I had a conversation with a leadership team recently that was incredibly frustrated by the initiative being taken by aides in the building. The complaint was that they were sitting around at the nurse’s station when they weren’t busy with cares. Leadership wanted them to be engaging with residents. But in most traditional nursing homes, this is not what CNA’s understand as their job. To get to this place we have to create a culture where engaging with residents is everyone’s job. Continue reading “Four Ways to Build the Culture You Want to See in Your Senior Community”
Enjoying and appreciating music may still appeal to persons living with dementia, but music may offer a lot more than pleasure: a connection to memory and emotional expression that might not be otherwise accessible. Read these simple but powerful stories to be reminded of the myriad ways we might incorporate music into daily life, to both entertain and ENGAGE!
The following story is from The Piper Assisted living and Memory Care in Kansas City, KS. Steve Harman, a Household Coordinator, is working on his CNA, and during a recent clinical at another community, he had this great experience.
Bologna Song Whets one Appetite!
Recently I spent a few hours with Mrs. B., who has pretty severe dementia and is known for not eating her meals. Usually when Mrs. B. sits down to eat, she is “full” before the meal is even served. The more people try to get her to eat, the more she refuses to eat. My experiment was to ask her about anything but her meal. My niece and I used to sing songs at the dinner table, which kept her from getting bored, so I tried this with Mrs. B. “Mrs. B., do you know any songs?” She replied, “Yes, all of them.” That being the case, I chose a musical masterpiece, the Oscar Mayer Bologna song. “Mrs. B., do you know this song? My bologna has first name...” She sang back to me, “it’s O-S-C-A-R!” “My bologna has a second name…,” I sang, and she replied with a full mouth. She had taken a big bite of food! So I patiently went through all the songs I knew the words for (5 commercials, Jessica by the Allman Brothers, and You Are my Sunshine). Somewhere in the middle, Mrs. B. started making up her own songs about the food on her plate. One was the word Gravy sung repeatedly to the tune of Happy Birthday. Another was a song about how good vegetables would be if they were cake. When she finally finished, she had consumed half of her plate, doubling her intake from the last three meals combined. Throughout this experience, she would occasionally ask to be taken to the front of the room where people congregate to watch television and other things. That was when it occurred to me: Mrs. B. was bored. She never asks to go home, or simply to leave the facility. She wanted to go to the front of the room because that’s where she can be entertained. I took her to the area where a volunteer had started playing guitar. On our way up there, I overheard one of the staff say, “I’ve never seen Mrs. B. so lively or excited like that. She seems to be excited about music.” I’ve only spent a small amount of time with Mrs. B., but several people have informed me that this was very different from her usual behavior. She was deemed difficult or grumpy. This was such an encouraging experience.
Shared by Stephen Harman, Household Coordinator
The next four stories are from WindsorMeade in Williamsburg, VA
The Tide is Changing….
A few weeks ago I worked on an evening shift as a CNA on the HealthCare unit. When I came on to the shift, which wasn’t my regular shift or job duties, I was very task oriented. I was focused on what needed to be done: who needs vitals taken, who gets a shower, what time is the meal, etc. After dinner I went to give a shower to one of our residents. The resident, Mr. W., was not happy about me interrupting his evening; he was quite happy just flipping through his magazine. This resident usually doesn’t speak words, and if he does speak them, it is normally just a few that don’t make a complete sentence. Many times he communicates only with sounds like bee-bops. It had been a few days since his last shower, though, and he needed one. I was too focused on what I had to do next and the tasks of the evening, but then I just stepped back, looked at his blue eyes and smiled. The tide had changed… I started singing “ I got the whole world in my hands….” He started humming and by the third verse he was singing with me, teary eyed. I have never heard him sing before. Then I quickly thought about what other songs he might know. So I started singing Amazing Grace, and he began singing with me — and we sang all the way to the shower. We sang during and after his shower until he was all clean, dry and cozy in his pajamas, under his warm blankets and off to sleep.
Shared by Angela Peay, LPN, AL Nurse Manager
Working in the Health Care dining room, I have had the pleasure of witnessing many beautiful moments. This one brought tears to my eyes.
Mr. D has both memory and hearing loss. His wife, Mrs. D, is an independent living resident, and comes to visit him regularly. I have heard her say many times that she knows he recognizes her as his friend, but she isn’t sure if he remembers the life they made together.
Recently, WindsorMeade installed a new piano and placed it in the resident lounge next to health care dining. On the weekends, we have volunteers come and play the piano during lunch and dinner services so the residents get to enjoy music while they dine.
A few weeks ago, Mr. D was already seated in the dining room and Mrs. D was walking up the hallway to join him. The pianist was playing a song that I don’t know the name of, but Mr. D certainly did. As he listened to the music, he stood up and called Mrs. D out by her nickname. I had never before heard him call her by any name at all. As she answered him from across the room, she stopped, looked at the pianist and said, “They played this song at our wedding 65 years ago.” As they hugged each other, it was obvious that in that moment of clarity brought on by a familiar song, he knew exactly who she was.
