positive care...the kitchen staff in our long-term care nursing homes continually develop new...

Positive Care

in all of our homes

THE KORIAN GROUP’S CORE ASSET

C O N T E N T S

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POSITIVE CARE: THE KORIAN GROUP'S CORE ASSET

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‘SNAPSHOTS OF LIFE’

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INNOVATIVE GEMS AT KORIAN

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IMPLEMENTING OUR APPROACH

64 MEDICAL SPECIALITIES

TRUE/FALSE QUIZ AND A WORD FROM

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FIND OUT MORE ABOUT…

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DREAMS FOR THE FUTURE

POSITIVE CARE THE KORIAN GROUP’S

CORE ASSET

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P 04 • Editorial

P 06 • Do you speak Positive Care?

P 08 • History and geography of Positive Care at Korian

P 10 • Milestones of a method that has been scientifically proven since 2003

P 14 • A closer look at the maintained abilities evaluation grid

P 18 • A closer look at the Korian Foundation

P 20 • Learn more about sensory and cognitive disorders

P 24 • Positive Care: responding to societal changes

P 26 • Helping and supporting seniors: Korian and residents

P 28 • Helping those who help others: Korian and families

P 30 • The specific characteristics of Positive Care in our facilities

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That’s right! Everybody at the Korian group - caregivers, doctors, physiotherapists, managers, caterers - is united in their goal to fulfil one mission

using the same approach: to enhance the happiness and well-being of our patients and residents in ways that go far beyond providing medical care and meeting their daily needs, as important as those factors may be.

We call this approach Positive Care, and it translates in many ways.

At Korian, we are particularly attentive to pain management. Our therapeutic programmes have been developed and perfected by our experts.

Every day, we pay close attention to the care and treatment of the people and families who place their trust in us.

And above all, we are always willing to question our own methods, to make progress and constantly strive to show more empathy and improve our listening skills to keep pace with the rising expectations of those who place their trust in us.

Sophie Boissard CEO of the Korian group

We are all Positive Care!

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Positive Care enhances seniors’ well-being and brings joy into their lives as part of an excellent standard of care. That is what sets Korian apart in the field of elderly health and care services.

Positive Care is more than just the non-medicinal treatments that we have long championed: it is a way of being and doing that is led from the heart, while maintaining a perfectly safe care framework.

It’s about establishing an individual care pathway for each person based on their needs and wishes, whatever health requirements they may have.

It is about seamlessly adjusting to each person’s pace and helping them to preserve their abilities in a specially adapted setting where they feel safe and confident.

That is what Positive Care means to us, as you will see throughout this booklet and through the contributions of our highly involved employees who are passionate about what they do and bring Positive Care to life every day.

We constantly strive to show more empathy and improve our listening skills to better meet the needs of those who place their trust in us.

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Above all, Positive Care is about empathy. This is what drives all of us at Korian to go beyond the quality of care to find ways of enhancing the well-being of our patients and residents and bring them joy. We not only care for our patients and residents, we also care about them.

We say ‘At Korian’ because this is one of the things that make Korian unique: we are the frontrunners in our field and have been for almost two decades. We laid the foundation and built a solid structure for this approach.

Positive Care has a solid foundation. For more than 15 years, a team of Korian’s dedicated doctors and care workers have observed the elderly, pursued by a recurrent question: why not focus more on preserving people’s abilities, independence, life choices, and hence, ultimately, their joie de vivre?

In parallel, another underlying trend was developing in medical circles and in society itself: a progressive shift towards non-medicinal treatments. Of course, medication should be provided when necessary, but only the right amount. And it should be combined with gentler approaches, such as physical therapies – physiotherapy, occupational therapy or rehabilitation – and cognitive and psycho-behavioural therapies, such as psychology, sophrology, relaxation or hypnosis.

So that’s how Korian gradually developed individual care pathways for patients and residents that include the treatment protocol, but also go beyond it to take in the bigger picture. Because Korian doesn’t just take care of people who are ill: they are people, and not only patients or residents, whom the group supports for greater well-being in every aspect of their lives: physical, mental, and emotional.

Happiness Integration Innovation FreedomHeart Empathy

Do you speak Positive Care?

DiDier ArmAingAuD Korian Group Chief MediCal, ethiCs and Quality offiCer

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We develop and spread this Positive Care attitude throughout our many facilities and incorporate it into all our services.

We have created a training programme for all our staff (caregivers, managers, activity leaders, caterers, etc.) and we provide this training to every staff member in each of our facilities. We aim to have all our staff trained by 2019. We are taking action in every country where Korian is present – France, Italy, Germany and Belgium.

But we don’t just roll out new programmes: we adapt. Because the care pathways of long-term nursing home residents, of patients staying a few days in one of our clinics, or of people staying for one month in one of our rehabilitation care clinics, are radically different. As are the care pathways of patients who stay for a few hours in a day care centre, who come for a simple consultation, or who receive care and support at home. To meet these individuals’ wide range of needs, we strive, now and forever, to personalise and fine-tune the meaning and practice of Positive Care in all our facilities.

That is why Korian is committed to a process of ongoing innovation: we don’t believe we are ever truly done with the process of constantly making strides towards Positive Care. Our clinics are already experimenting with virtual-reality hypnosis to relieve pain and reduce the use of strong painkillers. The kitchen staff in our long-term care nursing homes continually develop new recipes to suit the appetite and pace of our most fragile patients. At Korian, Positive Care has become a process of continuous improvement that supports both the heart and the mind.

In our training programmes, we use specialised eyeglasses that allow us to see the world the same way as people with impaired vision: cataracts, glaucoma, age-related macular degeneration... when our employees put them on, they are better able to understand how a person with this impairment sees the world. This spirit of empathy is what Positive Care is all about!

DAviD FOULON, CAre DireCtor, FrAnCe SeniorS

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Korian’s Positive Care approach was developed more than 15 years ago by Korian’s teams. It was inspired by the work of the famous Italian doctor and psychologist, Maria Montessori.

Maria Montessori is known the world over for devising the educational method named after her. She was one of the first women to qualify as a doctor in Italy in 1896, at the age of 26, and worked at the psychiatric clinic at Rome University. After that she created a school to train teachers in a new teaching method that was revolutionary at the time. This method allowed so-called ‘disabled’ children to take the same tests as other pupils. She then went on to expand her method to encompass all children.

Today, there are more than 20,000 Montessori schools on all continents. The key concept behind the Montessori method is the idea that education is not about imparting knowledge, but rather assisting the child’s natural development in an environment designed for the characteristics and needs of their age.

It is an open method based on observation and considering the child as a person worthy of interest. It caters to the child’s needs, which Maria Montessori explained as:

« Help me to do it myself ».

History

History and geography of Positive Care at Korian

Maria Montessori Doctor and educator

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Didier Armaingaud is passionate about providing support to the elderly, on both a professional and a human level. He expanded on the Montessori method and the findings of many other specialists and researchers specialised in the needs and medical conditions of elderly individuals. He believes that “staying independent is primarily an issue of being able to choose.” This has led to his deep respect for each individual’s needs and a desire that emerged during his time with Korian to do everything possible to help individuals do things for themselves, throughout their entire lives. This is a reflection of Maria Montessori’s well-known phrase, ‘Help me to do it myself’.

History and geography of Positive Care at Korian

At Korian, Positive Care is both an approach and a method, and it is spreading like wildfire. This type of commitment requires the support of dedicated teams, which is why each person is encouraged to seek out, create, and invent new proposals for their own facility that, if proved to be a success, can be incorporated into our overall Positive Care initiative.

As a European group, Korian draws on its diversity and strength to enhance Positive Care. Each country and facility is free to initiate new approaches, as shown in the table below:

Through this creativity, Positive Care acts as a positive feedback loop, becoming a process of constant improvement that is unique to Korian.

Geography

non-meDiCinAl treAtmentS in our long-term CAre nurSing homeS

« Tant de choses à vivre ensemble : accompagner nos aînés par le projet personnalisé » (‘So many moments to enjoy together: caring for our seniors through a personalised plan’) Didier Armaingaud and Émilie Li Ah Kim, Le Cherche Midi, 2013.

ALL COUNTRIES Germany France Belgium Italy

• Formacube Senior • Memory workshops • Social activities

• 10-minute Activity • Memory voyages • Dementia Tablet

• Snoezelen • Basal Stimulation • Aromatherapy • Memory voyages

• Memory Tablet

• Play area: mediation through toys

• Flash Activities

• Activ84Health (Google bicycle)

• Dance Therapy

• Dementia Care Mapping

• Memoride (memory bicycle)

• The Magic Table

• Validation Therapy • Memory Care (cupboard

with toys) • The CRDL https://crdlt.

com/

• Empathy Box • Memory Cards• ROT (Reality

Orientation and Reminiscence Therapy)

• Doll Therapy • ‘Art and Music’:

mediation therapy

• Praxis Fine Programme • Fall Prevention • Korianfit • Functional stimulation

through activities

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Milestones of a method that has been scientifically proven since 2003

The following is an overview of the major phases of implementing the Positive Care approach in our long-term care nursing homes.

The creation date of the group’s first internal training institute. Its main mission was to develop the value of Kindness among all network stakeholders. In 2010, this training became the BEST (Welfare, Ethics and Care for All) programme, a key part of every employee’s training at Korian.

After a study visit to the United States in 2010, Dr Didier Armaingaud decided to implement cognitive re-appropriation therapies for people suffering from neurodegenerative pathologies within the network of long-term care nursing homes.

Cognitive re-appropriation primarily consists of a comforting, easy-to-understand environment that stimulates residents’ intuitive memory. Within our facilities we have gradually developed small adapted living units made up of a lounge, a dining area equipped with a kitchen, and an area for leisure activities.

“We have based the design of these areas on a number of studies by researchers such as Professor Camp and Professor Ledoux, an American neuropsychologist specialised in the long-term preservation of deep memory among people suffering from Alzheimer’s disease, as well as the research paper published by Laura Gitlin and Tracey Vause Earland, ‘Améliorer la qualité de vie des personnes atteintes de démence : le rôle de l’approche non pharmacologique en réadaptation cognitive‘ (Enhancing the Quality of Life of People with Dementia: the role of the non-pharmacological approach in cognitive rehabilitation).”

