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Life Enrichment Nov 2010

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					                                                    Table Contents
                                                   Table ofof Contents



  I.    Mission & Values
        - Mission & Values………………………………………………………………………….. 01-01
        - The Promise………………………………………………………………………………… 01-02

 II.    Life Enrichment Standards and Job Expectations
        - Role of the D.L.E………………………………………………………………………....... 02-01
        - Role of the Resident Assistant……………………………………………………… 02-02
        - 11 Key Elements of Programming………………………………………………… 02-03
        - Activity Program Expectations…………………………………………………….. 02-04
        - Manager on Duty’s Role in Activities…………………………………………….. 02-05
        - Best Practices for Scheduling Activities……………………………………….... 02-06
        - Creating Enrichment in-between Activities…………………………………… 02-07
        - Life Skills…………………………………………………………………………………… 02-08
        - Lighthouse Lingo………………………………………………………………………… 02-09
        - Lighthouse …………………………………………………………..………………..…... 02-10
        - Cardinal Sins………………………………………………………………………………. 02-11
        - Monthly Activity Calendar…………………………………………………………... 02-12
        - Sample Activity Calendar…………………………………………………………...... 02-13
        - Outing/Events……………...…………………………………………………………...... 02-14

III.    Lesson Plans ………………………………………………………………………………… 03-00

IV.     Resident Council
        - Resident Council Policy……………………………………………………………… 04-01
        - Resident Council Form………………………………………………………………. 04-02

 V.     Tools, Supplies, Equipment…………………………………………………………. 05-00

VI.     Volunteer Program
        - Volunteer Standards………………………………………………………………….. 06-01
        - Volunteer Application………………………………………………………………... 06-02
        - Volunteer Orientation Outline……………………………………………………. 06-03
        - Volunteer Sign in/out Sheet……………………………………………………….. 06-04

VII.    Betty’s Harbor Standards
        - Moments of Joy…………………………………………………………………………... 07-00
        - Joining the Journey…………………………………………………………………….. 07-01
        - Personhood………………………………………………………………………………. 07-02
        - Learning to Communicate……………...…………………………………………… 07-03
        - Making Connections…………………………………………………….………........ 07-04
        - Purposeful Living………………………………………………………………………. 07-05
        - Milieu Effect……………………………………………………………………………….. 07-06
        - Taking Care of the Whole Family………………………………………………… 07-07



Life Enrichment Manual                11/15/10                                LE-TOC
                                                        Mission & Values (cont.)
                                                           Mission & Values

           LIGHTHOUSE COMMUNITIES OF NEW PERSPECTIVE

                                     OUR MISSION
 To provide personalized assistance in a secure, social, home-like environment
   while helping seniors preserve their independence and age with dignity.




                                      OUR VALUES
                                       INTEGRITY
                                         SAFETY
                                        PASSION
                                          FUN
                                         CARING

                  OUR GUIDING PRINCIPLES OF SERVICE
                We take PRIDE in enhancing our residents’ quality of life as we:

   Provide for the Whole Person, Body, Mind and Spirit.
   Respect Individuality and Personal History.
   Initiate Activities that Enrich the Resident Experience.
   Develop Relationships between Staff, Residents, Family and Friends.
   Encourage Independence and Freedom of Choice in a Beautiful, Secure Setting.
         OUR FOUNDATIONAL BELIEF: That all seniors deserve a Quality of Life that allows
                              them to age with Dignity and Grace!

           LIGHTHOUSE COMMUNITIES OF NEW PERSPECTIVE

Life Enrichment Manual                      11/15/10                               LE-01-01
                                                            Mission & Values (cont.)

OUR VALUES:
Integrity       (Do the right thing—regardless.)
       To do what is right at all times
       We will never compromise the values for short term results
       Possess and demonstrate broad skills and knowledge
       We will be committed to self-improvement through education
       Demonstrate honesty in all decisions
       Takes responsibility for personal and company growth
Safety       (Peace of mind—every day.)
       Commits to “safety first”
       Complies with all regulatory agencies
       Sets and maintains consistently high standards
       Ensures the security of residents and team members
       Never compromises safety
Passion        (Love what you do—live what you love.)
       Strives to meet the diverse needs of residents, families and team members
       Champions team spirit
       Craves and delivers superior performance
       Enjoys overcoming barriers to great service
       Looks for innovative solutions to all challenges
Fun     (A vibrant, active life—for the fun of it!)
       Exhibits a sense of humor
       Takes the Mission seriously—but not oneself
       Adds personality to the resident’s experience
       Demonstrates and creates enthusiasm for the job
       Seeks to convert an adverse situation into a positive customer experience
       Creates a friendly environment

Caring       (Everyone matters—everyone family.)
       Have deep regard for the dignity, independence and individuality of each resident
       Maintains respectful relationships with team members, residents and families
       Strives to be a role model at work and in the community
     Embraces a healthy balance between work, family and community.
OUR GUIDING PRINCIPLES OF SERVICE
We take pride in enhancing our residents’ quality of life as we:



Life Enrichment Manual                           11/15/10                              LE-01-01
        Provide for the Whole Person, Body, Mind and Spirit.
             Demonstrate real love and care for the entire person. Work to
              preserve as much as practical the health of the body, the
              soundness of the mind and the vigor of the spirit.
        Respect Individuality and Personal History.
             Demonstrate a real interest in and respect for the past life
              experiences of each senior. Give attention and respect to each
              individual—for who they were, and who they still are.
        Initiate Activities that Enrich the Resident Experience.
             Demonstrate through individualized activities and creative
              options that life is still full of variety and interest.
        Develop Relationships between Staff, Residents, Family and
        Friends.
            Demonstrate that we value family and friends and encourage their
              involvement, by spending time with them—and encouraging one
              another.
        Encourage Independence in a Beautiful, Secure Setting.
             Demonstrate that we value our resident’s right to self-reliance by
              empowering seniors and their families to make choices that
              enable them to live as independently as possible.




Life Enrichment Manual                 11/15/10                            LE-01-01
                                                  The Promise (cont.)
                                                    The Promise



          Team Member Promise
                            Each and Every Day, I Will:



                Smile and Greet Everyone I Have Contact With


                             Do What is Right, Regardless


                               Assume the Best Intentions


                    Treat Others As I Would Like To Be Treated


                         Celebrate the Accomplishments of Others


                  Care for Our Residents as if They Are My Own
                                     Family


                                Strive to Make Work Fun



                Leadership Promise
Life Enrichment Manual                 11/15/10                         LE-01-02
        As a Leader Within a Lighthouse Community, I Will:


                         Passionately Live by Our Mission


                 Always Be Aware of My Role as a Leader


                         Own the Development of My Team


 Be Teachable, Never Forgetting the Front Line Knows Best


        Know the Interests, Goals, and History of My Team


   Treat My Team Members with Respect & Kindness at All
                        Times


                             Always Lead by Example

                              Never, Never Give Up




Life Enrichment Manual                11/15/10              LE-01-02
                                                             Role Role of the D.I.E.
                                                                  of the D.I.E. (cont.)

POSITION:                             Director of Life Enrichment
JOB SUMMARY:                          The person is responsible for implementing a

                                      comprehensive activity focused care program of daily

                                      therapeutic and social activities. General responsibilities
                                      include providing activities based on the needs, interests,
                                      and capabilities of the residents while meeting the physical,
                                      social, emotional, spiritual, and cognitive needs.



REPORTS TO:                           Executive Director



DUTIES:
    1. Implements a comprehensive activity focused care program.

    2. Develops and posts a monthly activity calendar for all neighborhoods within the
       community or campus that complies with our activity standards located in the Life
       Enrichment Manual.

    3. Improves residents’ quality of life by providing for physical, social, emotional, spiritual,
       and cognitive needs.

