| Dear Debbie: Archive #03 |
| ARCHIVES |
| 16 JAN 2007 |
ABOUT DEBBIE |
| Have a question you'd like a professional Activity consultant to answer? Why not ask Debbie Hommel? |
| DEBBIE HOMMEL |
| The Activity Director's Office 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 THE ACTIVITY DIRECTOR'S OFFICE 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 |
| Dear Debbie Questions & Answers |
RESPONSE: I hear the frustration in your question. I think it is a misconception that we must keep
individuals with AD "busy" for eight hours a day. Constant involvement in active programming could
be over stimulating. As activity professionals, we create opportunities for our residents. Those
opportunities are a balance of group and individual activities, active and passive participation and
periods of rest. To achieve this, we need the support of interdisciplinary staff. If you are running a
group program with some of your population - the team needs to join in and assist with the rest
of your population. So, to answer your question "how can one person keep 52 resident with AD busy
for eight hours?" - it cannot be done. It takes a cooperative team to create a meaningful lifestyle for
these residents. One person alone cannot do it. You could facilitate it, come up with ideas and
offer direction to the team members - but you cannot do it alone. With 52 residents on the unit, they
need to be assessed as to what their needs are. Some need groups, some need individual
approaches, some need a balance of the two. As the activity professional, you define the programs
and approaches for each person. The team needs to help carry them all out. If you are a part of care
planning, that is where the discussion should begin. Hope that helps and good luck, Debbie
______________________
QUESTION: I was an assistant activities director at an assisted living facility and became the
director. Where can I find information to become certified?
RESPONSE: If you told me which State you worked in, I could better tell you specifics about
instructors in your area. To find instructors in your State, visit the NCCAP web site. They have an
instructor page which lists approves instructors by State. They also have a listing of instructors who
are approved to teach the courses through independent study.
http://www.nccap.org/about/educators/index.sht
_____________________
QUESTION: I'm trying to find the track 5 certification form on line. I'm done with training but would
like to send it in by 12/06.
RESPONSE: The Track 5 for NCCAP has been extended to June, 2007. (But still get it out
as fast as you can). Here is the link to the NCCAP download page. Track five is listed and you can
download and print it out from this page. http://www.nccap.org/about/downloads.shtm
_____________________
QUESTION: What kind of training is required to be an activity professional? Is the training geared
specifically to geriatrics? I work with adults with developmental disabilities and really could use
some training somewhere. Any info would be greatly appreciated!
RESPONSE: There is very specific training to be an activity professional. The National Certification
Council for Activity Professionals has developed a course which includes specific curriculum for the
working activity professional in LTC. It includes information about the elder resident, documentation
relevant to nursing homes and medical day care, and programming for the elder participant. You can
access information about the MEPAP (Modular Education Program for Activity Professionals) at the
NCCAP web site. www.nccap.org
Your work with developmentally disabled is related to what we do in that you are assessing and
adapting programs to your population. The technique is similar but the population and regulations
are different. If you need additional information, feel free to email me back
________________________
QUESTION: Hello, I am a Activity Director in a rehabilitation health care facility I have 55 residents
and a lot of them are in room on bed rest or in room because of major health problems. My question
is on doing 1:1's some have family's there all day and just a few doesn't have anyone. I have no
assistant its just me and no volunteers Do I have to chart in program notes for the visits or just chart
on my activity 1:1 sheet the time and date and who did the activity some of the CNA's do individual
time with a lot of the residents. I have no advisor I'm sort of on my own. I need some advice and
help. Thank you so much.
RESPONSE: Activities is defined as group programs offered by the facility as well as family visits,
amongst other things. So, the family visits would count toward the resident's quality of life and
"activity". In your progress notes, I would mention the family visits (frequency and what they do while
there). In your 1-1 documentation (1-1 activity sheet you mention), if you see the family visiting, that
could be noted. Many 1-1 or attendance logs have a code for family visits. As far as the CNA's doing
things, yes - that could be noted as well. Some facilities keep a room visit activity log in the resident's
room for the staff to note what was offered to the resident. It includes information such as date of
visit, length of visit, what was offered and how the resident responded. The visit sheet is kept in a
private location (inside closet door or similar place) that the CNA's know about. We provide the
supplies and such and the CNA or other staff can offer it. Once a month, we take the in room visit
sheet back and post a new one and the activities the other staff have offered can be integrated into
our documentation and notes. Make sure the specific in room interventions you create are included
within the care plan and discussed with the charge nurse so she/he can assist with encouraging the
CNA's to offer what you have suggested. If you have any other questions, feel free to email me back.
