PACE (Program for All-Inclusive Care for the Elderly) desires to provide high-quality care in the community to older people with chronic needs. Like many senior living environments, the COVID-19 pandemic disrupted and complicated many routine tasks of the care provider. As time constraints complicate the daily workflow of therapists and nurses, WalkWise helps them efficiently coordinate services in the following key areas:
Participant activity data at-a-glance
Continuing last week’s theme of “eyes on” capabilities, participant activity data is easily accessible on our web app. For those in the field, the mobile app (smart phone or tablet) is an important tool to gain insight prior to participant visits. Equally important for many care providers is the ability to share this information with the participant in real-time as a way to encourage walker compliance and address large gaps in activity.
Our team’s use of WalkWise spans the continuum of care needs. We’re able to be preventative by keeping track of activity levels and encouraging increased activity when appropriate, but we can also detect changes in the data from day to day that helps us prevent emergency room visits and hospitalizations.
Executive Director, Northland PACE
Simple prioritization
We are all aware of the adage there are only so many hours in a day, and PACE care providers know this better than anyone. WalkWise provides a unique way to gain insight into those participants that require acute attention via our intuitive notification system. The dashboard can also sort participants by their last walker motion or how active they were the previous night.
Time to ask “Tom Riddle” about his frequent night walking
Efficiently coordinate services
With WalkWise working 24 hours a day, 7 days a week, programs can better deploy services and interventions when and where they are needed, ultimately saving time and money.
According to the National Pace Association’s vision, the PACE Model of Care is recognized among consumers, health care providers, and government leaders as the most innovative, accessible, valuable, and effective model of care promoting the highest level of independence for individuals with significant health care needs. The PACE care provider is central to a program’s success, and WalkWise helps them efficiently serve participants.
Despite their success at keeping seniors safe during the pandemic, PACE (Program for All-Inclusive Care for the Elderly) across the country continues to struggle with staffing shortages, limited day center capacity, and burnout. These “day-in and day-out” issues are commonplace in an increasingly popular model of care that enables skilled nursing eligible individuals to continue to live within their community as long as possible. Growing pains of PACE programs, coupled with enduring pandemic issues, require creative solutions to effectively and efficiently care for their participants. WalkWise continuously grows with PACE across the country because it mitigates care provider challenges in compelling ways.
Just one way WalkWise helps save time…
Even before the pandemic, the lack of constant “eyes on” was a challenge for programs. Now that nurses and therapists are running all over town delivering more home-based care, there’s even less time to make a phone call and check in with participants.
Imagine being able to check in on them with a glance! Many programs use the WalkWise Dashboard in the morning to make sure participants are out of bed and that nothing unexpected happened during the night. Instead of checking in with each participant, they can focus on the ones that may need more attention that day.
Plus, if you know someone is up and moving around, you’ll have a lower chance of missing them on the phone or showing up during a nap!
PACE knows to expect the unexpected!
When disaster strikes, it’s great to have a quick way to check on many participants at once, as shown in this example from a program this summer:
We have been using WalkWise for about 3 months. Recently, it became a tool for us to use in an unexpected way! We had a city-wide power outage and had a group of staff that were meeting to determine which participants we needed to call/check in on. After making calls, there were some participants we weren’t able to get ahold of and were unsure if they were okay or if they had power. I pulled up the WalkWise dashboard and was able to see recent activity and recent “check-ins” with the cellular nodes. Some of the participants we couldn’t get ahold of were showing recent activity and node check ins, so we knew they had power and were doing okay! I have loved WalkWise from day one and this was another example of how we could use it to make sure our participants were safe during a city-wide power outage!
Rehab Services Supervisor, Immanuel Pathways Eastern Nebraska PACE
WalkWise Dashboard – It might be helpful to check in on Luna this morning!
The PACE model of care serves a vulnerable and costly population with demonstrated efficacy. PACE is an important component in cost-effective long-term care options that offer the elderly and their caregivers access to high-quality care. A critical step in continuing the success of PACE is for care providers to have the necessary tools to save time and focus on priorities. WalkWise is proud to be one of these solutions!
Essential Tips for Family Caregivers During The COVID-19 Crisis
December 22, 2020
Seeing a loved one age is never easy. When that person can no longer take care of his or her own health, however, it can be downright overwhelming if you are a family caregiver. This is especially true when there is a global pandemic complicating the process even further. As long as you keep these tips fromWalkWisein mind, however, you should be able to find the compassionate care your loved one needs without sacrificing his/her safety.
Having The Right Legal Paperwork is Essential
Having to make decisions about another person’s health and well-being can be an enormous undertaking for family caregivers. So if you want to avoid any added stress or tension for your family, the AARP explains that you should make sure you understand whichlegal paperworkis needed before you begin making choices for your senior loved one.