    4. Communicates changes in residents’ abilities in morning Stand Up meeting.

    5. Supports the Lighthouse mission, values, and principles through implementation of
       activity programs.

    6. Participates in Morning Stand Up, Weekly Managers’ Meeting, Monthly Town Hall,
       Service Plan Meetings, and all other meetings assigned by the Executive Director.

    7. Provides visual orientation for residents through seasonal and holiday decorations and
       programming. All seasonal decorations are to be up at least three weeks prior to any
       upcoming holiday.

    8. Recruits, trains, and supervises all volunteers. A minimum of 10 volunteer hours per
       week are required in each community.

    9. Motivates, inspires, coaches, and trains Resident Assistants to use their individual talents
       to provide scheduled activities.



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    10. Informs family of resident participation in daily activities through attending all Service
        Plan Meetings.

    11. Implements all pertinent Lighthouse Signatures.

    12. Partners with the Director of Marketing to offer opportunities/events that encourage
        community participation in the community activities.

    13. Manages spending and matches limits set by the activity budget.

    14. Maintains all activity supplies as needed to comply with the Life Enrichment standards,
        including maintaining the Hobby Stations in Betty’s Harbors.

    15. Will honor and work though our Team Member and Leadership Promises.

    16. Will participate in the Manager on Duty rotation and work any/all weekends as needed to
        provide the activity program.

    17. Other duties as assigned by the Executive/Campus Director.

This organization reserves the right to revise the essential position functions as the need arises.

I have read the job description above and agree to abide by all duties as stated.




Signature of Director of Life Enrichment                               Date




Signature of Executive                                                 Date




Life Enrichment Manual                         11/15/10                                        LE-02-01
                                                  Role of the Resident Assistant

POSITION:                       Resident Assistant

PURPOSE:                        Provides assistance to residents in activities of the daily
                                living according to federal and state laws and regulations
                                and according to the policies of the Community. Monitor
                                residents for change in condition, behaviors and
                                signs/symptoms of illness. Participates and assists with
                                social activities. Also is responsible to communicate
                                resident changes or concerns to supervisor.



ACCOUNTABLE TO:          Director of Wellness, or designated manager

Our Resident Assistants play a critical role in assisting our residents with
activities. Each day, the resident assistants need to:

    1) Be aware of their role in activities as stated in their job descriptions
    2) Be aware of the daily calendar of events planned in the neighborhood in
       which they are working
    3) Be eager to invite, encourage, and assist residents to all activities
       planned during their shift
    4) Must lead at least one activity per shift worked
    5) Inspire residents to participate
    6) Must engage three residents per shift in a life skills activity
    7) Be aware of the current and past interests of each resident assigned
    8) Be familiar with each of the residents’ personal autobiographies
    9) Never forget that we, as Lighthouse team members, are here to provide
       for the whole person: body, mind, and spirit


Inviting, encouraging, and assisting residents to life enriching activities is an
important job responsibility.




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                                                           11 Key Elements of Programming

Every activity should include one or more of the following key elements, and each of the key
elements should be present in the calendar of scheduled activities:

    1.    Sensory Stimulation/Solace Activities – The goal of these programs is to offer stimulation to one or
         more of the senses. Examples are pet therapy, bread baking, music, or any theme that incorporates
         seeing, hearing, smelling, tasting, and/or touching. These kinds of activities are especially beneficial
         to resident in later stages of memory loss and with residents on hospice.

    2. Physical Activities – These programs are offered daily to every resident and are designed to promote a
       physical wellness for the resident. Examples are chair exercises, movement to music, ball toss,
       walking, strength training, and dance.

    3. Cognitive/Intellectual Activities – These are programs offering intellectual stimulation to support
       mental awareness and cognition. Examples are current events, trivia, discussion sessions, and any
       other mental stimulation.

    4. Emotional/Pastime Activities – These programs offer opportunities to explore a sense of
       self/personhood. They empower the resident to explore needs, feelings, and concerns through
       socialization. Examples are discussions or games, social gatherings that offer opportunities to
       reminisce, or any other related activity in a one to one or group setting.

    5. Self-Respect/Life Skill Activities – These programs also promote personhood. They call the resident
       to involvement and independence at any level based on the ability of that individual. Examples are
       Resident Council, woodworking, chores, gardening, laundry work, or any activity that focuses on past
       lifestyles or accomplishments, culture and beliefs.

    6. Male Oriented Activities – These activities focus on the interests and values that male residents have
       in common. Frequency need is based on resident population. Examples are a group project with Boy
       Scouts, military friends clubs, or any other male oriented interests.

    7. Intergenerational Activities – These programs involve all age groups. They provide opportunities for
       meaningful exchange and are age appropriately presented. Examples are outings, craft projects, or
       indoor, sing-a-longs.

    8. One-to-One Activities – These are implemented in a resident’s apartment or done in a setting that
       allows individual attention to the resident. They are best used when a resident does not want to or is
       not able to attend group events. Examples are books, room decorating, massage, or socialization.

    9. Community Based Activities – These programs offer opportunities to stay in touch with the local
       community. Bake sales, volunteerism, joining a “walk for a cause”, or inviting organizations to visit
       in your community.


    10. Spiritual Activities – These are programs to offer residents the opportunity to continue practicing their
        religious beliefs. Examples are church services, communion, inspirational readings, and Bible study.


    11. Cultural Activities – These are programs designed to expose residents to all cultures. Examples are
        activities that honor traditions, artists, slide show presentations, or museum outings.




Life Enrichment Manual                               11/15/10                                            LE-02-03
                                                   Activity Program Expectations




   POLICY: Every activity calendar will include activities that are planned in
   accordance with our mission, providing for the whole person: body, mind,
   and spirit. More specifically, each monthly calendar will include the
   minimum standards listed below.


  Daily Activities Expectations: Each day, our residents are entitled to five or
  more planned activities per day. All residents are welcome and encouraged to
  join all of the offered activities. Minimum standards include:

    1. 5 or more activities are offered on the activity calendar in every
       Lighthouse neighborhood.

    2. At least 5 activities per day are led by Lighthouse team members or a
       designated volunteer.

    3. Daily activities must include:
            Exercise
            Afternoon Social that includes hydration
            One activity offering a snack & beverage
            Music activity
            A minimum of two activities in the morning, two in the afternoon,
               and one after supper.

    4. All daily activities must be planned in advance and placed on the monthly
       activities calendars.

    5. All residents must be invited, encouraged, and assisted to all calendar-
       planned activities by Lighthouse team members or designated volunteers.

    6. All Resident Assistants must be aware of the calendar-planned activities
       and the times each one begins.




Life Enrichment Manual                  11/15/10                               LE-02-04
                                                 Manager on Duty’s Role in Activities




          As the Manager on Duty, you’re empowered as the “Worker

        Bee” to ensure the           LIGHTHOUSE EXPERIENCE continues on
                                 Saturday and Sunday.



                           Use the four “B”s as your guide:
           1) Be Visible: this is not the time to get office work done. Tour the
              community, assist in the dining rooms, support the concierge, and greet
              all fellow team members.

           2) Be Available: let the staff know you’ve arrived and are there to
              support and serve them.

           3) Be In the Moment: you are empowered as the leader. Execute on
              any/all resident or staff concerns. Quickly provide solutions. Don’t be
              afraid to act. Ask for forgiveness later.

           4) Be There to Delight: the community will take on your attitude and
              disposition. Remember that you are there to “delight” our residents,
              families, and team members




                         Delighting the Residents
       Our residents deserve the same opportunities to socialize and
       engage in events on the weekends as they do during the week. The
       role of the Manager on Duty is to ensure that all calendar-planned
       activities are occurring in all neighborhoods. It is essential for the
       “MOD” to walk through the community several times during their
       shift to ensure the programs are occurring as scheduled. The MOD
       is strongly encouraged to join the fun! Remember, you’re there to
       “delight” the residents.




