Therapy « The Professional Geriatric Care Manager’s Blog

Hoarding Heartache

July 18, 2011 at 10:30 am | Posted in Pat Linard, PR | Leave a comment
Tags: Education, Health, Help, Life, News, Support, Therapy

I attended a seminar recently on hoarding at The Brownstone in Paterson, NJ. (Just a little aside, for those of you who are fans of Real Housewives of New Jersey, The Brownstone is the catering place owned by Caroline Manzo and her family of Franklin Lakes, NJ.) It was a lovely venue for a difficult topic; the event was sponsored by a local nursing home and rehabilitation facility. I learned some very interesting things in this three hour seminar from what hoarding is to tips on how to deal with it. Although most people would consider it a mental health issue, it is not listed as such in the Diagnostic and Statistical Manual of Mental Disorders.

The bottom line, however, is that hoarding is a disorder that is extremely difficult to resolve. Usually it has roots in information processing deficits and emotional dysfunction. And they are now thinking that it could also have a genetic component. Many people would consider it an obsessive compulsive disease, however hoarding has only the compulsive part since hoarders don’t obsess about what to save. They save it all! Every item has the same “value” as another, whether it be a drug store flyer or a stock certificate.

I learned some good tips about working with older adults who may be a hoarder. They and their possessions need to be respected. Although safety is of the utmost importance, it is best not to be critical of the client’s environment. The client needs to be involved in any decisions and it is best if the clean-up process is done slowly and with gradual changes.

Hoarding is a difficult problem to work with it, but there are organizations that are available to help and often a therapist can assist in the desensitization process. Often, medication management can be of help with drugs to treat anxiety and attention deficit disorder. Hoarding is a topic that is gaining more and more attention.

Distinctive Care Geriatric Care Management serves Bergen, Passaic, Rockland and Orange County with nurses licensed in New Jersey and New York. We help families dealing with various issues related to their elderly loved ones and would be happy to discuss any concerns you may have related to long term care. Please contact us in our Ridgewood Office at 201-587-5283 to schedule a consultation.

Validation Therapy

June 15, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Alzheimer's Disease, Dementia, Education, Family, Help, Therapy, Tips

Yesterday, I had the opportunity to attend another one of Sophia Heftler’s continuing education programs, this one on Alzheimer’s Disease and Dementia Care. She is certified to teach this program by the National Council of Certified Dementia Practitioners (NCCDP). I would highly recommend it for any health care professionals who care for patients with dementia.

Among many points covered was the importance of using validation therapy, versus reality orientation, when dealing with a client with dementia. It is better to “enter their reality” and show empathy and respect for their feelings than to continually try to correct them. If we can help a person identify and describe the feelings behind difficult behavior, we acknowledge and validate their thoughts and feelings. By allowing negative thoughts to be expressed and respected, and then redirecting the conversation toward a more positive outlook, the interaction will have lasting beneficial effects.

In our rushed world, I am sometimes quick to set the facts straight when my parents are confused about something, instead of trying to understand the concerns which lurk behind their statements. Now I have a refreshed determination to apply the validation approach to them, as well as other older adults I encounter.

Pet Assisted Therapy

April 29, 2011 at 10:30 am | Posted in Sophia Heftler, GCM | Leave a comment
Tags: Life, Pet Assisted Therapy, Therapy

Pet Assisted Therapy is a form of therapy that has been around for many centuries. There are many forms of it, but most people are familiar with therapy dogs. Therapy dogs must go through a rather rigourous training program and must pass a special test to become certified. Benefits of utilizing a certified therapy dog include the knowledge that the dog has passed the comprehensive testing process, is insured and that the handler, too, is prepared to work with the dog appropriately.

Other animals used for pet assisted therapy include fish, birds, rabbits, and many others, even some reptiles. Van Saun Park in Bergen County, NJ, has a special program which brings various zoo animals into nursing facilities.

Distinctive Care has Romeo, our therapy dog, who is an instrumental member of our team and the work we do. As Romeo’s mom and handler I have the privilege of working very closely with him and our Clients. His effect on our Clients has been nothing short of amazing, as I have watched him bring catatonic Clients back into the moment, Clients who have lost the ability to speak utter words, and just plain joy to the majority of our Clients.