________________________
QUESTION: I am a certified Activity Director in a snf/ rehab. The capacity of the building is 127
beds but our census is 112. I am a staff of two including myself. My first question is regarding
staffing for an act dept. Is there any reg that states how many staff are sufficient in activities? My other
question is, In our facility, we have a new MDS coordinator that started. She wants to take a social
services section of the MDS and add it to Act's. Can she do that? Sincerely
RESPONSE: Unfortunately, there are no federal regulations which define staffing ratios. I am from
NJ and we are one of the few states who have staffing ratios within our state regulations. If you let me
know which state you worked in, I could try and find out for you. But, in NJ - your staffing
ratios would not work for us.
Regarding the MDS question, the MDS coordinator "coordinates" the completion of the MDS so the
different sections can be divided amongst the professionals who might best answer that section.
There are a number of questions on the social functioning section that are relevant to activities so it
would not be hard to complete. But, I do hear the concern in your email - because it is more work on
minimal staffing. Sorry I am not much more help than that.
_____________________
QUESTION: Is there a specific activity assessment that can be used for Alzheimer's residents? Or
what information should be on the assessment? We recently opened an Alzheimer's unit and have a
lot of questions.
RESPONSE: A different assessment for the dementia unit is not a bad idea. Focusing more
specifically on cognitive and behavioral issues would allow a more thorough assessment of the
resident's needs and abilities. Instead of just noting "alert, confused or forgetful", the assessment
could break down a number of the cognitive functions such as memory, attention span, problem
solving, reasoning, etc. Additionally, more information could be noted regarding behaviors and
triggers to behavior. As far as any one assessment to recommend, I do not have one. If you have
any additional questions regarding the unit and programming, feel free to email me back.
________________________
QUESTION: I am a new activity Director, at our facility. I have not ever worked at a nursing facility
before. I am having trouble with the paper work and how a care plan is done how often? How to do
the assessment, how to write a care plan, properly, Please help me the surveyors will be coming into
our facility soon. Desperately in need
RESPONSE: You need to invest in some good books to act as an on-site guide. Some good
documentation books are Activity Documentation in a Snap
http://www.idyllarbor.com/cgi-bin/SoftCart.exe/books/B457.HTM?E+scstore
The Care Plan Cookbook http://www.rec-therapy.com/rtc_cookbook.html
Assessment the Cornerstone of Activity Programs
http://www.venturepublish.com/itemDetails.asp?ItemID=CAP69&ReferringURL=list&CategoryID=2
There are also some web sites to provide you with information. My web site has a page on helpful
information about documentation http://www.dhspecialservices.com/documentationtips.htm
If you go to many of the other activity web sites, many of them have pages for documentation.
The other suggestion is to talk to your MDS coordinator. He/she can tell you time frames. Usually,
the initial assessment has to be done within 14 days, the care plan within seven days of that and
progress notes and care plan review every 90 days. If you have medicare or short term residents,
that may change things. You need to talk with the person in charge of the MDS. Your social worker
may also be able to guide you as to time frames of documentation. There are state/federal regs and
then there are facility policy. You need to find out both.If I can be of any other assistance, email me
back. Good luck,
________________________
QUESTION: What are some company names that have diversional activities for geriatric patients. I
am looking for catalogs or websites. Thanks for your help,
RESPONSE: I personally like to use real items from the home that can be sought through
donations from families and staff (baby clothes, old jewelry, buttons, old photographs...that sort of
thing.) I think the residents respond better to familiar items from their past. But catalogs that sell
plastic manipulatives and puzzles are:
Sea Bay Game Co.: http://www.seabaygame.com/index.html
S & S: http://www.ssww.com/store/browse/grp=HCR/
Nasco: http://www.enasco.com
Good luck,
________________________
QUESTION: I am a new program Director on an Alzheimer's unit in a skilled nursing facility in Ma.
I need to hire a 40 hour staff person with experience. Any words of wisdom for the most effective way
to accomplish this? Is there a local organization I could contact? Just discovered this site and I think
it will be great help.
RESPONSE: Hi, congratulation on your new position. Finding and hiring and keeping the right
people as employees is harder than it looks. As far as an association in MA, I am not certain. Here
are the names of the state contacts for NCCAP - they might know of a local or state association in
your state.