Life Enrichment Manual                     11/15/10                                     LE-02-05
                                                 Best Practices for Scheduling Activities

The Director of Life Enrichment has an important role to balance the best times to
conduct activities according to resident preferences along with balancing the ideal
times for activities to be led by a Lighthouse team member.

Best Practices:
    1) Ask for input from the Resident Assistants on best time to conduct activities.
       Team Member Promise . . . “never forget the front line knows best.”

    2) Avoid a meal time collision. Food will win every time.


    3) Avoid scheduling activities during Resident Assistant shift overlap by at least 30 minutes.


    4) Avoid heavy care times. 6AM – 9AM are traditionally very heavy. As well as after
       7:30PM.


    5) Evenly distribute activities between Resident Assistant shifts. For example, 5 or more
       activities must be offered each day: 2 in the AM, 2 in the PM, and 1 after supper is best
       practice.


    6) Try planning an activity immediately following a meal. As an example, if breakfast ends
       around 9AM, Lighthouse team members can invite, encourage, and assist residents
       straight from the dining room into the activity room. You’ll be able to increase
       participation by getting residents to the next activity before they return to their
       apartments.

    7) Include nutrition and hydration whenever possible. Offering a small serving of water
       after exercise is a nice way to finish the program.

    8) K.I.S.S. – keep it simple. Be sure to schedule activities that can be understood by your
       team and by the residents. Calling exercise Tai Chi
       sounds exciting, but may not be understood by the residents. Calling it “exercise class”
       may entice more participation.




Life Enrichment Manual                       11/15/10                                     LE-02-06
                                               Creating Enrichment in-between Activities

It’s very important to ensure that each of the activities planned on the calendar occur, begin timely,
and are well-attended. As important is the stimulation and excitement we provide in between
planned activities.

Place yourself in the residents’ shoes for a day. Imagine hour by hour how you spend your day off
work. Perhaps you go shopping, add a trip to the gym, watch a TV program, or have a dinner with
friends later. Those are your own planned activities. What is it you’re doing between those
activities? You might be paying bills, doing laundry, house chores, napping, listening to music, etc.

As Lighthouse team members, it is our responsibility to offer an environment that provides seniors
ample life enriching opportunities, even when an activity isn’t planned. Those opportunities can
move in dozens of directions: sensory stimulation, household chores, spontaneous sing-a-longs,
hobbies, puzzles, stimulating music, relaxing music, bird watching, a stroll outside, assisting with
table setting and meal preparation. Whatever the mood, whatever might stimulate the resident…the
choices are abundant. It is our mission to make those opportunities happen every single day.



Staging the Environment -- Our environment must always be staged in a way that encourages
spontaneous participation in activities, hobbies, chores, or any life skills activity. As Lighthouse
team members, we should be in a habit of “staging.”

Lighting – Be sure lights are turned on including end table lamps, hallway lights, etc. Lighting will
stimulate energy. Be sure blinds are open to let natural light in, turn the lights up during meals and
during programming. Lighting definitely impacts mood and energy.

Sounds – Age-appropriate music should always be playing in the front foyers and living spaces.
Change the tempo to adhere to the mood. Soft music at dinner, sing-along oldies in the afternoons,
big band/swing during exercise are all great choices and can impact well being immensely.

Sights – Our neighborhoods need to be visually stimulating, yet foster serenity and simplicity. Be
sure there are plenty of activity items within arms’ reach of the residents and team members without
over-cluttering. If a resident is sitting at a table, put games, puzzles, magazines, hobbies in front of
them. If they see it, they just may use it. Out of site is definitely out of mind. In other words, get the
stuff out of the closet.

Smells – The comfort and serenity of the aroma of a home cooked meal is always comforting.
Offensive odors are agitating. The lack of any aroma is under-stimulating. Adding aromas that are
pleasant can stimulate, can relax, can inspire, can trigger a fond memory. Plug-in aromatic devices,
baking bread or sweets, the lemon fresh scent of cleaning the kitchen are all things we need to be
doing regularly.




Life Enrichment Manual                           11/15/10                                        LE-02-07
                                                                       Life Skills

Life Skills are everyday tasks that residents have practiced throughout their lives and are still
capable of completing. Each person has a different background and different life experiences;
therefore, is familiar with different life skills.

Think of things you do every day. Repeated things that you do are life skills. As we engage our
residents in life skills, we are bringing them meaning, purpose, and moments of joy.

As a Lighthouse team member, we want you to be dynamically determined on each of your shifts to
engage residents in life skills. Every Resident Assistant, within Betty’s Harbor, is required to engage
a minimum of three residents in life skills activities per shift worked.

 Examples include:
Setting tables, wiping tables, clearing tables, doing dishes, helping with meal preparation,
vacuuming, sweeping, dusting, folding clothes, office work, yard work, etc.

It’s also a good idea to break the life skills tasks into simple steps. For example, instead of asking a
resident to set a table, you could ask the resident to place a napkin on each place setting.



Hobby Stations

 In every one of our Betty’s Harbors, you will notice a stylish piece of furniture that was strategically
 designed to provide opportunities for meaning and purpose. Each hobby station comes equipped
 with baskets or boxes filled with themed life skills and/or enriching activity stimulation. Each
 Hobby Station will have six to nine baskets or boxes. It is the Director of Life Enrichment’s
 responsibility to maintain those boxes with items to match its theme.

Examples of Hobby Station baskets/boxes:
       Laundry or socks unmatched, needing to be folded
       Coupon books to be cut
       Needlepoint, crocheting, sewing tools and supplies
       Handyman tools, bolts, un-assembled parts or objects
       Woodworking tools and un-assembled wood
       Reminiscence photos, photo books
       Nursing items: baby doll, pacifier, sippie cup, baby blanket
       Sensory stimulation objects
       Vanity items such as dressy gloves, brush, hats, jewelry, scarves
       Office work item such as envelopes and documents to be folded and stuffed




 Life Enrichment Manual                          11/15/10                                         LE-02-08
                                                    Lighthouse Lingo
                                                  Lighthouse Lingo (cont.)

We use very intentional language at the Lighthouse to clearly and
consistently communicate our philosophies and values.

Lighthouse Language                        Non-Lighthouse Language

Community                                  Home, facility

Team member                                Employee, associate, staff

Move-in and Move-out                       Admission and discharge

Residents, guests                          Patients, clients, tenants, them,
                                           those people

Neighborhoods, centers                     Wings, units

Dining Room                                Cafeteria, mess hall

Executive Directors                        General managers

Controlled Access                          Locked units, Secured
                                           Neighborhoods

Continence products                        Diapers

Assistance with eating                     Feeders

Betty’s Harbor                             Special care unit or Alzheimer’s unit,
                                           memory care

Folded napkins, aprons                     Bibs

Bathtique or Spa                           Shower Room

We / us                                    You / them

Home Office                                Corporate




                    More Language you’ll hear as a team member:


Life Enrichment Manual                11/15/10                             LE-02-09
                                      10 Foot Rule

                                        K.I.S.S.

                                   The Power of Nice

                     Yes is the Answer, Now What is the Question?

                                    Here to “Delight”

                          Just Fix It, Ask for Forgiveness Later

                                    Moments of Joy

                                   Moments of Truth

                                   Save the Seniors

                                     2nd Paycheck

                                    Trust, But Verify

                                You See It, You OWN It

                          Everyone Matters, Everyone Family




Life Enrichment Manual                  11/15/10                     LE-02-09
                                            Lighthouse Signatures

A "Signature" is something unique we do just to “delight”
our residents. By definition, a signature is what a company
does especially well; it’s the odd or unique process that makes a
company stand out in the customers’ minds.


