| Dear Debbie: By Debbie Hommel, BA, CRA, ACC, Executive Director of DH Special Services |
| For more Dear Debbie: Visit her ARCHIVES |
| Updated 28 JUN 2008 |
ABOUT DEBBIE Debbie Hommel, BA, CRA, ACC, is the Executive Director of DH Special Services. She is a Certified Activity Consultant on State and National level, with over twenty-seven years of experience in providing direct care and consultation to long term care, medical day care, assisted living, and ICF/MR facilities throughout New Jersey, New York, Maryland, and Pennsylvania. She is an experienced trainer and workshop presenter, conducting a variety of seminars throughout the Tri-State area for the Activity Professional, Administrator, and allied healthcare professional. Debbie Hommel is an active member of Activity Professional Associations on State and National levels. She is ACC certified through the NCCAP. She is a founding member of the New Jersey Activity Professionals' Association, serving terms as Vice President and President. She received the Weidner Lifetime Achievement Award in 1994 and the Monmouth & Ocean County Activity Professionals Life Achievement Award in 1999. |
| Have a question you'd like a professional Activity consultant to answer? Why not ask Debbie Hommel? |
| DEBBIE HOMMEL |
| Home ACTIVITY DIRECTOR TODAY by Linda Lucas, AD Activity Ideas That Work The original website of Gina Salazar, AD Debbie Hommel's AD Tips and Dear Debbie: by Debbie Hommel Executive Director DH Special Services Current Activities in Longterm Care Page by Kate Lynch, Editor of Current Activities in Longterm Care The Alternative Solutions Page by Sandra Stimson Executive Director Alternative Solutions in Long Term Care Silvana's Practical Insights by Silvana Clark, Professional speaker www.silvanaclark.com silvanac@msn.com The NAAP Page National Association of Activity Professionals The NCCAP Page National Certification Council of Activity Professionals The Print Shop The Home of Activity Director Monthly* & Your Free Facility Newsletter* Robert Lucas, HFA Editor-in-Chief Free PDF Downloads* Poems, Jokes & Such Resource Links Prayer Requests * Adobe Acrobat software is required. Get it free at Adobe Acrobat Nursing Home Activities Defined Activity Professionals' Shopping Page ACTIVITY DIRECTOR TODAY Providing Internet Resources for Activity Professionals in Long Term Care Settings admin@theactivitydirectorsoffice. com Copyright 2004-Present The Activity Director's Office All Rights Reserved Disclaimer |
| Questions & Answers |
| ACTIVITY DIRECTOR TODAY Providing Internet Resources for Activity Professionals in Long Term Care Settings admin@theactivitydirectorsoffice.com Copyright 2004-Present The Activity Director's Office All Rights Reserved Disclaimer |
QUESTION: Good Morning, Can you provide any information regarding Florida's
Activity Director's Association?
We currently have no contact information and as advocates for residents in long-
term care, we need to be able to share information regarding activities with the smaller
assisted living facilities within our state.
Any contact person or group within the Tampa Florida area would be greatly
appreciated.
ANSWER: I personally do not have a contact for the Florida Activity Association but
these are the instructors of the MEPAP. I would think they would have a contact for the
group as promoting professional affiliation is part of the course.
They should be able to tell you info about the Florida state activity association.
Good luck,
Debbie
_____________________
QUESTION: I live in Iowa and am planning to move to Florida. It has long been my
desire to become an activities director (for which an area community college used to
have a program for,but no longer has it). My question is, WHERE do I go to get trained
and certified and what are the requirements for the state of Florida in this area? I have
searched the web and have been very disappointed in the available information on
schooling. Schools advertise a program and then don\'t have it listed. Is training
required? Can I do an online program? Please let me know, as I am getting very
frustrated. Thank You for your time.
ANSWER: You can go to the NCCAP web site and they have all the instructors listed.
www.nccap.org and go to instructor page and then you would click on the icon for
Florida. They teach the MEPAP in Florida and there are several instructors who teach
regularly. If you contact them, they may be able to direct you to an appropriate
training. There are also several instructors on the instructor page who offer the course
on line which is another option.
Hope that helps and good luck,
Debbie
_____________________
QUESTION: I have taken the 40 hour activity course and want to know what is the next
step up the ladder from there. Where would i go for more training. Thanks
for the info.
ANSWER: I would need to know what state you work in to individually recommend a
course. But, if you have taken a 40 hour activity course - there is the MEPAP course
(an 180 hour course) for activity professionals which is nationally recognized. You can
find instructors of this course on the NCCAP web site. http://www.nccap.
org/about/educators/index.shtml
If there is not an instructor in your area, you can look into the independent study
programs.
If you are not interested in that, I would suggest looking into actual college
courses. If you are not nationally certified, you will need a minimum of 12 college
credits to obtain that, in addition to the MEPAP.
If you need additional information, feel free to email me back, Debbie
_____________________
QUESTION: I am a Activity Director, plus my other job duties include computer, office
duties & tenant social work. This is new for me and it has come to be over
whelming and i have a hard time not bringing it home with me. I have never
worked with seniors, but i just love providing Activities for them and the
rewards i get of knowing they are happy. This is the first time i have left
my 2 kids, ages 13 and 9 alone for a summer and that is causing sadness for
me as well. Any suggestions or comments?
Thank you
ANSWER: First, welcome to the world of elder activities. It kind of sounds like you are
working in senior housing rather than a licensed facility?
In any case, your concerns about brining work home, etc., are a common complaint of
many activity professionals. We have a hard time turning the job off. Most of us are
always thinking of things for our residents and programs when out shopping and at
home. In order to not burn out, you will need to make a effort to separate yourself from
your job when you leave the facility. If you are working with a higher functioning
population, possibly they could help with some of the tasks you have to do in preparing
and organizing. Possibly creating an "auxiliary" or volunteer corp would be something
the residents would be interested in.
Regarding leaving your children home - that is a tough one which all working parents
grapple with. Would your community allow for them to come to work with you a few
days a week to help with activities? They could easily call a bingo game or run a craft
group independently for sure. The 13 year old might be able to do some of the clerical
duties you mention?
If you need additional information, feel free to email me back and good luck, Debbie
_____________________
QUESTION: What are the federal guidelines for non-certified activity staff to document
in resident charts? I have staff that will be certified by the end of the
year, however they aren't currently. Should I be the only one to document?
Should I co-sign with their entries? Help! I work in a CCRC in Washington,
DC. Thanks.
ANSWER: The federal regulation states the assessment and care plan should be
completed by or "under the supervision" of a qualified professional which means those
individuals who do not meet the definition of a qualified professional can document
under the supervision of someone who does meet the definition. How you supervise is
a policy decision. Co-signing is one way to show you are monitoring content. I would
suggest creating a training protocol and checklist to verify you have trained your staff
to complete documentation properly. Each staff member who is involved in charting
would be oriented to documentation protcols and it would be documented. You could
co-sign each entry but that is not mandated. You could also to periodic chart audits
and QA's to ensure content is appropriate.
But, to answer your questions - No - you do not need to be the only one
documenting. You can train and supervise other staff. And co-signing as a means to
monitor would be a decision your facility/department would have to make.
Good luck,
Debbie
_____________________
QUESTION: Hello;I'm an Activity Director in Shreveport, Louisiana, I lost my original
certification. I have a bad copy of it, how do I get another one.
ANSWER: Do you mean your NCCAP certification? If you are referencing NCCAP, I
am sure they can give you a copy. Their web site is www.nccap.org If you are
referencing your basic activity course certificate, you would have to contact your
instructor. As an instructor myself, I have records of everyone who has completed my
course and I could provide them with a copy of their certificate if they lost it.
Good luck,
Debbie
_____________________
QUESTION: What are the requirements in New York State to be an Activities Director
in a nursing home?
ANSWER: hese are the qualifications, according to State NY standards.
(2) The activities program shall be directed by a qualified professional
who:
(i) is a qualified therapeutic recreation specialist who is eligible for certification as a
therapeutic recreation specialist by a recognized accrediting body on or after August 1,
1989; or
(ii) has 2 years of experience in an age-appropriate social or recreational program
within the last
5 years, 1 of which was full-time in a patient or resident activities program in a health
care setting; or
(iii) is a qualified occupational therapist or occupational therapy assistant.
If you have any other questions, feel free to email me back, Debbie
_____________________
QUESTION: I have several questions. First of all I'm new to finally joining NJAPA, (just
joined tonight), I'm extremely eager to get certified! I love my job and my residents and I
want to make a BIG difference in their lives. I have also signed up for your first home-
study course. Can't wait. My dearest friend, Stephanie G., who is in your Part 2 class,
has inspired me to go for certification. However, I did not finish college, I do have my
old transcripts. Yes, it's been quite a while. Does NCAAP accept my old transcripts
toward my certification? I now have the opportunity to start attending seminars, and
was curious, are all seminars/lectures toward CEUs points? Or, just the ones
mentioned they are?
Lastly, do you know how I could start my own branch of Mocap for Middlesex
county? I know a lot of people who would like to attend the MOCAP that Kevin runs, but
the meetings are too far for some to attend. If I start one in Middlesex county, I'm sure a
lot of Activity people would be extremely happy. I haven't been to one, (too far). What
do they do at these meetings?
Once again, thanks for all your help with these questions. Looking forward to
taking your first class in the Fall and your home-study course.
ANSWER: Hi, congratulations on taking your first steps toward being a career activity
professional. Obtaining national certification and becoming a member of professional
organizations is part of our commitment to the profession and what we do.
As far as your college credits go, NCCAP accepts them if you have an official
transcript from an accredited college or university. When selecting seminars to attend,
the first criteria is that they have to fall into the NCCAP body of knowledge which you
can find on page 8 of the certification standards which you can download and print out
from the NCCAP site (www.nccap.org) The second criteria would be to look for NCCAP
approved courses. Any independent study or on line coursework has to be NCCAP
approved for them to accept it. If you attend (in person)inservices or seminars that are
not NCCAP approved, they will accept it if it is within the body of knowledge and you
have a certificate siting information they require (sponsoring agency, speaker,
speaker's credentials, topic, location and number of hours).
As to your final question regarding initiating a professional group... I would
suggest contacting NJAPA as they might support you in developing a charter group.
There is also RADA in NJ which is a group in Union and other counties up north who
you might network with. However, to initiate your first meeting - simply contact a few
local facilities near you to see if there are a few other activity professionals interested
in starting the group. Then just sent out a mass mailing to all the nursing homes,
assisted living facilities and medical and social day care centers in your county.
You can start with an interest survey of sorts or just schedule a meeting and hope
interested people show up. If you have a guest speaker and offer people contact
hours for education, they might be more apt to attend.
Good luck and if you need more information, feel free to email me back.
Debbie
_____________________
QUESTION: Dear Debbie, i have been an activity director for 24 years and i love it.
with things changing i need information on culture change in nursing homes,
what are surveryers looking for. please e mail me some information. thanks
ANSWER: I really can't speak for Texas surveyors but here in New Jersey, the
surveyors are interested in individualized care. Culture change models focus on
person centered concepts of individualization, team approach and non-traditional
approaches to long term care. I have heard increasing emphasis on a holistic team
approach, where each staff member truly knows the resident and their life story. It is
no longer only the activity professional's job to know the resident as a person and meet
the individual quality of life needs of the resident. It is everyone in the building's job to
care for the residents as individual people, regardless of what the employee's
individual function may be.
