Technojoy for Elders

Isolation is obviously a huge issue for elders living in nursing homes. Of course, there are mobility issues in getting from one room to another in the facility, but even residing in a nursing home keeps elders from the rest of the community. Many residents don’t have phones in their rooms and therefore don’t have the opportunity to pick up the phone to say hi to someone whenever they want. Then there are cognitive impairments that further isolate them by breaking the bridge of communication and understanding with others.

The thing that has made all of our lives easier may be just the tool to address all these isolation issues: the computer. I’ll first say that the gender gap in technology has, itself, caused some isolation for elders in the same way I feel out of the loop with text-messaging teens. It is quite possible that someone living in a nursing home had not even used a computer earlier in life. However, for starters, email makes communication with friends and family more frequent and common than visits, especially from those who live far away. Checking email has become part of daily life for many of us. It can be part of elders’ daily lives too.

Obviously computer skills and access can be the hurtle for elders but HP makes a “printing mailbox” that along with service by Presto, allows people to receive email and photos without a computer and with very little technical knowledge. The system only receives (you can’t reply or send from it) messages from approved email addresses, which means no spam. Imagine one on every hallway, neighborhood or household. If you ever lived away from your loved ones for a period of time, you know how much “mail” can make your day. It is such a simple, and inexpensive, way to bring joy to elders.

Taking elders and computers to the next step is It’s Never 2 Late, a company started by Jack York in ‘99. Using adaptive hardware including touch screens and modified keyboards, the software is designed specifically for nursing homes. It offers engaging activities for elders from puzzles and games to a flight simulator. But, it also has many applications for perpetuating person-centered care. Staff can create power point type presentations to profile each resident in a “get to know me” fashion. One facility made a short video to show other staff members a way to transfer an elder from wheel chair to bed in a way that did not agitate the particular resident. The content can be personalized to meet the needs of individuals and community. Computers have enhanced our lives in many ways and it is exciting to see the possibilities they can offer in nursing homes as well. Contact glenn@actionpact.com for more info on It's Never 2 Late.

Meet me on the Web

Social networking on the Web is not just for kids anymore. For elders, a virtual community is suited to best serve the real need for social interaction. In the late stages of life, and of course when one is living in a nursing home, there’s a good chance that family and friends are scattered geographically. Limited mobility leaves elders dependent on others for initiating visits. With email, suddenly no one is so far away.

While it’s great to be in touch with loved ones, it’s also nice to meet new people and the Web can help there as well. Inspired by the idea of MySpace – meeting new people around the world with whom you share interests – but finding it quite youth slanted, Marian Van Eyk McCain started ElderwomanSpace for social networking for women of the “third age.” It’s an offshoot of her Elderwoman site Just like other online social networks, there are discussion groups, photo sharing, blogs and comment boards. It’s easy to lose track of time this way and while it is still a screen and not a face you are facing, humanity and discovery still comes through. The women on ElderwomanSpace talk about everything from gardens to their families to the issues facing elderwomen.

So, how can we get folks in nursing homes on the Web? Do elders have access to computers at your facility? Any ideas about getting folks interested activities on the net? The Web is really the most immediate tool we have for combating the isolation elders face in nursing homes and it is right in front of our faces, literally. How can we put it to good use?

Elder Storytelling on the Web

It is easy for us to get to hear the stories of the famous people and events in history, but I think the combined stories of ordinary folks are the ones that can best paint a story of our past and our humanity. I’m not alone in this. Anyone ever heard of Ken Burns?

Can you imagine what a nursing home would look like if we could see the stories of our elders projected on the walls and floating around in the air? Such a wealth! Taping into elders’ wealth of stories can make the day more enjoyable and rewarding for everyone. Elders have an opportunity to give of themselves and staff get to know them better giving all involved a greater sense of meaning and purpose.

Friends and family know each other’s stories. It’s one of the reasons we find story telling essential for creating home in long-term care. We get to know each other this way. We can also help facilitate relationships when we recognize a common bond between residents and staff members.