Romeo is available for visits. To arrange for a visit please call Distinctive Care’s Ridgewood office at 201-857-5283. We assist Clients in counties throughout northern New Jersey and in parts of New York State.

Additionally we have a community program available to nonprofit organizations available. If you are interested in this program please contact our Director of Community Relations, Pat Linard directly at 551-580-5639.

Healthy Gardening

April 28, 2011 at 10:30 am | Posted in Amy Shein, GCM | Leave a comment
Tags: Community, Gardening, Health, Life, Personal, Therapy, Tips

I was visiting one of my clients who has Alzheimer’s yesterday and happens to live in an assisted living facility. The activates director had asked me if I would like to come join in with my client next week to help plant and start their new garden at the facility. They would be planting all around the grounds and making it the residents’ project. I thought that was such a fabulous idea! Allowing all the residents to help make their home beautiful and special in a group effort is something so priceless. It will show how welcoming their home is to family, friends and all others that come to work and live at the facility. Planting a garden isn’t only a great way to promote physical fitness, it also promotes mental health. There are a number of groups that have been established to promote the use of horticultural therapy with persons who have mental illness. Planting has been recognized for hundreds of years as having healing and restorative benefits. Recent research has shown specific stress reduction effects, which is of benefit to persons with depression, anxiety disorders, and many other mental illnesses. Plant gardening is now being formally incorporated into many therapy programs as part of many patients’ care. Some botanical gardens have partnered with health and human services agencies to provide horticultural therapy programs to the community. Plant gardening for health will provide us with an environment filled with beauty, fragrance, and healthy food. A perfect garden would include all types of plants, including flowers, leafy shrubs, herbs, and vegetables. Depending on your gardening choices, your garden may result in fresh-cut flowers for your home, or for gifts. I am looking forward to pitching in with my client next week and her fellow residents, to making a beautiful garden come together. I will have to take lots of pictures to share with my co-workers and other clients. Hopefully I can pass the word on to many of the other skilled nursing homes, long-term care and rehabilitation centers that I visit of this wonderful idea to start a community garden.

Validation Therapy

March 4, 2011 at 10:30 am | Posted in Sophia Heftler, GCM | Leave a comment
Tags: Alzheimer's Disease, Dementia, Education, Help, Therapy, Validation Therapy

In my earlier post I talked about the stigma associated with nursing homes. Today I thought I would share with you the experience I had in providing sensitivity training to the staff of a local nursing home. This particular nursing home is a facility that Distinctive Care makes referrals to, so we know they are a high quality facility. The fact that the administrator (who has been with the facility for 8 years) and the Director of Nursing (who has been with the facility for 7 years) decided to bring this program in for the staff is telling with regard to the fact that they are dedicated to ensuring the best of care for the residents with dementia.

Validation Therapy is the brainchild of Naomi Feil, a social worker. It is a process in which the caregiver doesn’t try to change the person she is caring for, but instead changes herself and actually enters the world of the person with dementia. Reality Orientation, which is a technique used in the past, is no longer used when the resident with dementia is asking for her mother who has been deceased for more than 40 years because researchers have determined that this causes the resident to relive the painful memory. Validation Therapy is not the same as “therapeutic lies” because, as Ms. Feil discovered, the person with dementia knows on some level that she is being lied to and this creates an environment of mistrust toward the caregiver.

Validation Therapy is used to validate the feeling behind the behavior the resident is displaying and to provide empathy and understanding, creating a feeling of trust and assisting the resident to resolve open issues they have in their lives before they die. It is not something that one can master overnight, but the interest and openess of these caregivers to learn about this technique and to incorporate it into their practice was amazing. The level of care and concern they showed during the inservice I provided was amazing.

They have promised me they are going to give it a try. A big part of Validation Therapy is asking questions of the resident to determine what the feeling behind the behavior is, as all behavior has meaning. As I was leaving the facility I heard a caregiver ask a resident who was repeatedly asking for her mother if she felt scared. The resident responded that she felt lost and scared. The caregiver then asked what her mother used to do for her in the past when she felt lost and scared. The resident replied that her mother used to rub her back and sing to her. The last thing I noted as I was walking down the hallway was the caregiver rubbing the resident’s back. She really understood what Validation Therapy is all about; I was very proud.

