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Today’s blog article comes from the desk of Barb Gabriel-Conley, MS CCC/SLP. Ms. Gabriel-Conley is a speech language pathologist, specializing in the treatment of memory and cognitive disorders at Santé of Chandler. Santé of Chandler proudly provides short-term inpatient rehabilitation care for the Chandler, AZ community.
“There is a fountain of youth: it is your mind, your talents, the creativity you bring to your life and the lives of people you love. When you learn to tap this source, you will truly have defeated age.”
― Sophia Loren
Ahh the golden years! Those years where life is supposed to be easier and filled with the luxuries of plenty of time to putter and tinker; time to cook and shop; time to have lunch with the ladies from the club; time spent golfing whenever you please ,and of course, plenty of grandchildren sitting on your lap.
But the truth is, nobody likes to write stories about the challenges that come with the golden years; fixed incomes, joint replacements, cataract removal, the dreaded colonoscopy and age related “memory loss.” The truth of the matter is that many of the things on the “Not-so-golden” list are things that we have little control over. The silver lining however, is that memory loss and the early changes in cognition that older adults are beginning to recognize, are amenable to many treatments and therapies. The key to treatment and management however, is early recognition and diagnosis of these memory and cognitive changes.
The misconception that memory loss as we get older is “normal” often leads to delayed diagnosis and treatment. In recent years, extensive research and study has been conducted in the area of memory and cognition, and the overwhelming evidence suggests that memory loss and cognitive changes are the early signs of a pathological change. But before we run into the streets in a panic because we can’t find our car keys, it is important to recognize that these ‘early’ signs of memory and cognitive change, can afford individuals an opportunity to do something about it.
As a speech language pathologist, I often treat individuals who are experiencing changes in their cognition and memory skills and as a result are having difficulty managing complex daily activities (managing the checkbook, managing medications, driving, etc.). The good news is that if recognized early and with a little moxy and motivation to address these changes, often cognitive rehabilitation and pharmacological support can help to ward off and slow down the deficits associated with changes in memory and cognition.
The bottom line is this: If you don’t use it, you lose it. For more information on Cognitive rehabilitation, please visit our website www.santechandler.com or feel free to come in for a tour. We’d be happy to tell you about our memory and cognitive rehabilitation programs!
Infinity Rehab recently faced a seemingly insurmountable task. Our partners, Prestige Care, Inc., recently acquired eight skilled nursing facilities in Oregon, Washington, and Idaho. In addition, two new Infinity outpatient clinics were scheduled to start in Washington. Now, this might seem like a simple transition of services for a rapidly growing contract therapy company that handles sub-acute and outpatient rehab for over 170 facilities across nine states. However, the nature of the acquisition and outpatient clinic start-ups required that our services were to be in place within a month.
We were up for the challenge. Our recruitment department worked diligently to retain a high percentage of existing staff while filling new positions for Physical, Occupational, and Speech-Language therapists. Approximately 75 new full-time, part-time, and on-call staff was hired on in addition to our normal increase of therapists at other rehab teams. Our HR team tirelessly processed each new hire, ensured compliance and made it a smooth transition into our family of therapists.
Computers and therapy equipment were deployed in a timely manner. Training sessions were scheduled and executed to bring new staff in line with Infinity Rehab corporate standards and processes. Our entire support staff worked very hard to ensure each new facility had the resources in place so residents and patients would continue to receive treatment and care.
The hard work paid off. Not only did we gain the trust of new clients, but also our new team members were thoroughly pleased with the effective and efficient transition. Here is just a sample of what they had to say:
“Thank you for all the support!”
“The transition was organized and we had all our staffing needs covered.”
“I appreciated the detailed communication and knowing what to expect the first two weeks!”
“The transition process on day one was hectic. The staff completed patient care, plus received training and shared their space with new people. I thought the overall training was great. The trainer was well informed and pleasant to work with and had answers and/or knew how to get the answers to our questions. The trainer left me with several contact people and phone numbers. In the long run, this was a pleasant experience and I am looking forward to my position with Infinity.”
“Having so many familiar people helps me to feel like part of the team and family much quicker.”