So, my guess would be - the surveyors are looking for individualization,
adapation, specialized approaches based on need, and a coordinated team
approach in meeting those needs.
I have a few sites about culture change and specific models on my web site.
http://www.dhspecialservices.com/culturechange.htm
_______________________
QUESTION: I am the AD in an Assisted Living Facility. We have 65 apartments and our
current pop is at 54 residents. My question is this: what is average percentage of
residents that typically participate in activities? I am averaging 12% at most activities
unless it is a dance or bingo. Thank you for your help!
ANSWER: I honestly have no formal data to help us here. But, my gut opinion says
that your percentage seems a bit low. To work on your low participation, here are
some things to think about:
*Do you do any kind of interest inventory or resident interest assessment upon
admission. Although AL does not require it, the information is very helpful in
developing a program which is tailored to the interests of the residents.
* What do the residents say in Resident Council? Have you tried to see new
ideas here?
* What is your method for communicating programming to the residents? Some AL
activity directors visit the dining room during meals to talk up the morning or afternoon
schedules. Some places have the daily schedule posted just about everywhere -
elevator, table tops, dining room.
* How helpful are your caregivers in encouraging attendance at programs?
Maybe you need to meet with your nursing department and discuss strategies where
they can promote the daily schedule.
* Introduce incentives to certain activities. For exercise programs, introduce a
chart - tracking attendance and progress. You could end with a party after a ten week
session and give out awards. Have raffles and door prizes at random programs so
they won't know when they might be offered.
Hope that helps and good luck,
Debbie
_____________________
QUESTION: I work in a long term care environment, where we are seeing more sexual
intimacy issues come up, In speaking with family and staff my question is;
is it mandated by state that we provide them with materials such as
Magazines or Movies if they are asking or showing this behavior? Or would
you have another suggestion or avenue to explore? Thank you
ANSWER: The regulations do not specifically specify providing residents with that type
of material. The regulations state we need to provide interventions and approaches
which meet their needs and interests. If it is deemed appropriate that those sort of
things are of interest to the individual, they can be offered. If this sort of thing conflicts
with the values of the facility (such as a religious run home), the facility has the right to
say it is against the values of the home. In that case, the home itself won't offer the
items directly. If/when offering this sort of thing, it should be offered in private and by
someone who can objectively offer the materials. Before offering such items, the
resident's cognitive status and ability to make decisions needs to be assessed. If they
are competent, can make decisions and can review the materials independently and
privately, there is no reason why they cannot have them. However, if the resident has
some cognitive loss and/or use of the materials contributes to negative behaviors,
offering the materials would not be a good idea and suitable alternative diversions
should be found.
Hope that helps,
Debbie
___________________
QUESTION: i've been working in activities for 5 years (assistant) and now iin a new
Activity Director i love my work but i have
never been able to spread my wings before now. Prayed to get here now in
here and feeling very overwhelmed with the room i have to spread in.
(smile)help
ANSWER: Congratulations on your promotion! It is exciting to finally be in the drivers
seat and scary too.
My best advice is to take your time and create a plan. Possibly spend a few days
making lists of everything you would love to do - new programs, new systems, new
ways of doing things. Once the list is made, you can evaluate all your thoughts and
prioritize. If you are new to the facility, you will need to win staff over before you begin
changing things. Some people are resistant to change, even if it is a good thing. So,
you need to feel out the waters, so to speak - is the staff eager for change or quite
content in how they are doing things. I would suggest involving the residents in any
changes to the schedule and also involve the staff in some of your ideas.
Most people are more supportive if they feel part of the process. Good luck and feel
free to email with any questions as you go along.
Debbie
___________________
QUESTION: I am in Westport, MA and looking for a MEPAP summer course. I have a
BA in English/Elem Ed and a MA in Adult Education. The past 6 years I have worked
with severe/profound children K-12. Looking for a career shift. Thanks for any advice.
ANSWER: There are several MEPAP instructors listed for Massachusetts. I would
suggest you contact them to see where and when they might be conducting their next
courses.
Name City Phone Alt. Phone Email Category
Pamela Bailey Buzzards Bay 508-759-9355 pambailey@Verizon.net
Martha Campbell Shirley 978-448-1170 gcoa@TownofGroton.org
Ann de Villafane Gardner 978-632-5477 Ann.devilleafane@genesishcc.com
Judith M. McLernon Revere 781-284-4952 mclun@comcast.com
Roberta Moran-Letvinchuck Rockland 781-878-8872 bobbitravels@gmail.com
Sandra Sarza Swansea 508-379-9843 sandysarza@aol.com
Glory Wideman-Hughes Dorchester 617-436-2233 Good luck!
Debbie
___________________
QUESTION: Do you have any notes or advice on writing care plans for an Activity
Director in a Long Term Care facility?
ANSWER: Hi, I wrote several articles which can be found on the archives section of
this site.
http://theactivitydirectorsoffice.com/DebbiesADTips_archive200704.html
http://theactivitydirectorsoffice.com/DebbiesADTips_archive200705.html
http://theactivitydirectorsoffice.com/DebbiesADTips_archive200706.html
There are also a few good books which I sell from my web site.
Documentation in a Snap
http://www.dhspecialservices.com/documentationsnap.htm
Care Planning Cookbook
http://www.dhspecialservices.com/careplancookbook.htm
Dementia Care Plan Dictionary
http://www.dhspecialservices.com/dementiacareplan.htm
Hope that helps,
Debbie
___________________
QUESTION: I have been the Activity Director at a SNF in WI for 9 years, we are
recently starting a restorative nursing program (which I am happy about). I
have been asked that activities runs a restorative group above and beyond
any group of exercises we already do. The committee met a few weeks ago to
discuss what exactly my staff does a varied times of the day. (Mind you it
is a 107 bed NH with 5 part-time staff working 7 days a week). I was a bit
taken aback as I feel like my staff and department were being thrown under
the bus and someone even made a comment that all my staff does is sit
around. My staff is hard working and devoted. I told the committee that the
residents in restorative are welcome to come to any exercise group we offer.
But we, of course would have to do ALL the transporting, as no one else
helps us with that either (nor do any other staff run activities- besides
us---- and I know what you are thinking....I brought up the F-tags since its
conception...to no avail)!
. Do you know of any regulations or have any info on activities role in
restorative nursing??? I am a bit frazzled and feeling defensive of my
staff. Any insight???? THANK YOU.
ANSWER: To my knowledge, there are no regulations defining the role of activities in
a restorative program. My understanding of restorative programs is that they focus on
increasing functional ability and there is a tracking system.
I have worked with some facilities where activities and the restorative aides do a
combined exercise program and a restorative dining program. It may not be a matter
of doing an extra exercise group but just a matter of
altering your approach and tracking participation differently. Here is an
interesting article on restorative programs and person centered care.
http://www.kabc.org/pdfs/promoting-resident-centered-care.pdf
I do agree with you about it being a team responsibility, including getting people to the
program.
Good luck,
Debbie
___________________
QUESTION: Do you have any tic sheets that you have to do to chart on residents in ltc
to show there activity level each day and if so can i see one on how you set
it up?
ANSWER: I assume you mean "attendance sheets". Have not heard of the term "tic"
sheets. I have some attendance sheets which track participation in groups. They
have a code for response levels. I don't have it on my computer - would have to fax or
mail them. Email me back with an address or fax number, if you are interested in that.
Debbie
_____________________
QUESTION: I was wondering if anyone knows of a good website, or maybe you know
some activities off hand that can be specific for palative care/ hospice/comfort care
residents.
ANSWER: I have a whole section for end of life issues on my web site www.
dhspecialservices.com
http://www.dhspecialservices.com/endoflife.htm
A very effective approach is music thanatology - there are a few sites noted on my web
page. Using bedside harpists seems to be interesting.
Also, the web site - Bill Moyers - On our own terms is good and Crossing the
Creek is very good.
Hope that helps,
Debbie
___________________
QUESTION: My new administrator wants me to implement a restorative care 4:1
w/low-functioning residents. I am concerned about proper training,
documentation ect. Do you have any resources you suggest for ideas and
documentation forms. I understand properly implemented, it can be captured
on MDS. I enjoy spending time w/ these residents and find it a challenge in
my very hectic day. I only have 1 aid and want to make the best of my time.
ANSWER: I would suggest discussing this program with the therapy department and
the nursing director. I would think they should be a part of this program.
They would also be able to help you with tracking forms as they both use those sorts of
things. Restorative means a lot of things and needs to be clearly defined in the
program. When your administrator says restorative for the lower functioning? What
does that mean? What is his expectation? You also have to make sure what you are
doing meets the criteria for reimbursement. I have been involved with facilities who
have restorative exercise and restorative dining programs. The emphasis on these
programs has been adaptive equipment, level of participation, and tracking progress.
But, I am a firm believer in the team approach and that is where restorative programs
should be - a collaborative effort amongst the team.
Here is an excellent article on restorative care.
http://www.kabc.org/pdfs/promoting-resident-centered-care.pdf
Good luck,
Debbie
___________________
QUESTION: I just recently was hired on for a activities asst. job working with mostly
with Alzheimers,Dementia and Parkinsons residents. I will be making up a
calendar of events. I of course am brand new to this and would like some
info on which way to go. I will be eventually take the certification but for
now am just trying to figure out what to do with them. I want to provide
them with wonderful activities and do a good job. Can you help me or send me
in the right direction??
ANSWER: An effective way to program on memory support units is to develop a daily
routine such as beginning with a morning coffee with some discussion (basic
reality/weather/reminiscing - depending on level of functioning); followed by exercise or
active game; followed by mental type activity; followed by setting up for lunch with
music. An afternoon routine should also be established. The routines would depend
on the level of functioning of your population. Within the established routines, you
would do different activities which focus on the type of activity being done. For
example, if 11 AM is your active time - there are a variety of active activities that could
be introduced at that time frame. Routines are important but you don't want to fall into
a rut. There are many resources for programming on the internet. I have some listed
on my web site. This is the link for all the activity web sites that I have found.
http://www.dhspecialservices.com/activitysites.htm
This is my link for a lot of the dementia based sites with ideas and resources. http:
//www.dhspecialservices.com/dementiasites.htm
Hope that helps a little bit. If you have further questions, feel free to email me back.
Debbie
___________________
QUESTION: Dear Debbie, I was a CNA then I didnt work for about 12 months for the
birth of my daughter. My certification ran out...Do I need to ReTest or How do I
get it back?
ANSWER: I honestly do not know much about the CNA certification and I think it varies
from state to state. i would suggest you get in touch with your State Department of
Health as they are the ones who manage the CNA testing and such.
Debbie
___________________
QUESTION: Is it mandated for special care residents to have activities offered from
8:00 am to 8:00 pm 7 days per week? If so, is it the recreation department
that supplies these activities. Thank you,
ANSWER: To my knowledge, there are no regulations which state activities are
mandated from 8 AM to 8 PM. Most regulations say programming should be provided
according to need of the resident. I know there was a similar question in a previous
"dear debbie" letter. To answer the first part of your question - activities should be a
balance of active and passive stimulation, structured and unstructured programs, small
and large groups.
To keep anyone in non-stop activities for 12 hours is excessive for any
population. To answer the second part of the question - the federal guidance from
6/06 stressed the interdisplinary nature of activities. Not sure if you are a nursing
home or an assisted living, but the growing school of thought is that all staff are
involved in delievering the activity program or engaging the resident in individualized
group and 1-1 activities.