Life Enrichment Signatures:


        Personal Autobiography for every resident


        Hobby Stations in Betty’s Harbors


        Quarterly “Pay It Forward Program”


        Monthly Manager-led hobby


        Memorial Program


        Quarterly Family Program


        Music is playing in the common living spaces at all times




Life Enrichment Manual          11/15/10                       LE-02-10
                                                                        Cardinal Sins

A cardinal sin is extreme way of saying “what we should not find or see in the
community/cottage.” Specifically pertaining to our life enrichment programming, we
should not observe:

        TV being used as a babysitter, as the primary method of programming, or being
        overheard during meals


        Age-inappropriate music


        Team members talking loudly to one another across the dining room or any common
        living area


        Any loud, distracting sounds


        Music and TV competing with one another


        Unsupervised activities with arts/crafts/chemicals/sharp objects involved


        Activity items made for toddlers. Some may serve as sensory stimulation, but “made for
        adults” items are much better choices


        Telling a resident “no.” A belief system of “anything is possible” and “yes is the answer,
        now what is the question” is our culture


        Any language or communication to residents that exemplifies paternal reprimand


        Planned activities on the calendar not implemented


        Activity calendars not posted timely


        Resident Assistants over-using office time instead of leading life skills or activities


         Lighthouse team members speaking about personal resident information in public areas.




Life Enrichment Manual                         11/15/10                                       LE-02-11
                                                           Monthly Activity Calendar

                               Process Owner: Director of Life Enrichment




POLICY: A monthly Activity Calendar must be developed and delivered to the
residents and posted in the common areas one day before the first of each month.


PROCESS:
     1. The DLE will write/develop the monthly calendar in consideration of all activity
        expectations as outlined in section 02-04.


     2. The DLE will post the calendar in conspicuous areas of each neighborhood or cottage.


     3. The calendar must be posted and delivered to each resident one day before the first of
        each month.


     4. Copies are also given to each department manager.


     5. A copy is posted in each break room and/or near each time clock.


     6. The posted calendar must be printed in at least 14 pt font.


     7. The activity events on the calendar should be named with K.I.S.S. in mind so that our
        residents are able to understand what to plan for and what they’re coming to.


     8. The DLE must use the company approved vendor for the development of the template.

     9. The events planned on the calendar must coincide with the monthly activities budget.

     10. The Executive Director reserves the right to approve or disapprove any items on the
         calendar.

     11. All activity calendars should fully represent the Lighthouse mission and values,
         providing for the whole person, body, mind, and spirit.




Life Enrichment Manual                        11/15/10                                      LE-02-12
                                               Sample calendar




Life Enrichment Manual   11/15/10   LE-02-12
                                                                  Outings/Events

Title of Outing: _______________________________________________________________________________________

Date of Outing: _____________ Time of Outing: _____________ Anticipated Return Time: ___________

Team Member in Charge of Outing: ________________________________________________________________

Contact Info/Phone Number: _______________________________________________________________________

Resident Sign Up:

__________________________________________________ ______________________________________________________

__________________________________________________ ______________________________________________________

__________________________________________________ ______________________________________________________

__________________________________________________ ______________________________________________________

__________________________________________________ ______________________________________________________

__________________________________________________ _____________________________________________________

__________________________________________________ _____________________________________________________

__________________________________________________ ______________________________________________________

__________________________________________________ ______________________________________________________



Copies of this form should be given to the following departments:

       RA office
       Dining Services (if outing occurs over a meal period)
       Concierge Desk

If the duration of the outing is expected to be greater than two hours, notification to the Nurse/RA
at Stand Up Meeting is required for appropriate medication packaging




Life Enrichment Manual                          11/15/10                                        LE-02-14
                                                                  Lesson Plans



      Policy: The Director of Life Enrichment will plan his/her activities in accordance with
      standardized lesson plans. Resident preferences, abilities, and limitations will also be
      considered when implementing activities according to the plans.




     Procedures:

         I.   Each DLE will be provided with a standard set of lesson plans.

         II. The activity calendar will be developed with the lesson plans in mind.

         III. The DLE may use the lesson plans to improve his/her implementation of the activities.

         IV. The DLE may also use the lesson plans to train the Resident Assistants on
                implementation.




Life Enrichment Manual                         11/15/10                                          LE-03-00
                                                                  Resident Council



     Policy: Resident council is an independent, organized group of persons who live
     in the assisted living community that meet on a monthly basis to discuss
     concerns, develop suggestions and plan monthly activities for the community of
     the lighthouse.



     Procedures:

         1. All department managers are required to attend.

         2.   Meetings will be held in the dining room or common space of the community.

         3. The meeting will be held at the same time and place each month.

         4. All assisted living residents, their families, and powers of attorney are welcome and
            encouraged to attend.

         5. Minutes will be taken at every meeting documenting what is discussed.

         6. Each department will have a chance to be focused on. Issues will be brought up and
            discussed and a plan of action will be decided on at the meeting.

              *If an issue cannot get worked out at the time of the meeting the department will have
              time after meeting to resolve the problem.

         7. Minutes from the previous month will be reviewed at each meeting.

         8. All minutes from the council meeting both comments and resolutions will be placed in
            the resident council binder and also in the Director of Life Enrichment’s office.




Life Enrichment Manual                         11/15/10                                      LE-04-01
                                                                    Resident Council Minutes

Date ________________________

Residents, Families, P.O.A.s in Attendance

______________________________              _____________________________               __________________________

______________________________              _____________________________               __________________________

______________________________              _____________________________               __________________________

______________________________              _____________________________               __________________________

______________________________              _____________________________               __________________________

______________________________              _____________________________               __________________________

______________________________              _____________________________               __________________________



Quick Review of Minutes From Last Meeting:
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________

Activities

_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________




Maintenance




Life Enrichment Manual                               11/15/10                                            LE-04-02
                                                       Resident Council Minutes (cont.)

_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________

Resident Care

_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________

Administration

_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________

Dining Services

_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________




Life Enrichment Manual                          11/15/10                                        LE-04-02
                                                              Activity Supplies
Games
Uno      Rummy      Jenga    Pictionary          Trivial Pursuit    Card Games    Dice Games
Shuffle Board   Bowling      Scrabble          Bingo       Wii     Puzzles    Brain Quest
Monopoly      Chess/Checkers      Pokino          Dominoes       Sequence    Lincoln Logs

Baking Supplies
Kitchen measuring tools     Baking Pans        Bread maker        Ice Cream Ball     Recipes
Canning Jars    Mixing tools

Gardening
Raised Boxes        Gloves     Rakes     Flowers      Vegetables Plants        Small pots
Watering Hose        Watering Can      Gardening Books

Music
Karaoke Machine      Keyboard    Song Books      Piano            CD Players
Age appropriate CD’s    Hymn Books     Mobil key Board

Exercise
Foam Noodles     One Pound Weights      Plastic Rings      Pedaling Floor Bikes
Beach Balls   Bean Bag Toss     Putting Green       Ring Toss     Bounce Ball
Lawn Dice     Parachute     Croquet      Exercise Books       Exercise DVD’s
Exercise CD’s

Crafts
Scissors      Glue       Tape       Multiple colors of paint     Paintbrushes       White paper
Colored paper Erasers        Crayons        Markers        Magic Markers        Play-doh
Sun Catchers      Wood Crafts        Mosaic supplies        Greeting Cards       Beads
Large Pipe Cleaners       Picture Books       Coupons to clip      Scrapbook Sheets Puzzles
Knitting Supplies (Needles, Knitting and Crocheting Yarn, etc.)      Crossword puzzles
Word searches       Trivia Books      Lacing Cards       Age Appropriate DVD’s       Glitter
Puffy Paint     Aroma Therapy Machine          Textured Objects        Beanie Babies
Rice Boxes with objects in the rice     Magazines        News Papers        Old Greeting Cards

Nursery
Baby Dolls       Baby Clothes      Baby Blankets




Life Enrichment Manual                        11/15/10                                      LE-05-00
                                                            Volunteer Standards



 Policy: Volunteering at the Lighthouse is an opportunity to fill a need in our
 communities by joining in on activities that enrich the lives of our residents.
 Volunteers are an important addition to the Lighthouse team. Volunteers have the
 opportunity to serve the residents in a variety of meaningful ways, including
 writing letters, reading together, going for walks, or even something as simple as
 sitting and chatting.