Diane Perry dperry@NHS.healthlink.org 978-921-5020 ext 2102
978-356-7127 (H)
Anne Eagan Activitylady@aol.com 508-879-8000 (w)
508-877-5780 (h)
I have a job board on my web site, where you can post the information. It is a free services. http://www.
dhspecialservices.com/jobboard.htm There are a lot of good web sites which can provide advice
and guidance for interviewing staff. Following is just one site...
http://www.hrm.msstate.edu/employment/HiringToolKit/Interviewing101.htm Just type in "conducting
an interview" and lots of sites come up. One school of thought is to have a list of prepared questions
that you would ask each candidate. The reasoning is - how can you evaluate each person to each
other - if you ask them all different questions. So, one bit of advice is to create a list of questions for
your interviews. Good luck,
________________________
QUESTION: Hi Debbie, I moved to Ca. from La. I have a Activity Director Certificate from La. will I
need to change my Certificate to Ca? Thank you
RESPONSE: You can check out this web site to look at the state regulations
http://www.hsr.umn.edu/NHRegsPlus/
The California regulations site a 36 hour course. How many hours was the one you took in LA?
This is the state NCCAP contact for CA. She would be better able to tell you what you need to work in
CA.
Kennie Benner-Hill kengram@pacbel.net 707-678-8800
There is also a news group of California Activity Professionals. You can post the question there and
hopefully someone from that state can better answer your question.
http://groups.yahoo.com/group/CaliforniaActivityProfessionals/
Good luck,
________________________
QUESTION: Do you have any suggestions for small low functioning groups, some of these are
folks that don't do anything but make eye contact, I do sensory lotions pictures etc, need some new
ideas thanks.
RESPONSE: You can't go wrong with theme sensory baskets. Theme baskets include a variety of
items focusing on each of the senses. For example, in an Autumn basket - you would have pine
cones, fall leaves, photos of fall foliage, small pumpkins, smells of cinnamon and apples, one of
those new age tapes made for the seasons (I have Autumn in New England and it just sounds cozy).
If the resident is NPO (cannot have anything by mouth), I would stay away from the food smells and
not offer anything to eat. But if they can eat, some applesauce or cinnamon tea would be nice.
You can make theme baskets based on seasons, holidays, life themes (babies, sports, cultures)
and anything else you identify as a past interest in the resident. Even if the resident does not
respond, we need to believe that it is bringing the resident some joy or comfort in it's familiarity.
individuals with AD "busy" for eight hours a day. Constant involvement in active programming could
be over stimulating. As activity professionals, we create opportunities for our residents. Those
opportunities are a balance of group and individual activities, active and passive participation and
periods of rest. To achieve this, we need the support of interdisciplinary staff. If you are running a
group program with some of your population - the team needs to join in and assist with the rest
of your population. So, to answer your question "how can one person keep 52 resident with AD busy
for eight hours?" - it cannot be done. It takes a cooperative team to create a meaningful lifestyle for
these residents. One person alone cannot do it. You could facilitate it, come up with ideas and
offer direction to the team members - but you cannot do it alone. With 52 residents on the unit, they
need to be assessed as to what their needs are. Some need groups, some need individual
approaches, some need a balance of the two. As the activity professional, you define the programs
and approaches for each person. The team needs to help carry them all out. If you are a part of care
planning, that is where the discussion should begin. Hope that helps and good luck, Debbie
______________________
QUESTION: I was an assistant activities director at an assisted living facility and became the
director. Where can I find information to become certified?
RESPONSE: If you told me which State you worked in, I could better tell you specifics about
instructors in your area. To find instructors in your State, visit the NCCAP web site. They have an
instructor page which lists approves instructors by State. They also have a listing of instructors who
are approved to teach the courses through independent study.
http://www.nccap.org/about/educators/index.sht
_____________________
QUESTION: I'm trying to find the track 5 certification form on line. I'm done with training but would
like to send it in by 12/06.
RESPONSE: The Track 5 for NCCAP has been extended to June, 2007. (But still get it out
as fast as you can). Here is the link to the NCCAP download page. Track five is listed and you can
download and print it out from this page. http://www.nccap.org/about/downloads.shtm
_____________________
QUESTION: What kind of training is required to be an activity professional? Is the training geared
specifically to geriatrics? I work with adults with developmental disabilities and really could use
some training somewhere. Any info would be greatly appreciated!