2003: The origins

2011: Launch of cognitive re-appropriation

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Following different discussions on the value of virtual games for preserving and strengthening functional and cognitive skills, we wanted to expand our therapeutic services on offer by developing ‘Korianfit’ in conjunction with Silverfit (see page 32).

The severe impact of neurodegenerative diseases on the quality of life of patients and their families prompted the Department of Health to set up a dedicated plan for these diseases, which have proven to be very challenging for our health system and research policies.

Based on this observation, the Korian Ageing Well Institute has led an applied research programme since 2014 in partnership with the Centre for Clinical Research on the Brain, Ageing, and Fragility at the Hôpital des Charpennes in Villeurbanne, France. Its aim is to provide concrete and innovative solutions for those working in the medico-social facilities that are home to nearly half of the people living with this disease.

2013: Development of Korianfit

2013: Creation of the Korian Ageing Well Institute in France

Nearly 900,000 people now suffer from Alzheimer’s disease

in France, a number expected to rise by almost 60% by 2040, taking into account changes in

life expectancy.

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In 2014, a Non-Medicinal Therapy Adviser position was created within the Medical Department in France, which made it possible to consolidate the therapeutic framework:

• Creation of networks of regional business line experts: Psychologists, Physical and Occupational Therapists;

• Systematic formalisation of treatments (treatments selected based on expert consensus backed by bibliographical evidence);

• Launch of the Korian Well-Being EVIBE Scale – A study by the Ageing Well Institute on its appropriation in long-term care nursing homes in 2016;

• Creation of a Korian evaluation grid for maintaining abilities. Find out more about the grid on pages 14-15.

2014 – 2016: design of the non-medical therapy approach

The results of the LUDIM study showed, through scientifically validated data, the positive impact of play on the behavioural disorders caused by Alzheimer’s disease. A guide was prepared based on the results of this first study. It provides professionals with tools to facilitate play based on non-medicinal therapy.

In 2014, the Korian Ageing Well Institute published the LUDIM study on using play as the framework for an educational approach.

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In order to enable caregivers to respond as quickly as possible to a behavioural crisis in a manner that is adapted to each patient, a trolley was developed by the Korian Ageing Well Institute so that caregivers can propose ‘flash activities’ to patients.

The trolley provides caregivers with various activities that may have an impact on behavioural disorders. A caregiver helps the residents choose an activity that will make the most sense for them.

As an extension of the approach initiated in 2014 with the Ageing Well Institute, the Foundation exemplifies Korian’s desire to fully fulfil its mission of social integration. By bringing together researchers in the fields of health and human sciences and elderly and geriatric health, care service professionals, as well as journalists, designers, and association leaders, the Korian Foundation for Ageing Well conducts societal and applied research studies to make sure that all people, whatever their age, family situation, or state of health, can be recognised as stakeholders within civil society and on a regional scale.

Find out more on pages 18 and 19 or at www.fondationkorian.com

In 2016: widespread implementation of therapeutic mediation through the flash activity trolley

2017: The Korian Ageing Well Institute becomes the Korian Foundation for Ageing Well (European status)

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This Korian grid was produced by a group of experts including occupational and physical therapists, psychologists, and caregivers. It is used to illustrate functional, sensory, cognitive (communication, memory and orientation), social, and domestic abilities. It allows you to see at a glance the person’s skills and the help or support they need. It was designed to be used by a team of professionals and is an essential, comprehensive tool for preparing individual treatment plans. It helps to direct the person towards domestic and social activities in line with their desires and skills, and to define the person’s individual treatment plan, which includes cognitive, functional, and behavioural approaches.

An objective multi-dimensional geriatric evaluation of the person’s resources must be carried out before the grid can be filled in. The evaluation is based on standardised tests (Get up and Go, MMSE, NPIES, MNA, etc.), observations, and discussions with the person and the person’s family.

MMSE : Mini Mental State ExaminationNPIES : Inventaire Neuro Psychiatrique Equipe Soignante

(Neuro-Psychiatric Inventory – Care Team)MNA : Mini Nutritional Assesment

A closer look at: the maintained abilities grid A unique multidimensional evaluation tool

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MAINTAINED ABILITIES GRID

Continence: r Urinary r Faecal Protections: r Independent r Assistance Assistant(s): r 1 r 2

r Independent r Assistance Assistant(s): r 1 r 2

Day

Night

4 - BOWEL AND BLADDER FUNCTION

IF YES

IF NO

FUNCTIONAL ABILITIES

3 - DRESSING ONESELF

Shower: r Standing r Sitting (shower seat) Assistant(s): r 1 r 2Grooming: r In bed r Sink r Standing r Assis Assistant(s): r 1 r 2

Selecting: r Independent r Advice r Assistance

Sorting: r Independent r Advice r Assistance

r Independent r With Assistance

when given the item:

I Independent VA Verbal assistance I Imitation IM Initiates the

movement OA Outside assistance TA Total assistance

1 - MOBILITY

2 - GROOMING

Dominant hand: r Right r LeftTransfert : r Independent Assistant(s): r 1 r 2Balance: r Sitting r Standing r Walking

Technical assistance for movement...

… indoors r r r r r

… outdoors r r r r r

arrière avant

G D

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SENSORY ABILITIES

2 - HEARING

4 - TASTE

3 - TOUCH

5 - SMELL

Eating: r Independent r Imitation r Verbal stimulation r Total assistance

Drinking: r Independent r Imitation r Verbal stimulation r Total assistance

Serving oneself: r Independent r Total assistance

Cutting: r Independent r Total assistance

Assistive equipment:

r Good from a distance r Poor from a distance r Good at close range r Poor at close range

r Blindness

r Left Eye Good r Right Eye Good Maintained tactile discrimination: r Yes r No r Non-assessable

Maintained: r Yes r No r Non-assessable

Maintained: r Yes r No r Non-assessable

Effective: r Yes r No

Effective: r Yes r No

at 1 metre: Reading test:

r 12 r 24

r 36 r 48

r 72 r 100

5 - EATING & DRINKING

1 - SIGHT

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COGNITIVE ABILITIES

SOCIAL AND DOMESTIC ABILITIES

r Write r Read and understand r Verbally alert r Use the bell

Understanding information: r Simple r Complex

r Oral r Written r Non-verbal

Oral r Written r

Non-verbal r

r Briefly introduce oneself r Remember short-term information

r Talk about distant memories r Remember an appointment

r Pass on knowledge r Perform an activity r Take photos r Welcome a new resident

r Take care of plants r Take care of an animal r Help set up a room

Temporal : r Independent r Outside assistance r Total assistance Spatial (Interior) : r Independent r Outside assistance r Total assistance Spatial (Exterior) : r Independent r Outside assistance r Total assistance

r Use the telephone r with outside help

r Computer

r Television r Supplies r Light tools

r Medication r Administrative r Financial r Can use a key

r Can set the table r Clear the table r Sweep r Dust the furniture

r Tidy up r Make the bed r Fold laundry

r Cook

r Garden

r Read

1 - COMMUNICATION

2 - MEMORY

3 - ORIENTATION

1 - DOMESTIC ACTIVITIES

5 - POTENTIAL SOCIAL ROLES

3 - POTENTIAL ACTIVITIES

2 - USE OF TOOLS

4 - INDEPENDENT MANAGEMENT

r Sing

r Draw

r Paint

r Rule-based games

r Musical instrument

……………………………

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‘Seniors’, ‘dementia’, ‘bedridden’, ‘Alzheimer’s’... the words we use to talk about old age are approximative, belittling, or even inappropriate. The fault lies in semantic shortcuts, changes in medical terms, or simply awkward language. With this in mind, the Korian Foundation launched a study to identify the semantic fields used to talk about the elderly and the terms that would be best to use in order to associate more positive values with old age so that our words can uplift others rather than bring them down.

This study shows that the words we use are often technical, sometimes misunderstood, and can be hurtful. An assessment of their impact made it possible to identify, on a comparative and objective basis, the ‘right words’ and the right practices for better referring to and describing the elderly, ageing, dependency, and the professions and practices related to old age (care facilities, care, housing, services, etc.).

The Korian Foundation has prepared a guidebook explaining which words to use and which not to use in order to speak positively about ageing, dependency, illness, and nursing homes.

For example:

- Elderly rather than old person

- Patient rather than ill person

- Take care of rather than look after

- Cognitive impairment or cognitive disorder rather than dementia

- Recommend rather than prohibit

- Residence rather than placement (in a facility)

The “Ageing Well: the right words” guide aims to raise awareness and convince healthcare professionals, institutions, and society as a whole of the importance of changing the words we use and the ways we think about ageing.

RAPPORT LES MOTS DU BIEN VIEILLIR PAGE 1

FONDATION KORIANPOUR LE BIEN VIEILLIR

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A closer look at the Korian Foundation Using the right words

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The EVIBE scale is a simple, quick, easy-to-use tool that requires no training.

Developed in 2014 and approved as part of a study in 2016 by the Korian Foundation, it correlates well with the QoL AD (Quality of Life-Alzheimer’s Disease) international reference scale.

Its long-term reliability has been verified.

The EVIBE scale is the ideal tool for ‘taking the temperature’ of a patient’s quality of life and can be used to monitor any fluctuations in well-being during treatments and activities.

The following people and facilities participated in this study in 2016: 135 people in 8 Korian long-term care nursing homes and one long-stay care unit (Hôpital des Charpennes; Hospices Civils de Lyon).

To easily assess the well-being of people with Alzheimer’s disease: The Korian Foundation has created EVIBE, the Instant Well-being Assessment Scale

FRONT SIDE made available to healthcare professionals.

1 : low level of well-being 5 : high level of well-being

REVERSE SIDE made available to patients.

3 DIAGRAMMES representing facial expressions (happy, neutral, sad)

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Respiratory, cardiac, digestive system, and movement disorders seem easy enough to understand intuitively. However, sensory and cognitive impairments, which affect 60% of our seniors in nursing homes, as well as patients with brain lesions (due to a stroke, a fall, etc.), may be less easy to understand.

But it is essential to know how to recognise and prevent them, as they may result in isolation, memory loss, and communication difficulties in seniors, seriously impairing their well-being.

It is also important to know that these impairments can be rehabilitated and that it is possible, if appropriate treatment is given early enough, to maintain and readapt these abilities.