 Procedures:
 Volunteers must abide by our house rules, mission, and values to ensure the highest
 caliber of volunteers, as well as the safety of our residents. The following process should
 be followed:

      1) A volunteer makes a first inquiry with a member of the management team,
         usually the Director of Life Enrichment. This can be done over the phone or in
         person. During this first meeting, the volunteer and the Director of Life
         Enrichment discuss the specific needs of residents at the community, as well as
         the strengths of the volunteer and how those strengths can be utilized at the
         Lighthouse. If both the Director of Life Enrichment and the volunteer agree that
         volunteering at the Lighthouse would be a good fit, the volunteer is given a
         volunteer application and background check to fill out and return (volunteers
         under the age of 14 must be accompanied by an adult or be assisting the Director
         of Life Enrichment).
      2) When the application is received, the volunteer is accepted contingent upon an
         acceptable background check and negative TB test. The volunteer’s
         background check must come back free of all criminal charges. At this time,
         the volunteer should be given a more thorough introduction to life at the
         Lighthouse. The Director of Life Enrichment should have the volunteer come in,
         and the Director of Life Enrichment should do the following:
              a. Collect the completed application, including the Volunteer Interest List
                  and Background Check.
              b. Give the volunteer a thorough tour of the Lighthouse, introducing him or
                  her to the staff and residents. The goal of the tour is to give the volunteer
                  a feel for what life at the Lighthouse is like.
              c. Show the volunteer the Activity Calendar, and discuss how the
                  volunteer’s interest (per Volunteer Interest List) can fit into the activity
                  program.




Life Enrichment Manual                       11/15/10                                    LE-06-01
                                                      Volunteer Standards (cont.)



               d. Determine a potential schedule for the volunteer (which days, times,
                  holidays, etc.). Explain that we are flexible regarding the volunteering
                  schedule, but we prefer to know when someone is coming to
                  volunteer, and would prefer a call if they cannot. (Note: “Drop-In”
                  volunteering is acceptable if that is the only way a volunteer can
                  commit, but a “heads-up” call to the Lighthouse is required.
                  Volunteers should not show up unannounced)
               e. Determine a potential schedule for the volunteer (which days, times,
                  holidays, etc.). Explain that we are flexible regarding the volunteering
                  schedule, but we prefer to know when someone is coming to
                  volunteer, and would prefer a call if they cannot. (Note: “Drop-In”
                  volunteering is acceptable if that is the only way a volunteer can
                  commit, but a “heads-up” call to the Lighthouse is required.
                  Volunteers should not show up unannounced)
               f. Before the volunteer leaves, the Director of Life Enrichment should
                  give him or her a business card and set a date for each of the
                  following:
                      i. New Team Member Orientation – each volunteer is expected to
                         go through day one of new team member orientation (9:00 am
                         – 2:30 pm). This must be completed with in thirty days of
                         starting.
                     ii. The volunteer’s TB test – One week prior to the volunteer’s first
                         visit, the Director of Wellness will administer a TB test. This
                         must be done before the volunteer starts.
                    iii. The first volunteer visit – this first visit should be at a time when
                         the Director of Life Enrichment is on-site.




 In order to provide our residents with the best possible experience, each community is
 expected to maintain a minimum of 10 volunteer hours per week.



Life Enrichment Manual                     11/15/10                                  LE-06-01
                                                              Volunteer Application



Name:                                                    Application date:____________________
Last, First, MI: _______________________________________________________________________________
Social Security#:__________________________
Home Address:
Street, City, State, Zip: _______________________________________________________________________
Telephone:___________________________________ Email Address: ______________________________
Secondary Contact:
Name:_____________________________________________
Relationship:______________________________
Address:_______________________________________________________________________________________
Telephone:_______________________________ Email Address: __________________________________
Criminal Conviction:
Have you ever been involved in any criminal proceeding in which you were found
guilty? ________________________
If yes, please describe_______________________________________________________________________
Information:
Age___________________
 *If you are under 14 years of age, you must be accompanied by an adult during the
time you are volunteering.
Have you ever used a name other than the one above? ______Yes_______No
If so, please provide______________________________________________________________
Have you ever been employed here? _______Yes _______No
If Yes, when? _____________________________________________________________________
Have you ever volunteered before? ________Yes________No
If Yes, where and when__________________________________________________________
Why would you like to volunteer?
_________________________________________________________________________________________
__________________________________________________________________________________________
Availability:
Circle the days you are available?
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
What times are you available?_______________________________________
Interests / Skills:
Circle the activities you are interested in:
Pet visits Pet Therapy Religious Programs Polishing Nails Playing Games
Baking Gardening Playing Musical Instruments Outdoor Chores Singing
Cleaning/Housekeeping Crafts Quilting or Knitting Book Clubs Serving in
the Dining Room Art Projects Fixing Things Leading Exercise Dancing
Reading Driving the Bus Helping with Resident Outings to Dinner or Shopping
Decorating Fundraising Events Teaching Sports Cards
Other______________________________________________________________________




 Life Enrichment Manual                          11/15/10                                           LE-06-02
                                                               Volunteer Application (cont.)

 APPLICANT ACKNOWLEDGEMENT
 I certify that all information I have provided in order to apply for and secure employment with this employer
 is true, complete and accurate.

 I understand that any information provided by me that is found to be false, incomplete or misrepresented in
 any respect, will be sufficient cause to cancel further consideration of this application, or immediately
 discharge me from employment, whenever it is discovered.

 I expressly authorize the employer, its representatives, employees or agents to contact and obtain a criminal
 background check, information from all references, employers, public agencies, licensing authorities and
 educational institutions and to otherwise verify the accuracy of the information provided by me in this
 application, resume or job interview. I also agree to obtain a tuberculosis test and the required time and
 place prior to starting in the position.

 The application will remain current for only 90 days from the date it was submitted. At the conclusion of that
 time, if the applicant has not heard from the employer and wishes to be considered for employment, it would
 be necessary for the applicant to reapply and complete a new application form.

 I understand the employer does not unlawfully discriminate in employment and no question on this
 application is used for the purpose of limiting or excusing the applicant from consideration for employment
 on the basis prohibited by applicable local, state or federal law.

 I understand that Wisconsin and Minnesota are “at will” employment states. NPSL. is an “at will” employer
 and each employee is an “at will” employee. “At will” employment means that you are free to leave our
 employment at any time for any reason you choose, and we are free to terminate that employment
 at any time for any reason we choose. There is no contract or agreement of any kind between any
 employee and or New Perspective Senior Living as his or her employer, requiring that you work
 for us for any period in the future or that we continue to employ you for any period in the future.

 Neither this application nor offer of employment can or does create a contract or agreement of employment
 for any specified period of time.

 I certify that I have read the above Applicant Acknowledgement and accept all terms.