Shared by Brian Eck, Health Services Dining Supervisor
Happily Lost in Music
I worked upstairs today in the HCU and ALU areas for the first time again in about two weeks. During lunch, a woman named Mrs. Kathy came in to play the piano. She started in the HC dining room and ended in the AL dining room. In HC, a few of the residents nodded their heads as she played. Mr. W. was one who stood out to me the most. He was nodding his head with his eyes closed, tapping his feet, and lightly tapping a fork on the table, enjoying the music. To be quite honest, I haven’t seen him this happy in such a very long time. His mood nearly brought tears to my eyes — tears of joy that is. Mrs. Kathy’s music generated so many smiles today that I asked her to return to us soon and to come more often.
Shared by Marquera Delk, Lead Server
Music Makes the Body Move
One of our residents loves music! Whenever he hears music, he is clapping his hands, moving his feet, and sings a long. We have purchased an Ipod shuffle for him and have downloaded music (Elvis is one of his favorites) onto the device. Family members have also brought in CDs for us to download music. Throughout the day, we give the resident his Ipod and he absolutely loves it! When he hears the music come on, he gives you the biggest smile and hug. When you walk onto Healthcare you will see him with his Ipod just dancing away. We are in the process of becoming “Music and Memory” Certified, where we will receive Ipods for the residents to listen to their preferred music. When that happens, I will sing, dance and clap, too!
Shared by Caroline Kaliris, Recreation Therapist
Dancing: It’s not just for feet!
The following story is from Uniting Wontama Orange in NSW, Australia
Love for Dancing Remembered and Shared
Last Friday evening we held our Annual Cocktail party with the theme of ‘Mad Hatters’. All of our residents across the site were invited along with their families and participated in making a hat to wear. We had a wonderful turnout and brought many smiles to many faces. We also had our Old Time Dancers come along and dance for and with our residents. It was heart-warming to see our residents enjoy themselves so much, and to watch those people who either have limited mobility or changed cognition ‘come to life.’ Once the music and dancing started, a gentleman who faces some of the more challenging aspects of living with dementia, was on his feet and danced the night away. The conversations that were possible with him during this time were both insightful and emotional, especially his ability to talk about his love for dancing in his younger days. An important objective we have been working towards focuses on making every moment count, even in the smallest of ways. This felt like a big success.
Shared by Helen Mobbs, Service Director
This sound of life – music – is SO IMPORTANT for us all. The common thread in these stories is that someone took the time to notice. The observations shared and then more people notice and are encouraged to provide music, share in the joy of music, or use it to help someone feel better and/or engage in a way they might not otherwise. So go out and look, listen and find ways to share music with those folks you serve. You will make life better in big and small ways, as Helen says above!
A recent episode of “Brain Games” featured a social experiment on human behavior. They staged a waiting room where everyone (except one person, the subject) was instructed to stand up every time they heard a beeping noise.
After only a few beeps, the subject began standing up with the rest. She was not rewarded or instructed to do so, but she did it anyway. Slowly all the other participants left the waiting room, leaving only the subject. She kept standing at the beep. Then as new subjects entered the waiting area, all but one person mimicked her behavior and stood at each beep.
We humans are funny creatures. We have a natural tendency to go along with the crowd. Perhaps wanting to fit in is a survival mechanism, or maybe it is a social thing. Regardless, the fact is that even without logical reason we will conform to the environment and behaviors around us. We see it in residents demanding clothing protectors, even thought they never used them before. We see residents head back to their rooms after the evening meal and, at the call light, race to go to bed even though they used to enjoy staying up in the evenings. Could this be an anchor that has held long-term care in its institutional mindset?
Doing what everyone else does is a powerful human trait, but maybe we can use this tendency to create positive change. If people are so strongly driven to replicate the behaviors they are exposed to, then let’s give them some positive behaviors to grab ahold. And this goes for staff, families and residents alike. Look at an objective in your daily environment. What behaviors are mimicked by others? Are they positive ones? Are we building people up or tearing them down? The good news I see in the Brain Game experiment is that even when just one person exhibited a behavior, those around joined in. So it only takes one person to get something positive started.
We have the opportunity to use this human trait to make change, to plant seeds for positive behaviors and actions. If those around join in and behave the way we behave, then we can be a catalyst for change. However, we must be very consistent and aware of how others see us. If we are positive and supportive sometimes, and grumpy and talk about others behind their backs at other times, which behavior will others most likely repeat? Try playing some brain games of your own, and present those around you with positive behaviors. At the same time be very conscious of any negative behaviors you may be conforming to and speak up about them.