Category Archives: Strategic Planning

Moving Modern Geriatrics to Take Advantage of Nurse, Family and Patient Intuitions

As our strategic plan moves forward in the health area, we are given a useful reminder in the New York Times of the value of instinct in alerting people to potential medical crises.  The Times article focus on the instincts of nurses, and is fascinating.  I have done a blog that asks if we can also take value from the intuitions of the family and the patient themselves

I suspect that we could “train” patients and families to be much more mindful about patient monitoring, including how to trust their instincts and how to communicate their feelings to the medical personal.  This, of course, should be accompanied by training of medical staff on how to take the most advantage of, and how to solicit such communications.  It is not hard to construct model ways of doing so.

I suspect that when things work, that is very much happening in our long term care facility already.  Nurses and care staff know the patients, and communicate with them regularly.  It makes such sense to empower them to raise their concerns, to train and encourage family and resident to do so too, and finally to ensure that all medical personnel not only listen to, but affirmatively seek such help as part of an inclusive team.

I am sure that this will fit in well with our general themes of community cultural change and inter-generational initiatives, as well as the specifics of modern geriatric medicine.

 

 

Our Intergenerational Music Program Featured as National Cutting Edge. Newspaper and TV

Collington is now the Poster Child for Intergenerational programs!

Samantha Flores and Collington are the featured story (with photo of our auditorium) in The New York Times reporing on a newly issued report on inter generation initiatives for seniors.  The story begins.

When Samantha Flores wasn’t taking classes at the University of Maryland for her master’s degree in cello performance this past academic year, she could often be found hanging out with a bunch of 80-somethings. Ms. Flores, 28, along with another music student, was participating in a new artists-in-residence program at Collington, a nonprofit retirement community in Mitchellville, Md.

As the article reported:

Marilyn Haskel, a 72-year-old resident of Collington involved in selecting the students, said the young people often invited fellow music students to practice on the grounds, resulting in pop-up concerts. With no family nearby, Ms. Haskel said, “it was delightful for me to sit down and have conversations about their careers and what they’re planning.”

When residents learned that Ms. Flores didn’t have a car, they often drove her to campus. Ms. Flores struck up close friendships with many of the residents, including one she met in September who had recently been given a brain cancer diagnosis.

“We bonded over Bach,” she said, engaging in lengthy conversations about him. When the man died in February, Ms. Flores played a piece he had requested at his funeral: Bach’s “Sarabande: Suite for Solo Cello No. 5 in C Minor.”

“I promised I wouldn’t cry, but you can’t help that,” she said. “It was a very emotional moment.”

The trigger for the article is a new report from Generations United and the Eisner Foundation survey of 180 intergenerational programs.

That report itself cites a Harris Poll that found:

[P]lenty of support for programs that bring diverse age groups together to fend off loneliness. Ninety-two percent of Americans believe intergenerational activities can help reduce loneliness across all ages.

Moreover,

A strong majority of Americans (94 percent) agree that older people have skills or talents that can help address a child’s/youth’s needs and 89 percent believe the same about children and youth addressing the needs of elders. More than four in ve Americans also say if they (85 percent) or a loved one (86 percent) needed care services, they would prefer a care setting with opportunities for intergenerational contact rather than one with a single age group. Americans were also clear that age segregation is harmful, finding that almost three quarters (74 percent) agree that “programs and facilities that separately serve different age groups prevent children/youth and older adults from benefitting from each other’s skills and talents.

Given all that is now happening in this field, way beyond music, we will need to keep innovatintg to stay in the lead — another major task for our strategic planning process.  Indeed, onsite child care was an idea that came up frequently in the process.

P.S.  One little thing I would like the photo committee to do is take on making a set of before and after photos of our residents, showing the huge impact grandchildren visits have on us.

P.P.S.  The TV version is on WJLA, here.

 

 

The Potential for Clinical Trials at Collington

As we move forward with our repositioning of health care at Collington,  of necessity the potential of Collington as a research location has taken a big of a back burner – but only for now.

This New York Times article is a timely reminder of how us seniors are often forgotten when it comes to clinical trials:

Salt matters to geriatricians. It’s associated with conditions many older people contend with, particularly high blood pressure, but also swelling and heart failure.

Though doctors frequently urge older patients to reduce salt in their diets, it’s not clear how much reduction is necessary to improve health, or even how much salt most people actually consume.

“There’s a lot of controversy, but that’s why we need the data,” said Dr. Covinsky. So he read on, until he reached the paragraph explaining that the study used “randomly selected, nonpregnant participants aged 20 to 69 years.”

He did a double-take. Once again, the population probably most affected — older adults — had been left out of an important study.

“How is this possible? Unacceptable!” Dr. Covinsky protested on Twitter. “I can think of no good rationale for this exclusion. This has got to stop.”

Indeed, I have been told by researchers that it is hard to recruit seniors for trials.  This may be for a variety of reasons, lack of trust, fear of the unknown, inconvenience, failure to understand modern protocols and informed consent.  As the Times adds:

Starting next January, [NIH] grant applicants will have to explain how they intend to include people of all ages, providing acceptable justifications for any group they leave out. The agency will monitor investigators to make sure they comply.

