Tidbit of the Week

  • Weekly Tidbit for January 21: Baby Steps Can Lead to Great Strides

    How often do you or members of your staff wheel residents up to tables for meals? As we think about simple ways to incorporate Function Focused Care into every day routines, especially for residents in wheelchairs, this is a great place to start…at the table.

    First, determine with staff which residents can self-propel to meals instead of being pushed. Choose a few residents to begin, and have staff give them extra time to get to the dining room. Be sure to encourage and praise these residents for their efforts and explain the benefits of this extra physical activity. Ask family members who come for meals to encourage their loved ones to self-propel as well. Sometimes it helps to stand next to the resident in their wheelchair and hold their hand as they self-propel. Talk to the resident about their day while walking together, and note that it’s nice to be able to look at them face to face while walking instead of standing behind them while pushing their wheelchair!

    Next, choose a few residents who are able to transfer with minimal assistance from one staff member. Have these residents transfer out of their wheelchairs and into regular dining chairs for at least one meal per day to begin. Explain to staff, residents and their family members why this is beneficial: transferring helps maintain lower body strength and therefore can help prevent falls; getting out of a wheelchair, even to sit in a different chair, can helps prevent pressure sores; and sitting in a regular chair can improve the sense of dignity for a resident, among other benefits.

    Start slowly…don’t pick one day to transfer everyone at once! Choose a few people to start with and go from there. Ask family members to assist by encouraging their loved ones, and encourage staff to spend a few minutes to do this. In the long run, it will help keep residents stronger and more functional, which saves time for everyone.

  • Weekly Tidbit for January 14, 2018: It's All About the Fall

    Anyone who has taken ice skating lessons as a child may remember the first thing you’re taught…how to fall. Teachers know you WILL fall, it’s just a matter of time. And if you know how to fall as safely as possible, you minimize your chances of getting hurt.

    So it isn’t such a stretch to think that teaching older adults HOW to fall may be a smart idea. After all, 1 in 4 Americans aged 65+ fall each year, and injuries and fatalities due to falls are increasing all over the world as the population ages.

    Here’s an article about something we wish we’d thought of—classes for falls. A recent article in the New York Times (see link below) describes classes in the Netherlands that use obstacles to help teach older adults how to navigate things like loose tiles and tricky ramps with 45 degree angles. After practicing how to avoid falls on the obstacle courses, students then learn the proper way to fall if they find themselves going down. This helps decrease their fear of falling, which is critical, since fear actually increases one’s risk of falling.

    Clink on the link below to read more about the classes and see great pictures from them:


    Do you know of any classes like these here in the U.S.? If so, please let us know! Perhaps this is something to consider developing here.

  • Weekly Tidbit for January 7, 2018: The Body Achieves What the Mind Believes

    We are delighted to announce the winners of our Holiday Photo Contest. Congratulations to Caritas House in Baltimore, Maryland! They sent a picture (see below) of their residents playing a spontaneous game of horseshoes. Their staff has won a pizza party. Keep up the great work and keep those residents moving!

    You may be familiar with the quote, “The body achieves what the mind believes.” During this time of year, New Year’s resolutions abound. Though resolutions often fall by the wayside by early spring, those who are successful have one thing in common: they believe they can do it.

    What do your residents believe they can do? Does your well-meaning staff tell residents to “Stay put and let me do that for you” or “Sit down before you fall!” or “Don’t walk by yourself…you might fall down!” Such statements, though well-intentioned, can condition residents to think they aren’t capable of doing things for themselves, or worse yet, make them fearful of even trying.

    Instead, consider using motivating phrases like, “ You can do it, I know you can!” or “You are looking stronger today, let’s give it a try.” Understandably, you may not want a resident walking alone if they are a high fall risk. But rather than telling them to sit so they don’t fall, how about “I’m glad you want to walk, Mr. Jones. I’d like to walk with you. Please wait for me and we can walk together.”

    This week, pay special attention to how you and staff speak to residents when it comes to performing activities of daily living and walking. Choosing encouraging phrases can make a big difference in their mindset—and in yours too!

    Have a great week!

  • Weekly Tidibt for December 24, 2017: Coping With Evening Agitation

    “‘Twas the night before Christmas and all through the house, not a creature was stirring, not even a mouse…” But perhaps, some your residents are?