The recreation department may develop the programs, think specific approaches
up for each resident and organize the interventions. But, all staff can participate in
implementing the programs and approaches.
Hope that answers your question - if not, email me back, Good luck, Debbie
___________________
QUESTION: Hello i am having me first resident council meeting what are some things i
should cover?
ANSWER: Hi, I have an article on the ADO about Resident Council Management.
http://theactivitydirectorsoffice.com/DebbiesADTips_archive200610.html
That should answer most of your questions. If you need more information, feel free to
email me back, Debbie
___________________
QUESTION: any ideas for a lady in her 50's on long term isolation that doesn't have
many interests.Thanks
ANSWER: Even though this person does not have "many" interests - you could work
on the few she has. Not knowing what they are - it is hard to suggest specifics. The
other angle you can approach is her age and generation.
Music, trivia and discussion topics of that era might be of interest. You might also do
some leisure/recreation exploration with this person. Assess why she does not have
many interests - was it because of working, raising a family? Now that she has some
leisure time, possibly she could develop some new interests. Conducting an intensive
leisure inventory might find some activities she might be interested in developing. You
don't mention her functional ability either - so if she is able to do things - maybe she
could develop an interest in crafts, individual games and those sort of things.
With more information on her functional ability (vision, dexterity,
endurance) could offer more suggestions.
Debbie
___________________
QUESTION: What are the requirements in New York State to be an Activities Director
in a nursing home?
ANSWER: These are the qualifications, according to State NY standards.
(2) The activities program shall be directed by a qualified professional
who:
(i) is a qualified therapeutic recreation specialist who is eligible for certification as a
therapeutic recreation specialist by a recognized accrediting body on or after August 1,
1989; or
(ii) has 2 years of experience in an age-appropriate social or recreational program
within the last
5 years, 1 of which was full-time in a patient or resident activities program in a health
care setting; or
(iii) is a qualified occupational therapist or occupational therapy assistant.
If you have any other questions, feel free to email me back, Debbie
_____________________
QUESTION: I have several questions. First of all I'm new to finally joining NJAPA,
(just joined tonight), I'm extremely eager to get certified! I love my job
and my residents and I want to make a BIG difference in their lives. I have
also signed up for your first home-study course. Can't wait. My dearest
friend, Stephanie G., who is in your Part 2 class, has inspired me to go for
certification. However, I did not finish college, I do have my old
transcripts. Yes, it's been quite a while. Does NCAAP accept my old
transcripts toward my certification? I now have the opportunity to start
attending seminars, and was curious, are all seminars/lectures toward CEUs
points? Or, just the ones mentioned they are?
Lastly, do you know how I could start my own branch of Mocap for Middlesex
county? I know a lot of people who would like to attend the MOCAP that Kevin
runs, but the meetings are too far for some to attend. If I start one in
Middlesex county, I'm sure a lot of Activity people would be extremely
happy. I haven't been to one, (too far). What do they do at these meetings?
Once again, thanks for all your help with these questions. Looking forward
to taking your first class in the Fall and your home-study course.
ANSWER: Hi, congratulations on taking your first steps toward being a career activity
professional. Obtaining national certification and becoming a member of professional
organizations is part of our commitment to the profession and what we do.
As far as your college credits go, NCCAP accepts them if you have an official transcript
from an accredited college or university. When selecting seminars to attend, the first
criteria is that they have to fall into the NCCAP body of knowledge which you can find
on page 8 of the certification standards which you can download and print out from the
NCCAP site (www.nccap.org) The second criteria would be to look for NCCAP
approved courses. Any independent study or on line coursework has to be NCCAP
approved for them to accept it. If you attend (in person)inservices or seminars that are
not NCCAP approved, they will accept it if it is within the body of knowledge and you
have a certificate siting information they require (sponsoring agency, speaker,
speaker's credentials, topic, location and number of hours).
As to your final question regarding initiating a professional group... I would suggest
contacting NJAPA as they might support you in developing a charter group. There is
also RADA in NJ which is a group in Union and other counties up north who you might
network with. However, to initiate your first meeting - simply contact a few local facilities
near you to see if there are a few other activity professionals interested in starting the
group. Then just sent out a mass mailing to all the nursing homes, assisted living
facilities and medical and social day care centers in your county.
You can start with an interest survey of sorts or just schedule a meeting and hope
interested people show up. If you have a guest speaker and offer people contact
hours for education, they might be more apt to attend.
Good luck and if you need more information, feel free to email me back.
Debbie
___________________
QUESTION: I am a CNA at a nursing home. I am interested in becoming an activites
director. Where do I begin?
ANSWER: The first thing you need to do is find out what the requirements in your
state are for the position. If you email me your state, I can help you there.
Then, I would suggest finding a paid position within the activity department. Gaining
paid activity experience is required for certification and most state require experience
for the director position.
After gaining a position in the department, I would seek out the required training
course in your state. Most states have accepted the Modular Education Program for
Activity Professionals as the training program.
A gain, I need to know what state you reside in prior to giving you concrete
information.
Email me back with more details.
Debbie
___________________
QUESTION: I have been working in Activities for 10+ years. I have been an Activity
Director for 2 years. The residents have changed at the place I have worked
since I started and we are moving in more memory impaired residents in to
the community even though we have a memory unit. The memory unit is full.
This leads me to my problem. I am having a problem meeting the needs of the
memory residents. The higher functioning residents will go to many of the
activities we provide. Our memory residents are getting lost in the shuffle.
There are 5 floors in the building and residents get lost frequently. Meals
are always on the first floor activities are mostly on the second floor.
There are many of them that sit in the Lobby after breakfast and just wait
for lunch. I have tried to do activities in the lobby to target these
residents but it is noisy and distracting.
Help me!
ANSWER: It sounds like you work in an assisted living facility? The layout and the way
you say your residents are changing gives me that impression. In an assisted living, it
is hard to meet the needs of the cognitively impaired resident when they are mixed in
with the general population. If they are getting "lost in the shuffle", your facility should
be proactive in meeting their needs before you have some negative outcomes in terms
of behaviors, falls or leaving the building unattended. Possibly setting up a pilot
program on one floor where the caregivers would direct these memory impaired
residents to gather. A staff member would be assigned to this group, which should be
out of the hub-bub of the facility, where it is less noisy and confusing. They could be
offered a daily routine of familiar programs that could be tailored to their ability and
keep them suitably occupied and challenged. To accomplish this, you would need
space and a staff member to meet the needs of these residents. Many assisted living
facilities are facing the same challenge as you are. The population is aging and
coming in more impaired than when assisted living was first introduced. The assisted
living profession needs to be proactive and address these changing needs as they
occur.
Good luck,
Debbie
_______________________
QUESTION: I am a resident in RI. I am 51 years old and reentering the work force
after raising children. I am very interested in becoming an activities
director for the elderly. Where can I go for the best on line education?
There are so many programs and it is very hard to make an intelligent
selection. Any ideas?
Thank you so much
ANSWER: Welcome to the profession of therapeutic activities. It is an exciting and
rewarding profession. As far as on line education, I cannot say which is the best. The
NCAAP web site lists the approved instructors and should select from that group.http:
//www.nccap.org/about/educators/index.shtml You should contact each of the
instructors or instructing agencies to discuss the way in which the information is
presented as each is different. Some instructors have weekly chat sessions and have
other ways to get interaction amongst the students.
Others allow the students to complete the course independently. You also need to
identify your learning style and see how it will coordinate with the instructors method of
presentation. Good luck!
Debbie
_____________________
QUESTION: I have been working in Activities for 10+ years. I have been an Activity
Director for 2 years. The residents have changed at the place I have worked since I
started and we are moving in more memory impaired residents in to the community
even though we have a memory unit. The memory unit is full. This leads me to my
problem. I am having a problem meeting the needs of the memory residents. The
higher functioning residents will go to many of the activities we provide. Our memory
residents are getting lost in the shuffle.
There are 5 floors in the building and residents get lost frequently. Meals are always
on the first floor activities are mostly on the second floor. There are many of them that
sit in the Lobby after breakfast and just wait for lunch. I have tried to do activities in the
lobby to target these residents but it is noisy and distracting. - Help me!
ANSWER: It sounds like you work in an assisted living facility? The layout and the way
you say your residents are changing gives me that impression. In an assisted living, it
is hard to meet the needs of the cognitively impaired resident when they are mixed in
with the general population. If they are getting "lost in the shuffle", your facility should
be proactive in meeting their needs before you have some negative outcomes in terms
of behaviors, falls or leaving the building unattended. Possibly setting up a pilot
program on one floor where the caregivers would direct these memory impaired
residents to gather. A staff member would be assigned to this group, which should be
out of the hub-bub of the facility, where it is less noisy and confusing. They could be
offered a daily routine of familiar programs that could be tailored to their ability and
keep them suitably occupied and challenged. To accomplish this, you would need
space and a staff member to meet the needs of these residents. Many assisted living
facilities are facing the same challenge as you are. The population is aging and
coming in more impaired than when assisted living was first introduced. The assisted
living profession needs to be proactive and address these changing needs as they
occur.
Good luck,
Debbie
___________________
QUESTION: help!!! i cannot find out the exact regulations regarding back ground
checks on volunteers-we have high school kids who want to volunteer for community
service hours so, I'm not sure if i really need to do background checks or not. I am in
Washington state-any info you can give me would be really helpful! Thanks so much!
ANSWER: I honestly do not think there are any regulations stating volunteers need
back ground checks. That would be a facility policy decision. The regulations state
the residents need to be kept safe. How the facility chooses to do that, is up to them.
There should be some sort of facility screening of volunteers, regardless of age. With
high school age volunteers, I would think introducing a parental permission slip would
be appropriate as well as a referral form from their school. For that age group, that
would be enough in terms of monitoring.
Debbie
___________________
QUESTION: I am a resident in RI. I am 51 years old and reentering the work force
after raising children. I am very interested in becoming an activities
director for the elderly. Where can I go for the best on line education?
There are so many programs and it is very hard to make an intelligent
selection. Any ideas?
Thank you so much
ANSWER: Welcome to the profession of therapeutic activities. It is an exciting and
rewarding profession. As far as on line education, I cannot say which is the best. The
NCAAP web site lists the approved instructors and should should select from that
group.http://www.nccap.org/about/educators/index.shtml You should contact each of
the instructors or instructing agencies to discuss the way in which the information is
presented as each is different. Some instructors have weekly chat sessions and have
other ways to get interaction amongst the students. Others allow the students to
complete the course independently. You also need to identify your learning style and
see how it will coordinate with the instructors method of presentation. Good luck!
Debbie
___________________
QUESTION: I am a CNA at a nursing home. I am interested in becoming an activities
director. Where do I begin?
ANSWER: The first thing you need to do is find out what the requirements in your
state are for the position. If you email me your state, I can help you there.
Then, I would suggest finding a paid position within the activity department. Gaining
paid activity experience is required for certification and most state require experience
for the director position.
After gaining a position in the department, I would seek out the required training course
in your state. Most states have accepted the Modular Education Program for Activity
Professionals as the training program.
Again, I need to know what state you reside in prior to giving you concrete information.
Email me back with more details.
Debbie
___________________
QUESTION: I have a resident who will become 100 years old this year. How can I get
a presidential recognition for her?
ANSWER: For an unusual gift for an elderly relative consider a birthday card from the
present or former presidents.
