residents helping residents: a dynamic shift in psychosocial care

ALFA 2015 ConferencePresented by Tess Aiello,

Holiday Retirement andKristine Theurer,

MA (Gerontology), MTA

Residents Helping Residents: A Dynamic Shift in Psychosocial Care

Loneliness and Depression in Senior Living

o loneliness and depression (Victor, 2012;

Snowden, 2010)

o diminished sense of purpose (Choi, 2008)

o limited opportunities for contribution (Brownie, 2014; Malderen, 2013)

“When the Golden Years are Blue”

o Prevalence of depression incare homes on admission

o 54% and 60% by follow-up(Neufeld, 2014)

o Assisted living—significantly higher depressive symptoms (58%) than community (19%) (McLaren et al. 2013)

o Retirement—depression (21%),loneliness (19%) (Adams, 2004)

“It’s hard to get to know anybody…”

“No one has time…”

“People here – they are always in a hurry…., they pass you by andsay ‘How are you?’ and then keep going.

No one has time – to look, to talk.”

“My room is at the end of the world.”

Theoretical Foundation

o Tom Kitwood’s Concept of Personhood

– Fundamental human drive towards helping others—when this drive is inhibited,beings do not thrive (Kitwood, 1997)

o Riessman’s Helper-Therapy Principle

– Helping others helps the helpee and helper

– Those observing receive benefits too (Riessman, 1965)

“Members use the power of their own experienceand of their own wounds

to lighten the burden of others,and heal themselves in the process.”

(Post, 2011)

Mutual/Peer Support

“We recognize peer support as an integral component of a mental health programfor older adults.”

US Institute of Medicine

(2012)

Research and Development

The Study (Theurer, 2012)

o 6-year pilot: residents chose components

o 2-year study: staff manual developed

o 65 residents, 7 staff

o Complex care and an adult day centre

Research and funding

o Simon Fraser University

o Social Sciences and Humanities ResearchCouncil of Canada

o Michael Smith Foundation for Health Research

What is the Java Music Club?

The first standardized mutual support groupfor senior living—themes,music, photos andreadings, a Talking Stick.

Why is it unique?

1. Peers helping peers2. A safe place to share3. Talking stick ↑ courage4. Something for everyone5. Equips residents to

support those that are lonely in their home

6. Targets lonelinessand depression

The Findings: The Staff’s Experience

“I knew this was a positive program. How positive it was going to be I couldn’t have even imagined.”

Donna Levi, Therapeutic Recreation Director

The Findings:The Resident’s Experience

o active participation of thosewith cognitive impairment

o 96% enjoyed the program

o low attrition rate (15.4%)

The Resident’s Experience

Resident reports indicate:

o a decrease inloneliness

o feelings of empowerment

o the development of new friendships

A New Sense of Belonging

“It's like brothers & sisters thatyou don't have.”

The Java Music Club and Java Memory Care

“I am amazed at how residents with dementia have responded…short, simple, yet profound answers.”

Hilary Lipsett, Staff

Research Published

Journal of Applied Gerontology 2012

The Development and Evaluationof Mutual Support Groupsin Long-Term Care

Kristine Theurer1, Andrew Wister2

Andrew Sixsmith2, Habib Chaudhury2

and Loren Lovegreen3

1University of British Columbia, Vancouver, Canada 2Simon Fraser University, Vancouver, Canada 3Case Western Reserve University, Cleveland, OH, USA

This is different, something special. It takes the loneliness away.Resident

A smashing success—everyone is loving the program!Schlegel Waterloo Research Institute for Aging

I have been doing the Java Music Club have felt honoured to hear the stories and feelings. I also personally feel grateful, I listen and they listen. Thank you for taking the time to train me and for developing such an innovative and needed program.

Jackie Kramer, Retirement Recreation, Village of Winston Park

• Implemented in 186 homes across Canada• Signature spiritual program• Included French translation for Quebec• Two trainings – one east coast, one west coast• Additional programing being developed for 2016

to address resident-resident bullying

“By the end of the hour, I witnessed all 10 of these residents coming together – they were hugging and holding each other’s arms as they left the room.”