Distinctive Care Geriatric Care Management has many in-services available for staff in facilities throughout New Jersey. If you are interested in bringing one of our programs to your staff please contact Pat Linard, our Director of Community Relations who will be able to provide you with a list of our current programs or let you know if we can customize a program based on your needs. She can be reached in our Ridgewood office in Bergen County at 201-857-5283.

Unconditional (Furry) Love

February 16, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Pets, Therapy

Call us crazy, but at a time when my siblings and I were already struggling to meet the 24/7 caregiving needs of both parents, we added another dependent to the family. Yes, my parents adopted a cat.

A lifelong cat lover, I must admit I was reluctant at first. Many would question the wisdom of adding a pet when both parents are struggling with health issues and advancing in age. But as Dad was recovering from his stroke and beginning to take very short walks in the neighborhood, we realized the highlight of his day came every time a neighbor’s cat trotted out to greet him.

Long story short, my parents adopted a senior-citizen-kitty on a trial basis. Well, the “trial” ended within 48 hours because Quinn immediately made herself at home and behaved as if she’d lived there all her life. She became a constant companion and lap-warmer to my Mom, who can no longer do most of the activities she used to enjoy, but is always ready to give and receive some TLC.

Older pets can be wonderful companions, especially for the elderly. Their personalities are well-established and their behavior is typically calmer. There is something special in the bond between a geriatric owner and a geriatric pet, who appreciates getting another chance at living a good life in its golden years. Animal shelters typically have a difficult time finding homes for older pets, and will often waive or reduce the adoption fees of an older animal. Should the owner be unable to continue caring for their companion, many shelters will require the animal be returned to their care.

Of course, for many older adults, pet ownership is not feasible due to the responsibilities required, the expense or even restrictions imposed by their living environment (residents of apartments, nursing homes, assisted living communities, etc.) For them, pet therapy can be ideal. Visits from a certified, trained therapy animal can bring joy and a break from the usual routine, without any long-term commitment required. It reminds me of those who say the best thing about having grandchildren is that you get to have fun with them AND send them home at the end of the day!

Distinctive Care Geriatric Care Management serves Bergen, Passaic, Rockland and Orange County with nurses licensed in New Jersey and New York. We help families dealing with various issues related to their elderly loved ones and would be happy to discuss any concerns you may have related to long term care. Our staff even includes Romeo, a professionally trained Pomeranian dog, certified in pet therapy. Please contact us in our Ridgewood Office at 201-587-5283 to schedule a consultation.

Post Traumatic Stress Disorder

February 11, 2011 at 2:30 pm | Posted in Sophia Heftler, GCM | 1 Comment
Tags: Behavioral, Cognitive, Geriatric Therapist, PTSD, Therapy, Trauma

Many of you who have been following this blog know how important mental health is to me, as I suffer from several psychological disorders and work very hard to help eliminate the stigma associated with mental illness. It’s very hard work and people are still very frightend by things they don’t understand. Recovery is possible, although it is an ongoing process. In the older adult population it is often difficult to diagnose and treat mental illness. Our Geriatric Care Mangers and Geriatric Therapist work with our Clients to determine whether treatment is necessary as part of the overall care plan and our goal of helping our elderly Clients reach their maximum level of functioning.

One of the things that I have noted during Distinctive Care’s assessment and evaluation process is that many of our older adults and senior citizen population actually suffer from Post Traumatic Stress Disorder (PTSD), which has a profound affect on their current quality of life.

Many people think about Vietnam War veterans when they think of PTSD, and of our current soldiers fighting in Iraq and Afganistan; however, the disorder was actually first noted after soldiers returned from WWII and it was referred to as “shell shock” or “combat fatigue”. Many of our Clients are veterans and we have found that those who present with behavioral or cognitive issues do have PTSD and are experiencing the signs of the disorder.

There are three cardinal symptoms of PTSD and to meet the criteria of diagnosis these signs must be present for a period of time greater than one month. After experiencing or even witnessing a traumatic event which resulted in intense fear, helplessness or horror the person involved in this may begin to experience symptoms either immediately or many years after the event. (In my case a devastating event triggered memories of a trauma I had experienced as a child some 30 years after the event.) If your elderly parent or loved one suffers from reexperiencing the event, avoidance (or numbing) of things associated with the event, and a heightened sense of arousal (anxiety attacks, hypervigilance or behavioral changes), he or she may be suffering with PTSD.