To receive a greeting from President George W. Bush, send your request to the White
House Greetings Office, Room 39, Eisenhower Executive Office Building, Washington,
DC 20502. Fax 202.395.1232. Or go to http://www.whitehouse.gov/greeting/
Include the full name(s), address and title (Miss, Mrs., Ms., Mr.) of the recipient, plus
the date and event being celebrated. Also, include your full name and phone number
in case there are any questions.
The White House Greetings Office will honor citizens with special presidential greetings
and acknowledgments for 80th and subsequent birthdays, 50th and subsequent
anniversaries, the birth of a child, Eagle Scout or Girl Scout Gold awards, weddings,
bar mitzvahs and bat mitzvahs, and it will send sympathy cards for a death.
Requests should be sent at least six weeks before the event.
The hand-addressed greeting will be mailed one week before the event.
Have fun,
Debbie
_________________
QUESTION: When you do an admission assessment for a new resident, how long do
you have to put on the chart. This is not the MDS assessment, this is the assessment
that you gather when they first come into the facility to have baseline.
ANSWER: Federal regulations mandate an initial assessment in the chart by day 14.
If they are receiving Medicare money (short term, sub-acute), it is five days.
You also need to check your State regulations but they usually coincide with Federal
regulations. You also need to check with your facility policy as that sometimes defines
a different time frame.
Debbie
_________________
QUESTION: I am so glad I found your site, I am a new activity director in a home who
has received a deficiency in activities for their lack of cognitively impaired
programming. How do you write a plan of correction? Is there a format? My
administrator wants me to write one, and I'm sad to say I have no idea.
ANSWER: In NJ, and I think it is a federal format - the format for a Plan of Correction is
a four step process as follows:
1. Define how you will fix the deficiency for those cited in the survey.
They usually cite specific residents by number and define how their needs were not
met as observed during the survey. In this section of the POC, you would define how
these residents would be reassessed and what you would do for each particular
resident. It is as if you are putting a mini-care plan for each one.
2. Identifying other residents at risk who have the potential to be affected by this
deficiency. They are saying they found a few residents who's needs were not met by
the practice and they want you to make sure there are no others. Usually people say
they will review each person with cognitive loss or use a population needs assessment
or something that reviews the overall needs of the population to identify any other
residents similar to the ones cited in the survey.
3. Systemic changes to resolve the deficiency. This means actual changes you will
introduce to fix deficiency such as added programs, revised programs, new
supplies/equipment, training of staff, added staff, changing of duties, communication
systems, consultants hired and that sort of thing.
4. Evaluation or monitoring of situation. They want to know how you are going to
evaluate and monitor the changes you introduce. You should create some sort of QA
tool to review the program. People often say staff rounds, programming monitoring and
observation by management and things like that.
Once you write POC, it is good practice to keep a folder or binder of information/efforts
associated with POC. Keep copies of all the training provided, receipts of supplies
purchased, copies of new policies and protocols, outcomes of QA or population needs
assessments, etc. That way if they have any questions about the resolutions - it is all
in one place and organized.
Good luck,
Debbie
___________________
QUESTION: I am starting a new position as of 2-1-08 as Activity Assistant. The
residents that I am doing activities with are low functioning don't know what to do. The
lady that had the job before me never stimulated their senses, never done any
aromatherapy, no mental stimulation. There were a lot of movies, bingo and coffee.
I would love to have these residents using their minds and their senses and exploring .
I don't want them sitting around with nothing to do. Please if you have any ideas on this
please let me know. Also. Since I am taking someone else's job.. How can I break the
ice with my residents as well as my nurses that are on the same floor as me?
ANSWER: Welcome to the world of therapeutic activities. It is a rewarding but
challenging profession. There are many resources on the internet for programming,
much of which would be appropriate for the more impaired resident. You might want to
look for information on sensory programming and activities for the cognitively
impaired. Many of the activity based web sites have sections on programming and
programming ideas. Check the link page on my site and this site (activity director's
office). My site has many activity links on this page : http://www.dhspecialservices.
com/activitysites.htm
and this page is just information on Alzheimers Disease http://www.dhspecialservices.
com/dementiasites.htm
There are also several good publications for activity planning which are helpful such as
Creative Forecasting and A New Day and the web site www.activityconnection.com
So, as far as new ideas go - there are many on the internet and in publications that
you can try. It is just a matter of seeking them out.
As far as your approach and "breaking the ice" as you say, I would suggest to
move forward in a slower manner rather than change everything the first week you are
there. Even if the existing program is not good and you see room for improvement,
people often resist change, even if it is for the better. You need to build trust with the
staff and residents before you change everything. Once trust is established, where
they see that you are committed to conducting decent programs and making a
difference. they will accept your suggestions better. Asking the staff for their
suggestions (as to what they have seen that works or not works) would involve them in
the process and make them feel important. I know they may not be activity/recreation
workers but they do work on the unit and have seen the life of the unit.
As far as finding out what the residents might want to do, you can ask them or if
they are that impaired and cannot respond - definitely check their assessments. The
assessments should provide you with a general listing of preferences, past lifestyles
and other information that would help you create appropriate and more interesting
activities.
good luck,
Debbie
___________________
QUESTION: I am seeking a assistant activity director's position in my area and
understand that on your website you have many positions in this area. Can you give
me the web-site to apply for such positions.
ANSWER: My web site has a job board with mostly jobs from NY, NY and PA. Not sure
where you live? http://www.dhspecialservices.com/jobboard.htm
___________________
QUESTION: Idea for beer and wine activities in nursing homes??
Staffing in 90 bed nursing home?
ANSWER: Not really sure what you mean by beer/wine activities? Most facilities have
happy hours where they serve such beverages. Usually music is played and it
resembles a social/party atmosphere. You would need to obtain physicians' orders for
each person who is drinking the beer/wine. You would need to keep a listing of those
residents allowed to drink, amounts allowed and track what they have. You would also
need to have a suitable alternative (fake beer or sparkling fake wine) for those unable
to have the beer/wine.
Other ideas might be to buy one of those beer making or wine making kits and turn
that into an activity. Or having a wine tasting party of different types of wines and their
use, etc. might be fun. You could combine the wine tasting with a travel group and
have the wine from that region or country.
Not sure if that is what your question about beer/wine activities was meant to be?
As far as staffing - that varies from state to state. In NJ, we have a minimum staffing
ration of one activity staff member to 53 residents. We are one of the few states that
has such a ratio. Staffing needs also depend on the size of your building (program
areas, units), the special needs of your residents (sub-acute, dementia), so it is hard to
say you should have a certain number of staff. Sorry, I cannot be much more help
than that.
Debbie
_____________________
QUESTION: I live in Ohio and I was told awhile back that I did not need to write a
5,14,30,60 day progress not on a resident unless there is a sig change or a readmit. I
was told to only do an Initial, quarterly and annually progress not and assessment.
Can you please help me? Is this true?
ANSWER: I do not know Ohio regs but according to Federal regs - the dates you site
have to do with the short term or Medicare regulations. The regulations state there
needs to be review/re-assessment for the Medicare residents on the time intervals you
mention. To include the activity/recreation department in those reviews is a facility
policy. If you are actively involved in the care of the sub-acute resident and are
participating in the plan of care, I would think you should be included in that review.
The regs state that those involved in the care of the resident should be involved in the
review. So, you have to check facility policy for that one. You would also have to check
your state regulations.
For traditional long term care residents, the time frames are upon admission, and
quarterly. You definitely do not need to write the 5, 14. 30 and 60 day notes for long
term care residents (private pay or Medicaid). The annual review referenced in the
federal regulations means the annual MDS. Many facilities write an annual note to
coincide with the annual MDS and call it an annual.
I am not sure if that was much help, but if you have further questions, feel free to email
me back.
Debbie Hommel, ACC, CTRS
_____________________
QUESTION: is there a way to figure out the activities that an Alzheimer's resident can
do, with the 7 stages?
ANSWER: I assume you are talking about the Global Deterioration Scale (GDS) also
known as the Reisberg Scale which is a staging tool for cognitive function. The scale
rate a resident from stage 1 which is considered "normal function" with no cognitive
decline to stage 7 which is very severe cognitive decline. For the most part, those
individuals who are staged at 1 - 3 are still living in their homes and in the community.
They could still participate in daily routines and tasks practiced in the past and present,
with minimal monitoring by spouse or family member. By stage 4 and 5, the individual
will need more supervision and might be placed in a memory support assisted living or
start attending a medical day care setting. Again, they will often function well within the
traditional programs offered in these settings. Activities that allow use of long term
memory, residual skills and activities from the past which are familiar are often
successful. By stage 6, they definitely need supervision of some kind. If they are kept
in the home, they would need constant support through caregivers. If they are in a
long term care setting, they would participate in the programs we develop for the
cognitively impaired. They would need a balance of active stimulation and periods of
quiet and rest. They would need familiar routines. By stage 7, they are reaching the
end stages of the disease and would be most likely involved in a sensory program of
some kind as they are often not task oriented and are minimally verbal at this point.
Hope that helps,
Debbie Hommel, ACC, CTRS
_____________________
QUESTION: I am taking a course right now and need to find a copy of the nursing
home regulation which requires nursing staff (and others) to be involved in activities for
residents. Do you have a copy?
ANSWER: You might be referring to the Federal regulations and the changes to the
guidance which were implemented 6/1/06. The regulation itself does not state nursing
assistants need to help but the guidance outlines the role of interdisciplinary staff. I am
attaching the guidance to this email.
_____________________
QUESTION: I'm an activities assist and I love my job. I've been working as an
assistant for three years and I now know what I want to be at 54yrs old. Do you think I'm
to old to go to school to be a director? Can I do this on line? What do I need for New
Hampshire? Thanks ahead of time for your help.
ANSWER: Hi, first of all - congratulations on finding this profession and realizing the
joy it brings you. It takes a special person to do this work. Secondly, to answer your
question about if you are "too old to go to school" - of course not. We, of all people,
know it is never too late. In our daily work, we encourage our residents to live life to
the fullest - regardless of age. If you have the desire, interest and motivation to pursue
this - then you can do this. After three years of doing the work of an assistant- you
know it is physically, mentally and socially stressful - so you know what you are facing.
If you have been able to manage being an assistant for three years, expanding your
skills as a director seem achievable for sure.
To answer your second question - yes, you can take the course work on line. To
complete independent study courses, you need to be self directed, self disciplined and
able to meet deadlines.
To answer your final question - I know NH has requirements but I cannot find them.
You can call your NH State Department of Health at 603-271-4814 .
Toll Free 800-852-3345 x 4814 for a copy of their regulations.
Good luck,
Debbie
_____________________
QUESTION: Is there any on-line certification training courses available for Activity
Director? I live in far No. California and the closest training class is over 800 miles
south. Appreciate any ideas. Thanks
ANSWER: Go to the NCCAP web site and go to the instructor page. They have a
listing of all the instructors who offer the course through independent study and on line.
www.nccap.org
Good luck,
Debbie
_____________________
QUESTION: Hello. I enjoyed your site. I am looking for a tracking tool for resident
concerns from Residents council. If you have any information it would be much
appreciated.
ANSWER: I am attaching one to this email but you can create one based on your
facility's needs. You create a form monitoring what it is you want monitored - issue,
people informed, people responsible, etc. Whatever form you choose should be
introduced to the administrative team and supported by the administrator. The team
needs to understand they need to respond to the concern/form within a reasonable
amount of time and the response needs to be returned in writing prior to the next
council meeting. The completed form should be shared with the residents at the next
meeting and filed with the council minutes.