“I have heard so many amazing stories from our Lifestyle and Program Managers from across Canada. They all give me goosebumps and bring tears to my eyes.”

Laura Forsyth – Director of Life Enrichment

The Serendipity Adult Day ServicesThe Salvation Army

ReferencesAdams, K. B., Sanders, S., & Auth, E. A. (2004). Loneliness and depression in independent living retirement communities: Risk and

resilience factors. Aging & Mental Health, 8(6), 475-485. doi: 10.1080/13607860410001725054

Brownie, S., Horstmanshof, L., & Garbutt, R. (2014). Factors that impact residents' transition and psychological adjustment to long-term

aged care: A systematic literature review. International Journal of Nursing Studies. doi: 10.1016/j.ijnurstu.2014.04.011

Canadian Institute for Health Information. (2010). Depression among seniors in residential care. Ottawa, Canada.

Choi, N. G., Ransom, S., & Wyllie, R. J. (2008). Depression in older nursing home residents: The influence of nursing home environmental

stressors, coping and acceptance of group and individual therapy. Aging & Mental Health, 12(5), 536-547.

Kitwood, T. (1997). Dementia reconsidered: The person comes first. Philadelphia: Open University Press.

McLaren, S., Turner, J., Gomez, R., McLachlan, A. J., & Biggs, P. M. (2013). Housing type and depressive symptoms among older adults: A

test of sense of belonging as a mediating and moderating variable. Aging & Mental Health, 18(8), 1023-1029. doi:

10.1080/13607863.2013.805402

Neufeld, E., Freeman, S., Joling, K., & Hirdes, J. P. (2014). "When the golden years are blue": Changes in depressive symptoms over time

among new admitted to long term care facilities. Clinical Gerontologist, In press. doi: 10.1080/07317115.2014.885919

Post, S. G. (2011). The hidden gifts of helping. San Francisco, CA: Jossey-Bass.

Riessman, F. (1965). The "Helper therapy" principle. Social Work, 10(2), 27-32.

Snowden, J. (2010). Mental health service delivery in long-term care homes. International Psychogeriatrics, 27(7), 1063-1071. doi: 10.1017/S1041610210000773

Theurer, K., Wister, A., Sixsmith, A., Chaudhury, H., & Lovegreen, L. (2012). The development and evaluation of mutual support groups in long-term care homes. Journal of Applied Gerontology, 33(4), 387-415. doi: 10.1177/0733464812446866

Van Malderen, L., Mets, T., & Gorus, E. (2013). Interventions to enhance the quality of life of older people in residential long-term care: A systematic review. Ageing Research Reviews, 12(1), 141-150. doi: 10.1016/j.arr.2012.03.007

Victor, C. R. (2012). Loneliness in care homes: A neglected area of research? Aging Health, 8(6), 637-649. doi: 10.2217/ahe.12.65

What People Are Saying...

Resident Enrichment & Java Music

RESIDENTS HELPING RESIDENTS: A DYNAMIC SHIFT IN PSYCHOSOCIAL CARE

How/Why Consider Java Music?

Memory Care Programming: expansion of music therapy programs and engagement between residents and memory care associates.

Independent Living Programming: enhancement to our emotional and spiritual activities while creating additional opportunities to expand our Seniors Serving Seniors volunteer opportunities.

Pilot Sites: Java Music agreed to support in piloting 14 Memory Care and 7 Independent Living Enrichment Programs.

Resident Enrichment Philosophy

Provide life-enriching activities and events for residents and potential residents that benefit them in every aspect of living:• Physically• Intellectually• Socially• Emotionally• Creatively• Spiritually• Vocationally

While continually looking for opportunities to promote their community and the Holiday Lifestyle. A few examples are:

Resident Enrichment Philosophy

Exciting Outings

Resident Enrichment Philosophy

Baseball Games

Resident Enrichment Philosophy

Random Acts of Kindness

Seniors Serving Seniors/Society Program

What:International award-winning volunteer program developed by Holiday Retirement.