The 5 senses (sight, smell, hearing, taste, and touch) are the sensors and channels through which information outside our body arrives in the form of sensations. These sensations are then sent to the brain, the seat of consciousness. It decodes the sensory information and gives them meaning.

Thus, our knowledge of the world and ourselves follows a constant pattern – it is a loop into which information is being fed at all times:

• People actively perceive the outside world;

• This information is repackaged, structured, and processed;

• We process and store information in our memory and this trace influences how we perceive the world in the future.

Why do we talk about ‘sensory and cognitive’ disorders?

Learn more about sensory and cognitive disorders

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Any impairment of the five senses or perception (decoding meanings; memory), can more or less seriously alter our ability to exist in the world and to communicate. These disorders can alter how we understand, perceive, and recognise our surroundings. But it is possible to retrain our senses, perceptions, and memory – the loss of these abilities is not necessarily permanent. That is what we strive to do in all Korian facilities, in particular through Positive Care.

Sight impAirment Myopia, presbyopia, and cataracts are relatively common disorders that can be treated effectively. But other vision problems can develop, inevitably generating considerable discomfort and isolation. A doctor should be consulted for certain problems:

• The person sees bright or snowy dots or black spots;

• Difficulty estimating distance;

• Reading problems;

• Difficulty distinguishing between objects with low contrast or at close range.

A full eye examination can reduce the risk of accidents (falls, bumps, mistakes leading to domestic accidents, etc.) and allow the person to live as independently as possible. If results of the eye examination are normal, other anomalies may explain the symptoms. In this case, a neurological exam will need to be performed.

Not everything can be treated with eyeglasses!

Some sight impairments can be completely

slowed down by physiotherapy and

occupational therapy!

Our Korian teams are fully capable

of providing this kind of care.

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heAring impAirment Hearing loss plays a significant role in cognitive disorders (perception, understanding, recognition, and more). People who have a hard time understanding what those around them are saying may feel anxious or become withdrawn. This makes communication more difficult. To prevent this from happening, keep an eye out for the following:

• The person has a hard time following conversations in a noisy environment;

• The volume of the television is too high.

Given that one out of every two people over the age of 60 has hearing impairment, it is important to perform a hearing test. Ask your general practitioner for a referral for the test.

impAireD tASte AnD Smell Over time, our sense of taste tends to wane. This may be connected to a loss of smell. A person may no longer enjoy the flavours of a meal, the joy of sitting around the table with friends and family, the smell of nature, or a favourite perfume.

This may not seem like a big deal at first but these losses can be dangerous. They can lead to accidents because the person is unable to detect an open gas valve, a pot that is boiling over, or the start of a fire. There is also a risk of malnutrition if the person no longer enjoys eating or no longer eats enough.

It is important to pay attention to the following signs:

• Loss of appetite;

• Weight loss;

• Unusual preference for very sweet or very salty foods.

At Korian, we pay close attention to the flavour and nutritional value of meals. For example, a person who cannot chew correctly will receive exactly the same meal as other residents – we will simply adjust the texture. For residents who may have a hard time staying in one place during their meal and who tend to ‘forget’ about their meal, we have created our special Gourmet Bites: delicious bites of food created from the regular menu so that residents can continue to maintain or gain weight!

ChriStophe pArrot, CAtering AnD ACCommoDAtion DireCtor , KoriAn FrAnCe

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tACtile DiSorDerS Contact, pain, and the feeling of cold or heat are essential sensations that tell us about our surroundings. Following changes in the nervous system, they may be impaired or greatly heightened.

We have 17,000 tactile receptors just in one hand – there may be serious consequences if these receptors fail to function normally. Everyday movements such as writing, picking up a coin, or even identifying the texture of an article of clothing may become much more difficult. Above all, there is a greater risk of injury. People who touch a sharp object with too much force may cut themselves. Be aware of the following signs:

• The person has a hard time ‘feeling’ the ground when walking (risk of falling or slipping);

• The person gets a cut or an injury without realising it;

• The person is scalded by hot water from the tap;

• The person feels heat and cold very little or too strongly.

The sense of touch can be stimulated and rehabilitated. Special equipment such as anti-slip rugs and tempering valves can be used to provide protection from certain dangers. In Korian facilities, we use ‘Snoezelen’ sensory stimulation areas that allow patients to exercise in a fun and safe environment while gaining a better use of their senses.

DID YOU KNOW?

The GGIR Grid is used to assess a person’s loss of physical or mental auto-nomy. The grid places the person in one of six groups. Each group indi-cates the level of care and help required for that person.

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Most of the seniors for whom we provide care live in one of our nursing homes (our clinical patients and patients in care homes represent a broader range of ages). If it seems like we mention nursing homes a lot, it is because major changes are currently under way in this sector.

pAul-emile hAÿ, meDiCAl DireCtor, FrAnCe SeniorS DiviSion

The health status of our new residents is an important issue. People who have lived by themselves (sometimes for too long) and who have developed medical conditions such as Alzheimer’s, Parkinson’s disease, or cognitive impairments may have been better off if they had started receiving care sooner.

People who have spent a long time living alone, with no more than one visit from a friend or family member per week, sometimes forget how to communicate with others.

These individuals tend to be older. Our duty is to ‘help them do it themselves’, in the words of Maria Montessori, and preserve their abilities.

Positive Care is our response to these changing needs, which, ironically, are the result of medical advances that enable more and more people to live longer. Dependency affects 20% of people over the age of 80 in France today.

A question of health

Positive Care:adapting to societal changes

“This person has so much more life experience than us – we owe the elderly our most sincere respect.”

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A question of culture

Our residents’ background and life experiences have also evolved over the past ten years. In the past we cared primarily for people (90% of whom are women) who have lived through wars and who had few opportunities for travel or study.

We are now seeing more women with advanced degrees who have worked outside the home and enjoyed holidays abroad, staying in hotels, and summer days spent on the beach.... It’s only natural that their expectations would be different from those of their elders.

Above all, the earlier generation of women wanted a simple, welcoming home with quality care services and upbeat entertainment and events.

The latter, growing generation of women are looking for innovation, excitement, and surprises. And while we strive to help them preserve their ability to ‘do it themselves’, we now also focus on finding out what it is that our residents want to do with their abilities. What good does it do our residents to be in good health if they are not surrounded by love, happiness, laughter, and plans for the future?

Positive Care, Positive Life…during the journey they take with us, and with the support of their family and friends, we hope to provide positive experiences and the best possible quality of life. And we see ourselves as fellow travellers accompanying them on every step of their journey.

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this phrase beautifully suMs up the positive Care that we provide to our residents.

DiDier ArmAingAuD, meDiCAl, ethiCS AnD QuAlity DireCtor For the KoriAn group

In every case, our success depends on the trust that our residents place in us. That is why we listen to them and pay close attention to what they say:

• We know that for some people it will be possible to awaken ‘sleeping’ abilities if we use emotional stimulation;

• We are aware that some people are not always able to keep up with a normal pace of life;

• We are dedicated to spending time with our residents and patients – not only when they are not feeling well, but on a regular basis;

• We strive to provide a daily routine that resembles a typical home life, where days, weeks, and months go by simply and peacefully.

We do not make choices for simplicity’s sake – we think about what is best for our residents. When a person living with us begins to lose their autonomy and is no longer able to tie their shoelaces, we do not automatically replace those shoes with ones equipped with Velcro fasteners. We first try to preserve that person’s abilities and work with him or her, if that’s what the person prefers to do.

Helping and supporting seniors: Korian and residents

“Putting our hearts in our hands”

750 facilities

250,000 patients/residents

49,000employees

(including more than 20,000 in France)

The leadingEuropean senior care services company

KORIAN is

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For residents with specific needs, we always pay close attention to:

• Maintaining physical and motor skills;

• Maintaining cognitive skills (memory, language, and executive functioning skills);

• Preventing psychological and behavioural disorders (which are often associated with cognitive impairment).

To do this, we engage in ongoing teamwork and bring together all our employees in the pursuit of the same goal:

THE POSITIVE CARE APPROACH: OUR STAFF MEMBERS ARE ATTENTIVE TO PATIENTS’ & RESIDENTS’ NEEDS

WHATMEDICAL & MEDICINAL TREATMENTS

NON-MEDICINAL TREATMENTS

DOMESTIC & SOCIAL ACTIVITIES

ENTERTAINMENT/HOBBIES

WHO

Doctors, nurses, caregivers

Psychologists, physiotherapists, occupational therapists, physical therapists and fitness instructors

Assistant caregivers in gerontology, qualified caregivers, medico-psychological assistants, Montessori instructors

Caregiver activity leaders

HOW

EVALUATION COLLECTION

Medical prescription

Therapeutic plan

Schedule of social/domestic activities

Events schedule

CARE PLAN

PERSONALISED PLAN LIFE PLAN

FOLLOW-UP: TRANSMISSION

CHECK-UP

77%Commitment rate for Korian staff members

94%of Korian employees take

pride in their work

Source: Internal Korian employee satisfaction survey 2017

More than 5% of employees

have a disability

After signing an initial agreement on the employment of people with disabilities in 2014, Korian renewed its commitment in November 2017 to employ workers with disabilities in France for an additional three years. This new agreement, which is part of Korian’s CSR strategy, was signed unanimously by the four representative trade union organisations. The implementation of this agreement will make it possible to create a community of disability officers throughout France and to strengthen training and access to employment for young people with disabilities. Following this initial agreement, the employment rate for people with disabilities reached 5.06%. Now, Korian intends to continue pursuing its commitment in order to reach an employment rate of 6% through its ambitious new hiring plan.

28


That is why the Korian psychologists and all our team members make themselves available to discuss, explain, and meet with friends and family members. We have developed Positive Care training programmes to help loved ones prepare themselves or recharge their batteries.

We believe it is essential to offer friends and loved ones the information they need to better understand the progression of the disease and practical advice for dealing with it. This is true whether their loved one is a patient staying for a short period of time, returning home after a stay, or is a long-term patient in an assisted living facility or care facility.

Friends and relatives should not wait until they are worn out from fatigue or lack of information to call on us for help. After performing a personalised check-up, it is possible to set up solutions and, if necessary, receive help from Korian physiotherapists, occupational therapists, psychologists, or speech therapists, who will provide the best possible care and advice. It is important to remember that overprotecting an ill person will only accelerate the person’s loss of

A patient’s friends and relatives – especially when the person has a long-term or progressive illness – often face the task with a great deal of courage. But they need to be informed.