Good luck,
Debbie
_____________________
QUESTION: I want to know what I need to become a Certified Activity Consultant. I
have been the field over 20 years. I have 3 degrees - AS, BS in physical Education,
and Masters in Health Administration.
ANSWER: To meet consultant standards, you can use your master degree as long as
it includes the criteria as defined in the certification standards (see page 4 of
standards booklet).
You would also need a minimum of two years experience (which you have). You would
also need 40 hours of continuing education in approved topics, completed within past
five years.
You would need 200 hours of consulting experience.
You would need to complete the MEPAP (I and II).
If you have any other questions, feel free to email me back,
Debbie
_____________________
QUESTION: I live in NC near Fayetteville. I am wondering what the starting pay is for
Activities Director's in my area.
ANSWER: I would suggest you contact your State Association for that information. In
NJ, our State group collects that information periodically and makes it available to
membership. Possibly the North Carolina group does the same.
http://www.coap-nc.org
NCCAP did a salary survey in 2005 but it is not broken down regionally.
http://www.nccap.org/survey/2005_salary_survey/NCCAP%202005%20SALARY%
20SURVEY%20RESULTS.pdf
Activity Director's Association?
We currently have no contact information and as advocates for residents in long-
term care, we need to be able to share information regarding activities with the smaller
assisted living facilities within our state.
Any contact person or group within the Tampa Florida area would be greatly
appreciated.
ANSWER: I personally do not have a contact for the Florida Activity Association but
these are the instructors of the MEPAP. I would think they would have a contact for the
group as promoting professional affiliation is part of the course.
- John Collins Orlando 407-282-9647 Collinshealthed@aol.com,
jcollinsacc@aol.com MEPAP 2nd Edition - Mary Anne Favale Ormond Beach 386-672-5392 386-295-3857 cell
mafcvf2@aol.com MEPAP 2nd Edition - Dina Giannet New Port Richey 727-847-0649
They should be able to tell you info about the Florida state activity association.
Good luck,
Debbie
_____________________
QUESTION: I live in Iowa and am planning to move to Florida. It has long been my
desire to become an activities director (for which an area community college used to
have a program for,but no longer has it). My question is, WHERE do I go to get trained
and certified and what are the requirements for the state of Florida in this area? I have
searched the web and have been very disappointed in the available information on
schooling. Schools advertise a program and then don\'t have it listed. Is training
required? Can I do an online program? Please let me know, as I am getting very
frustrated. Thank You for your time.
ANSWER: You can go to the NCCAP web site and they have all the instructors listed.
www.nccap.org and go to instructor page and then you would click on the icon for
Florida. They teach the MEPAP in Florida and there are several instructors who teach
regularly. If you contact them, they may be able to direct you to an appropriate
training. There are also several instructors on the instructor page who offer the course
on line which is another option.
Hope that helps and good luck,
Debbie
_____________________
QUESTION: I have taken the 40 hour activity course and want to know what is the next
step up the ladder from there. Where would i go for more training. Thanks
for the info.
ANSWER: I would need to know what state you work in to individually recommend a
course. But, if you have taken a 40 hour activity course - there is the MEPAP course
(an 180 hour course) for activity professionals which is nationally recognized. You can
find instructors of this course on the NCCAP web site. http://www.nccap.
org/about/educators/index.shtml
If there is not an instructor in your area, you can look into the independent study
programs.
If you are not interested in that, I would suggest looking into actual college
courses. If you are not nationally certified, you will need a minimum of 12 college
credits to obtain that, in addition to the MEPAP.
If you need additional information, feel free to email me back, Debbie
_____________________
QUESTION: I am a Activity Director, plus my other job duties include computer, office
duties & tenant social work. This is new for me and it has come to be over
whelming and i have a hard time not bringing it home with me. I have never
worked with seniors, but i just love providing Activities for them and the
rewards i get of knowing they are happy. This is the first time i have left
my 2 kids, ages 13 and 9 alone for a summer and that is causing sadness for
me as well. Any suggestions or comments?
Thank you
ANSWER: First, welcome to the world of elder activities. It kind of sounds like you are
working in senior housing rather than a licensed facility?
In any case, your concerns about brining work home, etc., are a common complaint of
many activity professionals. We have a hard time turning the job off. Most of us are
always thinking of things for our residents and programs when out shopping and at
home. In order to not burn out, you will need to make a effort to separate yourself from
your job when you leave the facility. If you are working with a higher functioning
population, possibly they could help with some of the tasks you have to do in preparing
and organizing. Possibly creating an "auxiliary" or volunteer corp would be something
the residents would be interested in.
Regarding leaving your children home - that is a tough one which all working parents
grapple with. Would your community allow for them to come to work with you a few
days a week to help with activities? They could easily call a bingo game or run a craft
group independently for sure. The 13 year old might be able to do some of the clerical
duties you mention?
If you need additional information, feel free to email me back and good luck, Debbie
_____________________
QUESTION: What are the federal guidelines for non-certified activity staff to document
in resident charts? I have staff that will be certified by the end of the
year, however they aren't currently. Should I be the only one to document?
Should I co-sign with their entries? Help! I work in a CCRC in Washington,
DC. Thanks.
ANSWER: The federal regulation states the assessment and care plan should be
completed by or "under the supervision" of a qualified professional which means those
individuals who do not meet the definition of a qualified professional can document
under the supervision of someone who does meet the definition. How you supervise is
a policy decision. Co-signing is one way to show you are monitoring content. I would
suggest creating a training protocol and checklist to verify you have trained your staff
to complete documentation properly. Each staff member who is involved in charting
would be oriented to documentation protcols and it would be documented. You could
co-sign each entry but that is not mandated. You could also to periodic chart audits
and QA's to ensure content is appropriate.
But, to answer your questions - No - you do not need to be the only one
documenting. You can train and supervise other staff. And co-signing as a means to
monitor would be a decision your facility/department would have to make.
Good luck,
Debbie
_____________________
QUESTION: Hello;I'm an Activity Director in Shreveport, Louisiana, I lost my original
certification. I have a bad copy of it, how do I get another one.
ANSWER: Do you mean your NCCAP certification? If you are referencing NCCAP, I
am sure they can give you a copy. Their web site is www.nccap.org If you are
referencing your basic activity course certificate, you would have to contact your
instructor. As an instructor myself, I have records of everyone who has completed my
course and I could provide them with a copy of their certificate if they lost it.
Good luck,
Debbie
_____________________
QUESTION: What are the requirements in New York State to be an Activities Director
in a nursing home?
ANSWER: hese are the qualifications, according to State NY standards.
(2) The activities program shall be directed by a qualified professional
who:
(i) is a qualified therapeutic recreation specialist who is eligible for certification as a
therapeutic recreation specialist by a recognized accrediting body on or after August 1,
1989; or
(ii) has 2 years of experience in an age-appropriate social or recreational program
within the last
5 years, 1 of which was full-time in a patient or resident activities program in a health
care setting; or
(iii) is a qualified occupational therapist or occupational therapy assistant.
If you have any other questions, feel free to email me back, Debbie
_____________________
QUESTION: I have several questions. First of all I'm new to finally joining NJAPA, (just
joined tonight), I'm extremely eager to get certified! I love my job and my residents and I
want to make a BIG difference in their lives. I have also signed up for your first home-
study course. Can't wait. My dearest friend, Stephanie G., who is in your Part 2 class,
has inspired me to go for certification. However, I did not finish college, I do have my
old transcripts. Yes, it's been quite a while. Does NCAAP accept my old transcripts
toward my certification? I now have the opportunity to start attending seminars, and
was curious, are all seminars/lectures toward CEUs points? Or, just the ones
mentioned they are?
Lastly, do you know how I could start my own branch of Mocap for Middlesex
county? I know a lot of people who would like to attend the MOCAP that Kevin runs, but
the meetings are too far for some to attend. If I start one in Middlesex county, I'm sure a
lot of Activity people would be extremely happy. I haven't been to one, (too far). What
do they do at these meetings?
Once again, thanks for all your help with these questions. Looking forward to
taking your first class in the Fall and your home-study course.
ANSWER: Hi, congratulations on taking your first steps toward being a career activity
professional. Obtaining national certification and becoming a member of professional
organizations is part of our commitment to the profession and what we do.
As far as your college credits go, NCCAP accepts them if you have an official
transcript from an accredited college or university. When selecting seminars to attend,
the first criteria is that they have to fall into the NCCAP body of knowledge which you
can find on page 8 of the certification standards which you can download and print out
from the NCCAP site (www.nccap.org) The second criteria would be to look for NCCAP
approved courses. Any independent study or on line coursework has to be NCCAP
approved for them to accept it. If you attend (in person)inservices or seminars that are
not NCCAP approved, they will accept it if it is within the body of knowledge and you
have a certificate siting information they require (sponsoring agency, speaker,
speaker's credentials, topic, location and number of hours).
As to your final question regarding initiating a professional group... I would
suggest contacting NJAPA as they might support you in developing a charter group.
There is also RADA in NJ which is a group in Union and other counties up north who
you might network with. However, to initiate your first meeting - simply contact a few
local facilities near you to see if there are a few other activity professionals interested
in starting the group. Then just sent out a mass mailing to all the nursing homes,
assisted living facilities and medical and social day care centers in your county.
You can start with an interest survey of sorts or just schedule a meeting and hope
interested people show up. If you have a guest speaker and offer people contact
hours for education, they might be more apt to attend.
Good luck and if you need more information, feel free to email me back.
Debbie
_____________________
QUESTION: Dear Debbie, i have been an activity director for 24 years and i love it.
with things changing i need information on culture change in nursing homes,
what are surveryers looking for. please e mail me some information. thanks
ANSWER: I really can't speak for Texas surveyors but here in New Jersey, the
surveyors are interested in individualized care. Culture change models focus on
person centered concepts of individualization, team approach and non-traditional
approaches to long term care. I have heard increasing emphasis on a holistic team
approach, where each staff member truly knows the resident and their life story. It is
no longer only the activity professional's job to know the resident as a person and meet
the individual quality of life needs of the resident. It is everyone in the building's job to
care for the residents as individual people, regardless of what the employee's
individual function may be.
So, my guess would be - the surveyors are looking for individualization,
adapation, specialized approaches based on need, and a coordinated team
approach in meeting those needs.
I have a few sites about culture change and specific models on my web site.
http://www.dhspecialservices.com/culturechange.htm
_______________________
QUESTION: I am the AD in an Assisted Living Facility. We have 65 apartments and our
current pop is at 54 residents. My question is this: what is average percentage of
residents that typically participate in activities? I am averaging 12% at most activities
unless it is a dance or bingo. Thank you for your help!
ANSWER: I honestly have no formal data to help us here. But, my gut opinion says
that your percentage seems a bit low. To work on your low participation, here are
some things to think about:
*Do you do any kind of interest inventory or resident interest assessment upon
admission. Although AL does not require it, the information is very helpful in
developing a program which is tailored to the interests of the residents.
* What do the residents say in Resident Council? Have you tried to see new
ideas here?
* What is your method for communicating programming to the residents? Some AL
activity directors visit the dining room during meals to talk up the morning or afternoon
schedules. Some places have the daily schedule posted just about everywhere -
elevator, table tops, dining room.
* How helpful are your caregivers in encouraging attendance at programs?
Maybe you need to meet with your nursing department and discuss strategies where
they can promote the daily schedule.