Person-centered care focuses on the individual, but a lot can also be gained from understanding the shared history of elders and the years that shaped their lives. Since history often repeats itself, you may be struck by similarities to current events to those events that have shaped our elders’ lives and world earlier in time. This is a great way to start a conversation with an elder about something you both have experienced. It is a way to recognize shared humanity.

There are some great websites dedicated to elder story telling. You could get lost for days in them, reading snapshots of people’s lives. I hope they will give you understanding and inspiration. These sites also have ways for readers to contribute stories. Pull yourself and an elder up to a computer and share a story with the rest of us! You could also use a story from one of these sites as an ice breaker or learning circle to get folks to share their own stories.

I, Witness to History was founded in 1996 by the residents and staff of Larksfield Place retirement community. They had their eye on the means as well as the end: “The process of writing one’s story, promotes personal insight, provides an added sense of self-worth, restores a measure of self-control in one’s life, and provides much-needed social interaction.”

The site is a huge library of stories that you can search by author or topic or just browse. There’s some great tips and info about collecting stories and creating a program like I, Witness to History. You’ll also find info on their inter-generaltional program.

I also love Time Goes By: What It’s Really Like Getting Older blog/site by Ronni Bennett. Time Goes By features great elder issue pages like Elder Video (links for clips featuring elders on YouTube). Ronni’s blog is fantastic and there are links to about a gazillion blogs by folks 50 and older and even a page of photos if the actual rooms where related bloggers do their blogging. There’s also info on setting up your own blog. It’s not for everyone, but I bet you could find a resident or two or four who would like to do their own blog. Not ready to commit to a blog? The Elder Storytelling Place –an offshoot of Time Goes By – is a great place to read and submit one-off stories by elders.

Know of other great places on the Web for elders to share their stories? Let us know in a comment.

The Future of Culture Change

There’s no denying it, the future, and frankly the present, of almost everything is on the Web. “Oh, certainly not elders and nursing homes,” you may say. But, yes! And here’s why: A)The Internet is a fast, effective and cheap way to spread information on things like, say, culture change. B) The Internet is a fast, effective and cheap way for people, like elders in nursing homes, who are separated from their families and the world in general because of limited mobility, to participate in community.

Over the next few weeks I’ll be blogging about the web and elders. Presenting elder centered websites, ways to be involved in the culture change movement on the web and ways and reasons to get elders in front of a computer. Plus, Action Pact has some great online tools coming down the pipe because the capabilities of the Web offer great learning opportunities.

I’d like to start things by saying while I am a member of Generation X, my computer skills are a bit of an embarrassment and even though the virtual dictionary is a click away, I usually find myself reaching for the bound Websters on my desk. I can think of five Baby-Boomer-and-beyond friends off the top of my head who spend more time on the net and are more comfortable with it than I am. I’m telling you this so you know we will be learning together. Because, let’s face it, our culture has changed the way it sends and receives information. Let’s hope the way we give and receive care in homes instead of institutions will catch on as quickly and well.

politics of change

I bet I'm not the only one whose ears have been perking up a lot lately because the word "change" has been popping up so much because of the presidential primaries. There's a great story about it from the Associated Press by Erin McClam titled 'Change' in the air, once again.

From it, a quote:"We're obsessed with it. We can't let it go, can we?" says Marian Salzman, chief marketing officer for advertising titan J. Walter Thompson. "It's the word of the day, minute and hour, and I don't even know what it means."

Ah, but we do! Doesn't it feel nice to be ahead of the curve? The culture of our country has a lot to do with the way we treat our elderly.The culture of the 60s and 70s that valued youth, productivity and efficiency is the culture that created an maintained institutional living for our frail elders. I'm hoping that our current culture that seems to value change and progress will support us in our need to find true home for elders. As a country and as the world of long-term care, can we really back up the talk of change with action? Are we as ready for it as we say we are?