 SIGNATURE OF APPLICANT __________________________________________ DATE _______________

                                      An Equal Opportunity Employer



Office Use:
Name Tag: ______________
TB Test: ________________
Interview Date: _________________
Orientation Date: _____________________




 Life Enrichment Manual                             11/15/10                                          LE-06-02
                                                         Volunteer Orientation Outline

Orientation is completed once per month in conjunction with New Team Member Orientation

                  Welcome & General Orientation                           Time
 Section I: Welcome
   Introductions/Ice breaker
                                                                      9:00-9:30 a.m.
   Review agenda
   Ground rules/Housekeeping
 Section II: Mission & Values
   Company History
   Our Foundational Belief
                                                                      9:30-10:00 a.m.
   Our Guiding Principles of Service
   Our Values
   Our Mission
 Section III: Community Orientation & Emergency Preparedness
   Tour
   Fire Safety
   Severe Weather                                                   10:00-10:55 a.m.
   Loss of heat/power
   Missing Resident
   Security System Malfunction
   Emergency Procedures Books
   Location of supplies, equipment, reference materials, MSDS
   Safety & OSHA Requirements

                                                                       Break 5 min.
 Section IV: Home Care Orientation
    Home Care Rule Overview (MN only)
    Reporting VA Maltreatment/Caregiver Misconduct
                                                                     11:00-12:45 p.m.
    Home Care Bill of Rights/Resident’s Rights
    Ombudsman Services
    Resident Confidentiality/HIPPA (Video)
Lunch (Lunch is on the house today)                                     12:45 p.m.
 Section V: Customer Engagement Philosophy
    Handling Resident & Family Complaints
                                                                      1:30-2:30 p.m.
    First Impressions
    Sales Process & Tour Training




Life Enrichment Manual                        11/15/10                                  LE-06-03
                                      Volunteer Sign In/Out Sheet



               Name      Time         Time     Volunteer Activity or
                          In           Out         Assignment




Life Enrichment Manual     11/15/10                           LE-06-04
                                    Joining the
                                     Journey




                             Creating & Celebrating
                               Moments of Joy




Life Enrichment Manual   11/15/10           LE-06-04
                                                       Moments of Joy


Betty’s Harbor Program Goal

The ultimate goal of our program is to create and celebrate moments of joy
with our residents.

Everything we do for residents should be focused on opportunities for success
and purpose. Through a personalized, relationship-based care approach, we
recognize that every action or behavior has meaning. We will use what we
know about each resident to interpret that meaning, and to apply approaches
that celebrate moments of joy.

Creating Moments of Joy is best accomplished through our mission and
values. As you provide care and services, remember to:

Provide for the Whole Person, Body, Mind, and Spirit You’ve been
carefully selected and strategically trained to provide each resident in Betty’s
Harbors with gentle, personalized services.

Respect Individuality & Personal History Read and be familiar with each
resident’s personal autobiography. It will enable you to work collaboratively
with residents and families to truly become an extension of each resident’s
own family.

 Initiate Activities That Enrich the Resident Experience “Celebrating
Moment s of Joy” is woven into our daily events whereby life skills, exercise,
story-telling, chores, creative crafts, are only the beginning. Be passionate and
obsessed with getting each resident involved in meaningful activities.

Develop Relationships Between Team Members, Residents, Family, and
Friends Welcome visitors and offer our community as a second home.
Remember that you’re a guest in the resident’s home. Remind families,
teammates, and residents that you are there to “delight” them.

Encourage Independence in a Beautiful, Secure Setting Enable residents
to do what they can, as long as they can. If they don’t use it, they will lose it.
Instead of teaching them to be dependent on us, foster their own success by
allowing them perform their own ADLs whenever possible.




Life Enrichment Manual                11/15/10                               LE-07-00
                                                 Moments of Joy (cont.)


Examples of Celebrating & Creating Moments of Joy:

        Using humor during interactions
        Asking a resident about his/her past hobbies
        Playing their favorite music during care
        Asking questions about the pictures in their apartments
        Giving a compliment
        Assigning a task or chore that they would enjoy
        Giving a 2nd helping of anything they seem to be enjoying
        Reading through their Autobiographies with them
        Praising residents for any big and small achievements
        Taking advantage of every opportunity to “lighten” the atmosphere
        Try asking this “How may I delight you today?”
        Singing with the residents
        Tucking a resident in at night
        Simply giving eye contact and smiling at a resident


     Tip for Resident Assistants: Prior to initiating care, try creating a
      moment of joy first. It will lead to less resistance and more enjoyment
      of the task.




Life Enrichment Manual               11/15/10                            LE-07-00
                                                                    Joining the Journey

       As Lighthouse team members, we must dedicate ourselves to joining the
       journeys of our residents. What does it mean to join a resident’s journey?

                         We view a resident’s entire lifetime as their journey.

 Childhood Adolescence               20s      30s        40s     50s        60s     70s          80+


Birth Childhood/Adolescence     Young Adult    Middle Age      Old Age/Retirement         Move into AL Death

 0           1-18                 19-39          40-60              61-80                       80+

       A typical resident’s lifespan is illustrated above. The average age of our
       residents is 86 years old. The average length of stay is 1.5 to 3 years. As you
       can see, we’re joining the residents’ journeys at the very end. The last 3 years
       of an 86 year olds life constitutes merely 3% of their lifespan.

       We are joining them for the last 3% of their lives. It’s very important to
       realize this as we care and provide services to seniors.

       They have experienced “life” far beyond what we can fully understand. They
       have contributed to society, lived through wars, survived economic
       depressions, and have paved the way for all of us to live a life of freedom and
       abundance.

       So what does it mean to join a resident’s journey?

               To meet the residents where they are today, whether it’s a good day or a
                bad day
               To realize that there is a well-accomplished “person” behind the disease
               To seize every opportunity to create and celebrate moments of joy
               To understand ourselves and all we have in common with the residents
               To connect and communicate with empathy and kindness in all of our
                interactions
               To strive to renew a sense of purpose and identity
               To be fully present and walk along side of them


       As we care for and provide services to residents, we are joining their journeys
       to provide the most life enriching experience possible. . .after all, they’ve
       earned it and deserve it.


       Life Enrichment Manual                    11/15/10                                  LE-07-01
                                                           Personhood


Responding with empathy is acknowledging their emotions. A resident says “I
am angry because my husband isn’t home yet!” Remember to join their
journey and view the world through the eyes. Responding with empathy:
look straight into their eyes first, then say: “you really do seem angry.”

The next technique to apply following empathy is:

Validation
Validation recognizes what residents are going through and finds meaning in
their actions and emotions. It helps us to connect with residents who are
upset or anxious while not judging them or trying to “redirect” their reality.
Validation recognizes personhood along with needs.

As a Lighthouse team member when we use validation we:

    1) Restore the personhood of residents with dementia
    2) Will not attempt redirection or therapeutic fibbing
    3) Respond with empathy while looking for meaning behind the
       communication patterns


Example continued from above:

Resident        “I am angry because my husband isn’t home yet!”

R.A.            Look straight into her eyes and say “you really do seem angry”

Resident        “Wouldn’t you be?!! He’s over two hours late!! I don’t if he’s hurt

                or he’s out with his buddies again!”

R.A.            Maintaining eye contact…”tell me about your husband. What time
                does he usually get off work?”

When you use validation, you’re joining their emotions. You’re mirroring
their upset nature and trying to find the meaning behind why she is upset that
he isn’t home yet. As this is done, the resident is being afforded the right and
the time to deal with what she thinks is happening.




Life Enrichment Manual                  11/15/10                             LE-07-02
                                                       Personhood (cont.)

Using validation allows the resident to communicate what is in their heart and
mind. Again, you’re connecting with their emotions. You may not have
experienced everything that an 80 year old has, but you may have felt all the
same emotions and then can connect with them in that way.

Another way of understanding validation is through the weather analogy.
During any trip or journey, we may come across storms, icy roads, or foggy
nights. Just as we need tools to help us get through inclement weather, we
also need tools to help us when we encounter some of the emotions the
residents are communicating. Validation is a tool to help us with
understanding.