* Introduce incentives to certain activities. For exercise programs, introduce a
chart - tracking attendance and progress. You could end with a party after a ten week
session and give out awards. Have raffles and door prizes at random programs so
they won't know when they might be offered.
Hope that helps and good luck,
Debbie
_____________________
QUESTION: I work in a long term care environment, where we are seeing more sexual
intimacy issues come up, In speaking with family and staff my question is;
is it mandated by state that we provide them with materials such as
Magazines or Movies if they are asking or showing this behavior? Or would
you have another suggestion or avenue to explore? Thank you
ANSWER: The regulations do not specifically specify providing residents with that type
of material. The regulations state we need to provide interventions and approaches
which meet their needs and interests. If it is deemed appropriate that those sort of
things are of interest to the individual, they can be offered. If this sort of thing conflicts
with the values of the facility (such as a religious run home), the facility has the right to
say it is against the values of the home. In that case, the home itself won't offer the
items directly. If/when offering this sort of thing, it should be offered in private and by
someone who can objectively offer the materials. Before offering such items, the
resident's cognitive status and ability to make decisions needs to be assessed. If they
are competent, can make decisions and can review the materials independently and
privately, there is no reason why they cannot have them. However, if the resident has
some cognitive loss and/or use of the materials contributes to negative behaviors,
offering the materials would not be a good idea and suitable alternative diversions
should be found.
Hope that helps,
Debbie
___________________
QUESTION: i've been working in activities for 5 years (assistant) and now iin a new
Activity Director i love my work but i have
never been able to spread my wings before now. Prayed to get here now in
here and feeling very overwhelmed with the room i have to spread in.
(smile)help
ANSWER: Congratulations on your promotion! It is exciting to finally be in the drivers
seat and scary too.
My best advice is to take your time and create a plan. Possibly spend a few days
making lists of everything you would love to do - new programs, new systems, new
ways of doing things. Once the list is made, you can evaluate all your thoughts and
prioritize. If you are new to the facility, you will need to win staff over before you begin
changing things. Some people are resistant to change, even if it is a good thing. So,
you need to feel out the waters, so to speak - is the staff eager for change or quite
content in how they are doing things. I would suggest involving the residents in any
changes to the schedule and also involve the staff in some of your ideas.
Most people are more supportive if they feel part of the process. Good luck and feel
free to email with any questions as you go along.
Debbie
___________________
QUESTION: I am in Westport, MA and looking for a MEPAP summer course. I have a
BA in English/Elem Ed and a MA in Adult Education. The past 6 years I have worked
with severe/profound children K-12. Looking for a career shift. Thanks for any advice.
ANSWER: There are several MEPAP instructors listed for Massachusetts. I would
suggest you contact them to see where and when they might be conducting their next
courses.
Name City Phone Alt. Phone Email Category
Pamela Bailey Buzzards Bay 508-759-9355 pambailey@Verizon.net
Martha Campbell Shirley 978-448-1170 gcoa@TownofGroton.org
Ann de Villafane Gardner 978-632-5477 Ann.devilleafane@genesishcc.com
Judith M. McLernon Revere 781-284-4952 mclun@comcast.com
Roberta Moran-Letvinchuck Rockland 781-878-8872 bobbitravels@gmail.com
Sandra Sarza Swansea 508-379-9843 sandysarza@aol.com
Glory Wideman-Hughes Dorchester 617-436-2233 Good luck!
Debbie
___________________
QUESTION: Do you have any notes or advice on writing care plans for an Activity
Director in a Long Term Care facility?
ANSWER: Hi, I wrote several articles which can be found on the archives section of
this site.
http://theactivitydirectorsoffice.com/DebbiesADTips_archive200704.html
http://theactivitydirectorsoffice.com/DebbiesADTips_archive200705.html
http://theactivitydirectorsoffice.com/DebbiesADTips_archive200706.html
There are also a few good books which I sell from my web site.
Documentation in a Snap
http://www.dhspecialservices.com/documentationsnap.htm
Care Planning Cookbook
http://www.dhspecialservices.com/careplancookbook.htm
Dementia Care Plan Dictionary
http://www.dhspecialservices.com/dementiacareplan.htm
Hope that helps,
Debbie
___________________
QUESTION: I have been the Activity Director at a SNF in WI for 9 years, we are
recently starting a restorative nursing program (which I am happy about). I
have been asked that activities runs a restorative group above and beyond
any group of exercises we already do. The committee met a few weeks ago to
discuss what exactly my staff does a varied times of the day. (Mind you it
is a 107 bed NH with 5 part-time staff working 7 days a week). I was a bit
taken aback as I feel like my staff and department were being thrown under
the bus and someone even made a comment that all my staff does is sit
around. My staff is hard working and devoted. I told the committee that the
residents in restorative are welcome to come to any exercise group we offer.
But we, of course would have to do ALL the transporting, as no one else
helps us with that either (nor do any other staff run activities- besides
us---- and I know what you are thinking....I brought up the F-tags since its
conception...to no avail)!
. Do you know of any regulations or have any info on activities role in
restorative nursing??? I am a bit frazzled and feeling defensive of my
staff. Any insight???? THANK YOU.
ANSWER: To my knowledge, there are no regulations defining the role of activities in
a restorative program. My understanding of restorative programs is that they focus on
increasing functional ability and there is a tracking system.
I have worked with some facilities where activities and the restorative aides do a
combined exercise program and a restorative dining program. It may not be a matter
of doing an extra exercise group but just a matter of
altering your approach and tracking participation differently. Here is an
interesting article on restorative programs and person centered care.
http://www.kabc.org/pdfs/promoting-resident-centered-care.pdf
I do agree with you about it being a team responsibility, including getting people to the
program.
Good luck,
Debbie
___________________
QUESTION: Do you have any tic sheets that you have to do to chart on residents in ltc
to show there activity level each day and if so can i see one on how you set
it up?
ANSWER: I assume you mean "attendance sheets". Have not heard of the term "tic"
sheets. I have some attendance sheets which track participation in groups. They
have a code for response levels. I don't have it on my computer - would have to fax or
mail them. Email me back with an address or fax number, if you are interested in that.
Debbie
_____________________
QUESTION: I was wondering if anyone knows of a good website, or maybe you know
some activities off hand that can be specific for palative care/ hospice/comfort care
residents.
ANSWER: I have a whole section for end of life issues on my web site www.
dhspecialservices.com
http://www.dhspecialservices.com/endoflife.htm
A very effective approach is music thanatology - there are a few sites noted on my web
page. Using bedside harpists seems to be interesting.
Also, the web site - Bill Moyers - On our own terms is good and Crossing the
Creek is very good.
Hope that helps,
Debbie
___________________
QUESTION: My new administrator wants me to implement a restorative care 4:1
w/low-functioning residents. I am concerned about proper training,
documentation ect. Do you have any resources you suggest for ideas and
documentation forms. I understand properly implemented, it can be captured
on MDS. I enjoy spending time w/ these residents and find it a challenge in
my very hectic day. I only have 1 aid and want to make the best of my time.
ANSWER: I would suggest discussing this program with the therapy department and
the nursing director. I would think they should be a part of this program.
They would also be able to help you with tracking forms as they both use those sorts of
things. Restorative means a lot of things and needs to be clearly defined in the
program. When your administrator says restorative for the lower functioning? What
does that mean? What is his expectation? You also have to make sure what you are
doing meets the criteria for reimbursement. I have been involved with facilities who
have restorative exercise and restorative dining programs. The emphasis on these
programs has been adaptive equipment, level of participation, and tracking progress.
But, I am a firm believer in the team approach and that is where restorative programs
should be - a collaborative effort amongst the team.
Here is an excellent article on restorative care.
http://www.kabc.org/pdfs/promoting-resident-centered-care.pdf
Good luck,
Debbie
___________________
QUESTION: I just recently was hired on for a activities asst. job working with mostly
with Alzheimers,Dementia and Parkinsons residents. I will be making up a
calendar of events. I of course am brand new to this and would like some
info on which way to go. I will be eventually take the certification but for
now am just trying to figure out what to do with them. I want to provide
them with wonderful activities and do a good job. Can you help me or send me
in the right direction??
ANSWER: An effective way to program on memory support units is to develop a daily
routine such as beginning with a morning coffee with some discussion (basic
reality/weather/reminiscing - depending on level of functioning); followed by exercise or
active game; followed by mental type activity; followed by setting up for lunch with
music. An afternoon routine should also be established. The routines would depend
on the level of functioning of your population. Within the established routines, you
would do different activities which focus on the type of activity being done. For
example, if 11 AM is your active time - there are a variety of active activities that could
be introduced at that time frame. Routines are important but you don't want to fall into
a rut. There are many resources for programming on the internet. I have some listed
on my web site. This is the link for all the activity web sites that I have found.
http://www.dhspecialservices.com/activitysites.htm
This is my link for a lot of the dementia based sites with ideas and resources. http:
//www.dhspecialservices.com/dementiasites.htm
Hope that helps a little bit. If you have further questions, feel free to email me back.
Debbie
___________________
QUESTION: Dear Debbie, I was a CNA then I didnt work for about 12 months for the
birth of my daughter. My certification ran out...Do I need to ReTest or How do I
get it back?
ANSWER: I honestly do not know much about the CNA certification and I think it varies
from state to state. i would suggest you get in touch with your State Department of
Health as they are the ones who manage the CNA testing and such.
Debbie
___________________
QUESTION: Is it mandated for special care residents to have activities offered from
8:00 am to 8:00 pm 7 days per week? If so, is it the recreation department
that supplies these activities. Thank you,
ANSWER: To my knowledge, there are no regulations which state activities are
mandated from 8 AM to 8 PM. Most regulations say programming should be provided
according to need of the resident. I know there was a similar question in a previous
"dear debbie" letter. To answer the first part of your question - activities should be a
balance of active and passive stimulation, structured and unstructured programs, small
and large groups.
To keep anyone in non-stop activities for 12 hours is excessive for any
population. To answer the second part of the question - the federal guidance from
6/06 stressed the interdisplinary nature of activities. Not sure if you are a nursing
home or an assisted living, but the growing school of thought is that all staff are
involved in delievering the activity program or engaging the resident in individualized
group and 1-1 activities.
The recreation department may develop the programs, think specific approaches
up for each resident and organize the interventions. But, all staff can participate in
implementing the programs and approaches.
Hope that answers your question - if not, email me back, Good luck, Debbie
___________________
QUESTION: Hello i am having me first resident council meeting what are some things i
should cover?
ANSWER: Hi, I have an article on the ADO about Resident Council Management.
http://theactivitydirectorsoffice.com/DebbiesADTips_archive200610.html
That should answer most of your questions. If you need more information, feel free to
email me back, Debbie
___________________
QUESTION: any ideas for a lady in her 50's on long term isolation that doesn't have
many interests.Thanks
ANSWER: Even though this person does not have "many" interests - you could work
on the few she has. Not knowing what they are - it is hard to suggest specifics. The
other angle you can approach is her age and generation.
Music, trivia and discussion topics of that era might be of interest. You might also do
some leisure/recreation exploration with this person. Assess why she does not have
many interests - was it because of working, raising a family? Now that she has some
leisure time, possibly she could develop some new interests. Conducting an intensive
leisure inventory might find some activities she might be interested in developing. You
don't mention her functional ability either - so if she is able to do things - maybe she
could develop an interest in crafts, individual games and those sort of things.