RESPONSE: There is very specific training to be an activity professional. The National Certification
Council for Activity Professionals has developed a course which includes specific curriculum for the
working activity professional in LTC. It includes information about the elder resident, documentation
relevant to nursing homes and medical day care, and programming for the elder participant. You can
access information about the MEPAP (Modular Education Program for Activity Professionals) at the
NCCAP web site. www.nccap.org
Your work with developmentally disabled is related to what we do in that you are assessing and
adapting programs to your population. The technique is similar but the population and regulations
are different. If you need additional information, feel free to email me back
________________________
QUESTION: Hello, I am a Activity Director in a rehabilitation health care facility I have 55 residents
and a lot of them are in room on bed rest or in room because of major health problems. My question
is on doing 1:1's some have family's there all day and just a few doesn't have anyone. I have no
assistant its just me and no volunteers Do I have to chart in program notes for the visits or just chart
on my activity 1:1 sheet the time and date and who did the activity some of the CNA's do individual
time with a lot of the residents. I have no advisor I'm sort of on my own. I need some advice and
help. Thank you so much.
RESPONSE: Activities is defined as group programs offered by the facility as well as family visits,
amongst other things. So, the family visits would count toward the resident's quality of life and
"activity". In your progress notes, I would mention the family visits (frequency and what they do while
there). In your 1-1 documentation (1-1 activity sheet you mention), if you see the family visiting, that
could be noted. Many 1-1 or attendance logs have a code for family visits. As far as the CNA's doing
things, yes - that could be noted as well. Some facilities keep a room visit activity log in the resident's
room for the staff to note what was offered to the resident. It includes information such as date of
visit, length of visit, what was offered and how the resident responded. The visit sheet is kept in a
private location (inside closet door or similar place) that the CNA's know about. We provide the
supplies and such and the CNA or other staff can offer it. Once a month, we take the in room visit
sheet back and post a new one and the activities the other staff have offered can be integrated into
our documentation and notes. Make sure the specific in room interventions you create are included
within the care plan and discussed with the charge nurse so she/he can assist with encouraging the
CNA's to offer what you have suggested. If you have any other questions, feel free to email me back.
________________________
QUESTION: I am a certified Activity Director in a snf/ rehab. The capacity of the building is 127
beds but our census is 112. I am a staff of two including myself. My first question is regarding
staffing for an act dept. Is there any reg that states how many staff are sufficient in activities? My other
question is, In our facility, we have a new MDS coordinator that started. She wants to take a social
services section of the MDS and add it to Act's. Can she do that? Sincerely
RESPONSE: Unfortunately, there are no federal regulations which define staffing ratios. I am from
NJ and we are one of the few states who have staffing ratios within our state regulations. If you let me
know which state you worked in, I could try and find out for you. But, in NJ - your staffing
ratios would not work for us.
Regarding the MDS question, the MDS coordinator "coordinates" the completion of the MDS so the
different sections can be divided amongst the professionals who might best answer that section.
There are a number of questions on the social functioning section that are relevant to activities so it
would not be hard to complete. But, I do hear the concern in your email - because it is more work on
minimal staffing. Sorry I am not much more help than that.
_____________________
QUESTION: Is there a specific activity assessment that can be used for Alzheimer's residents? Or
what information should be on the assessment? We recently opened an Alzheimer's unit and have a
lot of questions.
RESPONSE: A different assessment for the dementia unit is not a bad idea. Focusing more
specifically on cognitive and behavioral issues would allow a more thorough assessment of the
resident's needs and abilities. Instead of just noting "alert, confused or forgetful", the assessment
could break down a number of the cognitive functions such as memory, attention span, problem
solving, reasoning, etc. Additionally, more information could be noted regarding behaviors and
triggers to behavior. As far as any one assessment to recommend, I do not have one. If you have
any additional questions regarding the unit and programming, feel free to email me back.
________________________
QUESTION: I am a new activity Director, at our facility. I have not ever worked at a nursing facility
before. I am having trouble with the paper work and how a care plan is done how often? How to do
the assessment, how to write a care plan, properly, Please help me the surveyors will be coming into
our facility soon. Desperately in need
RESPONSE: You need to invest in some good books to act as an on-site guide. Some good
documentation books are Activity Documentation in a Snap
http://www.idyllarbor.com/cgi-bin/SoftCart.exe/books/B457.HTM?E+scstore
The Care Plan Cookbook http://www.rec-therapy.com/rtc_cookbook.html
Assessment the Cornerstone of Activity Programs
http://www.venturepublish.com/itemDetails.asp?ItemID=CAP69&ReferringURL=list&CategoryID=2
There are also some web sites to provide you with information. My web site has a page on helpful
information about documentation http://www.dhspecialservices.com/documentationtips.htm
If you go to many of the other activity web sites, many of them have pages for documentation.