For example, you may know that a power of attorney is necessary, but there are different types of power of attorney forms that will grant you authority over different aspects of your loved one’s care. A conventionalpower of attorney can be drafted to cover financial choices when an individual experiences a decline in cognitive health, while a medical power of attorney can ensure that caregivers can make decisions regarding a loved one’s healthcare. If your loved one is nearing the end of his/her life, it may also be a good idea to have them complete a living will form along with any other advance medical directives.
Finding Ways to Pay for Care is Also Important
Unless your loved one planned ahead to pay for their care, you may also have to deal with the added strain of coming up with ways to cover these costs. Planning ahead for long-term care needs can provide seniors and families with additional options for paying for care, including long-term care insurance.
Even if your loved one is still relatively healthy, you should consider helping them come up with a plan for their future care. If the need for long-term care is more urgent, know there may befinancial resources available that can provide your loved one with the proper care without causing you undue burden.
For instance, if your loved one owns a home you can leverage that property to offset care expenses. FamilyAssets notesselling the home is usually the fastest and most efficient way to get the cash your family needs. Just keep in mind that you may need to take added precautions due to COVID-19. These added measures can include using online real estate tools, like 3D walkthroughs, virtual open houses and video-conference tours.
Ensuring Compassionate Care Should Be a Priority
Once you have the legal and financial matters sorted out, you can begin focusing on finding the right type of care for your loved one. For many caregivers, this can mean deciding betweenin-home care or residential options. In-home care for your senior or disabled loved ones can include non-medical home care, recovery care for injuries, home health care and respite care.
The latter can be beneficial if you would like to provide care for your loved one on your own but may not be available 100% of the time. There are also gadgets that can ease your responsibilities, like the WalkWisesmart walker attachment or a home security system.
Hospice and palliative care may also be necessary for seniors who are affected by terminal illnesses. Residential care can include assisted living, skilled nursing homes and senior living communities.
Of course, you will need to ask a few additional questions to ensure your loved one’s safety when transitioning during the pandemic. If you do decide that residential care is the best bet for keeping your loved one safe and healthy, also make sure you choose a compassionate and reputable facility.
Making decisions regarding a loved one’s health and care can be challenging, especially when you are doing so during a global pandemic. Staying focused on practical steps, like completing legal paperwork, sorting out finances and choosing the right long-term care, can help you avoid any added emotional strain. Above all, choosing professionals you can trust is the most important step in keeping your loved one safe from COVID-19 while finding the right care.
Turn to WalkWise for more information on helping seniors and their caregivers live healthy and balanced lives.
The Discursive Nature of Senior Social Vulnerability
November 30, 2020
An astute colleague of mine shared the following sobering factoid with our team a couple of months ago:
Approximately 5,400 seniors in Massachusetts nursing homes died, apart from their loved ones, over a four-month period from COVID-19. That’s equivalent to a fully loaded 737-jet crashing every day for a month.
Alarming, sensational, and viscerally reactionary in its framing, the above revelation gave our team cause to pause and think. Current data exposes that 40% of all COVID related cases occurred within the confines of nursing homes. Socially, the demographic grouping of seniors put them at the epicenter of susceptibility. From a business standpoint, the firmographic segmentation brings the industry of senior living to the forefront of concern and care. Simply, this is the tip of the iceberg of a multiplicity of discussions about senior social vulnerability.
If COVID – or prevention thereof – is the diagnosis, then social isolation is inevitably the prescription. However, the taxonomic analysis of social isolation and its subsidiaries of adverse events make for a non-congruent and messy reality; senior social vulnerabilities exacerbated by COVID are discursive in nature – expansive in scope and digressing from subject to subject.
The Overwhelming Conversation of Social Vulnerability
The World Health Organization defines vulnerability as the degree in which a population, individual, or organization is unable to anticipate, cope with, resist and recover from the impacts of disasters. Therefore, to discuss the impact of COVID on already in place social vulnerabilities is synonymous with discussing types of topics all at once, yet somehow maintain a sense of focus and clarity. The following infographic displays tiers and subsets of vulnerabilities. It illustrates how a multitude of factors can complicate a conversation of COVID as it relates to those that are vulnerable in niche ways.
Where things become even trickier is the problem-solving side of the discourse; how do we as a society develop solutions for COVID prevention to as many people as fast as possible while still factoring in the specificity of all vulnerabilities the individual may be subjected to? For those of us who have had our keen eyes and ears on the news media as we watch experts and policymakers alike wrangle for answers can readily recognize that one-size-fits-all methodologies are not readily consumed (mask wearing), nor do piecemeal tactics (mandating gathering sizes) garner mass adherence.
In a word, the conversation is overwhelming. However, we cannot withstand COVID resurgence after COVID resurgence. We can also not assume a vaccine is a silver bullet to eradicate COVID to erroneously go back to ‘normal’.