With proper treatment, recovery is possible. Current treatments include cognitive behavioral therapy (talk therapy with a mental health professional), medical management (prescribed antidepressant medication and monitoring) or a combination of both. The combination treatment has been found to be most effective.

Interestingly enough studies have found that women suffer from PTSD at higher rates than men despite the fact that most of our veterans are men. In the older adult population many women suffered abuses that were never spoken of, and as they age and begin to suffer from cognitive decline associated with Alzheimer’s Disease and other dementias they begin to relive the abusive event and behavioral symptoms which are really symptoms of PTSD.

Many of our elderly have lived through The Great Depression, are Holocaust survivors, victims of Japanese Interment Camps and are WWII veterans. We have discovered that many of these elderly loved ones are sufferning with PTSD and have witnessed the improvement in their quality of life with proper treatment. This is something I am passionate about having experienced what it is like to live with this disorder and have worked with our staff to educate them on the importance of thourough investigation of the root of behavioral problems…all behavior has meaning and as Geriatric Care Managers it’s our mission to investigate the meaning behind untoward behaviors that are affecting the quality of life of both our Clients and their caregivers.

Please feel free to contact me at Distinctive Care if you need help dealing with behavioral issues. I can best be reached at our Ridgewood office in Bergen County at 201-857-5283 to discuss your individual issues. Distinctive Care serves Clients in Bergen and Passaic County in New Jersey and Rockland, Orange and Westchester Counties in New York. Our Professional Care Managers are all Registered Nurses and we have a Geriatric Therapist on staff. We work very closely with the area’s most highly regarded geriatricians and are very strong advocates for our Clients. If you are at the point where you are thinking about making the call, it’s probably really time to make the call…you will speak with me personally and may find that just having the conversation is exactly what you needed to help get you through the challenges that come with being a caregiver.

Pet Therapy

July 28, 2010 at 4:12 pm | Posted in Pat Linard, PR | Leave a comment
Tags: Caregiver, pet therapy, Seminar, Therapy

It is easy to see how important a pet is in the life of a family. What is not as easy to see is how important a role a pet can play in the life of an elderly or ill person. Healing with Love through Pet Therapy will be presented by Sophia Heftler, RN, CMC, CALA of Distinctive Care Geriatric Care Management in Ridgewood, NJ on Wednesday, August 4 from 5:30-7:00 PM at Sunrise Senior Living of Wayne in Wayne, NJ. A special guest appearance will be made by our own pet therapy dog, Romeo, a lovable, lap size 5 year old Pomeranian.

Studies have shown that the emotional bond between man and animals is indeed healing. This talk will tell you how the presence of a pet in a loved one’s life can not only offer comfort and dispel loneliness, but can also lower blood pressure, lower heart rate and calm anxiety. Whether it be in the home or in an assisted living facility or a rehabilitation and nursing home, a pet can make the difference, whether it be for one hour or 24 hours. Come learn the special training that is required of therapeutic pets before they earn that special distinction between pets. To join us, call (973) 628-4900. Wine and cheese…coffee and dessert will also be served.

Complementary and Alternative Therapies in Dementia Care

May 20, 2009 at 2:30 pm | Posted in Barbara Siembieda, GC | 1 Comment
Tags: Alzheimer's Association, Dementia, Therapy

I attended a very informative session at the recent Alzheimer’s Association New Jersey Conference that explored the varied alternative and complementary therapies available to dementia patients. Research that deals with the easing the effects of dementia behaviors seems to show promising results in the search for new and more non-pharmacological care options for patients with dementia and Alzheimer’s disease. A person-centered care approach was presented in conjunction with a broad spectrum of therapies taken from cultures spanning the globe including: acupuncture/acupressure and Tai Chi (Chinese), ayurvedic (Indian), herb and food extracts, essential oils and aromatherapy, yoga, meditation and guided imagery, massage, light therapy and vitamin and dietary supplements, reflexology, energy fields medicine such as reiki and QiGong, dance and music therapy and, something new to me, Bach flower therapy. It was suggested that these therapies, when applicable to the patient’s level of care and ability and appropriate for incorporation into their care plan, produce a calming and comforting effect that can decrease restlessness and agitated behaviors. Though cost and availability determine the availability of such therapies, they do provide promising and exciting new horizons in the field of dementia and Alzheimer’s disease care.