Infinity Rehab has faced many challenges over the 13-years since we began offering sub-acute and outpatient rehab services. Our ability to meet those challenges head on, exceed the expectations of our clients, and continually provide a high level of care to those we serve has been a cornerstone of our business. It is with the dedication of our home office staff and every one of our therapists in the field that we continue to grow and succeed. We look forward to the next big challenge.
Angus Brown, Infinity Rehab Regional Sales Director, Joins the Washington Health Care Association Future Leaders Program
Infinity Rehab would like to congratulate Angus Brown, Regional Sales Director, for being chosen as a member of the Washington Health Care Association’s Future Leaders Program. The WHCA Future Leaders Program is comprised of eight
healthcare professionals that have been diligently selected from the three primary constituency groups (Assisted Living, Skilled Nursing, and Associate Business Members) and WHCA’s Women in Long Term Care Committee. Members have been identified for their passion and commitment to improving the quality and standards of care in the State of Washington.
2012 marks the inaugural launch of the Future Leaders Program. Its core mission is to prepare future leaders of both WHCA and the healthcare industry in Washington to anticipate change and to successfully advocate on behalf its constituents. The program consists of quarterly meetings and annual courses where members take part in a multitude of curriculum.
Angus Brown says he is deeply committed to improving the health care industry and long-term care services for seniors in the Pacific Northwest. “I think this is a terrific opportunity for me. Being a part of the Future Leaders group will give me the chance to truly make a difference.”
For over fifteen years, Angus has accumulated a unique managerial skill set by leading teams in a multitude of fields; including medical staffing services. His professional achievements and team-building credentials are highlights in his prominent success story. Angus is a frequent moderator and guest speaker at professional events. His passion for coaching and mentoring others has greatly attributed to the continued growth of Infinity Rehab.
LYNDEN – The Christian Health Care Center has partnered with health Ministries Network, an extension of PeaceHealth St. Joseph Medical Center, to provide complimentary healthcare support to senior citizens recovering from injury or illness.
Representatives of both organizations worked together to develop the customized care transition program that helps patients return home as safely as possible after receiving medical treatment. The new program is modeled on the work of Dr. Eric Coleman, professor of medicine at the University of Colorado.
“Studies have shown that providing additional support during transition times can reduce the chances of re-injury and re-admittance to the hospital by up to 30 percent,” said Dick Cathell, administrative liaison of Health Ministries Network and St. Joseph Medical Center.
Eligible patients returning home from CHCC’s rehab program are offered the opportunity to receive personal visits from Faith Community Nurses, including one at the healthcare center prior to discharge, one in their home and several phone calls over the next three to four weeks.
FCNs are professionally registered nurses. They help patients and their loved ones advocate for their personal needs, monitor the recovery process, prepare for follow-up visits with medical professional, navigate the complicated health care system, and provide support with medication management.
“Christian Health Care Center is an early-adapter when it comes to preventative health and wellness. They are currently the only care facility in our region that offers free transitional support. While unique now, we believe care centers across the nation will soon offer programs like ours to their patients,” said Cathell.
To learn more bout care transition services at Christian Health Care Center, visit chcclynden.org or call social services at 360-354-4434.
Today’s blog is a continuation from last weeks Bring on the Green! Horticulture and Therapy. Cathi Lamoreux, CCC/SLP – an Infinity Rehab Director of Rehab – oversees rehabilitation services for several therapy departments in the Spokane, WA area. Cathi also has a certificate in Horticultural Therapy and is always finding ways to integrate creative therapy techniques to better suit individual patients. Recently, she has introduced horticulture into her sessions.
It isn’t really hard to figure out how to incorporate healthy gardening and nature activities into your practice. As with any activity, the hard part is often the prep prior to the session, accessibility, having the time to gather supplies and set up the activity, engaging others to help with transport, clean up and the list goes on.
I find that the pressures of productivity often cause us to become less creative and to stick with our tried and true exercises and activities. It isn’t that we don’t want to introduce something new or more creative, it is just that there isn’t a great deal of time to even think up something fun, meaningful and unique.
