Tug
of War with the Departments?
By
Ginger Johnston, ADC
Do
you ever feel as if you are in a war zone at your facility?
Every department has a mission, and they only have eight
hours to meet their goals. Have we lost sight of the
reason that we get up and go to work every day? I remember
when I decided that I wanted to go into the Activity
field. Young and full of ideas, hoping to change the
opinions of those in our community about Long Term Care
facilities. "You have heard the comments, "How
can you work there, it is so sad and depressing?!"
Well, not to me, my residents are full of life and have
so much to offer. Yes, things have changed since I found
my passion twenty years ago. I seem to have less time
to spend with the residents/clients and more time spent
doing paperwork. Sound familiar?
So,
what is it that an Activity Professional does for the
resident's? BINGO, Birthday Parties, and Bible Study?
Maybe thirty years ago that would have been the answer,
but that's certainly not the case today. Today's Activity
Professional has expanded the choices available to the
resident's. NCCAP, encourages Activity Professionals
to continually seek current skills and tools to augment
the best program possible for the residents/client's
that we serve in the various facilities, according to
the areas of interest that the resident's life style
has indicated as their meaningful quality of life. We
are encouraged to continue to engage the residents in
meaningful activity programs of their choosing; remembering
to look at the residents past but to also respect any
new interest they may like to try. As we all know, it
is never too late to take up a new hobby. The days seem
to go by a little faster when we are busy. So, our goal
is to enhance the lives of the resident's that we serve
at our facilities, through the programs that we schedule.
We are all aware of the wars that unfortunately are
going on in the world and if you are working in a Long
Term Care facility you may feel that some days you yourself
are at "war" with other departments. The resident's
have 24 hours in their day, just as we do. How much
of their time is spent with pursuing leisure activities
or spent being involved in a group setting for socialization
with others? For most of our residents much of their
time is taken with their ADL care, treatments, meals,
as well as physical, occupational, and/or speech therapies.
We all know what our Nursing departments goals are,
to ensure that the residents receive medical treatment
as ordered, get the residents up and dressed, and to
make sure that they are clean, dry and comfortable.
Our Dietary department's goal is to provide nutritional
meals within their dietary restrictions, while providing
meals that are pleasurable to the palate, as well as
attempts to make special foods for those that have weight
loss issues.
The
department that seems to be in the biggest "war"
with the Activity department is our Therapy department.
It seems as if the Activity department and the Therapy
department are in a "battle" over the resident's
time. We all know that our Administrators are looking
to get reimbursement any way that they can. You guessed
it, Activities is not a reimbursable treatment in your
facility (only through the daily PPD rates), and sometimes
it seems as if our efforts go unnoticed. The burnout
rate for Activity Professional is very high. The average
length of time, it has been estimated for an individual
to work as an Activity Professional at any one job is
eighteen months. The reason for this I believe is simple.
Some people become frustrated, feeling that they are
expected to act as "baby sitters" when the
nursing staff becomes weary of caring for the more difficult
residents, coupled with being told that therapy treatments,
receiving the higher rug rates, are what bring in the
revenue. So, is one department more important than the
other? No! Both the Activities department and the Therapy
department should look at the whole picture of each
resident. There is a need for our Activity Professionals
as much as there is a need for the Therapist for the
overall well being of the resident.
Are
you aware that you can capture your activity programs
on the MDS? Evaluate your existing activities program,
take a look at the activities your residents already
participate in and see which of those fall under the
umbrella of restorative nursing. Maybe your resident
dismisses the Activity staff upon invitations to recreational
activities. Some of the individuals that we serve seem
to have a loss of interest in some activity programs
and they may tend to withdraw with non-involvement during
an anticipated short stay at your facility. The goal
is to regain their physical endurance and return home.
I think that I would have the same thought process.
We all want to be at home, especially at the holidays.
Yet, our residents need respectful encouragement to
retain social contacts and recreational involvement.
We all know that our residents need opportunities to
participate in life long leisure activities, which both
relax and hopefully energize the residents. So why not
work with our Therapy department to augment the residents
rehabilitation goals? Offer programs of interest to
the residents between therapy sessions. Educate the
residents to the program goals that may be similar to
the goal of our therapies. If the resident has a goal
to walk 50-100 feet, why not walk down to the activity
room? Promote gradual exposure to alternate activities
to assist with their comfort level.
The
bottom line is, "What does the resident want to
do?" Can the residents refuse a therapy treatment?
Yes, they can however after (3) three refusals the resident
is discharged from therapy treatment. We as Activity
professionals can never give up on the resident regardless
of their participation or refusal of activities. Discuss
with your Therapy department the resident's interest
that they have shown with regard to recreational activities.
This is when our Therapy department could, and should
offer their treatment at a different time. The resident
should not have to choose between socialization and
receiving their therapy session. Why
not both?
Working
in the Activity field has its own rewards and its own
unique challenges. There are endless opportunities for
us to change and rearrange the day-to-day moments that
we have. It is up to you, to make a change and decide
which way that we will go. Will we be at "war"
with our Therapy Departments or will we do whatever
it takes to make our residents time in our facility
meaningful?
In
2007 envision the gift that you are, to the individuals
that you serve. Sometimes the most difficult times that
we face are our very best teachers in life. There is
good to be found in all situations. Embrace your Therapist;
they have so much to offer to our residents.
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