Residents Helping Residents: A Dynamic Shift in Psychosocial Care
ALFA 2015 Conference Presented by Tess Aiello, Holiday Retirement and Kristine Theurer, MA (Gerontology), MTA
Loneliness and Depression in Senior Living
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loneliness and depression (Victor, 2012; Snowden, 2010)
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diminished sense of purpose (Choi, 2008) limited opportunities for contribution (Brownie, 2014; Malderen, 2013)
“When the Golden Years are Blue” o Prevalence of depression in care homes on admission o 54% and 60% by follow-up (Neufeld, 2014)
o Assisted living—significantly higher depressive symptoms (58%) than community (19%) (McLaren et al. 2013)
o Retirement—depression (21%), loneliness (19%) (Adams, 2004)
“It’s hard to get to know anybody…”
“No one has time…” “People here – they are always in a hurry…., they pass you by and say ‘How are you?’ and then keep going. No one has time – to look, to talk.”
“My room is at the end of the world.”
Theoretical Foundation o
Tom Kitwood’s Concept of Personhood – Fundamental human drive towards helping others—when this drive is inhibited, beings do not thrive (Kitwood, 1997)
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Riessman’s Helper-Therapy Principle – Helping others helps the helpee and helper – Those observing receive benefits too (Riessman, 1965)
“Members use the power of their own experience and of their own wounds to lighten the burden of others, and heal themselves in the process.� (Post, 2011)
Mutual/Peer Support “We recognize peer support as an integral component of a mental health program for older adults.� US Institute of Medicine (2012)
Research and Development The Study (Theurer, 2012) o 6-year pilot: residents chose components o 2-year study: staff manual developed o 65 residents, 7 staff o Complex care and an adult day centre Research and funding o Simon Fraser University o Social Sciences and Humanities Research Council of Canada o Michael Smith Foundation for Health Research
What is the Java Music Club? Why is it unique?
The first standardized mutual support group for senior living—themes, music, photos and readings, a Talking Stick.
1. 2. 3. 4. 5.
Peers helping peers A safe place to share Talking stick ↑ courage Something for everyone Equips residents to support those that are lonely in their home 6. Targets loneliness and depression
The Findings: The Staff’s Experience
“I knew this was a positive program. How positive it was going to be I couldn’t have even imagined.” Donna Levi, Therapeutic Recreation Director
The Findings: The Resident’s Experience
o active participation of those with cognitive impairment o 96% enjoyed the program o low attrition rate (15.4%)
The Resident’s Experience Resident reports indicate: o a decrease in loneliness o feelings of empowerment o the development of new friendships
A New Sense of Belonging
“It's like brothers & sisters that you don't have.�
The Java Music Club and Java Memory Care
“I am amazed at how residents with dementia have responded…short, simple, yet profound answers.” Hilary Lipsett, Staff
Research Published Journal of Applied Gerontology 2012 The Development and Evaluation of Mutual Support Groups in Long-Term Care Kristine Theurer1, Andrew Wister2 Andrew Sixsmith2, Habib Chaudhury2 and Loren Lovegreen3 1University of British Columbia, Vancouver, Canada 2Simon Fraser University, Vancouver, Canada 3Case Western Reserve University, Cleveland, OH, USA
This is different, something special. It takes the loneliness away. Resident
A smashing success—everyone is loving the program! Schlegel Waterloo Research Institute for Aging
I have been doing the Java Music Club have felt honoured to hear the stories and feelings. I also personally feel grateful, I listen and they listen. Thank you for taking the time to train me and for developing such an innovative and needed program. Jackie Kramer, Retirement Recreation, Village of Winston Park
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Implemented in 186 homes across Canada Signature spiritual program Included French translation for Quebec Two trainings – one east coast, one west coast Additional programing being developed for 2016 to address resident-resident bullying
Laura Forsyth – Director of Life Enrichment “By the end of the hour, I witnessed all 10 of these residents coming together – they were hugging and holding each other’s arms as they left the room.” “I have heard so many amazing stories from our Lifestyle and Program Managers from across Canada. They all give me goosebumps and bring tears to my eyes.”
The Serendipity Adult Day Services The Salvation Army
References Adams, K. B., Sanders, S., & Auth, E. A. (2004). Loneliness and depression in independent living retirement communities: Risk and resilience factors. Aging & Mental Health, 8(6), 475-485. doi: 10.1080/13607860410001725054 Brownie, S., Horstmanshof, L., & Garbutt, R. (2014). Factors that impact residents' transition and psychological adjustment to long-term aged care: A systematic literature review. International Journal of Nursing Studies. doi: 10.1016/j.ijnurstu.2014.04.011
Canadian Institute for Health Information. (2010). Depression among seniors in residential care. Ottawa, Canada. Choi, N. G., Ransom, S., & Wyllie, R. J. (2008). Depression in older nursing home residents: The influence of nursing home environmental stressors, coping and acceptance of group and individual therapy. Aging & Mental Health, 12(5), 536-547. Kitwood, T. (1997). Dementia reconsidered: The person comes first. Philadelphia: Open University Press. McLaren, S., Turner, J., Gomez, R., McLachlan, A. J., & Biggs, P. M. (2013). Housing type and depressive symptoms among older adults: A test of sense of belonging as a mediating and moderating variable. Aging & Mental Health, 18(8), 1023-1029. doi: 10.1080/13607863.2013.805402 Neufeld, E., Freeman, S., Joling, K., & Hirdes, J. P. (2014). "When the golden years are blue": Changes in depressive symptoms over time among new admitted to long term care facilities. Clinical Gerontologist, In press. doi: 10.1080/07317115.2014.885919 Post, S. G. (2011). The hidden gifts of helping. San Francisco, CA: Jossey-Bass. Riessman, F. (1965). The "Helper therapy" principle. Social Work, 10(2), 27-32. Snowden, J. (2010). Mental health service delivery in long-term care homes. International Psychogeriatrics, 27(7), 1063-1071. doi: 10.1017/S1041610210000773 Theurer, K., Wister, A., Sixsmith, A., Chaudhury, H., & Lovegreen, L. (2012). The development and evaluation of mutual support groups in long-term care homes. Journal of Applied Gerontology, 33(4), 387-415. doi: 10.1177/0733464812446866 Van Malderen, L., Mets, T., & Gorus, E. (2013). Interventions to enhance the quality of life of older people in residential long-term care: A systematic review. Ageing Research Reviews, 12(1), 141-150. doi: 10.1016/j.arr.2012.03.007 Victor, C. R. (2012). Loneliness in care homes: A neglected area of research? Aging Health, 8(6), 637-649. doi: 10.2217/ahe.12.65
What People Are Saying...