The other suggestion is to talk to your MDS coordinator. He/she can tell you time frames. Usually,
the initial assessment has to be done within 14 days, the care plan within seven days of that and
progress notes and care plan review every 90 days. If you have medicare or short term residents,
that may change things. You need to talk with the person in charge of the MDS. Your social worker
may also be able to guide you as to time frames of documentation. There are state/federal regs and
then there are facility policy. You need to find out both.If I can be of any other assistance, email me
back. Good luck,
________________________
QUESTION: What are some company names that have diversional activities for geriatric patients. I
am looking for catalogs or websites. Thanks for your help,
RESPONSE: I personally like to use real items from the home that can be sought through
donations from families and staff (baby clothes, old jewelry, buttons, old photographs...that sort of
thing.) I think the residents respond better to familiar items from their past. But catalogs that sell
plastic manipulatives and puzzles are:
Sea Bay Game Co.: http://www.seabaygame.com/index.html
S & S: http://www.ssww.com/store/browse/grp=HCR/
Nasco: http://www.enasco.com
Good luck,
________________________
QUESTION: I am a new program Director on an Alzheimer's unit in a skilled nursing facility in Ma.
I need to hire a 40 hour staff person with experience. Any words of wisdom for the most effective way
to accomplish this? Is there a local organization I could contact? Just discovered this site and I think
it will be great help.
RESPONSE: Hi, congratulation on your new position. Finding and hiring and keeping the right
people as employees is harder than it looks. As far as an association in MA, I am not certain. Here
are the names of the state contacts for NCCAP - they might know of a local or state association in
your state.
Diane Perry dperry@NHS.healthlink.org 978-921-5020 ext 2102
978-356-7127 (H)
Anne Eagan Activitylady@aol.com 508-879-8000 (w)
508-877-5780 (h)
I have a job board on my web site, where you can post the information. It is a free services. http://www.
dhspecialservices.com/jobboard.htm There are a lot of good web sites which can provide advice
and guidance for interviewing staff. Following is just one site...
http://www.hrm.msstate.edu/employment/HiringToolKit/Interviewing101.htm Just type in "conducting
an interview" and lots of sites come up. One school of thought is to have a list of prepared questions
that you would ask each candidate. The reasoning is - how can you evaluate each person to each
other - if you ask them all different questions. So, one bit of advice is to create a list of questions for
your interviews. Good luck,
________________________
QUESTION: Hi Debbie, I moved to Ca. from La. I have a Activity Director Certificate from La. will I
need to change my Certificate to Ca? Thank you
RESPONSE: You can check out this web site to look at the state regulations
http://www.hsr.umn.edu/NHRegsPlus/
The California regulations site a 36 hour course. How many hours was the one you took in LA?
This is the state NCCAP contact for CA. She would be better able to tell you what you need to work in
CA.
Kennie Benner-Hill kengram@pacbel.net 707-678-8800
There is also a news group of California Activity Professionals. You can post the question there and
hopefully someone from that state can better answer your question.
http://groups.yahoo.com/group/CaliforniaActivityProfessionals/
Good luck,
________________________
QUESTION: Do you have any suggestions for small low functioning groups, some of these are
folks that don't do anything but make eye contact, I do sensory lotions pictures etc, need some new
ideas thanks.
RESPONSE: You can't go wrong with theme sensory baskets. Theme baskets include a variety of
items focusing on each of the senses. For example, in an Autumn basket - you would have pine
cones, fall leaves, photos of fall foliage, small pumpkins, smells of cinnamon and apples, one of
those new age tapes made for the seasons (I have Autumn in New England and it just sounds cozy).
If the resident is NPO (cannot have anything by mouth), I would stay away from the food smells and
not offer anything to eat. But if they can eat, some applesauce or cinnamon tea would be nice.
You can make theme baskets based on seasons, holidays, life themes (babies, sports, cultures)
and anything else you identify as a past interest in the resident. Even if the resident does not
respond, we need to believe that it is bringing the resident some joy or comfort in it's familiarity.
| for Activity Professionals in Long Term Care Settings admin@theactivitydirectorsoffice.com Copyright 2004-Present The Activity Director's Office All Rights Reserved Disclaimer |
| THE ACTIVITY DIRECTOR'S OFFICE |