Understanding the Past
Joining a resident’s journey is accelerated by gaining a deeper understanding
of his/her past life experiences. It’s essential to find out who the person has
been throughout their life. Appreciating someone’s history and culture is a
great way to connect and build a relationship.

What tools do we have to learn more about the residents past? :

        Personal autobiographies or social histories
        Negotiated Service Plans
        Photographs in their apartments
        Their family and friends
        The residents themselves


Quiet Moments
Taking a moment to quickly clear our thoughts enables us the strength to
empathetically enter the world of the resident. It’s a good idea to take a
moment to prepare for a possible challenging interaction.

Whenever you get a chance, take a breath, breathe out slow, and take your
mind to relaxing place. This produces a state of calmness that will make you
much more effective when dealing with challenging interactions with
residents.



Life Enrichment Manual                11/15/10                              LE-07-02
                                                  Personhood (cont.)




References
Feil, N., (2003). Validation:The Feil Method. Cleveland: Edward Feil
Productions

Feil, N. (2002). The Validation Breakthrough. Second Edition. Baltimore, MD:
Health Professionals Press.

Feil, N., Altman, R. (2004). Validation theory and the myth of the therapeutic
lie. American Journal of Alzheimer’s Disease and Other Dementias.
March/April, p. 77, 78.




Life Enrichment Manual              11/15/10                             LE-07-02
                                                 Learning to Communicate

           We have learned how to create and celebrate moments of joy.

           We have learned the value of joining the resident’s journey.

          We have embraced the dire need for maintaining personhood.

 We have also learned the importance of quiet moments prior to validation.

Now it’s time to learn how to most effectively communicate with residents
who have dementia.

Step 1          Quiet Moment
Step 2          Observe the Non-Verbals
Step 3          Mirror Emotions
Step 4          Create a Moment of Joy
Step 5          Approach
Step 6          Ask
Step 7          Listen
Step 8          Provide Empathy
Step 9          Eye Contact
Step 10         Touch

Step 1          Quiet Moment

At the beginning of your shift or just before entering a resident’s apartment,
it’s a good idea to take a moment to take a deep breath, exhale, enable yourself
to calm down and clear your mind.

Step 2          Observe the Non-Verbals

Study the resident’s face and body to determine how they may be feeling and
what emotions are at play. Does their jaw appear tense or relaxed? Are their
arms relaxed? Are their fists clenched? Is he sitting upright or slouching? Are
they smiling or frowning? Are their feet tapping?

All of the observations we make can quickly tell us what’s happening
emotionally before initiating care.




Life Enrichment Manual                11/15/10                            LE-07-03
                                                 Learning to Communicate (cont.)




Each item pointed to above will give insight to a resident’s emotions.

What are the forehead, the eyes, the mouth, the jaw, the hands, and the overall
body position and body movements telling you?

Step 3          Mirror Emotions

Mirroring someone’s emotions is a way to connect with a resident on their
level. It’s an example of joining their journey. If their brow is furrowed,
furrow yours. If their tone is calm, match his/her tone.



It will build trust with the resident so that you’re next steps will occur easier.




Life Enrichment Manual                11/15/10                               LE-07-03
                                                  Learning to Communicate (cont.)


Step 4          Create a Moment of Joy

Prior to initiating care, try creating a moment of joy first. It will lead to less
resistance and more enjoyment of the task.

Examples of Celebrating & Creating Moments of Joy:

        Using humor during interactions
        Asking a resident about his/her past hobbies
        Playing their favorite music during care
        Asking questions about the pictures in their apartments
        Giving a compliment
        Assigning a task or chore that they would enjoy
        Giving a 2nd helping of anything they seem to be enjoying
        Reading through their Autobiographies with them
        Praising residents for any big and small achievements
        Taking advantage of every opportunity to “lighten” the atmosphere
        Try asking this “How may I delight you today?”
        Singing with the residents
        Tucking a resident in at night
        Simply giving eye contact and smiling at a resident


Step 5          Approach

A resident who is angry needs more distance. Stand at least a few feet away.

A resident who is very angry or hostile, remember the 5 foot rule and stay at
least that distance to avoid injury.

It’s also important to not give deep eye contact to a resident who is hostile as
it may ignite combative behavior.

A resident who is in the mid to later stages of memory loss who has minimal
verbal communication skills needs less distance. Move in closer and use touch
once you have established a connection.

Residents who are less social or more introverted also need a closer approach
in order to build trust.

Two things to always keep in mind: 1) A slow, gentle approach will lead to
less resistance. 2) Tone of voice should mirror. When in doubt, always use a
warm, gentle tone of voice.
Life Enrichment Manual                 11/15/10                               LE-07-03
                                              Learning to Communicate (cont.)

Step 6          Ask

Always remember to ask rather than to tell. Again, never use a paternalistic
approach. They are not our children. They are our elders who need to be
respected. Instead of saying “You need to come to the bathroom” or “It’s time
for your bath”, try saying “Would you like to walk with me to the bathroom.”

This is especially important with residents, again, who are angry. Try this
sequence of questions in your approach:

               Ask open questions “who, what, where, when, how?” This will
                show them that you are interested.

               Avoid closed questions like “Do you feel angry?”

               Avoid asking “why?” They may not know, it puts them on the spot
                and the question why requires an explanation that is difficult for a
                person with memory loss.

               Rephrase what they are saying so they know they are heard
               Ask the extreme….this will enable the resident to express him or
                herself more fully. Example: “What’s the worst thing about not
                being at work right now?”

Step 7          Listen

Try to listen for the NEED. Does the resident have an unmet need?

Is the need to feel loved? Is it the need to feel safe or secure? Is it

a need for something more physical? Are they cold, hungry, thirsty?

Step 8          Provide Empathy

Using empathy shows respect, improves communication, and reduces
frustration. It builds trust and dignity when you try to enter into another
resident’s world and feel the way they feel.
Responding with empathy is acknowledging their emotions. A resident says “I
am angry because my husband isn’t home yet!” Remember to join their
journey and view the world through the eyes. Responding with empathy:
look straight into their eyes first, then say: “you really do seem angry.”


Life Enrichment Manual                   11/15/10                             LE-07-03
                                           Learning to Communicate (cont.)

Step 9          Eye Contact

After you’ve observed, gotten close, make eye contact. It will enable you to
connect with the resident and will foster trust.

Step 10         Use Touch

We recommend you use touch carefully. Knowing the resident is the key to
knowing when and how to apply it. Touching will help with connecting and
with trust. Touch should almost always be gentle. Examples of touch are:
gentle touch on the shoulder or arm, holding a resident’s hand on the way to
the bathroom, a needed hug, patting circles on the back of a resident’s neck,
etc.

Ask you use the ten steps to effectively communicate with residents with
memory loss, the most important thing to remember is to listen for and
discover the unmet need.




Life Enrichment Manual              11/15/10                             LE-07-03
                                                         Making Connections



                         Everyone Matters, Everyone Family
When we refer to the word “connecting” we’re talking about knowing residents on a whole
new level. It’s a deeper understanding of their needs. It’s a deeper level of trust between
you and the them. It’s a deeper insight into the personhood of the resident. It’s a deeper
level of engagement between you and the residents. Making connections is at the heart of
our relationship based approach, emulating significance, meaning, and the essence of
family.

So how do we make connections? It begins with passionately “knowing” the resident.
When you know and understand their likes, dislikes, past hobbies, previous jobs, pet
peeves, nuances, and things that make them laugh, you are able to establish a more
intimate relationship. You can pick out things that you know about them to some of the
same things that interest you. You can take those things and provide them during care,
during meal service, during activities, during all of your interactions. For example, if you
know a resident who grew up on farm and also loved country western music. You can play
country western while providing care. You can whistle an old Willie Nelson song while
perhaps cleaning their bathroom. You’ll remember to get them to the activity when
country music entertainers are performing. You’ll provide them with props and picture
books having anything to do with the farm. You may even take them for a stroll or a scenic
drive when the corn has grown 4 feet high by the 4th of July.