Resolution

Anytime is a great time to make changes in the culture of a nursing home. But, of course a new year and the feeling of a clean slate that comes with it can give you an extra push. One of the hardest things about making a change is the attachment we feel to the old way. Behavioral habits are hard to break, but making a change also means we must realize the way we have been doing things for so long has not been the right or best way. That can be tough to swallow. Making changes in the name of "New Year's resolutions" can give us a pass on the stigma of old habits. We can move forward by simply declaring, "Out with the old in with the new!"

I saw this paragraph in a story about resolutions that can increase our longevity (5 great ways to care for ourselves and elders):

"But don't let these bad habits of the past discourage you - it is never too late to make new choices. What you did in the past can be changed, and your body will respond in kind. What matters is what you do from this moment forward."

I love that line: "What matters is what you do from this moment forward." My resolution this year is to make that my mantra to remind myself every minute is a new opportunity to accomplish something good.

Best of luck on your journeys in this new year. May the best of 2007 be the worst of 2008.

Home for the Holidays

Around Christmas, when I was a little girl, we used to turn off the lights at night, turn on the tree lights and christmas music and just watch the tree and the snow falling past the window behind it. All of us on the couch just relaxing and taking it all in. Well, our tree is up and it is snowing great big Hollywood flakes outside (stunning if you don't have to drive in it) and I can tell you what I'll be doing tonight after the shoveling. I've brought a tradition from my parents house to my house. Later in the week we'll make Sandbakkles, a Christmas tradition from my husband's Norwegian heritage taught to him by his grandmother. What will you do?

Living in the midwest, we have a culture built around winter, not just Christmas and I think the dark days and cold have us looking for Christmas joy for most of December. Honestly, I think I love all the little things leading up to Christmas at least as much as the holiday itself. December is a time for rituals and comfort. I bet your residents have all sorts of ideas as to what that means to them. Activities for the month of December can be sort of a no-brainer: Christmas concert from a local choir, putting up a tree and decorations, making cookies, religious services, etc. Most of us partake in all those things to some degree, but it is the specifics about the way we do those things that make them our personal traditions. Talk to the residents about their own personal spin on the holidays and personalize the holiday activities in your organization. And then, for Santa's sake, tell us about it! Leave a comment on how you went about getting input from residents and how you incorporated that input into your festivities. Sharing traditions is a great topic for a learning circle or breaking the ice(pun intended) to get to know someone better.

Slow But Sure

I think all the makeover shows on TV have made us believe big change can happen overnight. Changing your hair or painting a wall is relatively easy to do – but even that can take some serious coaxing and time. How many of us know someone who is clinging to the hairstyle they had in the mid-70s and the avocado green and harvest gold wallpaper from the same time.

Culture change can be like that. It took 30 plus years for long-term care to become the institution it is. The transformation to home will take awhile. Action Pact consultant Megan Hannan knows only too well. In a special guest blog she talks about the role of “slow” in culture change and that speed is not as important as continuing to take the next step:

I was recently co-facilitating a session on listening and barriers to communication in a nursing home that has been working hard toward the Household Model for over a year. After the session, my co-facilitator, Kim a medical technologist at the Hillsboro Medical Center, said she was so surprised at how much people were willing to talk, share, and come up with solutions and ideas. I asked her, “Do you think things are changing?”
She said, “Well, yes. It is slow but sure.”
That phrase really stuck with me and I think it is such an important description of the way we feel change happens best – slow but sure. It is the sure part that we all want. We want people to “get it.” However, it is the slow part that many of us struggle with.

The staff member in this story is a member of the High Involvement team in her organization. Their team has been through some S...L...O...W.. times. There were times when they tried something that did not get good responses and when others in the organization were just not as excited as the members of the team. But eventually, they started to have more response, positive reactions, and spontaneous questions and suggestions.

It was painful to go through the slow times. In some organizations the philosophy might be get it or get out. However, this process of personal transformation, which is necessary for organizational transformation, takes time and lots of opportunities for people to see, here, feel and discuss what the change might be. This High Involvement team didn’t give up – painful as it could be – and found other ways, asked different questions, created new opportunities and kept at it. Their tenacity puts the “sure” in “slow but sure.”