all new staff and
family members
– We are in the process of creating a booklet for family
members that explains the location of the systems within
the community and basic navigation information
Wrapping Up
• Engagement is no longer a novelty, becoming
market expectation
• It’s not about aging, its about staying
connected