They don’t always understand the illness, its symptoms, and how to deal with it. It can be exhausting.

Helping those who help others: KORIAN AND FAMILIES

2928


autonomy. Expecting too much from a patient can cause stress and trigger behavioural problems.

Despite their best efforts, family caregivers can find themselves in overwhelming situations, raising the risk of exhaustion and isolation. That is why we at Korian strive to provide them with help so that they can strengthen their skills and the quality of the care they provide.

This allows them to find out more about the progression of the disease and adapt their behaviour to communicate better with the person who is ill.

We provide essential information on day-to-day care, the importance of rest and relaxation, ways to handle any mood changes and unpredictable behaviours from the patient, and the importance of communication. Finally, in preparation for a long-term stay, we focus on explaining how the facility operates, welcoming the patient and his or her family, and describing the role of the care assistant in interacting with Korian staff.

30


You may have noticed that this booklet highlights a Positive Care approach that revolves around our seniors’ life plans. The large number of seniors among our residents and patients has led us to embark on a major development plan: long-term care facilities and nursing homes represent the majority of our facilities.

Positive Care is practised throughout the entire network. One example in France is our post-acute and rehabilitation care facilities: these clinics help to rehabilitate patients so that they are fully healed before they return home.

The Korian post-acute and rehabilitation care facilities welcome individuals with treatment-related or pre-existing disabilities. These facilities offer an individual, personalised, systematic approach with a full medical exam, follow-up, and end-of-stay assessment.

“Taking the measure of an individual’s abilities upon entering a rehabilitation facility in order to optimise them before the person’s departure: this is at the heart of what we do.”

niColAS mérigot, exeCutive vp FrAnCe heAlthCAre DiviSion

The specific characteristics of Positive Care in our facilities

FOCUSHEALTH

291 Long-term care nursing homes

7 Hospital home care facilities

(palliative, nutrition, and medical dressings)

75 Specialised clinics

(post-acute and rehabilitation care facilities, postoperative and psychiatric facilities)

In France, Korian operates a network of

366 FACilitieS, inCluDing:

3130


A FEW DEFINITIONS

Post-acute and rehabilitation care clinics: the post-acute and rehabilitation care clinics welcome patients requiring full or partial hospitalisa-tion. Over a period of several weeks, they receive persona-lised therapeutic support in order to prevent or reduce the consequences of any deficiencies and to promote their recovery and return to everyday life.

Long-term care nursing homes: these facilities wel-come people over the age of 60 with a loss of physical and/or mental autonomy.

Home care services: these include hospital home care (HHC) and home nursing services (HNS) and are provided at the patient’s residence.

Assisted living facilities: they welcome autonomous individuals and provide them with a safe living environment, adapted equipment for their well-being, and additional options including dining and laundry services.

All Korian clinics and facilities make it a priority to provide the right medication for each individual. The cornerstone of our care can be summed up as ‘maximum personalisation’. Our care teams, under a doctor’s supervision, are skilled in adapting patients’ medication intake in order to give them the right quantity and to optimise both the effectiveness of care and the patient’s well-being.

Proper treatment and well-being are intrinsically linked. Positive Care helps to improve patients’ symptoms during their period of hospitalisation. We have developed specific protocols that are particularly effective for fibromyalgia; we promote hypnosis for pain management rather than painkillers (whenever possible, of course). And we incorporate sophrology into our treatment plans to promote our patients’ relaxation and recovery.

In terms of nutrition, we offer high-protein meals for individuals suffering from obesity, and our ENT clinic in Aix-en-Provence is equipped with a kitchen that can create a variety of textures, from liquid to solid, so that solid foods can be reintroduced under medical supervision.

In this field of care, we have made the link between the dual purposes of care (such as re-education or rehabilitation) and recreation (to promote well-being).

Dr FAribA KAbiriAn, meDiCAl DireCtor, FrAnCe heAlthCAre DiviSion

“People come to Korian because we are specialised in medicinal treatments. When they arrive, we readjust their medication intake because they have been prescribed a lot of drugs. That helps us to improve their symptoms during this intense period of time.”

32


NON-PHARMACOLOGICAL TREATMENTS AS PART OF

A COMPREHENSIVE APPROACH

3332

P 34 • Maintaining cognitive abilities

P 36 • Korianfit, the magic table, Snoezelen area, memory games tablet, art therapy, doll therapy, clinical hypnotherapy glasses, aromatherapy, light therapy, etc.

34

To prevent, delay, or mitigate the cognitive difficulties associated with ageing, such as Alzheimer’s disease or dementia, we use three types of approaches within our non-medicinal treatment programme.

Improving psychological and social functioning

“We have set up “Memory Boxes” in which the family and the resident select objects to place in the box that have a connection to his or her past (newspaper clippings, mementoes, photos, etc.). These customised boxes are stored in a visible, well-known place that is accessible to everyone. The box acts as a tool during discussions with the staff. Friends and relatives can also use them when they come to visit. The box is an excellent conversation starter.”

On the memory games tablet or with the Seniors Formacube

”Each session is adapted to the person’s level of ability to keep him or her motivated. In groups, residents never do the same exercises together so that no one feels like they have failed in comparison to their neighbour. It helps people learn to do things together and not in someone else’s place. Residents such as Mrs C quickly learn to love it: she asks again and again when the next session will be. It acts as a benchmark for the days of the week and it’s her favourite social activity.”

mAthilDe tro, poSitive CAre nAtionAl CoorDinAtor,

heAD oF non-meDiCinAl treAtment, FrAnCe SeniorS DiviSion

Cognitive stimulation

Cognitive training

Maintaining cognitive abilities


3534

Cognitive re-appropriation allows every person to enjoy a meaningful activity thanks to an environment and equipment that are specifically adapted to his or her abilities and habits. This mainly entails:

• An easy-to-understand environment with clearly visible and identifiable bedroom doors, lavatory doors of a different colour, staff doors that blend into the wall décor, and soft lighting in corridors at nightime.

• Equipment that is adapted to the person’s habits and abilities: for those who wish to help prepare soup, for example, we provide a wide variety of knives and sharpeners so that everyone can find the type of equipment they are accustomed to using.

Cognitive re-appropriation


36

MR R AND THE WORKER’S UNIFORM

At Korian we have a wide variety of approved methods and techniques at our disposal to provide care to our patients and improve their well-being.

But it is important to note that the most essential thing for us is the empathy, kindness, and care we have for our residents. Above all else, we need this empathy in order to be able to understand them and provide the best solution.

We know that a behavioural disorder is primarily a reaction of distress when faced with a situation that the person does not understand or an environment that is not adapted to their needs. For example, when a resident suffers a fall, we know to react immediately in order to keep him or her safe and calm. Keep reading to find out more about the case of Mr R.

Korianfit, the magic table, Snoezelen area, memory games tablet, art therapy, doll therapy, clinical hypnotherapy glasses, aromatherapy, light therapy, etc.

Mr R was in a room in which a technician was installing some equipment. He suddenly started shouting and hitting objects with his cane. A nurse took him gently by the elbow and accompanied him to the corridor, where he immediately calmed down. But as soon as he returned to the room, Mr R began shouting again while looking at the man who was working. A caregiver offered him a relaxation ball, which is one of the mediation objects available on the Korian Flash Activities trolley**, which calmed him down. During this time, the team discussed what could be making him so anxious – did he have a bad experience in the past that was causing him to worry at the sight of the technician? The worker returned the next day dressed in civilian clothing, and Mr R never again had a negative reaction to his presence.


3736

Snoezelen Area Imagine an area with stimulation and relaxation materials: here you’ll find bubble tubes, illuminated wires that look like LED spaghetti strands, mattresses, music, and an essential oil diffuser to help a person relax.

Flash Activities trolleyThe Flash Activities trolley is our ‘emergency trolley’ for residents who are in distress. It contains a wide range of mediation objects.

We evaluate each resident in advance to select items that are most likely to relieve his or her anxiety. When a stressful situation arises,

we know right away which object to propose to bring about an immediate calming effect.


38

MRS B’S CAKE

Doll therapy“Applying the right approach for the patient and the most appropriate treatments can mean using

alternative therapies.”

SteFAniA SCotti, pSyChologiSt, S. mArtA CAre home, milAn

When preparing Mrs B’s personalised life plan, she told us what would bring her the most joy: to be able to see her grandson Louis. It should have been a simple request and yet, it wasn’t the case….

Her diagnosis of Alzheimer’s disease had been confirmed: she no longer knew what day it was or where she was, which caused her to feel highly anxious and experience moments of aggression. Because of this, her son told the psychologist that he did not want her to meet her grandson. He was afraid that these problems and her overwhelming anxiety could have a negative effect on the child.


3938

Everyone in the family remembered her chocolate cake recipe. We asked her to invite her grandson to celebrate his birthday in a few months with her famous chocolate cake.

To relieve her anxiety, Mrs B did a few sessions with the empathy doll. Of course, she knew that this doll was not a real child, but it helped to calm her. She also enjoyed multi-sensory stimulation sessions (known as Snoezelen*) for twenty minutes, twice a week for thirteen weeks. This programme helped her to relax and feel safe, and she no longer needs to take sleeping pills at night.

Mrs B maintained her balance and mobility with Korianfit, our digital exercise platform. Her therapist prescribed a six-week programme during which she practiced useful everyday movements for five to ten minutes a day. She enjoyed playing with the little fox on the screen, running back and forth as she moved her body to grab bunches of grapes on the screen. She was good at the game. Her fellow players applauded her for her high scores. Her hand problems were tricky: she would need help on the day of her grandson’s birthday to make the cake, but her group of supporters rallied behind her. Her son quickly acknowledged that “Mum is more normal” and that ”she is less distressed”. A birthday party was soon planned for Louis at the facility!

In the shared kitchen, everyone rolled up their sleeves to help with the cake – it turned out perfectly!

Mrs B headed to a toy shop in the city centre to buy a gift for Louis, accompanied by the activity leader.

On her grandson’s birthday, Mrs B brought the cake, which Louis and his father seemed to love. Mrs B’s eyes twinkled as she brought Louis his gift…and they spent the entire afternoon together!