With more information on her functional ability (vision, dexterity,
endurance) could offer more suggestions.
Debbie
___________________
QUESTION: What are the requirements in New York State to be an Activities Director
in a nursing home?
ANSWER: These are the qualifications, according to State NY standards.
(2) The activities program shall be directed by a qualified professional
who:
(i) is a qualified therapeutic recreation specialist who is eligible for certification as a
therapeutic recreation specialist by a recognized accrediting body on or after August 1,
1989; or
(ii) has 2 years of experience in an age-appropriate social or recreational program
within the last
5 years, 1 of which was full-time in a patient or resident activities program in a health
care setting; or
(iii) is a qualified occupational therapist or occupational therapy assistant.
If you have any other questions, feel free to email me back, Debbie
_____________________
QUESTION: I have several questions. First of all I'm new to finally joining NJAPA,
(just joined tonight), I'm extremely eager to get certified! I love my job
and my residents and I want to make a BIG difference in their lives. I have
also signed up for your first home-study course. Can't wait. My dearest
friend, Stephanie G., who is in your Part 2 class, has inspired me to go for
certification. However, I did not finish college, I do have my old
transcripts. Yes, it's been quite a while. Does NCAAP accept my old
transcripts toward my certification? I now have the opportunity to start
attending seminars, and was curious, are all seminars/lectures toward CEUs
points? Or, just the ones mentioned they are?
Lastly, do you know how I could start my own branch of Mocap for Middlesex
county? I know a lot of people who would like to attend the MOCAP that Kevin
runs, but the meetings are too far for some to attend. If I start one in
Middlesex county, I'm sure a lot of Activity people would be extremely
happy. I haven't been to one, (too far). What do they do at these meetings?
Once again, thanks for all your help with these questions. Looking forward
to taking your first class in the Fall and your home-study course.
ANSWER: Hi, congratulations on taking your first steps toward being a career activity
professional. Obtaining national certification and becoming a member of professional
organizations is part of our commitment to the profession and what we do.
As far as your college credits go, NCCAP accepts them if you have an official transcript
from an accredited college or university. When selecting seminars to attend, the first
criteria is that they have to fall into the NCCAP body of knowledge which you can find
on page 8 of the certification standards which you can download and print out from the
NCCAP site (www.nccap.org) The second criteria would be to look for NCCAP
approved courses. Any independent study or on line coursework has to be NCCAP
approved for them to accept it. If you attend (in person)inservices or seminars that are
not NCCAP approved, they will accept it if it is within the body of knowledge and you
have a certificate siting information they require (sponsoring agency, speaker,
speaker's credentials, topic, location and number of hours).
As to your final question regarding initiating a professional group... I would suggest
contacting NJAPA as they might support you in developing a charter group. There is
also RADA in NJ which is a group in Union and other counties up north who you might
network with. However, to initiate your first meeting - simply contact a few local facilities
near you to see if there are a few other activity professionals interested in starting the
group. Then just sent out a mass mailing to all the nursing homes, assisted living
facilities and medical and social day care centers in your county.
You can start with an interest survey of sorts or just schedule a meeting and hope
interested people show up. If you have a guest speaker and offer people contact
hours for education, they might be more apt to attend.
Good luck and if you need more information, feel free to email me back.
Debbie
___________________
QUESTION: I am a CNA at a nursing home. I am interested in becoming an activites
director. Where do I begin?
ANSWER: The first thing you need to do is find out what the requirements in your
state are for the position. If you email me your state, I can help you there.
Then, I would suggest finding a paid position within the activity department. Gaining
paid activity experience is required for certification and most state require experience
for the director position.
After gaining a position in the department, I would seek out the required training
course in your state. Most states have accepted the Modular Education Program for
Activity Professionals as the training program.
A gain, I need to know what state you reside in prior to giving you concrete
information.
Email me back with more details.
Debbie
___________________
QUESTION: I have been working in Activities for 10+ years. I have been an Activity
Director for 2 years. The residents have changed at the place I have worked
since I started and we are moving in more memory impaired residents in to
the community even though we have a memory unit. The memory unit is full.
This leads me to my problem. I am having a problem meeting the needs of the
memory residents. The higher functioning residents will go to many of the
activities we provide. Our memory residents are getting lost in the shuffle.
There are 5 floors in the building and residents get lost frequently. Meals
are always on the first floor activities are mostly on the second floor.
There are many of them that sit in the Lobby after breakfast and just wait
for lunch. I have tried to do activities in the lobby to target these
residents but it is noisy and distracting.
Help me!
ANSWER: It sounds like you work in an assisted living facility? The layout and the way
you say your residents are changing gives me that impression. In an assisted living, it
is hard to meet the needs of the cognitively impaired resident when they are mixed in
with the general population. If they are getting "lost in the shuffle", your facility should
be proactive in meeting their needs before you have some negative outcomes in terms
of behaviors, falls or leaving the building unattended. Possibly setting up a pilot
program on one floor where the caregivers would direct these memory impaired
residents to gather. A staff member would be assigned to this group, which should be
out of the hub-bub of the facility, where it is less noisy and confusing. They could be
offered a daily routine of familiar programs that could be tailored to their ability and
keep them suitably occupied and challenged. To accomplish this, you would need
space and a staff member to meet the needs of these residents. Many assisted living
facilities are facing the same challenge as you are. The population is aging and
coming in more impaired than when assisted living was first introduced. The assisted
living profession needs to be proactive and address these changing needs as they
occur.
Good luck,
Debbie
_______________________
QUESTION: I am a resident in RI. I am 51 years old and reentering the work force
after raising children. I am very interested in becoming an activities
director for the elderly. Where can I go for the best on line education?
There are so many programs and it is very hard to make an intelligent
selection. Any ideas?
Thank you so much
ANSWER: Welcome to the profession of therapeutic activities. It is an exciting and
rewarding profession. As far as on line education, I cannot say which is the best. The
NCAAP web site lists the approved instructors and should select from that group.http:
//www.nccap.org/about/educators/index.shtml You should contact each of the
instructors or instructing agencies to discuss the way in which the information is
presented as each is different. Some instructors have weekly chat sessions and have
other ways to get interaction amongst the students.
Others allow the students to complete the course independently. You also need to
identify your learning style and see how it will coordinate with the instructors method of
presentation. Good luck!
Debbie
_____________________
QUESTION: I have been working in Activities for 10+ years. I have been an Activity
Director for 2 years. The residents have changed at the place I have worked since I
started and we are moving in more memory impaired residents in to the community
even though we have a memory unit. The memory unit is full. This leads me to my
problem. I am having a problem meeting the needs of the memory residents. The
higher functioning residents will go to many of the activities we provide. Our memory
residents are getting lost in the shuffle.
There are 5 floors in the building and residents get lost frequently. Meals are always
on the first floor activities are mostly on the second floor. There are many of them that
sit in the Lobby after breakfast and just wait for lunch. I have tried to do activities in the
lobby to target these residents but it is noisy and distracting. - Help me!
ANSWER: It sounds like you work in an assisted living facility? The layout and the way
you say your residents are changing gives me that impression. In an assisted living, it
is hard to meet the needs of the cognitively impaired resident when they are mixed in
with the general population. If they are getting "lost in the shuffle", your facility should
be proactive in meeting their needs before you have some negative outcomes in terms
of behaviors, falls or leaving the building unattended. Possibly setting up a pilot
program on one floor where the caregivers would direct these memory impaired
residents to gather. A staff member would be assigned to this group, which should be
out of the hub-bub of the facility, where it is less noisy and confusing. They could be
offered a daily routine of familiar programs that could be tailored to their ability and
keep them suitably occupied and challenged. To accomplish this, you would need
space and a staff member to meet the needs of these residents. Many assisted living
facilities are facing the same challenge as you are. The population is aging and
coming in more impaired than when assisted living was first introduced. The assisted
living profession needs to be proactive and address these changing needs as they
occur.
Good luck,
Debbie
___________________
QUESTION: help!!! i cannot find out the exact regulations regarding back ground
checks on volunteers-we have high school kids who want to volunteer for community
service hours so, I'm not sure if i really need to do background checks or not. I am in
Washington state-any info you can give me would be really helpful! Thanks so much!
ANSWER: I honestly do not think there are any regulations stating volunteers need
back ground checks. That would be a facility policy decision. The regulations state
the residents need to be kept safe. How the facility chooses to do that, is up to them.
There should be some sort of facility screening of volunteers, regardless of age. With
high school age volunteers, I would think introducing a parental permission slip would
be appropriate as well as a referral form from their school. For that age group, that
would be enough in terms of monitoring.
Debbie
___________________
QUESTION: I am a resident in RI. I am 51 years old and reentering the work force
after raising children. I am very interested in becoming an activities
director for the elderly. Where can I go for the best on line education?
There are so many programs and it is very hard to make an intelligent
selection. Any ideas?
Thank you so much
ANSWER: Welcome to the profession of therapeutic activities. It is an exciting and
rewarding profession. As far as on line education, I cannot say which is the best. The
NCAAP web site lists the approved instructors and should should select from that
group.http://www.nccap.org/about/educators/index.shtml You should contact each of
the instructors or instructing agencies to discuss the way in which the information is
presented as each is different. Some instructors have weekly chat sessions and have
other ways to get interaction amongst the students. Others allow the students to
complete the course independently. You also need to identify your learning style and
see how it will coordinate with the instructors method of presentation. Good luck!
Debbie
___________________
QUESTION: I am a CNA at a nursing home. I am interested in becoming an activities
director. Where do I begin?
ANSWER: The first thing you need to do is find out what the requirements in your
state are for the position. If you email me your state, I can help you there.
Then, I would suggest finding a paid position within the activity department. Gaining
paid activity experience is required for certification and most state require experience
for the director position.
After gaining a position in the department, I would seek out the required training course
in your state. Most states have accepted the Modular Education Program for Activity
Professionals as the training program.
Again, I need to know what state you reside in prior to giving you concrete information.
Email me back with more details.
Debbie
___________________
QUESTION: I have a resident who will become 100 years old this year. How can I get
a presidential recognition for her?
ANSWER: For an unusual gift for an elderly relative consider a birthday card from the
present or former presidents.
To receive a greeting from President George W. Bush, send your request to the White
House Greetings Office, Room 39, Eisenhower Executive Office Building, Washington,
DC 20502. Fax 202.395.1232. Or go to http://www.whitehouse.gov/greeting/
Include the full name(s), address and title (Miss, Mrs., Ms., Mr.) of the recipient, plus
the date and event being celebrated. Also, include your full name and phone number
in case there are any questions.
The White House Greetings Office will honor citizens with special presidential greetings
and acknowledgments for 80th and subsequent birthdays, 50th and subsequent
anniversaries, the birth of a child, Eagle Scout or Girl Scout Gold awards, weddings,
bar mitzvahs and bat mitzvahs, and it will send sympathy cards for a death.
Requests should be sent at least six weeks before the event.
The hand-addressed greeting will be mailed one week before the event.
Have fun,
Debbie
_________________
QUESTION: When you do an admission assessment for a new resident, how long do
you have to put on the chart. This is not the MDS assessment, this is the assessment
that you gather when they first come into the facility to have baseline.
ANSWER: Federal regulations mandate an initial assessment in the chart by day 14.
If they are receiving Medicare money (short term, sub-acute), it is five days.
You also need to check your State regulations but they usually coincide with Federal
regulations. You also need to check with your facility policy as that sometimes defines
a different time frame.
