THE HEART OF SENIOR LIVING
However, he said the only negative situation he has experienced was when a resident roughly grabbed his dog’s paw. “She didn’t yelp or bite, and she wasn’t hurt. But we have to be cautious and keep an eye on these interactions.” Ultimately, Steinberg said, there are
tremendous benefits to dogs, many that outweigh the risks. He said, “I have seen many people with agitated behaviors that were de-escalated by the presence of dogs.” In fact, he said that in one building, the nurses would call him and ask him to bring the dogs to someone’s room when they got agitated or upset. Steinberg also noted that in one com-
munity, people are actually encouraged to bring their dogs to work. “It makes the place seem for homelike. The dogs are part of the daily routine, and they bring the stress down for residents and staff alike,” he said.
Robo-Dogs Can Help When it’s not possible or feasible to have real dogs onsite, robotic dogs can help. Amanda Maske, RN, vice president of healthcare services, ALG Senior, has used these successfully with many of her
residents. For instance, one memory care resident was having two to three falls daily and was very agitated. Staff and the family were discussing if it might be necessary to discharge him or move him to another level of care for his own safety. “We had a robotic dog that no one had
ever used. I got it working and took it to him. It made a huge difference. He loved that dog and took it everywhere. You could see how happy it made him, and eventually his falls went down to zero,” Maske said. The man was able to stay in the unit and enjoy a quality of life until he passed away. At ALG Senior, robotic pets are part of
Reflections, a person-centered memory care program that features proven interventions and an innovative app, is maximizing qual- ity of life for ALG Senior residents while engaging staff. “This program is designed to capture
our resident’s special moments, but also to reflect on who they were in the past,” said Maske. She stressed that it allows her team to validate residents’ lives and give them purpose. The program features themed life en- gagement stations that are strategically
placed throughout the community, said Maske, “to evoke memories of familiar work, chores, and life experiences residents may have had.” Thes stations, along with a calm and quiet physical environment, are designed to provide meaningful interaction for residents. In addition to robotic pets, the program focuses on aromatherapy, natural light, and music. ALG Senior has a behavioral expressions
intervention component in its electronic records. If there is an issue or a behavior, the resident is presented with one of these four efforts based on their preferences and history. This is then documented on a flow sheet and tracked over time. Data for the pilot was difficult to track because it was conducted during the pandemic. Residents were more isolated, and staff turnover made consistency and follow through challenging. However, they saw a decrease in reported behaviors and falls. Maske noted, “The feedback we got from administrators and staff was very positive; and we even got a letter from a family mem- ber thanking us for what we were doing.” The kudos from staff were especially meaningful as they were generally skeptical at first.
AMONG THE FREQUENTLY ASKED QUESTIONS CONCERNING THE PROGRAM
Memory care is a very personalized practice, and it is essential to have a way to communicate and share care plans, outcomes, innovations, and ideas with staff and families alike. Staff turnover makes consistent care and communication challenging. At the same time, when things are changing on a daily basis, something that worked last night may not work tomorrow. When something does work, it’s important for staff to be able to share this information.
To address these issues, ALG Senior uses Ella, an app that provides decision-making support at the point of care. It empowers caregivers by prompting them to provide person-centered care practices. Ella lets users add a reaction/behavior with specific questions related to that reaction. Caregivers also can choose from a library of interventions/approaches to prevent/reduce reactions. It eventually will be powered by an algorithm that utilizes resident-specific history, preferences, and past successes or failures with various nonpharmacologic care practices.
It is important for staff to know what has worked or not work with specific residents. For example, if someone was a florist and a team member has found that giving them flowers to arrange calms them down, they can document and share this with other team members. “There are a number of nonpharmacologic interventions that are very effective if you know the person; and these also can help reduce transfers and increase lengths of stay,” said Michelle Kronquist, director of psychological services for ALG.
Kronquist noted that the app provides tools and interventions that caregivers need to meet residents’ needs and assists in achieving important outcomes. She adds, “When adverse behaviors are de-escalated and prevented due to Ella’s interventions caregivers’ productivity, satisfaction, and engagement is improved.”
While the app is clinically focused, Kronquist noted, it has a business side by enabling facilities to target all the right codes so they can bill more accurately.
50 SENIOR LIVING EXECUTIVE MAY/JUNE 2023
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