Redefining Public Health for Seniors
Let’s go back to that notion of a 737-jet crashing every day. When the unthinkable becomes a reality, shock can morph into an unsettling acceptance of reality where would’ve-could’ve-should’ve blame-worthy diatribes befall all of us, not just the experts and policymakers. Remember when our marching orders were to simply ‘flatten the curve’ and keep the spreaders at bay? The senior population – the ones most adversely affected by COVID – can look longingly at a calendar and be crestfallen with cause as they realize there were precise dates where the current COVID state of affairs could have been vastly different.
Yes, COVID is and was a tempest. Now, the journey necessitates itself to recover from potential worsening disaster. The silver lining to these dark clouds is redefining public health for seniors, and by immediate extension, public health for all.
Civic public health organizations carry the mantra to ‘prevent, promote, protect’. In a large part, many of the functions that can help seniors endure in a COVID world are already in place; telehealth, visiting nurses, PACE (programs for all-inclusive care for the elderly), remote patient monitoring, to name a few.
Public health is ‘the science and art of preventing disease, prolonging life and improving quality through organized informed choices of society, organizations, communities and individuals’, as defined by the CDC. Social vulnerabilities for seniors are nothing new. The fact that COVID has exasperated these will ultimately lead to better policy and better care from public health entities.
A Vaccine is Nigh
On October 2, the National Academy of Medicine revealed its recommendations for COVID-19 vaccine distribution. The report proposes distributing a vaccine in four phases in order of priority:
Health-care workers
Emergency responders
People with underlying conditions
Older adults living in group settings
The third and fourth phase of this list should look familiar to you by now and is the raison d’être of this month’s blog. For the first time in history, the recommendations above – commissioned by the National Institutes of Health and the US Centers for Disease Control and Prevention – state that priority be given to people who score high on the CDC’s Social Vulnerability Index. The goal: to rectify the pandemic’s disproportionate burden and work toward a new commitment to promoting health equity.
Like many public goods that are availed to us, fairness is key yet not always practiced. When a vaccine does become available, it will require for the vast majority of us the opportunity to express civic responsibility; allow those that have these vulnerabilities maintain a front-of-line standing. Disparities of care can absolutely be avoided by allowing those in need access to this lifesaving remedy.
A solid argument can be made that the American COVID response could have prevented the death toll equivalent of a 737-jet crashing daily. It is given that the conversation of senior social vulnerability is both complex and overwhelming, but one that can be championed. It is abundantly clear that our very next line of COVID defense – the vaccine – ought to be administered primarily to those that need it most.
Technology For Seniors And The Caregivers That Love Them
October 15, 2020
There are millions of us caring for aging loved ones. And it’s often a stressful labor of love. But, the technology available now has made it easier on us than our parents and grandparents had it when they had to do the same. If your senior has yet to jump headfirst into the digital world, it’s time to start. The following tips and technologies can help ease them into it while easing your mind.
Digital Security
Before you acclimate yourself or your senior loved one to technology, it’s crucial that everyone understand digital security. This applies particularly to seniors who will spend more time online as they learn to navigate the internet. There are plenty of digital safety articles available, and they can help you help your loved one stay guarded against cybercriminals, identity theft, and online bullying.
Activity Tracking
When you think of an activity tracker, a watch probably comes to mind. But, fortunately, this is not the only option available. Seniors who utilize a walker will benefit from a WalkWise attachment and membership. This nonintrusive device can keep you abreast of your loved one’s activities and, more importantly, can send you an immediate alert should their walker wind up in a position that may indicate a fall. This is crucial in helping you maintain a watchful eye on your loved one when you can’t be there.
There are millions of us caring for aging loved ones. And it’s often a stressful labor of love. But, the technology available now has made it easier on us than our parents and grandparents had it when they had to do the same. If your senior has yet to jump headfirst into the digital world, it’s time to start. The following tips and technologies can help ease them into it while easing your mind.
Digital Security
Before you acclimate yourself or your senior loved one to technology, it’s crucial that everyone understand digital security. This applies particularly to seniors who will spend more time online as they learn to navigate the internet. There are plenty of digital safety articles available, and they can help you help your loved one stay guarded against cybercriminals, identity theft, and online bullying.
Activity Tracking
When you think of an activity tracker, a watch probably comes to mind. But, fortunately, this is not the only option available. Seniors who utilize a walker will benefit from a WalkWise attachment and membership. This nonintrusive device can keep you abreast of your loved one’s activities and, more importantly, can send you an immediate alert should their walker wind up in a position that may indicate a fall. This is crucial in helping you maintain a watchful eye on your loved one when you can’t be there.
Per statistics cited by Griswold Home Care, seniors are seen in the emergency room every 11 seconds for falling accidents and, sadly, the disproportionate number of deaths in the elderly due to falls means that a related fatality occurs every 19 minutes.