What could be done to grant her wish?

And on the big day…


40

INNOVATIVE GEMSAT KORIAN

4140

P 44 • Italy: a spotlight on empathy and hospitality

P 46 • France: putting ideas into practice

P 48 • Belgium: a spotlight on innovation

P 50 • Germany: a spotlight on clarity and freedom

42

INNOVATIVE GEMS

The diversity of the Korian group, which has facilities in France as well as, Italy, Belgium, and Germany, is a constant source of enrichment for our Positive Care. Despite our different experiences, complementary cultures, and unique histories, we share the same commitment, which regularly yields original innovations that we can use to benefit all our facilities.

With:

• 4 values for the Korian group;

• 4 pillars for Positive Care;

• 4 countries involved in its development.

It would be difficult for us to explain to you in this booklet all the research that has been done and the contributions that each person has made. That is why we have chosen to present to you each of these four countries’ contributions to one of the main pillars of Positive Care, while highlighting their consistently complementary strengths, the exploratory research that was carried out locally and then spread to other countries, and the virtuous circle of progress and innovation that is the result of a personal investment by all of our staff throughout Europe.

KindnessResponsibility

InitiativeTransparency

Belgium

France

Germany

Italy

Sophie boiSSArD, KoriAn group ChieF exeCutive oFFiCe

4342

INNOVATIVE GEMS

www.korian.com

ITALY FRANCE BELGIUM GERMANY

POSITIVE CARE

AlADAr iAneS MediCal direCtor

FAribA KAbiriAn MediCal direCtor

franCe healthCare division

pAul-emile hAÿ MediCal direCtor franCe seniors

division

mArC vlAeminCK operations and

Quality direCtor

SASChA SASSen Quality direCtor

mAriuCCiA roSSini, Ceo Korian italy

ChArleS-Antoine pinel, exeCutive vp

franCe seniors division

niColAS merigot, exeCutive vp

franCe healthCare division

DominieK beelen, Ceo Korian belGiuM

Arno SChwAlie, Ceo Korian GerMany

44

INNOVATIVE GEMS

ITALY

mAriuCCiA roSSini, Ceo

KoriAn itAly

A spotlight on: empathy and hospitality

‘When the patient is happy, the family is happy’

PILLAR 1 OF POSITIVE CARE

Empathy boxes, memory cards, doll therapy (also known as ‘empathy doll’), mediation ROT Therapy, art and music therapy… all of these innovations come to us from Italy and are now widely used within the Positive Care we provide at Korian. Even the names of these methods are a perfect example of the importance of empathy at Korian Italy!

• The empathy doll, a landmark method first used by Korian in Italy, highlights this very human-centred approach that is also open to friends and loved ones. It is used with patients suffering from cognitive impairment. This doll is shaped like a human or animal baby such as a kitten or puppy and it helps to calm and reassure an anxious patient. And we also help the family learn how to use it! Psycho-educational group meetings are held for family members of patients with cognitive impairment to train them in strategies for managing behavioural disorders.

• Environmental or individual music therapy sessions, which may be recorded with a musician and/or a singer, are also very important in Italy. The medical director is also directly responsible for organising aromatherapy and music therapy sessions in all our centres and units. The results have an immediate practical benefit in everyday life. For example, the music played at lunch and dinner helps residents recognise mealtimes.

Our Italian management staff strongly believes that the most important thing for patients today is human relationships, and for all staff members to adopt and take ownership of new changes within the organisation. That is why Korian Italy, and the entire group, believes it is so important for all the staff to receive training in developing a truly holistic approach to caring for patients.

14 Specialised clinics,

assisted living facilities, and home care services

42 Long-term care nursing homes

4544

INNOVATIVE GEMS

ITALY

In addition to empathy, the value of hospitality has a very specific meaning in Italy. Whether for demographic reasons or because of a unique sense of community, smaller retirement communities are developing quickly at the expense of larger retirement homes. And Positive Care provides a particularly suitable approach for these communities as well, offering well-structured assistance for residents. In a country in which Korian’s management tries, among other things, to reconstruct the environment and customs of its residents by respecting their traditions and heritage, Positive Care makes perfect sense.

The Positive Care therapies combine a concern for individual needs with the flexibility to be adapted to every type of retirement home. They have been used and adopted by multidisciplinary teams and improved through ongoing dialogue among our teams in several European countries.

AlADAr IANES, meDiCAl DireCtor

KoriAn itAly

With Positive Care, we work to maintain the ties between our residents and their lives”

46

INNOVATIVE GEMS

FRANCE SENIORS/HEALTHCARE

ChArleS-Antoine pinel, exeCutive vp, FrAnCe SeniorS DiviSion

Putting ideas into practice

Positive Care is a very sensitive way of being able to do what needs to be done while always keeping another person’s needs foremost in your mind.”


Many of the Positive Care tools and methods were developed in France, including the memory tablets, Ludospace, and the Flash Activities trolley.

Today, one of the major priorities for our teams in the France Seniors and France Healthcare Divisions is to accelerate the change in perception:

• Of our patients and residents: by no longer focusing on a disease. Using the ‘maintained abilities grid’ (rather than a list of pathologies) symbolises our desire to always look for the positive in life and to focus on well-being, so that each person can live according to his or her aspirations and possibilities.

• For our staff, because for them Positive Care now represents a connection, an identity, including some great success stories, helping us all to be proud of how we work at Korian and the values that we share while enabling us to do even better in the future.

366 facilities in France

291 long-term care nursing homes

• 75 specialised clinics (post-acute and rehabilitation care; psychiatric care)

• 7 hospital home care facilities in six French departments (Aude, Cher, Puy-de-Dôme, Yvelines, Tarn, and Vosges) with a total population of nearly 2.5 million people

• 3 home nursing care services (Chambéry, Sanary sur mer, Saint Etienne)

Key FigureS For KoriAn FrAnCe

The Korian group has

Its healthcare division activities (excluding long-term care nursing homes)

include:

4746

INNOVATIVE GEMS

FRANCE SENIORS/HEALTHCARE

niColAS mérigot, exeCutive vp FrAnCe heAlthCAre DiviSion

I am bowled over by the

virtual reality helmets and

very interested in hypnosis!”

Positive Care is, in itself, second nature to medical care professionals. Evaluating a patient’s abilities and supporting the person as he or she progresses and recovers is the day-to-day mission in our clinics and post-acute care facilities.

Their work is underpinned by the national guidelines for the treatment of pain, as well as the accurate reassessment of drug prescriptions. And when these facilities concentrate, as they do every day, on true teamwork, real-life experience, and the patient’s wishes rather than simply performing medical procedures, they prove themselves to be at the forefront of this movement. And the same is true when they use 3D hypnosis, for example, to reduce the use of painkillers during painful care procedures.

Starting in October 2018, Korian healthcare facilities will begin testing the first

3D glasses designed for pain relief through

hypnosis. They are used to perform some potentially

painful care or medical procedures with class II

analgaesics instead of class III analgaesics (which are

classified as narcotic drugs). This is a major step

forward for our patients’ health and a safer form of

pain relief.

48

INNOVATIVE GEMS

BELGIUM

bArt botS, Former Ceo oF KoriAn belgium

A spotlight on: innovation

Human beings must be first and foremost in everything we do. People see that care is not only medical and paramedical, but also human and social.”


Innovative projects in Belgium? There are plenty of them! Let’s look at a few examples:

• The CRDL (or CRADLE), a soft cuddly object that transforms human touch into music…and which sings like a bird or plays another soft sound when you touch it, helping to ‘wake up’ and bring joy to patients who have withdrawn from ordinary life;

• The activ84health, a panoramic stationary bicycle that is used to travel through every neighbourhood in Belgium (virtually of course). Riders can even pedal past their former home! And each time a person ‘takes a ride’, there are always three or four other spectators who come to watch photos of the neighbourhood scroll by!

• A variety of programmes to teach residents to use digital tablets;

• And so much more.

But here we have chosen to shine a spotlight on a success story that is 100% Positive Care: the Residents’ Parliament at the Prieelshof Nursing and Care Home. The Residents’ Parliament is a gathering place for all residents. The Parliament submits residents’ requests for the home. These requests are then processed and implemented. Their slogan is ‘YOUR CHOICE, OUR TALENT!’

The following list is an impressive example of some of the achievements that have resulted from the interaction between the Residents’ Parliament and the home’s staff:

• Improving breakfast by organising breakfast buffets;

• Improving palliative care staff communication with all residents when a death occurs;

A network of approximately

360 FTEs

and 450 independent nurses

for home care services

90 Retirement homes

(including 26 retirement homes and assisted living facilities at a single site)

8 Assisted living facilities

4948

INNOVATIVE GEMS

BELGIUM

mArK VLAEMINCK, QuAlity DireCtor, KoriAn belgium

We are committed to

developing activities that

are meaningful, which respect the wishes of

each resident, and cooperating

with local organisations,

schools, and music groups

so that we can be actively

involved in the community.”

• Collaborating with various public services in the town: an event was held in cooperation with the local police on recent deaths in the communi ty ; the res idents ’ participation was so greatly appreciated by the community that they were asked to be part of the local senior council!

• Organizing a choir made up of residents, staff, and family members, who gave a Christmas concert;

• Organizing activities with animals: Since many residents have had to leave behind their beloved pets, activities with animals were held in the garden that opens up onto the street, allowing the entire neighbourhood to join in the fun with the residents;

• Making special arrangements for people in wheelchairs to be able plant and harvest vegetables in the garden, which are happily shared to make soup for the entire floor of residents!

• Preventing falls with ‘Walker Rock’ and ‘Radio-Therapy’, allowing residents to enjoy music while they exercise;

• Appointing a resident postal worker to distribute newspapers and magazines. A small team of ‘administrative’ residents help prepare parcels and affix stamps to envelopes when it’s time to send out invoices.

Many other ideas have been submitted for this nursing home – all of which are displayed in the corridor of the nursing home on the ‘BETTER EVERY DAY’ board. This initiative is a true example of how listening, mobilising others, and fostering creativity can promote the well-being and happiness of all. It’s an example that we take to heart, just like all the other examples of Positive Care at Korian!