Moreover, there are often problems with exclusions of research candidates who have multiple medical conditions (like almost all seniors.)

This has all led to the idea that Collington may indeed be a perfect research partner.  We have many scientists here, and many with experience with statistics, data, and research protocols.  We are an easy to reach population, and we are also racially diverse — another important consideration.  Moreover, we might be able to help enroll and provide services associated with the research to those in the community.  (In particular, fear of not being helped with other conditions is a major deterrent to certain categories of patients.

So, as we move forward, lets keep this is mind.

Salt, anyone?

p.s. Dorothy Yuan adds the following thoughtful comment.

You have absolutely right that we have an ideal population for clinical trials.  I can already think of many parameters.  First, the age bracket is quite limited.  Second, living conditions are similar.  Third,  access to minimal  medical care is generally available.  Forth, although the daily menu provides a lot of choices it is still rather limited in scope. Fifth, and most important, easy access for researchers to do follow-ups.
Whereas these conditions are not suitable for all areas of study.  For example, salt intake will be rather difficult since we don’t prepare our own meals.  However, we would be ideal for many other studies.  
All we need is a way to advertise our availability. 

 

News and Perspectives on Strategic Planning and Implementation Steps

Editors Note:  Periodically we post perspectives pieces in which we offer some broader thoughts on where our community is going.  We do this not only for each other, but to show our friends what is happening here.

As many know, our Strategic Planning document has been published, and concrete steps have been announced to move its items forward (see page 15 of our Courier dated Feb 26 to March 4).  This is a very important document for all of our lives, and not just because of the concrete steps, such as completely repositioning our health care, that are being and will be undertaken under its banner.

Every few weeks, the Committee, which is a Board Committee with heavy resident and staff participation, will be releasing an update on activities and plans in the Courier.  Residents will also be hearing about that in various fora, including the RA Council and the Community Meeting.

Indeed, such an update is in the most recent Courier.  It includes the very important news with respect to the critical health care partnership, that:

After a significant amount of due diligence, we have narrowed potential partners down to 3 providers. We are continuing due diligence and believe a final recommendation will be made to the Board in June for their endorsement.

Similarly with respect to the physical redesign of the Creighton Center (which is of course deeply integrated with our conceptual redesign:

A Request for Proposals (RFP) has been developed and has gone out to several national and local architectural firms. An ad hoc committee of the Strategic Planning Committee will oversee the RFP process and final recommendations on an architecture firm. We expect this process to be completed by the end of June as well. 

The is no need to note what a wonderful acceleration this represents.

The Report notes that the “Collington Culture and Stakeholder Engagement” implementation rollout will begin in September, and the other two will start in 2019. This delay will enable us to take full advantage of what we are learning about how best to work together in the initial groups and apply that will the next ones.

Speaking for my self, I feel very confident that these processes will be rich in resident input, and that the transformative quality will be clear from how things work out  Just look at the Landing Bistro and the new Physical Therapy staff and spaces.  These both reflect the values and principles processes established in the Srategic Planning process.  I hope that these will similarly increasingly influence everything here at Collington.

 

 

 

 

Vitalize360 Launching This Week — Meet and Greet Friday in the Game Room

This is the week that our Vitalize 360 program gets its real launch and sign-up opportunity.  A project of Kendal, it provides us Collington residents the opportunity to get a “life coach,” who will help us bring together whatever resources and help to decide what they want to achieve next in our lives.  If one of us does not yet know what this is, our new staffer Kim Rivers will help us figure that out too.  Once a goal is identified, Kim will help pull together the Collington resources, staff and residents, to support the process.

Often this is thought of in traditional medical terms, such as achieving a particular “vital sign” milestone, or getting physically strong enough to, for example, get on a plan to visit grandchildren.

But many of us feel that the most exciting engagements that this makes possible are more intellectual, political, academic, etc.  Dianna Cox, who runs the project, and was here for a great presentation yesterday, gave an example of a man who had decided to challenge his golf club’s men only policy, and did so successfully.  (Other more transformative possibilities might come to mind.)

Tomorrow, Friday March 9 at 10:30 in the Game Room, there will be a meet and greet to get to know  Kim and learn more about the project.

Here is the PowerPoint that Nancy Cox presented.

Here is a short video:

It is important to note that Vitalize 360 is a key pat of our strategic plan, both as a specific element, and as something that will help build culture-transformative energy.

Indeed, a recent article in the Journal of Aging Research and Healthcare, here, concludes:

In this project, COLLAGE [Vilalize at one location] 360, a comprehensive assessment system and wellness coaching program that focuses on prevention and wellness was implemented in one continuing care retirement community. Following completion of two assessment tools through directed conversations with a wellness coach, older adults developed an individualized vitality plan that outlined life goals, supporting goals and action plans for goal achievement. Results from this program suggest engagement in the assessment and wellness coaching process via the COLLAGE 360 program translated into sample older adults sensing that they live in a more supportive environment when compared with elders not receiving any wellness coaching. In addition, the older adults had positive responses in the areas of mood and life satisfaction. Strategies to improve health and well being need an extended focus beyond the older adult‘s medical conditions and consider psychological, spiritual and social needs with personal preferences being paramount. These issues are foundational to a person- centered, health promotion approach needed among older adults.

Do not miss the opportunity.