Senior-Friendly Websites
When communication is essential with your loved one, make sure they are up to date on the latest websites that help them do just that. Facebook is one excellent example, and it’s no secret that those over age 65 are quickly taking over this social media platform. More than just social media, however, other websites, including the AARP and Pogo, are excellent places for seniors to find pertinent information as well as fun and games.
Smart Home Accessories
Smart home devices, appliances, and accessories have gotten a lot of attention throughout the last five years or so. These are things, like speakers, thermostats, and lights, that automate many processes within the home. Furthermore, a smart home hub, such as the Google Home, can help seniors make voice-activated phone calls. They can digitally drop in on friends and family, and, as a caregiver, you can check on them without having to make the drive to their home.
A smart refrigerator is a slightly larger investment than any of the above, but it’s one way that you can monitor your seniors’ nutrition without constantly asking them if they have eaten. A smart fridge can be accessed from anywhere via your mobile device. Similarly, a digital security system may be logged into remotely and will help you put eyes on your parents or grandparents. You can also monitor who is at the door using a video-enabled doorbell, and motion-activated exterior lights can keep your loved one’s doorway, driveway, and entrances well lit if they need to enter or exit the home after dusk.
While it’s still difficult to care for an aging loved one, even if you live next door, technology puts you that much closer when you can’t physically be there. Whether it’s chatting online via Facebook or simply checking to make sure they have milk and eggs, technology is a blessing bestowed upon us by the 21st century. Let it work for you, and don’t be afraid to suggest any of the above to the seniors you love.
This blog was guest written by: Mary Shannon from seniorsmeet.org
This week is “Falls Prevention Awareness Week.” Though we believe that fall prevention must be practiced every day, this is a good opportunity for us to share our passion with all of you.
Before we dive into different fall prevention tactics, I would like to paint a picture of how detrimental they are to the senior population.
According to Daily Caring, 1 Seniors aged 65+ have a greater than 25% chance of falling. If they fall once, they then have a 50% chance of a second fall. Falls are serious for seniors as they are not always able to fully recover from the trauma. Their overall health could decline and their independence lowers significantly.
Count to 11 – 2Every 11 seconds a senior is being treated in an emergency room for a fall-related injury. 3Every 19 minutes, an older adult dies from a fall. As we have stated in a previous blog post, if falls were a plague, we would be taking them more seriously and they would be considered a national health crisis. The number of seniors falling in the U.S. – evidenced from the statistics above – are alarming and need to be prevented.
Though we cannot completely eradicate falls, we can do our best to create a preventative plan. If we could even prevent 10% of all falls, we could save the healthcare system over $5 billion a year and keep more people safe in their homes.
Here are 5 fall prevention tips that you may want to consider for your elderly loved one.
Medication Management
It’s necessary for many seniors to take daily medication, but a combination of medications or a strong negative reaction could affect one’s balance. If your loved one is on a new medication and they seem to be slightly off balance, it does not hurt to reach out to their doctor and see if the medication may be the problem. Keep a close eye when they receive a new prescription and always read the side effect labels on the container. Make sure to keep a list of all the medications that are being taken, including over the counter and supplements. This keeps all the information easily accessible in case dizziness or loss of balance occurs.
Medication Management
It’s necessary for many seniors to take daily medication, but a combination of medications or a strong negative reaction could affect one’s balance. If your loved one is on a new medication and they seem to be slightly off balance, it does not hurt to reach out to their doctor and see if the medication may be the problem. Keep a close eye when they receive a new prescription and always read the side effect labels on the container. Make sure to keep a list of all the medications that are being taken, including over the counter and supplements. This keeps all the information easily accessible in case dizziness or loss of balance occurs.
More Walking and Exercise
“Walking is man’s best medicine,” is a quote by Hippocrates that we have used since the founding of WalkWise. When you do not use the muscles that improve gait and balance, you lose them. There are many exercise routines for seniors that include props like chairs, walkers, and other devices to make these activities less challenging. Doing roughly 20 to 30 minutes of exercise a day can drastically improve one’s overall balance. The benefits of exercise are not solely physical, but also promote mental wellness.
Use Assistive Devices
As mentioned, once a senior has fallen, they have a 50% higher chance of falling a second time. This is an opportune time to talk about using a walker. Effective use of a walker is a proven way to prevent falls. The most important thing to remember about assistive devices is they must be utilized. They cannot help if they are sitting in the corner. Our device, the smart walker attachment, allows one to see the daily activity of the walker user. If you see big gaps in activity, make sure to have a conversation about the benefits of using the walker and how it promotes overall independence.
Use Assistive Devices
As mentioned, once a senior has fallen, they have a 50% higher chance of falling a second time. This is an opportune time to talk about using a walker. Effective use of a walker is a proven way to prevent falls. The most important thing to remember about assistive devices is they must be utilized. They cannot help if they are sitting in the corner. Our device, the smart walker attachment, allows one to see the daily activity of the walker user. If you see big gaps in activity, make sure to have a conversation about the benefits of using the walker and how it promotes overall independence.