Purpose:To provide opportunities for all 35,000 residents and 10,000 associates to sustain the foundation of the company’s Grass Roots philosophy, which is to serve seniors, each other, and society.

Mission Statement:“To coordinate opportunities for senior citizens to serve other seniors as well as society, and in return, enhance purpose and passion in their lives, and enrich the lives of the individuals they serve.”

A few examples are:

Seniors Serving Seniors/Society Program

Habitat for Humanity

Seniors Serving Seniors/Society Program

Holiday Hunger-Aid: Food Drive

Seniors Serving Seniors/Society Program

Back-to-School Fundraiser

Seniors Serving Seniors/Society Program

National Police Week: Buddy Bear Drive

Java Music Club Experience

Quiet & Organized Location

Java Music Club Experience

Enticing Refreshments

Java Music Club Experience

Open Conversation

Java Music Club Experience

Engaging Chimes

Java Music Club Experience

Talking Stick = You Have the Floor

Java Music Club Experience

Increasing Resident Engagement & Friendships

A Resident Experience~ Jim & Lise

“They all welcomed me and showed me a lot of kindness and love my very first time. Then I felt like I could share my heart and my feelings. I loved that because it’s like a family; it felt

really close to my heart.”

A Resident Experience~B.J & Fran

“I think it gives everybody a little spiritual uplift also and we can all use that. We’ve all had ups and downs in our lifetime and trust me, when you get to be as old as I am, you’ve been

up and you’ve been down.”

A Resident Experience~Peg

“It is one of the best things I’ve done. I have been able to let go of a lot of stuff I’ve been holding on to. Listening to these people talk about their lives has been an awakening for

me. I feel so much better now.”

A Resident Experience~Jan

“It’s good to be with my friends. We get to visit and sing lovely songs. I’ve gotten to know them in a new way. I really enjoy it.”

Pilot Site Survey Results

17

3

1

Who typically facilitates the Java Music Club at your community?

EnrichmentCoordinator

Manager

ExternalVolunteer

Pilot Site Survey Results

12

8

1

What has the facilitator's experience been like with the

program?

Positive, easyto execute

Improving, it'sjust taking ussome time

Negative, veryhard toexecute

Pilot Site Survey Results

13

5

3

Did you feel trained and ready to execute the Java Music Club after the

webinar training?

Yes, the webinartraining wasperfect

No, additionaltraining isimportant to thesuccess

I didn't attendthe webinartraining

Pilot Site Survey Results

20

1

Do you find the printed materials and leader guide easy to follow?

Yes

No

Pilot Site Survey Results

9

6

4

2

How many residents attended your first Java Music Club experience?

4-6

7-10

16+

11-15

Pilot Site Survey Results

13

12

8

6

6

42

What benefits to participants have you seen?

Increasedengagement ofquieter residents

Improved bondingbetween groupmembers

Increasedsupportive/helpingbehavior

Increased focus onstrengths andcapabilities

Pilot Site Survey Results

16

3

2

How often do you have the Java Music Club scheduled as a regular program on

your activities calendar?

Once a week

Once a month

Twice a week

Pilot Site Survey Results

19

2

Do you see a future for Java Music Club in your community?

Yes

No

Next Steps

Problem Solve: work hand-in-hand with Java Music Club and the few communities experiencing confusion to ensure a positive experience and increased resident engagement.

Budgeting: work to incorporate Java Music Club into our 2016 budgets. With an expanded portfolio, it’s important to ensure a positive experience and then budget accordingly.

Rollout: if/when budgets are approved, roll out Java Music Club one region at a time to ensure success of the program.

Contact Info

Kristine Theurer,MA (Gerontology), MTA

info@javamusicclub.com

Tess Aiello, Holiday Retirement

tess.aiello@holidaytouch.com