Resident Enrichment & Java Music RESIDENTS HELPING RESIDENTS: A DYNAMIC SHIFT IN PSYCHOSOCIAL CARE
How/Why Consider Java Music?
Memory Care Programming: expansion of music therapy programs and engagement between residents and memory care associates. Independent Living Programming: enhancement to our emotional and spiritual activities while creating additional opportunities to expand our Seniors Serving Seniors volunteer opportunities. Pilot Sites: Java Music agreed to support in piloting 14 Memory Care and 7 Independent Living Enrichment Programs.
Resident Enrichment Philosophy Provide life-enriching activities and events for residents and potential residents that benefit them in every aspect of living: • Physically • Intellectually • Socially • Emotionally • Creatively • Spiritually • Vocationally While continually looking for opportunities to promote their community and the Holiday Lifestyle. A few examples are:
Resident Enrichment Philosophy Exciting Outings
Resident Enrichment Philosophy Baseball Games
Resident Enrichment Philosophy Random Acts of Kindness
Seniors Serving Seniors/Society Program What: International award-winning volunteer program developed by Holiday Retirement. Purpose: To provide opportunities for all 35,000 residents and 10,000 associates to sustain the foundation of the company’s Grass Roots philosophy, which is to serve seniors, each other, and society. Mission Statement: “To coordinate opportunities for senior citizens to serve other seniors as well as society, and in return, enhance purpose and passion in their lives, and enrich the lives of the individuals they serve.� A few examples are:
Seniors Serving Seniors/Society Program Habitat for Humanity
Seniors Serving Seniors/Society Program Holiday Hunger-Aid: Food Drive
Seniors Serving Seniors/Society Program Back-to-School Fundraiser
Seniors Serving Seniors/Society Program National Police Week: Buddy Bear Drive
Java Music Club Experience Quiet & Organized Location
Java Music Club Experience Enticing Refreshments
Java Music Club Experience Open Conversation
Java Music Club Experience Engaging Chimes
Java Music Club Experience Talking Stick = You Have the Floor
Java Music Club Experience Increasing Resident Engagement & Friendships
A Resident Experience ~ Jim & Lise
“They all welcomed me and showed me a lot of kindness and love my very first time. Then I felt like I could share my heart and my feelings. I loved that because it’s like a family; it felt really close to my heart.”
A Resident Experience ~B.J & Fran
“I think it gives everybody a little spiritual uplift also and we can all use that. We’ve all had ups and downs in our lifetime and trust me, when you get to be as old as I am, you’ve been up and you’ve been down.”
A Resident Experience ~Peg
“It is one of the best things I’ve done. I have been able to let go of a lot of stuff I’ve been holding on to. Listening to these people talk about their lives has been an awakening for me. I feel so much better now.”
A Resident Experience ~Jan
“It’s good to be with my friends. We get to visit and sing lovely songs. I’ve gotten to know them in a new way. I really enjoy it.”
Pilot Site Survey Results
Who typically facilitates the Java Music Club at your community? 1 3
Enrichment Coordinator Manager External Volunteer 17
Pilot Site Survey Results
What has the facilitator's experience been like with the program? Positive, easy to execute
1
8 12
Improving, it's just taking us some time Negative, very hard to execute
Pilot Site Survey Results Did you feel trained and ready to execute the Java Music Club after the webinar training? Yes, the webinar training was perfect
3
5 13
No, additional training is important to the success I didn't attend the webinar training
Pilot Site Survey Results
Do you find the printed materials and leader guide easy to follow? 1
Yes No
20
Pilot Site Survey Results How many residents attended your first Java Music Club experience? 2 4
9
4-6 7-10
16+ 11-15 6
Pilot Site Survey Results
What benefits to participants have you seen? 4
2 13
Increased engagement of quieter residents Improved bonding between group members
6
Increased supportive/helping behavior
6 12 8
Increased focus on strengths and capabilities
Pilot Site Survey Results How often do you have the Java Music Club scheduled as a regular program on your activities calendar? 2 3 Once a week Once a month Twice a week 16
Pilot Site Survey Results Do you see a future for Java Music Club in your community? 2
Yes No
19
Next Steps
Problem Solve: work hand-in-hand with Java Music Club and the few communities experiencing confusion to ensure a positive experience and increased resident engagement. Budgeting: work to incorporate Java Music Club into our 2016 budgets. With an expanded portfolio, it’s important to ensure a positive experience and then budget accordingly. Rollout: if/when budgets are approved, roll out Java Music Club one region at a time to ensure success of the program.
Contact Info
Kristine Theurer, MA (Gerontology), MTA info@javamusicclub.com Tess Aiello, Holiday Retirement
tess.aiello@holidaytouch.com