Modify and Clean the Home
Rugs, extension cords, and other knick knacks could be a tripping hazard. Make sure to create clear pathways in the home. This is especially important between the bedroom and bathroom. One simple way to modify the home is to add motion-activated night lights. These lights will help guide a senior to and from the bathroom, kitchen, or bedroom at night. Install grab bars in the bathroom and consider adding a shower chair. Finally, try rearranging the most used items in the kitchen to a lower more accessible height. This allows your loved one to reach them without the need of a step stool.
Keep Family Members Informed
One of the most important fall prevention tactics is simply to keep family members informed. Sometimes primary caregivers are not always able to be around, so others may need to fill in the gaps. Create a list of all safety precautions, medications, and the assistive devices that may need to be used and make sure the list is in an easily accessible place. I recommend having it on the refrigerator and saved in a Google doc. Now, it can be referenced at any time if there are any questions.
Fall prevention must be practiced every day. All too often, when a fall prevention plan is not executed there are consequences. Regularly follow these tips to help limit the potential for serious falls that may result in hospitalization.
Once again, Falls Prevention Awareness week is here— a time where we focus on the best practices to limit catastrophic injuries in order to keep seniors independent. Even in the best of times, preventing falls is a challenging undertaking. To say the least, COVID-19 has made it significantly more difficult.
The conditions that make falls so costly and deadly have almost all been exacerbated by the pandemic. First, falls have increased because older adults are trying to do things themselves that previously would have been taken care of by friends, family, or caregivers. By preventing the spread of the virus through social isolation, we have unintentionally increased the likelihood of serious injury. What’s more, social isolation has also increased fall response time, turning 20 minutes on the floor into hours. Especially when bleeding occurs, a small increase in fall response time can be a matter of life or death. Fewer visits from family, friends, and caregivers combined with a lack of social engagement outside the home means that there are fewer natural opportunities for people to be found on the floor. And of course, “being found on the floor” is the way that many (if not most) falls are detected.
Exercise programs, like Tai Chi classes or SilverSneakers, can be great ways to improve strength and balance to decrease the risk of falls and make falls that do occur less dangerous. Unfortunately, senior centers, senior living communities, and fitness centers are all finding it difficult to engage seniors with these programs virtually. They are doing the best they can, but nothing will replace in-person classes with a professional trainer. In lieu of these programs, we must find ways to encourage people to be active on their own, as simply increasing walking and overall activity will improve leg strength and balance. Fitness trackers can be helpful, especially when families are engaged and helping to encourage activity.
Proper medication management and early detection of worrying symptoms are known strategies for preventing falls, but both have been hampered by the virus. Providers cannot reach as many patients due to the added travel time that in-home visits require. Programs that are now relying on telehealth have been telling us for months that it can be a challenge to get an iPad up and running, even when a tech savvy family member is able to assist with the setup. Even when telehealth is possible, it is difficult to assess medication management, vision loss, hearing loss, or other factors that impact fall risk.
Providers and families must take this crisis as a step toward remote patient monitoring, telehealth, and medication management technologies. To provide all three, it would cost between $500 – $1,500 per person per year; a true bargain compared with the massive costs of falls, medication noncompliance, and other preventable medical costs.
The good news: many falls are preventable if we adopt the right approaches, technologies, and mindset. COVID-19 has made fall prevention more challenging, but we can face that challenge if we coordinate among healthcare providers, solutions providers, caregivers, and families. Isn’t that what Fall Prevention Awareness Week should be about?
Written by Peter Chamberlain, WalkWise Founder and CEO.
The Serious Benefits of Laughter Therapy for Seniors
July 24, 2020
My grandmother was an avid reader of Reader’s Digest Large Print. I was fascinated at a young age that this periodical was at least half the size of other journals; Time, Life, and Better Homes & Garden to name a few. It was comical to me that my grandmother had a pocket-size magazine with large words; why not simply make the pages big, like the others? Little did I know at the time that this particular subscription was due to her poor eyesight. However, the small size allowed this general-interest family magazine to adopt the slogan, “America in your pocket”.
I enjoy Reader’s Digest as a direct result of observing my grandmother reading it and chuckling to herself. My parents became subscribers, and to continue the legacy, I did as well. Why? As my grandmother articulated to me when pressed, Reader’s Digest is part philosophy, part Americana, and part humor. It is the latter that interested me most. My grandmother offered the following as part of her favorite monthly features; Enrich Your Word Power, Points to Ponder, Humor in Uniform (my grandfather was a verteran of WWII), and Laughter, the Best Medicine.
In essence, there was enough within the confines of this magazine to captivate and mold my young mind. Hearing a grandmother chuckle is enough to fill you with wonder and a budding sense of philosophy and humor; not bad for a publication that reaches 40 million people in more than 70 countries via 49 editions in 21 languages.