50

INNOVATIVE GEMS

GERMANY

Arno SCHWALIE, Ceo KoriAn germAny

ChriStiAne SCHÜCK, QuAlity mAnAger in ChArge oF poSitive CAre, KoriAn germAny

A spotlight on: clarity and freedom

Positive Care is a unique approach that allows us to make a difference in Germany.”

With Positive Care, our medical care staff enjoy using a variety of new materials. They receive intensive training, and thanks to the constant flow of ideas amongst themselves, our teams improve their skills.”

Dementia tablet, Snoezelen, and basal stimulation…all of these methods originated in Germany, a country that supports our Positive Care movement every day.

Every country in the Korian group has its own traditions and characteristics, and Germany is no exception with its specific organisational structure and certain unique care professions, like the social educator. Germany has developed its own way of thinking about Positive Care, which in turn enriches our shared vision at Korian. The German view combines a strong demand for clarity with a freedom of imagination that we will explain in greater detail through the experience of ‘Fairy Tales and Dementia’.

In his book ‘Naissance de la Vieillesse’ (The Birth of Ageing), the psychiatrist Claude Olivenstein speaks about the joy felt by our seniors when they “rediscover the laughter of a certain innocence”. That is what happens in Lichtenau, where residents and caregivers meet every week to happily listen to well-known fairy tales that are beloved by all – it’s a real treat for listeners.

But fairy tales aren’t very serious!

As a form of dramatic expression, fairy tales are a source of entertainment for us all: they are often funny, they express our desires, keep the audience on their toes, remind us of our shared culture, and allow for a moment of relaxation and communion. They spark the interest of our patients with dementia: their simple format and reminders of childhood and the past all capture their attention. Fairy tales take us back not only to our own past, but also to a collective past that we have carried with us for a long time.


5150

INNOVATIVE GEMS

GERMANY

evA LETTENMEIER, heAD oF CuStomer

relAtionS, KoriAn germAny

Positive Care can break down the

barriers of jargon and

preconceived notions and

clarify what we do for

residents and families.”

In 1900, Freud was the first person to discover the symbolic nature of fairy tales. Just like myths and legends, he showed how they dive into the most primitive parts of the psyche.In ‘The Uses of Enchantment’ (1976), the psychoanalyst Bruno Bettelheim shows how fairy tales – texts that are transmitted from one generation to the next – speak to the listener’s specific anxieties. Fairy tales stimulate our imagination and help us to see our emotions more clearly, but also to be aware of our obstacles, while also suggesting potential solutions.

Beyond merely being fun to listen to, the fairy tales that are told to our residents captivate, motivate, and soothe them:

“Each of our residents remembers the fairy tales from their childhood. It is fascinating to see how positively they react to fairy tales. Although they may be a bit restless at the start of story time, they become more and more captivated as time passes, their eyes sparkle, and they applaud joyfully when the story is over!

We have also noticed that it is not only the residents who benefit from these stories: our employees also enjoy them. They are happy to attend, they participate as well, and they feel a certain relief as it becomes easier to strike a balance between the residents and their day-to-day tasks.”

(thomAS riChter, nurSing CAre ServiCeS - liChtenAu)

All of these experiences are like good fairies watching over our residents and patients, in a spirit of Positive Care….

175 Nursing homes

52 Assisted living

facilities

26 Home care services

52


5352

P 54 • Implementation and training: the Korian Academy

P 57 • Focus on France: Positive Care and the hospitality professions

P 60 • Focus on France: Positive Care and management

54


At Korian, Positive Care is currently a comprehensive approach that acts as our North Star. It’s a common thread for all our staff as we embark on our shared journey of supporting our patients and residents.

Our 49,000 employees and assistants include not only many caregivers but also all those who work in administration, hotel services, and dining. Our staff members are unlike any others – they are straightforward, generous, and extraordinarily committed to their work. Everyone is aware of the profound importance of his or her job and takes pride in helping our patients and seniors.

We manage a total of nearly 750 facilities that take care of and support 250,000 people every year, including 100,000 in France.

In France, 100 facilities per year are trained in the use of non-medicinal treatments, which are the very heart of Positive Care. Our caregivers and Directors as well as the entire Management Committee have undergone full training. All of our internal communications are posted on the intranet and reinforced via email, regional officers, and management conventions and regional meetings.

We are fully committed to Positive Care.

Implementation and training: the Korian Academy

750 facilities

250,000 patients/residents

49,000employees

and trainees

5554


In France:

Our leading priorities include employee training and skills development. We are constantly looking for new ways to improve the care we give to the some 100,000 people that we support every year in France. That is why the Korian Academy, our internal academy that has been at the heart of our development practices for ten years, offers 120 training programmes and 11 professional training courses. More than 19,000 trainees attended the Korian Academy in 2017. By 2020, thanks to the growth of distance learning and the launch of a unique in-house platform, our goal is to be able to train 100% of group staff members every year.

We have also initiated an active partnership policy and work continuously with esteemed research partners such as the Centre Hospitalier Universitaire de Montpellier, the CEA, Hospices Civils de Lyon, the Institut de Formation en Soins Infirmiers, the Institut de Formation des Aides-Soignants, and universities such as Université Paris Dauphine, Paris 1 Panthéon Sorbonne, François Rabelais de Tours, and Université de Technologie de Troyes.

WHO are we?

19

The Geriatric Passport: the #1 geriatrics training programme for the care professions in France

5,000 employees are enrolled in the

programme

SKILLS 1 SKILLS 2 SKILLS 3

SKILLS 4 SKILLS support

ELDERLY CARE AND WELL-BEING

(28 HOURS)

4 Pass skills

PERSONALISED CARE PLANS

AND CONTINUITY OF CARE

(65 HOURS)

9 Pass skills

END-OF-LIFE CARE AND SUPPORT

(25 HOURS)

9 Pass skills

PROCEDURAL ANALYSIS

(21 HOURS)

-

STIMULATING ELDERLY PEOPLE

(35 HOURS)

6 Pass skills

Duration: 36 months

One of the highlights of 2017 was the development of the geriatric passport, the first job training programme focused on the field of senior care. It offers 193 hours of training, two thirds of which are face-to-face. It is designed for caregivers, medico-psychological assis-tants, educational and social assistants, and State-registered nurses. To date, 5,000 Korian employees have enrol led in this programme.

nADège plou, humAn reSourCeS DireCtor, KoriAn FrAnCe

56


And our approach starts before you even step foot in one of our facilities! We take pride in getting to know each person as an individual, in his or her own home and everyday surroundings. We are able to find out about the person’s expectations, preferences, and habits in terms of food and activities.

Then, as part of our Positive Care approach:

• We introduce all the caregivers to the new resident, including the head nurse;

• The nurse always meets with the resident after his or her first night at the facility;

• We offer a geriatric assessment for all stays of more than two weeks;

• We allow carers who are friends or family members of the resident to meet with a psychologist if they so desire;

• We provide the resident’s loved ones with training on functional or cognitive conditions, care, posture, food textures, and bladder and bowel control.

With Korian, the story starts early:

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We believe that the pleasure of eating is a true form of therapy for our residents and patients.

Our priority is to offer delicious dining options in our facilities with traditional, family-style recipes encompassing a wide variety of raw and local products.

We have adapted the dining services in our facilities to the tastes, habits, and preferences of our residents.

For example, did you know that fried eggs are one of the most highly requested dishes in our facilities? That’s why we have added them to our menus. Another example is baked goods. Every afternoon, we offer a snack that includes a sweet treat baked in our own ovens. Our approach to dining highlights traditional recipes like mashed potatoes, omelettes, and homemade salad dressings.

Dining services

POSITIVE CARE AND THE HOSPITALITY PROFESSIONS

FOCUS FrAnCe

ChriStophe pArrot, DireCtor oF Dining AnD hotel ServiCeS, KoriAn FrAnCe

These Positive Care commitments are, of course, reflected in our hospitality professions, including our hotel and dining services, reception, and activities staff. Our approach to hospitality is welcoming and joyful. It factors in each person’s ability’s while improving his or her well-being through countless caring gestures.”

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We could talk endlessly about how our hospitality staff work together as a team and exemplify Positive Care in everything they do:

Mealtime at Korian is a perfect example. Rather than struggling to convince residents to eat when they suffer from a condition that makes them agitated or unable to concentrate on eating, we offer delectable tasty bites that residents can enjoy in the dining room or in their own room. These little gourmet bites are based on that day’s menu but are re-textured and redesigned to make them easy to swallow (in a single bite). Our cooking staff are specifically trained to make them and the results in terms of weight gain have been excellent.

We strive to create a comfortable, pleasant environment for our residents. This means:

• Respecting our residents’ privacy by always knocking before entering or never entering a room if the resident is somewhere else;

• Respecting each resident’s physical needs and promoting self-respect.

Ties to the family:

• The Korian Generations app, which was specially designed for our seniors;

• Every child who visits a resident receives a gift;

• Each person’s birthday is celebrated individually according to the person’s preferences;

• Friends and family members can be invited to share a meal.

Social activities are an integral part of the care provided in each of our homes:

• A range of workshops and leisure and cultural activities, with at least three activities offered every day;

• Engaging daily activities (cooking, gardening, DIY, or handicrafts).

Activities

Well-being and private life

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Korian employees are proud to share their thoughts on these topics:

“You and I look at a crêpes workshop as a simple cooking class. But for other people it may be therapeutic: they need to remember the recipe, prepare the ingredients, mix the batter, cook the crêpes, and taste them. Their memory, movement, and fine motor skills as well as all their senses will be mobilised.”

“In one of our facilities, the activity leader has set up a weekly discussion time to talk about activities. The activity leader has invited a sommelier, a florist, and others to meet with the residents. In turn, the residents – including a professional magician, a musician, and a builder – share their knowledge with the rest of the participants.”

“Games, play, and relying on everyday movements to maintain one’s identity.”

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3 questions for the Facility Director

What do you think about the role of Korian managers in implementing the Positive Care approach?

The coordination role of every Korian manager is crucial to our Positive Care. The manager needs to create the right conditions for the growth of Positive Care by incorporating all the teams and promoting communication among

staff members.

What makes Positive Care so unique?

It is more demanding than a traditional approach: it requires time, patience, and a true investment in terms of how the facility is organised.

Schedules have to be adapted and we have to listen to our residents very carefully. In a retirement home, all residents become potential active stakeholders: that calls for a lot of time and attention on our part.