To inspire you to make the effort, here are a few benefits of gardening activities:
• Exercise the eyes through visual scanning, seeing near and far, and improving special relationships
• Exercise hands, fingers, arms and upper body
• Motivate the resident to walk, stoop, bend, reach and maintain balance
• Gives mild to moderate exercise in coordination, strength, stamina and physical activity when frequently nothing else will
• Gives enormous pleasure through the senses; seeing, smelling, feeling, tasting and hearing
• Motivates residents to use adaptive equipment as needed
• Provides pleasurable physical activity for those with physical disabilities or sensory impairments who wish to enjoy gardening in any setting
• Increases orientation
• Exercises the attention span
• Gives practice in following directions
• Exercises the mind in terms of memory, logic and safety judgment
• Increases interest in gardening and the natural world
• Teaches new skills and techniques in horticulture
• Stimulates understanding such abstract concepts as time, growth, death and change
• Gives greater awareness of living things around us
• Promotes interaction by providing a common interest to discuss
• Improves social skills, self-esteem and confidence
• Gives practice in expressing opinions, formulating descriptions, asking questions, and exploring our sense of humor
• Helps residents learn more effective work attitudes and behaviors
• Motivates residents to work cooperatively with other people as a team
• Promotes healthy interdependence
• Lets residents explore horticulture as a hobby
• Lends itself to many social activities; clubs, garden socials, contests, special meals, cultural celebrations and parties
• Gives reason to go on field trips and getting to know the community better; garden-related businesses, greenhouse, nurseries, botanical gardens, parks and recreational gardens
• Increases self-esteem
• Provides opportunities to relieve tension, frustration and aggression
• Promotes interest and enthusiasm for the future
• Provides opportunity for creativity and self-expression
• Success-oriented activity builds a “can-do” attitude
• Satisfies some of the client’s needs to be nurturing and caring
• Enhanced skills for greater independence
• Lifts the spirits of those who have little sense of purpose or hope through isolation and loss due to illness, accident, disease process, retirement or bereavement
Here is a list of some great ideas that will help you get started with bringing horticulture into your therapy sessions:
• Planting seeds for fast growing plants such as wheat grass, marigolds
• Flower arranging while reminiscing about past gardens
• Take a bird walk and ID birds (keep count, discuss habitat, note different colors)
• Read seed & nursery catalogs – find your favorite flower and tell why
• Plant indoor bulbs – amaryllis, paperwhites, hyacinths
• Make centerpieces for the DR tables or a resident’s room
• Tomato tasting
• Cooking with herbs
• Using herbs as aromatherapy
• ID cones
• Plant a container with colorful annuals and/or vegetables on a patio where it can be viewed
• Watering and weeding of containers and/or gardens
• Garden mobiles
• Garden Party
• Plant trivia – hold “did you know” sessions, challenge residents to recall one piece of trivia and tell their tablemates or roommates and report back the next day
• Make herbal or lavender pillows
• Herbs – Growing and cooking with herbs
• Make holiday napkin rings using vines, leaves and dried flowers
• Water indoor plants
• Make painted rocks
• Make plant labels for plants in the garden and/or containers
• Recite poetry in the garden
• Make Tussie Mussies
• Valentine’s Day crafts
• Watch a gardening show or video and ask/answer questions
• Tend bird feeders
• Make a water garden
• Watch butterflies
• Match pictures of flowers, birds and/or butterflies to the real thing
• Make potato prints
• Order spring bulbs from catalogs
Being there when we see a breakthrough smile of someone who is depressed, watch for the first time when someone stands following an injury, or hear an aphasic resident speak makes it all worthwhile. Breaking out of our routines and trying something new is also rewarding as a therapist and reinforces why chose to do what we do.
As health care reform changes the landscape for acute and post-acute care, one of the first priorities is to reduce re-hospitalizations of Medicare patients. Up to 25% of patients discharged from Hospitals re-admit within 30 days. It is estimated that 75% of those re-admissions are avoidable with more attention to care transitions.
Infinity Rehab is assembling powerful resources to assist their clients in reducing re-hospitalizations. The first step is this: providing training for our clients on the Interact™ System.
What is INTERACT?