    People with dementia often struggle with restlessness, agitation, irritability or confusion that can begin or worsen in late afternoon and early evening, and can continue into the night. Commonly called “sundowning”, this phenomenon not only affects the person experiencing it, but can leave staff and other residents feeling frustrated and tired, and impact their mood and ability to function the next day.

    According to the National Institute on Aging (NIA), possible causes for sundowning include confused sleep-wake cycles due to disease-related brain changes, being overly tired, hunger, thirst, depression, pain and boredom. Signs of sundowning may include increased confusion or anxiety and behaviors such as pacing, wandering or yelling. The NIA has some helpful suggestions for coping with and preventing sundowning.

    Some of their tips include:

    • Try to determine the cause of the resident’s behavior and address it.
    • If person becomes agitated, listen calmly to his/her concerns and frustrations and try to reassure the person that everything is ok.
    • Reduce noise, clutter, or the number of people in a room.
    • Distract the person with a favorite snack, object or activity. For example, offer a drink, suggest a simple task like folding towels, or turn on a familiar and fun TV show (not the news!).
    • Make early evening a quiet time. Play soothing music or encourage a family member or friend to call during this time.
    • Close curtains at dusk to minimize shadows and the confusion they may cause. Turn on lights to help minimize shadows.
    • Go outside (or at least site by a window) since sunlight exposure can help reset a person’s body clock
    • Participate in physical activity every day. This can be a formal exercise class, or simply going for walks and participating in self-care.
    • Keep naps short and not too late in the day.
    • Get enough rest at night.

    Sundowning can be exacerbated by serving coffee, cola or other caffeinated drinks late in the day; serving alcoholic drinks, which can add to confusion and anxiety; and too many activities during the day.

    Finally, if these approaches don’t help, a medical exam may be needed to rule out pain, a sleep disorder or other illness, or a medication side effect.

    We wish you all a happy and healthy holiday!

  • Weekly Tidbit for December 17, 2017: Educate Residents about FFC

    Now that your staff has learned about Function Focused Care (FFC) and its many benefits, let’s take a moment to focus on the residents. What do they know about Function Focused Care?

    One of the most common challenges to implementing this philosophy of care is resident motivation. We have found that teaching residents about FFC and its benefits can help increase their participation in activities of daily living and physical activity. If staff, families and residents are all “talking the same language” about FFC, then we can develop common goals and celebrate successes together.

    Consider having one of your FFC champions hold an informational session with residents to teach them about Function Focused Care. Your intervention nurse can help with this too. You may even decide to make one of your more active and outgoing residents a “resident FFC champion” who can help motivate fellow residents to attend exercise classes, go walking, etc.

    How about a contest for residents, such as who can participate in the most activities or reach their walking goals for a prize? Be creative and share your success stories and ideas with us.

  • Weekly Tidbit for December 3, 2017: Let's Get Moving...Are You Game?

    An interesting study published last month in JAMA Internal Medicine found that game-based interventions helped increase physical activity among families: http://www.bu.edu/sph/2017/11/10/families-move-more-when-exercise-is-a-game/

    In the study, families tracked their daily step counts using a FitBit or Smart phone app. Those in the intervention group who were tracking their steps took considerably more steps than those who were not tracking steps. After the 12-week intervention ended, though physical activity decreased in both groups, the intervention group who originally tracked their steps were still taking more steps than the control group. The study incorporated goal-setting, performance feedback, a point-system (points were taken away when a selected team member’s goal wasn’t reached for the week), rewards when a certain level was reached, and support from family members.

    With the holiday season here and more families and friends visiting your residents, consider forming some teams and creating friendly competition to keep everyone moving and in high spirits—and good health—for the New Year!

  • Weekly Tidibt for November 26, 2017: Holiday Shopping List

    Since the holiday season has begun, many of us are making our shopping lists. We know that finding the perfect gift for a loved one who is older can be challenging, so we’re passing along some ideas. Of course, we encourage gifts that promote exercise and independence! Below are some ideas (we’ve also attached a holiday flier with these ideas to include in your mailings to families or hang in your facility) along with links to websites where these products can be found:

    Happy shopping, and most importantly, we hope you and your family have a safe and joyous holiday season!

  • Weekly Tidbit for November 19, 2017: Turkey Dance!

    Turkey Day is almost here, so we thought we’d have some fun and share this cute song and dance with you:

    Turkey Dance: The Gobble!

    Play it for your residents to get them to DANCE, DANCE, DANCE for a few minutes each day this week!