One cannot necessarily estimate how much work will be required to help Ms Bernard, a renowned pianist suffering from cognitive impairment, perform at a piano recital. Or how many schedules need to be juggled to allow a staff member to spend an hour one-on-one with Mr Delmas every day? But since then, his periods of anxiety in the evening have disappeared. It’s good for everyone, including the other residents and our staff!

POSITIVE CARE AND MANAGEMENT

FOCUS FrAnCe

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What do you think are the main benefits of Positive Care?

There are so many advantages:

• The greater satisfaction of residents and their families, which enhances the reputation of our facilities;

• The pride felt by Korian employees in working for a group that is a pioneer in its field;

• The improved functioning of the facility, day in and day out.

Better prevention of situations that are stressful to seniors to create an environment that promotes the well-being of everyone, including our staff.

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LONG-TERM CARE NURSING HOMES

Care professions• Coordinating doctors• Doctors• Coordinating nurses• State-accredited nurses• State-accredited

head nurses• Caregivers

• Medico-psychological caregivers

• Physiotherapists• Occupational therapists• Psychologists• Physical therapists• Professionals specialised in

adapted physical activities

priSCillA Clot-FAybeSSe, CoorDinAting DoCtor

Axelle Collet, heAD nurSe

thierry bertou, FACility DireCtor

A coordinating doctor has to pay attention to residents’ life stories and understand what they have been through in order to better understand them and provide better treatment.”

We have to understand our residents to know how to respond appropriately.”

We are in their lives – we are actually in their home. So we are here to bring them joy while anticipating their expectations and needs.”

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Hotel/Dining and Activities Professions• Hotel Services Managers• Chefs• Cooks• Assistant Cooks• Prep Cooks• Technical Managers

• Hotel Services Staff• Social Activities Staff• Technical Staff• Activity Leaders• Housekeepers• Laundry Attendants

FrAnçoiSe ZAZZAron, hotel ServiCeS mAnAger

luDoviC lhuSSier, CooK

It’s extremely meaningful and important to make residents

happy so that they can feel at home.”

Making our residents happy at mealtime is very important. It’s one of their favourite times of day and they look forward to it.”

• Facility Directors• Deputy Directors• Executive Assistants• Administrative Officers

• Reception Staff

Administrative Professions in our Facilities

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MEDICAL SPECIALITIES

TRUE/FALSE QUIZ

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P 66 • Quiz: Are you Positive Care?

P 68 • Quiz: What do Korian Physical Therapists do?

P 69 • Quiz: What do Korian Occupational Therapists do?

P 70 • Quiz: What do Korian Physiotherapists do?

P 71 • Quiz: What do Korian Psychologists do?

P 72 • A word from…

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MEDICAL SPECIALITIES TRUE/FALSE QUIZ

QUIZ : ARE YOU POSITIVE CARE?

When you see people with disabilities in the street…a. You wonder what you can do to helpb. You feel sorry for themc. You look away and try not to bother them

A little girl falls from her bicycle in front of you and stands back up…

a. You help her back on her bicycleb. You call a doctorc. You run to comfort her

In general, you prefer to…a. Help people improveb. Take care of othersc. Convince others

The idea of working in physical contact with other people… a. Doesn’t bother youb. Might be something you could get used toc. Bothers you

Understanding how the human body works…a. Is interesting, especially if you also try to understand the

individual and his or her needsb. Is extremely interestingc. Is not very interesting

Other people say that you are…a. Considerateb. Observantc. Unique

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Mostly A’s:

You are already an ambassador for Positive Care!

Mostly B’s:

Positive Care is an approach that will pique your curiosity.

Mostly C’s:

You are not personally interested in Positive Care, but you are happy that it is offered by professionals.

Are you curious to find out more? You may already know about what occupational therapists, physiotherapists, psychologists, and physical therapists do…but we would like to tell you about what is so special about these professions at Korian. Here’s a hint: it all has to do with Positive Care!

Occupational and physical therapists, psychologists, physio-therapists, podiatrists, speech therapists, and art therapists are all regularly available in our facilities to support and care for residents and patients, especially those with sensory, cognitive, or motor impairments. We have selected four of these professions to describe to you in further detail and we encourage you to visit our facilities to learn more about the other professionals that constantly work as a team to care for our residents.

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What they doMain objectives

QUIZ: WHAT DO KORIAN PHYSICAL THERAPISTS DO?

TRUE/FALSE quiz

a. Korian physical therapists practice psychotherapy

b. They help patients improve their balance

c. They can help patients reduce the amount of anti-anxiety medication they take

a. false b. true c. true

• Facilitate muscular, mental, and emotional relaxation.

• Encourage verbal and non-verbal communication.

• Help the patient perform activities required in daily life.

• Reduce behavioural disorders.

• Reduce the sensation of pain and manage pain through multi-sensory approaches.

• Maintain motor skills through activities that are meaningful to the individual.

• Promote positive body image.

They treat psychomotor disorders, including body pattern or body image disorders, muscular and/or emotional regulation disorders, and behavioural or balance disorders.

They evaluate the patient’s abilities using specifically adapted tests.

They prepare an individual treatment plan with care goals and periodically reassess the patient’s results. They use methods such as bodily expression, relaxation, and rhythmic or gymnastic activities in individual and group settings.

Physical therapists are skilled listeners who make time for their patients in order to observe and understand their problems and propose creative solutions.

Our physical therapists provide therapy in the form of physical movement to improve the person’s psychomotor disorders. Their work is based on improving the link and the harmony between the mind and the person’s motor skills in order to help the individual as a whole. They offer prescription-only rehabilitation sessions for individuals and groups. Physical therapists are State-accredited and hold a three-year degree from an institute approved by the regional prefect. Students with a baccalaureate (secondary school) diploma or an equivalent diploma must pass an exam before being admitted to these institutes. Over the past five years, the field of physical therapy has become its own area of specialisation within our facilities, as part of our focus on using non-medicinal approaches whenever possible.

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What they do

TRUE/FALSE quiz

a. Korian occupational therapists work with devices that can improve patients’ independence and comfort

b. They use natural, plant-based medicine

c. They create menus for better nutrition

a. true b. false c. false

At Korian, our occupational therapists work constantly to:

Improve patients’ and residents’ ability to participate in daily activities (by using assis-tive technologies, adapting activities to suit the person’s abilities, adapting their living environment, and participating in physical activities);

Help patients improve their posture;

Implement safety strategies during daily activities;

Prevent musculoskeletal disorders, support patients with Alzheimer’s disease and related disorders, and assist patients with sensory and motor disorders;

Implement strategies to guarantee safety and adapt activities of daily living to the person’s needs;

Prevent sk in and musculoskeleta l disorders.

• Training in the use of technical measures for mobility, balance, meals, grooming, dressing, hobbies, and cognition.

• Adjustment and adaptation of wheelchairs.

• Creation of technical aids to improve posture and perform the activities of daily living.

• Implementation of measures to prevent and treat bedsores.

• Adapting bedrooms and living areas to accommodate each individual’s needs.

• Adapting the activities of daily living and hobbies to the person’s preferences and their maintained abilities.

Sample recommendations

The goal of occupational therapy is to maintain and restore motor skills in a safe, independent, and effective manner. They work to improve quality of life and maintain the person’s ability to perform their daily activities by using activities to rehabilitate, prevent injury, and improve the person’s comfort and safety. Occupational therapists hold a diploma accredited by the State that requires three years of post-secondary education in France.

QUIZ: WHAT DO KORIAN OCCUPATIONAL THERAPISTS DO?

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What they do

TRUE/FALSE quiz

a. Korian physiotherapists offer physical therapy only in our clinics

b. They can help a patient or resident improve their respiratory capacity

c. Their goal is to help the patient avoid any physical exertion

a. false, they are always present in our nursing homes – b. true c. false, their goal is to improve the patient’s ability to exert physical effort

They work in close collaboration with the care staff in one of our clinics, post-acute care facilities, or Korian nursing homes, providing physical therapy and rehabilitation to maintain or restore patients’ functional abilities. They help to continuously improve care by coordinating treatments and quality procedures.

Physiotherapists primarily provide physical therapy to residents:

Rehabilitation after an accident;

Rehabilitation of the musculoskeletal system, i.e. everything that allows patients to move, walk, and maintain their balance;

Improvement of respiratory capacity;

Improvement of the ability to exert physical effort.

Examples of preventive actions

• Strength training

• Workshops on preventing falls

Physiotherapists – or masseur-physiotherapists, as they are known in France – offer medically prescribed services to rehabilitate patients either manually or with the use of medical devices. They can also offer fitness and relaxation classes or massages and hydrotherapy treatments. Physiotherapists hold a three-year State diploma from an institute accredited by the regional prefect.

QUIZ: WHAT DO KORIAN PHYSIOTHERAPISTS DO?

First and foremost, physiotherapists study the person’s medical file and perform an eva-luation of the patient’s abilities in order to define the objectives, methods, and tech-niques that will be used in physical therapy, then propose a specially adapted rehabilita-tion programme.

There are many potential techniques: move-ments with or without medical devices, physiotherapy techniques (heat, cold, and ultrasound treatments), massages, or mobilisation.

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What they do

TRUE/FALSE quiz

a. Korian gerontological psychologists can help families prepare for the end of life

b. They help residents adapt when they arrive in our facility

c. They organise special events to entertain patients and residents

a. true – b. true – c. false, that is the speciality of our Korian activity leaders – although the psychologist is welcome to attend!

• Cognitive stimulation workshop.

• Carer support group.

• Individual treatment plan.

• Clinical interview.

• Evaluation of cognitive, mood, and behavioural functions.

• Analysis of caregiving practices with the care staff.

Psychologists assist residents from the day they arrive until they leave. After a compre-hensive individual evaluation, they adjust their treatment to the resident’s needs and abilities.

They act as a go-between with the person’s family, helping to resolve arguments and assist family members in feeling less guilty about their relative going to a nursing home.

Finally, they listen and make recommenda-tions to the team of caregivers, so they can adapt their day-to-day care strategies and better cope with the stress of their work.