INTERACT (Interventions to Reduce Acute Care Transfers) is a quality improvement program that focuses on the management of acute change in resident condition. It includes clinical and educational tools and strategies for use in every day practice in long-term care facilities. For more information about the INTERACT tool, visit www.interact2.net.
Infinity Rehab will record a 2-part web training seminar on the INTERACT tool, available February 15th 2012. In-person training for our client facilities will be offered at our Northwest Symposium, March 11th at the Red Lion Jantzen Beach in Portland Oregon, and again on April 14, 2012 at the Holiday Inn in Rolling Meadows, Illinois.
For more information on either viewing the web training or attending the in person training, please contact us at 1-888-75-REHAB, or click here.
Wikipedia defines Telehealth as “the delivery of health-related services and information via telecommunications technologies.” Over the past decade, telehealth has been embraced by virtually all aspects of medicine – from dentistry to neurology.
About 4 years ago, Infinity Rehab encountered the following situation: A lone therapy department, located in Washington State, was primarily staffed by a Physical Therapy Assistant (PTA). The issue with this is that in the state of Washington, every patient needs to be seen by a Physical Therapist (PT) every 5th visit for a formal assessment of the patient’s rehabilitation progress.
We were having a difficult time finding a PT to complete the 5th visit on a consistent basis. One solution was to pay a Washington licensed PT from Oregon to drive up to the facility, complete the 5th visit and then drive home. This solution was expensive and wasted a lot of the PT’s time. The PT could have been administering care to a patient instead of spending hours on the road driving between therapy departments.
So, what to do? Tim Esau, PT and Director of Compliance, looked into the possibility of doing 5th visits via Telehealth. After researching various solutions, he contacted Global Media Group, Inc. regarding their webcam, speakers and software for conducting Telehealth visits. Infinity Rehab purchased the equipment and began testing how the remote visitation process would work.
Tim then approached the State Physical Therapist Licensing Board of Washington to get approval to conduct 5th visits via Telehealth. The State Board requested a demonstration and decided (after months of Tim working with them) that the Telehealth approach to care satisfied the State rulings on 5th visits.
The way it works is the PTA brings the patient to the gym and calls the PT via Telehealth. Once the connection is completed, the PTA gives a synopsis of what is happening with the patient, what the concerns are, and the PT can ask questions or observe part of the therapy session that day. The PT then documents the visit and makes recommendations as needed.
- Compliance with state regulations for 5th visits.
- No drive time/expense for therapist
- Therapist can work on other jobs while waiting for the visits to occur
- Therapist can talk to the patient and visualize activities if questions arise (stand up, walk, observe a contracture, etc.).
- Therapist cannot have hands on with the patient
- Patients who are bedbound cannot be seen, as they need to come to the gym/office where the webcam is.
- Cannot bill for therapist’s time (we are working on this but the PTA’s time can be billed because the patient is there and are discussing the patient’s progress).
Infinity Rehab has been successfully conducting 5th visits via Telehealth for about 3 years now for multiple facilities throughout Washington. Two Physical Therapists are currently trained on the aspects of Telehealth: Tim Esau and Joan Brassfield. This is an exciting development in therapy and Infinity Rehab looks forward to expanding this program as the need/opportunity is found.
Infinity Rehab was named “Business Partner of the Year” by the 2011 Oregon Health Care Association, the state’s largest association of providers of skilled nursing, assisted living, and senior housing services. “This is a great honor to have and a testament of our dedication to upholding our integrity, continual innovation, and exemplary service for our business partners,” said Mike Billings, President of Infinity Rehab. Below is an excerpt from the OHCA awards ceremony:
“Infinity Rehab continuously demonstrates dedication and commitment to the facilities and communities that they serve. The exceptionally qualified staff makes the difference by combining skill, practical expertise and a motivating attitude that results in positive outcomes and newfound hope for residents & families. Infinity Rehab’s superior caring services far exceed expectations and repeatedly contribute to the success of their patients. This in turn, facilitates hope and ultimately the transition to a better quality of life.
They are consistently scoring high marks on satisfaction surveys, receiving positive feedback and recommendations from residents and their families. There is almost weekly feedback from residents & families who rate the quality of services as “phenomenal” and “unsurpassed”. Infinity Rehab works above and beyond their duties as a contracted service provider. Each member of their team has a positive attitude and a strong work ethic.”