    Another trick: How about making your residents who like to sit (but who you know can stand) stand up to give you and other staff members some big holiday HUGS....maybe even a few times each day this week? They will be doing “sit to stand” exercises that are great to maintain leg strength, but they’ll be focused on giving and receiving a warm embrace.

    Have a happy and healthy Thanksgiving!

  • Weekly Tidbit for November 12, 2017: Short Bursts of Activity Can Have Long-Lasting Effects

    Now that Autumn is here, lots of us are watching our favorite football teams play their game. Just as football players exert loads of energy in quick, short plays on the field, older adults can enjoy shorter bursts of activity as well. Longer duration exercise options (such as an exercise class) can be intimidating for some residents who don’t like the idea of formal “exercise”.

    Here are some ideas for 10-minute bursts of activity to help your residents incorporate physical activity throughout the day:

    • Dance, dance, dance…turn off those TVs, put on some tunes and dance! Usually about 3 or 4 songs will take 10 minutes. To make it interesting, have a dance competition, and whoever dances the longest wins. Have staff take turns picking some of their favorite dance songs to play to engage them as well.
    • Walk…if you have pedometers, have residents set daily walking goals with friends. Those in wheelchairs can self-propel. You can also map out 10-minute walks within your facility, ideally with a destination area for walkers (e.g. get a cup of coffee at the café, or see a lovely plant or garden).
    • Clean your room! Encourage residents to dust their rooms, sweep floors, etc.
    • Toss a beach ball with other residents while discussing news of the day.
    • Grab those foam noodles, free weights or resistance bands…are they tucked away in a cabinet somewhere? Do they stay in the physical therapy room? Pull them out and sit them by the televisions and outside the dining rooms. Encourage residents to do exercises while waiting for meals to be served or while watching TV.

    Motivation is always a big factor—everyone needs a little extra push. Remind and encourage your residents to do these spurts and do them together! You can also share with them the results if this recent study, which showed that older adults who exercised regularly, especially by walking, had more success in recovering from a disability:


    When a resident engages in activity, especially someone who hasn’t done so in the past, acknowledge their effort with a hug or an extra few minutes of attention. This can go a long way. Families often know best what motivates their loved ones, so communicate with them and let them help with encouraging their loved one too.

  • Weekly Tidbit for November 5, 2017: The Time Crunch

    This week we’ll address a common concern among busy assisted living staff…the TIME CRUNCH! With an endless list of things to do each day, who has time for Function Focused Care?

    But consider this: Function Focused Care(FFC) is not something we do in addition to care. It is not simply one more thing added onto the bottom of your list. Rather, it is how care is provided and incorporated into everything you do with a resident. With a little bit of practice, FFC will become a habit that fits into the daily routine of you and every caregiver at your site.

    For example, when you are getting someone up in the morning, you can evaluate range of motion and strength as they get dressed. Test them a bit by leaving something they may want such as a brush up on a higher shelf than it normally is. See if they reach up to get it. When you are walking to the dining room, observe their balance and gait. Watch for how steady they walk. Do they grab furniture or touch walls?

    Once you determine their capability, focus on what a resident is able to do, and give them the opportunity to do it. You may be surprised by what they can accomplish with a little encouragement. Let them wash their face while you wash their lower body, ask them comb their hair while you get their clothes out, have them self-propel in the wheelchair instead of pushing them to meals and activities. Not only does this help with strength and range of motion, it can save you time too!

    In terms of goals, pick one resident a week for whom to develop short and long term goals. Get residents and their families involved in goal identification and motivation strategies. A goal might be walking 50 feet so they can get to the dining room to sit for a meal, getting out of a wheelchair and into a regular chair for meals, or doing 10 sit-to-stands a day to help prevent a fall or be able to get up off the toilet by oneself. Setting goals and learning what motivates each resident requires sharing ideas and testing stuff out to see what works…what’s realistic. Be creative!

    Finally, think for a moment about the many physical and psychological benefits of function focused care, including maintaining the independence and dignity of residents. We are confident you will agree that spending a few minutes with your staff to teach them how to evaluate residents’ capabilities, setting a few simple goals for residents, showing them how to use the “hand-over-hand” technique for residents who need assistance with grooming and feeding, and brainstorming ideas for motivating residents is worth all of the benefits that the residents—as well as staff—will ultimately enjoy. We are here to help you with this process and look forward to sharing your success stories throughout the coming year.