Making connections is also about empathetically understanding what stimuli evokes
emotions. What will upset them? What will make them smile? What will evoke fear?
What music makes their feet tap? What noises or sounds make them irritated? What
smells reminds them of home? When a hug is needed? A deeper connection is made when
we not only understand this, but proactively act upon this knowledge.

Imagine you own mother or grandmother here at the Lighthouse. Imagine her in the
presence of somene who deeply understood her. Imagine her in the presence of someone
who was “connected” with her. Isn’t this what you would want? As a Lighthouse team
member, isn’t that the role you want with our residents?




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                                                              Purposeful Living



No matter what our age, we all need meaning and purpose in our lives. We need a reason
to get up in the morning. We need something worthwhile to occupy our time. We want to
provide the same opportunity for our residents. We want them to feel significance and we
want them to have things to do. A great way to engage a resident in a meaningful activity is
through providing life skills opportunities.

Life Skills are everyday tasks that residents have practiced throughout their lives and are
still capable of completing. Each person has a different background and different life
experiences; therefore, is familiar with different life skills.

Think of things you do every day. Repeated things that you do are life skills. As we engage
our residents in life skills, we are bringing them meaning, purpose, and moments of joy.

As a Lighthouse team member, we want you to be dynamically determined on each of your
shifts to engage residents in life skills. Every Resident Assistant, within Betty’s Harbor, is
required to engage a minimum of three residents in life skills activities per shift worked.

Examples include:
Setting tables, wiping tables, clearing tables, doing dishes, helping with meal preparation,
vacuuming, sweeping, dusting, folding clothes, making beds, arranging flowers, handyman
tasks, office work, yard work, etc.

It’s also a good idea to break the life skills tasks into simple steps. For example, instead of
asking a resident to set a table, you could ask the resident to place a napkin on each place
setting.




Life Enrichment Manual                      11/15/10                                     LE-07-05
                                                          Purposeful Living (cont.)


Hobby Stations
 In every one of our Betty’s Harbors, you will notice a stylish piece of furniture that was
 strategically designed to provide opportunities for meaning and purpose. Each hobby
 station comes equipped with baskets or boxes filled with themed life skills and/or
 enriching activity stimulation. Each Hobby Station will have six to nine baskets or boxes. It
 is the Director of Life Enrichment’s responsibility to maintain those boxes with items to
 match its theme.

Examples of Hobby Station baskets/boxes:
     Laundry or socks unmatched, needing to be folded
     Coupon books to be cut
     Needlepoint, crocheting, sewing tools and supplies
     Handyman tools, bolts, un-assembled parts or objects
     Woodworking tools and un-assembled wood
     Reminiscence photos, photo books
     Nursing items: baby doll, pacifier, sippie cup, baby blanket
     Sensory stimulation objects
     Vanity items such as dressy gloves, brush, hats, jewelry, scarves
     Office work item such as envelopes and documents to be folded and stuffed


It is the jobs of all of our Lighthouse team members to engage the residents in life skills
activities and to make use of the Hobby Stations.




Life Enrichment Manual                      11/15/10                                    LE-07-05
                                                                Milieu Effect



The word milieu refers to environment or life space. At the Lighthouse, when we refer to
the Milieu Effect we are referring to the impact our Betty’s Harbor neighborhoods have on
residents.

Our environments are therapeutically designed for creating and celebrating moments of
joy through purposeful living and life skills opportunities. As Lighthouse team members, it
is our responsibility to maintain such a life space.

What we should be doing daily:

        Turning on all hallway lights, common area lights, table lamps.
        Opening blinds in the apartments every morning and also in the common spaces.
        Turning age appropriate music on in the common areas and also in resident
        apartments. Music should be playing at all times in the common spaces.
        Removing clutter and disorganization anywhere visible to residents.
        Minimizing the use of televisions unless the program is “past-oriented.”
        Maximizing the use of our Hobby Stations.
        Minimizing boredom by constantly offering residents things to do.
        Removing trip hazards or any hazards impacting life safety.
        Adding pleasant aromas that are fresh or may stimulate fond
        memories…..baking/cooking are great ways to invigorate the environment.
        Rectifying any unpleasant odors immediately.
        Rectifying anything that is not clean or sanitary.
        Tidying resident apartments.
        Removing any noises or sounds that trigger irritation.
        Maintaining gentle, calm communication between our team members and residents.




Life Enrichment Manual                    11/15/10                                  LE-07-06
                                                            Milieu Effect (cont.)



    As a reference, Wikipedia describes Milieu:

        Milieu Therapy is a planned treatment environment in which everyday events and
        interactions are therapeutically designed for the purpose of enhancing social skills
        and building confidence. Academics are woven into the daily routine using an
        integrative and interactive approach that incorporates learning styles and areas of
        interest.
        The milieu, or "life space," provides a safe environment that is rich with social
        opportunities and immediate feedback from caring staff. The milieu is not static but
        it is flexible and features normalizing and developmental perspectives that use
        common structures intended to be familiar to all children, such as daily routines,
        consistent rules and activities. The therapy is planned in such a way that it is
        constantly supporting, guiding and reinforcing the child's ability to learn life tools,
        such as problem solving and coping skills, while at the same time offering a safe
        place for these skills to be practiced and integrated into the child's repertoire of
        strategies. The milieu takes into consideration the perspective of the child as well as
        the perspective of the milieu at large. A simple example of this is a "wrap-up group"
        at the end of the day, where kids first tell what they appreciate from that day, and
        what their high point and low point are. Metaphorically, this teaches kids that every
        day has its ups and downs, yet there is always something that can be appreciated.
        They could do a self-evaluation and get feedback (not criticism) from the other kids.
        This is a very powerful group and can give kids an opportunity to see how others
        view them in a non-threatening forum.
        One of Milieu therapy's primary goals is to teach kids "how" to "fit in" socially and
        emotionally in their world without changing "who" they are. They learn new skills
        that help them to better understand themselves and their relationships. The milieu
        is not a static environment, but is flexible and incorporates the use of common
        structures familiar to all children, such as daily routines, predictable rules and
        activities.

As you go about your day as a Lighthouse team member, always keep in mind the impact
the environment has on our residents’ health and well being. Also keep in mind the impact
you have on the Milieu Effect.




Life Enrichment Manual                      11/15/10                                    LE-07-06
                                                        Taking Care of the Whole Family



As residents move into the Lighthouse and we join their journeys, we also must embrace
the families, friends, and visitors of those residents. It’s important to keep in mind the
emotional struggle the families are going through as they are dealing with their “Mom’s” or
“Dad’s” memory loss.

A note from a sixty year old daughter:

“Sometimes I look right into my Father’s eyes and I ask myself where did he go? How could
this strong and steady person who guided me through childhood have become so
dependent and pathetic? How could this man, who was so meticulous with his appearance,
have forgotten to shave or put on his socks this morning? What do I tell me son when his
favorite Grandpa just soiled himself and doesn’t remember his name?

There are many ways that we can ease the burden and help alleviate some feelings that
families are struggling with:

    1)    Simply listen
    2)   Offer empathy and a shoulder
    3)   Remind them how much joy their loved one is bringing to you
    4)   Actuate the positive by telling them the things he/she is still accomplishing
    5)   Involve them in the journey. Invite them to events, activities, support groups, .etc.

At times a family member might be mad at you. Try not to take it personal. Remember
what their dealing with is grieving over losing their “Moms” and “Dads.”




Life Enrichment Manual                       11/15/10                                    LE-07-07

				
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