Infinity was nominated for this award by several letters from customer facilities, most specifically West Hills rehab, who named Sarah Shearer Smith, Senior Director of Rehab and her team of professional therapists.
We want to thank Sarah, the therapists at West Hills, and all of our therapists who work each day to improve the lives of our patients, our customers and our co-workers. You are all winners!
Infinity Rehab accepted over 120 students in six states this year for clinical internships! Maxwell Perkins, MS, OTR, Director of Clinical Services, says this speaks volumes about Infinity Rehab’s commitment to our therapists and their education. “Continuing education for our therapists is a cornerstone to how Infinity Rehab operates. Student internships are the beginning of that high level of professional education we provide.” Infinity Rehab has contracts with approximately 75 universities throughout the U.S. These clinical internships include PT, OT, PTA, OTA and SLP. We offer skilled nursing and rehab clinical internships as well as outpatient – all targeted at rehab therapy services for a geriatric population.
The goal of our clinical internship program is to provide students with an excellent learning experience by leveraging the clinical focus and resources of Infinity Rehab. At the start of the internship, each student receives a comprehensive Student Resources Manual, which contains a wealth of information that serves as a reference guide for not only the duration of the student internship, but well into their professional therapy career. The content contained in the packets range from cognition tests that can be performed with patients to therapy product reviews – with the majority of the content being written by Infinity Rehab therapists.
The internship is a time for the student to grow as a therapist and to experience how professional therapists present themselves in a clinical setting. A high percentage of students that enter our internship program end up starting their career’s with Infinity Rehab after graduation. Perkins sees that as a major positive for us. “The clinical internship program is a great asset for Infinity Rehab because bringing all this new talent into our ranks really keeps us fresh and on our toes with what’s happening in the therapy world.”
According to a recent report from the National Center for Health Statistics, 40 percent of visits to the emergency room (ER) by nursing facility residents were “potentially preventable.” With a heightened focus on reducing those preventable trips to the ER, one area that comes under scrutiny is that of medication management.
Self-administration of medication is an area that is frequently overlooked when attempting to reduce the amount of preventable trips to the ER. Often, elderly clients have several physicians and specialists who all have prescribed one or more medications to manage chronic conditions.
Sometimes the sheer amount of medications can be overwhelming for a patient to remember proper dosages and correct dates and times to take certain pills. Being able to adhere to a medication regime independently will reduce de-compensation of chronic conditions and improve health maintenance.
The ability for therapists to gain insight into the cognitive deficits many patients exhibit is critical to providing quality patient care. It is necessary for therapists to assess a patient’s ability to manage administration of their medications safely and accurately in order to assure a safe discharge. One tool that assesses this area is the Medbox Medication Assessment, which is part of the Cognitive Performance Test developed by Theresa Burns, OT.
The Medbox Assessment evaluates the patient’s ability to set up a weeks worth of medication using daily pillbox containers. They must follow the instructions on the labels of sample medication bottles. The assessment scores patients by the cognitive-functional level on the ability to interpret and follow medication labels along with being able to identify inaccuracies with the prescribed medications and how to correct the errors. The complexity of the task is adjustable to match the cognitive ability of the patient.
An example of the test is for a therapist to instruct a patient to follow the directions of four bottles of dummy medication and two pillboxes. The therapist then assesses the patient’s ability to accurately follow the instructions on the medication label. The test leaves some room for error, such as missing a single dosage, which allows for the patient’s care plan to be adjusted according to the level of adherence with the assessment. Results of the test are used to predict the performance of the patient’s individual regime by linking the cognitive ability of the patient with the complexity of the patient’s medication regime. It helps identify what amount and level of assistance the patient will require for medication management once discharged. This information can then be presented to families and caregivers.
Maxwell Perkins, Director of Clinical Services, M.S, OTR/L, says The Medbox Assessment correlates with the Allen Cognitive Levels (ACL), which is the corner stone of Infinity Rehab’s cognitive performance assessments. Both the Medbox Assessment and the ACL are tools that help therapists gain insight into cognitive deficits someone may have and how that cognitive deficit affects them functionally.