Philosophy and Humor
Without diving too deep into a historical and philosophical treatise on humor, the ancient Greeks turned comedy into an art form. Fast forward, French philosopher René Descartes uttered, Cogito, ergo sum – I think, therefore I am. Yes, we humans are meaning seekers; we think, overthink, then think again. Making sense of the world is our reason for being. However, with current events in mind, we know that the whole world cannot be intelligible. Humor is therefore, to some extent, a public phenomenon. Descartes viewed humor as joy mixed with hatred. So, during trying times, a little levity can do a lot of good. This need not mean we have to vacate our intellectual prowess. In fact, wit is intellectual. Austrian-British philosopher Ludwig Wittgenstein was convinced that a serious and good philosophical work could be written that consisted entirely of jokes. To illustrate one could say, “I used to be indecisive, but now I am not so sure”.
Taking Humor Seriously
Ancient Roman poet and satirist Horace observed, Ridentum dicere verum quid vetat – What is there against telling the truth in laughter? Certainly, we don’t need to quote a latin-speaking dead guy to experience the obvious. Today, we simply say, “It’s funny because it’s true!” In our post-satirical age, we live in a society where the news is funny and comedy is the news. How many times have you witnessed recent events and thought, you cannot make this up?! Humor and laughter provide needed relief to what ails us. Humor has an indefinability. It breaks conventions and pushes boundaries. Humor is playful. When in doubt, doubt!, as they say. Friedrich Nietzsche, German philosopher and cultural critic, noted that maturity is regaining the seriousness of a child at play. Through this lens, it is worthy for us aging humans to take seriously the benefits of humor and its pleasant byproduct, laughter.
Laughter, The Best Medicine
A study published by PubMed Central (archive of biomedical and life sciences journal literature at the U.S. National Institute of Health’s National Library of Medicine) proves that laughter therapy is an important strategy which has been recommended by experts for increasing health promotion in older adults (see footnote). As the elderly population increases, health problems, especially mental health problems, of such an age become more important. The study uses controlled sessions of ‘laugh therapy’ – where group participants laugh artificially until the laughter becomes genuine, releasing anti-stress and joyful hormones, and ultimately promoting relaxation.
The study concludes that this form of therapy improves general health. Results obtained from this study help authorities in the field of geriatric care to adopt precise plans and policies to increase general health by making “senior citizens and their families aware about the advantages of laughter therapy and establishing laughter therapy clubs”.
We are all aware of mechanisms beyond laughter therapy that can replicate similar outcomes; TV sitcoms, morning coffee with the fellas, a riveting game of pinochle with the ladies, playing fetch with a puppy, watching a friend or relative fall off a dock at the lake, or retelling an old yarn that grandma borrowed from Reader’s Digest. I would be remiss if I didn’t share a few of these jokes for you – dear reader – to help send you on a merry way to overall improved health.
Three old guys were out walking.
First one said, “Windy, isn’t it?”
The second one said, “No, it’s Thursday!”
The third one said, “So am I. Let’s go get a beer!”
—
“Oh God,” sighed the wife one morning, “I’m convinced my mind is almost completely gone!”
Her husband looked up from the newspaper and commented, “I’m not surprised: You’ve been giving me a piece of it every day for thirty years!”
—
I’m pretty black and white about most things. Except retirement homes, that’s a grey area.
“Walking is man’s best medicine” – Hippocrates By Aaron Lamb, Director of Business Development
1Ghodsbin, Fariba et al. “The effects of laughter therapy on general health of elderly people referring to jahandidegan community center in shiraz, iran, 2014: a randomized controlled trial.” International journal of community based nursing and midwifery vol. 3,1 (2015): 31-8.
“With the right music, you either forget everything or remember everything.”
July 24, 2020
During our childhood we sing the ABC’s to remember the alphabet, listen to nursery rhymes for basic understanding of what’s good and bad, and in many cases share music to connect with others.
As music extends past our childhood and into our adult life, many people go to concerts to feel joy and become one step closer to the artist they love. Others turn up the radio as loud as possible to keep their usually mundane commute interesting. Some invite people to the dance floor to connect and have a good time.
There is something about music and its universal language. No matter where you go, it is always present.
Imagine sitting in a coffee shop and hearing a song you haven’t listened to in years; you can recall the chorus, hum the tune, and in some cases sing every word. For people with dementia, much is the same. It allows them to reconnect with their past, even if only for a moment. For them, music is vital, and it could be one of the last pieces of their history they haven’t forgotten.
I had the privilege to talk with Evie Straus, MT-BC/L (Music Therapist-Board Certified/Licensed). She works with senior living residents to improve their overall health and wellbeing. During our Q&A, She dives deep into the goals and benefits of music therapy.