Debbie
_________________
QUESTION: I am so glad I found your site, I am a new activity director in a home who
has received a deficiency in activities for their lack of cognitively impaired
programming. How do you write a plan of correction? Is there a format? My
administrator wants me to write one, and I'm sad to say I have no idea.
ANSWER: In NJ, and I think it is a federal format - the format for a Plan of Correction is
a four step process as follows:
1. Define how you will fix the deficiency for those cited in the survey.
They usually cite specific residents by number and define how their needs were not
met as observed during the survey. In this section of the POC, you would define how
these residents would be reassessed and what you would do for each particular
resident. It is as if you are putting a mini-care plan for each one.
2. Identifying other residents at risk who have the potential to be affected by this
deficiency. They are saying they found a few residents who's needs were not met by
the practice and they want you to make sure there are no others. Usually people say
they will review each person with cognitive loss or use a population needs assessment
or something that reviews the overall needs of the population to identify any other
residents similar to the ones cited in the survey.
3. Systemic changes to resolve the deficiency. This means actual changes you will
introduce to fix deficiency such as added programs, revised programs, new
supplies/equipment, training of staff, added staff, changing of duties, communication
systems, consultants hired and that sort of thing.
4. Evaluation or monitoring of situation. They want to know how you are going to
evaluate and monitor the changes you introduce. You should create some sort of QA
tool to review the program. People often say staff rounds, programming monitoring and
observation by management and things like that.
Once you write POC, it is good practice to keep a folder or binder of information/efforts
associated with POC. Keep copies of all the training provided, receipts of supplies
purchased, copies of new policies and protocols, outcomes of QA or population needs
assessments, etc. That way if they have any questions about the resolutions - it is all
in one place and organized.
Good luck,
Debbie
___________________
QUESTION: I am starting a new position as of 2-1-08 as Activity Assistant. The
residents that I am doing activities with are low functioning don't know what to do. The
lady that had the job before me never stimulated their senses, never done any
aromatherapy, no mental stimulation. There were a lot of movies, bingo and coffee.
I would love to have these residents using their minds and their senses and exploring .
I don't want them sitting around with nothing to do. Please if you have any ideas on this
please let me know. Also. Since I am taking someone else's job.. How can I break the
ice with my residents as well as my nurses that are on the same floor as me?
ANSWER: Welcome to the world of therapeutic activities. It is a rewarding but
challenging profession. There are many resources on the internet for programming,
much of which would be appropriate for the more impaired resident. You might want to
look for information on sensory programming and activities for the cognitively
impaired. Many of the activity based web sites have sections on programming and
programming ideas. Check the link page on my site and this site (activity director's
office). My site has many activity links on this page : http://www.dhspecialservices.
com/activitysites.htm
and this page is just information on Alzheimers Disease http://www.dhspecialservices.
com/dementiasites.htm
There are also several good publications for activity planning which are helpful such as
Creative Forecasting and A New Day and the web site www.activityconnection.com
So, as far as new ideas go - there are many on the internet and in publications that
you can try. It is just a matter of seeking them out.
As far as your approach and "breaking the ice" as you say, I would suggest to
move forward in a slower manner rather than change everything the first week you are
there. Even if the existing program is not good and you see room for improvement,
people often resist change, even if it is for the better. You need to build trust with the
staff and residents before you change everything. Once trust is established, where
they see that you are committed to conducting decent programs and making a
difference. they will accept your suggestions better. Asking the staff for their
suggestions (as to what they have seen that works or not works) would involve them in
the process and make them feel important. I know they may not be activity/recreation
workers but they do work on the unit and have seen the life of the unit.
As far as finding out what the residents might want to do, you can ask them or if
they are that impaired and cannot respond - definitely check their assessments. The
assessments should provide you with a general listing of preferences, past lifestyles
and other information that would help you create appropriate and more interesting
activities.
good luck,
Debbie
___________________
QUESTION: I am seeking a assistant activity director's position in my area and
understand that on your website you have many positions in this area. Can you give
me the web-site to apply for such positions.
ANSWER: My web site has a job board with mostly jobs from NY, NY and PA. Not sure
where you live? http://www.dhspecialservices.com/jobboard.htm
___________________
QUESTION: Idea for beer and wine activities in nursing homes??
Staffing in 90 bed nursing home?
ANSWER: Not really sure what you mean by beer/wine activities? Most facilities have
happy hours where they serve such beverages. Usually music is played and it
resembles a social/party atmosphere. You would need to obtain physicians' orders for
each person who is drinking the beer/wine. You would need to keep a listing of those
residents allowed to drink, amounts allowed and track what they have. You would also
need to have a suitable alternative (fake beer or sparkling fake wine) for those unable
to have the beer/wine.
Other ideas might be to buy one of those beer making or wine making kits and turn
that into an activity. Or having a wine tasting party of different types of wines and their
use, etc. might be fun. You could combine the wine tasting with a travel group and
have the wine from that region or country.
Not sure if that is what your question about beer/wine activities was meant to be?
As far as staffing - that varies from state to state. In NJ, we have a minimum staffing
ration of one activity staff member to 53 residents. We are one of the few states that
has such a ratio. Staffing needs also depend on the size of your building (program
areas, units), the special needs of your residents (sub-acute, dementia), so it is hard to
say you should have a certain number of staff. Sorry, I cannot be much more help
than that.
Debbie
_____________________
QUESTION: I live in Ohio and I was told awhile back that I did not need to write a
5,14,30,60 day progress not on a resident unless there is a sig change or a readmit. I
was told to only do an Initial, quarterly and annually progress not and assessment.
Can you please help me? Is this true?
ANSWER: I do not know Ohio regs but according to Federal regs - the dates you site
have to do with the short term or Medicare regulations. The regulations state there
needs to be review/re-assessment for the Medicare residents on the time intervals you
mention. To include the activity/recreation department in those reviews is a facility
policy. If you are actively involved in the care of the sub-acute resident and are
participating in the plan of care, I would think you should be included in that review.
The regs state that those involved in the care of the resident should be involved in the
review. So, you have to check facility policy for that one. You would also have to check
your state regulations.
For traditional long term care residents, the time frames are upon admission, and
quarterly. You definitely do not need to write the 5, 14. 30 and 60 day notes for long
term care residents (private pay or Medicaid). The annual review referenced in the
federal regulations means the annual MDS. Many facilities write an annual note to
coincide with the annual MDS and call it an annual.
I am not sure if that was much help, but if you have further questions, feel free to email
me back.
Debbie Hommel, ACC, CTRS
_____________________
QUESTION: is there a way to figure out the activities that an Alzheimer's resident can
do, with the 7 stages?
ANSWER: I assume you are talking about the Global Deterioration Scale (GDS) also
known as the Reisberg Scale which is a staging tool for cognitive function. The scale
rate a resident from stage 1 which is considered "normal function" with no cognitive
decline to stage 7 which is very severe cognitive decline. For the most part, those
individuals who are staged at 1 - 3 are still living in their homes and in the community.
They could still participate in daily routines and tasks practiced in the past and present,
with minimal monitoring by spouse or family member. By stage 4 and 5, the individual
will need more supervision and might be placed in a memory support assisted living or
start attending a medical day care setting. Again, they will often function well within the
traditional programs offered in these settings. Activities that allow use of long term
memory, residual skills and activities from the past which are familiar are often
successful. By stage 6, they definitely need supervision of some kind. If they are kept
in the home, they would need constant support through caregivers. If they are in a
long term care setting, they would participate in the programs we develop for the
cognitively impaired. They would need a balance of active stimulation and periods of
quiet and rest. They would need familiar routines. By stage 7, they are reaching the
end stages of the disease and would be most likely involved in a sensory program of
some kind as they are often not task oriented and are minimally verbal at this point.
Hope that helps,
Debbie Hommel, ACC, CTRS
_____________________
QUESTION: I am taking a course right now and need to find a copy of the nursing
home regulation which requires nursing staff (and others) to be involved in activities for
residents. Do you have a copy?
ANSWER: You might be referring to the Federal regulations and the changes to the
guidance which were implemented 6/1/06. The regulation itself does not state nursing
assistants need to help but the guidance outlines the role of interdisciplinary staff. I am
attaching the guidance to this email.
_____________________
QUESTION: I'm an activities assist and I love my job. I've been working as an
assistant for three years and I now know what I want to be at 54yrs old. Do you think I'm
to old to go to school to be a director? Can I do this on line? What do I need for New
Hampshire? Thanks ahead of time for your help.
ANSWER: Hi, first of all - congratulations on finding this profession and realizing the
joy it brings you. It takes a special person to do this work. Secondly, to answer your
question about if you are "too old to go to school" - of course not. We, of all people,
know it is never too late. In our daily work, we encourage our residents to live life to
the fullest - regardless of age. If you have the desire, interest and motivation to pursue
this - then you can do this. After three years of doing the work of an assistant- you
know it is physically, mentally and socially stressful - so you know what you are facing.
If you have been able to manage being an assistant for three years, expanding your
skills as a director seem achievable for sure.
To answer your second question - yes, you can take the course work on line. To
complete independent study courses, you need to be self directed, self disciplined and
able to meet deadlines.
To answer your final question - I know NH has requirements but I cannot find them.
You can call your NH State Department of Health at 603-271-4814 .
Toll Free 800-852-3345 x 4814 for a copy of their regulations.
Good luck,
Debbie
_____________________
QUESTION: Is there any on-line certification training courses available for Activity
Director? I live in far No. California and the closest training class is over 800 miles
south. Appreciate any ideas. Thanks
ANSWER: Go to the NCCAP web site and go to the instructor page. They have a
listing of all the instructors who offer the course through independent study and on line.
www.nccap.org
Good luck,
Debbie
_____________________
QUESTION: Hello. I enjoyed your site. I am looking for a tracking tool for resident
concerns from Residents council. If you have any information it would be much
appreciated.
ANSWER: I am attaching one to this email but you can create one based on your
facility's needs. You create a form monitoring what it is you want monitored - issue,
people informed, people responsible, etc. Whatever form you choose should be
introduced to the administrative team and supported by the administrator. The team
needs to understand they need to respond to the concern/form within a reasonable
amount of time and the response needs to be returned in writing prior to the next
council meeting. The completed form should be shared with the residents at the next
meeting and filed with the council minutes.
Good luck,
Debbie
_____________________
QUESTION: I want to know what I need to become a Certified Activity Consultant. I
have been the field over 20 years. I have 3 degrees - AS, BS in physical Education,
and Masters in Health Administration.
ANSWER: To meet consultant standards, you can use your master degree as long as
it includes the criteria as defined in the certification standards (see page 4 of
standards booklet).
You would also need a minimum of two years experience (which you have). You would
also need 40 hours of continuing education in approved topics, completed within past
five years.
You would need 200 hours of consulting experience.
You would need to complete the MEPAP (I and II).
If you have any other questions, feel free to email me back,
Debbie
_____________________
QUESTION: I live in NC near Fayetteville. I am wondering what the starting pay is for
Activities Director's in my area.
ANSWER: I would suggest you contact your State Association for that information. In
NJ, our State group collects that information periodically and makes it available to
membership. Possibly the North Carolina group does the same.
http://www.coap-nc.org
NCCAP did a salary survey in 2005 but it is not broken down regionally.
http://www.nccap.org/survey/2005_salary_survey/NCCAP%202005%20SALARY%
20SURVEY%20RESULTS.pdf
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