Q: Why does music last within the brain while other memories are lost?
A: Our connection to music is typically the strongest during our teen and young adult years because those are the years of self-identification, self-expression, and emotional development. Our memories are often connected to music because of the structure of our brains; the brain thrives on structure and rhythm. That’s why when an older adult can no longer remember what day it is, they can still remember all the words to “You are My Sunshine.”
Q: What are the benefits of music, specifically for people with dementia?
A: There are so many benefits to using music to connect with older adults, but it really depends on what the resident needs. Sometimes I will pass by a resident in the hall that maybe I have been working with for a goal of memory recall and reminiscing.
But as I pass by, I notice the resident is agitated and anxious. So, I begin singing a song I know they are familiar with and they begin to sing along. The music can help re-orient them to reality and help them remember and know they are safe. Music can be beneficial for the psycho-social, physical, and emotional needs of a resident. That is what makes music so unique because it helps the whole person.
Q: We have all seen YouTube videos of music “bringing someone back” for just a moment, is there a scientific reason why?
A: Well that takes us back to how the brain thrives on rhythm and melodic structure. Structure is a way we learn and retain. Music is different than simply speaking, the melodic structure is strong in the brain because the brain itself thrives on rhythm and repetitive melodies. That is why we often learn information to the tune of a song such as the ABCs. So, when names, reality orientation, and different memories are lost, music can be recalled because of the melodic and rhythmic triggers. Because of this, different songs trigger different memories and these memories can trigger emotions.
Q: What is your primary job as a music therapist?
A: I work to make connections through music. Before COVID-19, I was doing music groups on each floor. Each group had three main goals, increasing socialization, memory recall, working on cognition, and it also included some sort of movement intervention. Increasing socialization would often involve singing a song the group knows together. Memory recall includes residents singing songs without having the lyrics available and also recalling memories about their younger years. A cognitive intervention could be a fill-in-the-blank song. This is where you take out key lyrics of a song and allow the client(s) to fill them in with their own lyrics. A movement intervention could be using egg shakers to move to the beat of a recorded song such as “Beer Barrel Polka.” While we shake, I give the group various directions on different movements for them to do throughout the song.
An example of a fill-in-the-blank song would be taking out words to the song “I’ve been Working on the Railroad.” You can take out the word’s “railroad” and “captain” and the phrase “Dinah, blow your horn.” Then you give the residents a chance to fill in their own jobs that they have worked, such as working in a diner or in the military. This allows the residents to recall the jobs they worked and when. Some would remember a job they worked in high school while others would name the jobs they worked as adults. For the last phrase of the first verse I will often put a resident’s name in and change the lyrics. So, at the end you are singing “Evie go to work.” The group often finds this funny and this improves camaraderie and socialization.
I also facilitated two sensory music groups for two different floors. When an older adult has advanced dementia, a larger floor group might be too much stimulation for them. These sensory groups had a maximum attendance of 6 residents that I chose for the group. Most of them were non-verbal but responded to music such as opening their eyes, holding my hand, and humming. In these sessions I included tactile, auditory, and sight stimulating interventions. One intervention for auditory stimulation was using an ocean drum in their lap and singing “My Bonnie Lies Over the Ocean.” The goal of this intervention was having the resident move the drum themselves. For tactile, I played a recorded version of “I’m Forever Blowing Bubbles” by Doris Day for the residents and blew bubbles for them. The goal of this intervention was that the residents interact with each other and the bubbles by popping them.
Q: Not including names, have you seen a senior be positively impacted by music therapy?
A: I have worked with a resident who would often have episodes of high anxiety and they would begin crying and become inconsolable. This resident knew me and that I would work with them. They would often sing and reminisce with me about their younger years. When I would observe the resident wandering the hallway crying, I would stop the resident and ask them if they wanted music. If they said yes, I would begin with their favorite songs such as “You are My Sunshine” and “In the Garden.” My relationship with this resident allowed me to help ease their anxiety and redirect them. By the end of the session, the majority of the time, the resident’s affect was bright and they were no longer crying.
Q: Can you explain how music can connect families with their loved one who has dementia?
A: Often when someone has dementia, it isolates them because they do not know what is happening or why they had to move from their home. Singing together and listening to music can help them connect with their families in ways they can’t while talking. Music connects and we all have memories that are associated with music. When someone with dementia is able to reminisce about their memories this often redirects their thoughts and brings them back to the moment. Whether or not they are oriented to that moment and time is not important.
Q: What are some good resources for family members that may want to try music therapy?
A: Music therapy can only be provided by a board-certified music therapist. However, families can use music to connect, try singing songs you know were popular during their twenties such as music by Hank Williams, Johnny Cash, and Doris Day. A wonderful book called “Music, Memory, and Meaning”, by music therapist Meredith Hamons, is a great resource. This book explains different ways you can use music to facilitate conversation between family members and the resident, giving various examples with many songs from the 1930s-1950s.
Q: Is there anything you would like the general public to know about music therapy?
A: Music therapy is an established, allied healthcare profession that uses music interventions to accomplish individualized goals within a therapeutic relationship. Music therapy is done by a credentialed professional who has completed an approved music therapy program. A music therapist assesses the strengths and needs of each client and uses music to facilitate interactions such as singing, moving to, and/or listening to music. Research in music therapy supports the effectiveness in many different areas such as physical rehabilitation, increasing quality of life, and providing emotional support for the client and their families.
The official definition from the American Music Therapy Association:
“Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.”
For more information on becoming board-certified, visit cbmt.org.
For more information on music therapy in general, visit musictherapy.org.
Thank you Evie for providing the WalkWise family with great information regarding Music Therapy!
Let’s talk about falling. As a toddler, it’s simply a part of life as one learns to use their legs for their intended purpose. As a kid, you might suffer a scraped knee while running around the playground with friends or if you fall off a bike. Oftentimes the most exciting plays in sports, such as baseball, volleyball, and soccer, involve an intentional dive to the ground. As an adult, falling becomes less frequent, but who hasn’t slipped on the ice or a freshly mopped floor? These instances rarely lead to serious injury, but even a broken arm will heal with time and some pain medication. Even the recent story of my sixty-year-old father falling into a leaf pile with a 30-pound leaf blower on his back was more amusing than concerning.
So why are falls a plague? Because they are impacting us more and more every year, there is no cure, and they are deadly. There was a time when falls affected almost no one, simply because humans did not typically live long enough for them to rear their ugly head. In this way, they are similar to heart disease and diabetes: modern medicine and food production has helped us live through so many other ailments that we are succumbing to new issues. For us to beat falls, we need to better understand why they happen and why they are dangerous.
Falls become more frequent as we age for several reasons. We lose balance as we lose strength in our muscles. We lose valuable reaction time. Our eyesight deteriorates, and thus we are more likely to miss something on the floor. Chronic diseases cause us to limp or walk with a less-than-ideal gait. Complex medications can cause us to be disoriented. While there are ways to mitigate all these risks, falls are undoubtedly a part of aging in our modern world.
Falls also become more dangerous. First, the falls themselves become less controlled. Despite the fact that younger people fall all the time, they usually have the coordination, muscle strength, and response-time to turn a fall into a controlled fall where damage is minimized. When I slipped on an icy patch in my driveway a few years ago, I was able to put my arm out and use my triceps to minimize the impact to my hip. Had my arm not been quick enough or strong enough, more force would have been delivered to my hip.
Second, more damage is done as a result of impact. Bones becoming more brittle as we age, and the same fall that ended with a bruise when you are 60 might lead to a broken bone when you are 70. Blood thinners are a common medication to reduce the risk of cardiac issues, but they prevent clotting and lead to more severe external and internal bleeding.
Third, uncontrolled falls have a greater chance of resulting in traumatic brain injuries from head impact. TBIs can be fatal themselves, but even when minor they can lead to decreased quality of life and be a complicating factor.
Fourth, our immune systems become more susceptible to infections as we age. Infections are common after an extremely invasive surgery, such as a hip replacement or repair. Of course, open wounds are also of concern. But infections can happen simply by being in a hospital, skilled nursing center, or even by spending too long in bed. When mobility is reduced post-fall, people can easily develop urinary tract infections by holding their bladder and not consuming sufficient fluids.
Fifth, many people do not receive immediate help when they suffer a fall. Social isolation is a well-documented issue among older adults, and this lack of regular human interaction can have huge consequences when it matters most. Even for people with vibrant social lives, they are not with their friends, families, or spouses all the time. Obviously, a call to 911 through a cell phone or emergency response pendant is ideal after a fall, but all too often these devices are forgotten or simply not worn regularly around the house. As a result, a study (1) found that the average response time to a fall is 4.5 hours, but those found deceased had been on the floor about 18 hours before found. If the fall was not fatal, the wait for help may be.
Lastly, many people lose their independence after a traumatic fall, which can lead to accelerated cognitive decline and the loss of will to live. One need only read Atul Gawande’s Being Mortal to understand the story of Alice, who’s loss of independence in a nursing home led to her passing away. The psychology is complex and not fully understood, but the idea that people need to make decisions for themselves and have hope of a better tomorrow is not new. Unfortunately, many of our modern methods for keeping people safe also impede their autonomy and independence.
If falls were a disease, there would be an emergency World Health Organization task force aimed at stopping this plague. While the problem of falls cannot be solved with a vaccine, there are a number of treatments intended to limit risk (using a walker is one of them). When we better understand the issues around falls, we can design solutions to limit the impact of this plague on our lives, and the lives of our loved ones.
Written by Peter Chamberlain, WalkWise Founder and CEO.