Psychologists know how to observe and listen carefully to individuals (one-on-one or in groups) to identify any behavioural disorders related to the person’s cognitive impairment and analyse and solve these disorders.Psychologists receive a State-accredited diploma after five years of university-level studies in psychology followed by a professional traineeship. While people are generally aware of what psychologists do, their areas of specialisation are less widely known, especially in the field of gerontology (which entails providing psychological support to the elderly).

QUIZ: WHAT DO KORIAN PSYCHOLOGISTS DO?

Examples of psychological support

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A word from…Our Korian staff would like to tell you about Positive Care in their own words.

mArK vlAeminCK, QuAlity DireCtor, KoriAn (belgium)

mAthilDe tro, poSitive CAre oFFiCer, FrAnCe SeniorS (FrAnCe)

My job is to spread the values of Korian and Positive Care throughout our homes. We are committed to organising activities that are meaningful and reflect our residents’ wishes and to cooperating with local organisations, schools, and music groups so that we can be a part of our community.”

“My major concern is dignity. When a person reaches the end of their life in a better condition, that’s dignity.”

In the facility where I worked, one of the caregivers was worn out. I told her about the training, she really got into it and changed how she saw herself and her work. With Positive Care, I feel more certain about the values I represent.”

We are always surprised by the physical and mental abilities that residents can mobilise.”

CArolinA hAnglberger, generAl exeCutive ASSiStAnt (bAvAriA)

AnD Former oCCupAtionAl therApiSt (germAny)

StéphAne héDont, KoriAn poSitive CAre oFFiCer

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SteFAniA SCotti, pSyChologiSt, S. mArtA CAre home, milAn (itAly)

DeniSe hAuSer, SChulZe KAtrinhoF SAArwellingen SoCiAl ServiCeS home (germAny)

giuSeppe ArDoino, meDiCAl DireCtor, ippoCrAte CAre FACility (itAly)

mAximiliAn gAbriele, meDiCAl DireCtor, S. mArtA CAre FACility, milAn (itAly)

When an elderly person is admitted to a facility, the staff also becomes part of their family.”

Positive Care opens up new doors for me in providing support to people with cognitive disorders. It has shown me new possibilities for helping them. Everything becomes possible, from improving their appetites to stopping their medication.”

I think that the culture of alternative therapy, with a different approach to illness, should be spread throughout all Korian facilities. […] Its main advantages are its effective results, the lack of medication for behavioural disorders, and quality of life in environments that are designed to manage symptoms.”

Positive Care reflects our interest in developing a unique framework for care [that is] homogenous in every country where Korian is present.”

Each nursing home is encouraged to organise activities focussed on music, art, and animal-assisted therapy. We strive every year to bring meaning to what we do.”

Sophie beeCKmAnn, ACtivity mAnAger in the bruSSelS region (belgium)

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P 76 • What is aromatherapy?

P 77 • What is light therapy?

P 78 • What is animal-assisted therapy?

P 79 • What is sophrology?

P 80 • What is relaxology?

P 82 • What is mindfulness meditation?

P 83 • What is hypnosis?

P 84 • What is hydrotherapy?

P 85 • What is horticultural therapy?

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DID YOU KNOW?

WHAT IS AROMATHERAPY?

• Over 40,000 years ago, indigenous Australians already used aromatic plants as a fumigant (by breathing in the smoke of burning aromatic plants) and in poultices (clay-based pastes applied to the skin).

• In 2800 BC, Egyptians used aromatic essences in the mummification process and as an ingested medication.

• In 2000 BC, Ayurveda, a unique medical approach with an emphasis on aromatic plants, emerged in India.

• In ancient Greece and Rome, Hippocrates (the father of Western medicine) and Galen described their knowledge of aromatic plants in a number of writings.

• Around the year 1200, Avicenna, a Persian prince and doctor, invented the first alembic for distilling aromatic plants and produced the first 100% pure essential oil: rosa centifolia.

• In the 1400s, ‘four thieves vinegar’ made up exclusively of plant essences was believed to protect users from the plague.

What are essential oils? An essential oil is a concentrated liquid extract that is obtained by distilling an aromatic plant (flower, leaf, wood, root, peel, or fruit) with steam. It is made up of over a hundred active, unique molecules.

How are they used in a context of care and well-being?It is important to thoroughly understand essen-tial oils and our staff have received the training they need to know which essential oils are appropriate or, inversely, much too strong for a person’s specific needs.

PLEASE NOTE! ALWAYS CONSULT WITH A PROFESSIONAL BEFORE USING ESSENTIAL OILS.

We select the best essential oils for relaxation as well as to stimulate and preserve our residents’ senses through:• diffusion in the air• aromatic patches• aromatic baths; gentle massage of the face,

hands, or feet; a variety of massages; and relaxation exercises for individuals in a fragile state.

We care about more than just our residents’ physical and emotional well-being. Our senses are valuable tools for communicating with others. Certain pleasant scents are powerful memory triggers and can bring up happy memories.

AROMATHERAPY is the art of using essential oils to treat and harmonise a person’s physical and mental health. It is a natural method based on the activity of the biochemical molecules that make up the essential oils.

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DID YOU KNOW?

• Light therapy is an effective solu-tion for people with limited exposure to daylight.

• Light therapy is provided between 4 and 8 p.m. and helps to push back the time a person falls asleep and wakes up. Our elderly residents sleep longer and no lon-ger wake up by themselves at 4 o’ clock in the morning!

• Bright lighting is an essential part of kee-ping our residents healthy, especially when their eyesight declines: as we age, we start to limit our movements due to a fear of falling.

• High-contrast lighting is better than yellow or warm lights, which reduce contrast.

Why does Korian offer light therapy?

In our nursing homes, light therapy is a valuable, effective aid for our residents.

As we age, the human body goes through significant changes. Disruptions in our biologi-cal clock can interfere with the balance and health of elderly individuals. These disruptions can affect hormonal secretions, alter behaviour, accentuate any sleep problems, and even lead to depression.

Thanks to light therapy, these changes can be stabilised. By simulating the sun’s light, this therapy offsets any lack of natural light for elderly individuals who may not leave the faci-lity very often in winter. It balances their internal clock and directly affects the quality of their sleep. The positive, scientifically proven benefits of bright artificial light have a lasting impact on the daily lives of our residents and care staff:

• Better quality and stability of sleep, even for residents with Alzheimer’s disease or other diseases;

• A reduction in insomnia and abnormal sleep patterns at night;

LIGHT THERAPY is a therapeutic technique used to treat depression and insomnia by exposing the patient to light rays that imitate those of the sun. Many people are sensitive to changes in season and suffer from seasonal depression during the limited daylight hours in winter. By exposing patients to white light that is infrared- and ultraviolet-free, light therapy can balance the secretion of melatonin, a hormone that regulates our biological clock.

WHAT IS LIGHT THERAPY?

• Better mobility during the day and less agita-tion at night;

• Significant decrease in seasonal affective disorder and chronic depression, mood impro-vements, and more energy and interactions with others.

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DID YOU KNOW?

WHAT IS ANIMAL-ASSISTED THERAPY?

• Animals were first voluntarily used for therapeutic purposes in the 9th century in Belgium, where convalescing patients were given birds to take care of.

• Florence Nightingale, the founder of modern nursing, kept a turtle at her hospi-tal during the Crimean War (1854-1856) to comfort the sick and injured.

• Boris Levinson, a paediatric psychiatrist and psychologist, used dogs and cats in the 1950s as part of his practice. He found animal-as-sisted therapy to be particularly useful for children with autism.

• Animal-assisted therapy has been shown to have a positive effect on patients’ cardiovas-cular system, blood pressure, and heart rate.

• Many people with depression lose an inte-rest in activities they used to enjoy: seeing their favourite animal can help them recon-nect with their surroundings.

• The presence of an animal can be an effective motivation for staying fit and can improve concentration.

• Animals can help improve the physical condition of people with disabilities: for exa-mple playing with a dog (giving commands, throwing a ball, etc.) can help individuals strengthen their voice, arms, and motor skills.

The ‘power’ of animals

Animal-assisted therapy can meet some of our fundamental needs: to feel loved for who we are as individuals, to feel useful, and to feel close to nature. The presence of animals is also a good way to relieve isolation and communi-cate our emotions, which is particularly useful for seniors and residents with an illness.

Dogs, cats, fish, rabbits, and turtles…oh my!

Dogs are most commonly used for animal-as-sisted therapy, but we have also seen that goldfish, cats, guinea pigs, turtles, horses, and even rabbits can have a beneficial effect!

AROMATHERAPY Animal-assisted therapy uses pets to:

• Reduce stress;

• Maintain and improve the health of individuals suffering from various disorders;

• Alleviate the effects of medical treatments and postoperative problems.

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DID YOU KNOW?

• Sophrology was created in Madrid in 1960 by Alfonso Caycedo, a neuropsy-chiatrist interested in hypnosis and Eastern philosophies such as yoga and Zen.

• Sophrology is appropriate for people aged four and older – as soon as we become truly aware of ourselves, we can practice sophrology.

• In nursing homes, only people with severe hearing loss cannot participate in sophro-logy sessions. Mobility and attention are not an impediment –individuals can participate as best as their abilities allow them to do. Sophrology can be adapted to the abilities and speed of each person.

It is used primarily for:• Preventing stress and promoting better

sleep, well-being, and relaxation;

• Medical purposes (pain relief and treatment of tinnitus, addiction, etc.)

• Improving sports performance, training, and physical recovery.

More and more companies are also offering sophrology to their employees.

Sophrology for seniorsSophrology is particularly well suited to the residents and patients we care for in our facilities.

As we age, we tend to disconnect from our bodies as we become burdened by pain, alte-red eyesight and hearing, a reduction in taste and smell, and clumsier movements.

Sophrology helps our elders feel more present in their own bodies through positive, non-pain-ful sensations. Special breath work helps them to feel livelier.

They are also able to stimulate their memory through pleasant recollections of past expe-riences and gain a more positive outlook

SOPHROLOGY is based on hypnosis and Eastern techniques such as yoga and Zen. It is a dynamic form of relaxation: exercises can be performed while seated or standing and the movements are gentle and can be adapted to suit each individual.

The aim of sophrology is to transform our anxiety into positive thoughts. It is both a psychological and a physical form of practice that focuses on physical sensations, breathing, and visualisation of soothing images.

WHAT IS SOPHROLOGY?

through constructive visualisation. Sophrology reminds them that we each have our own, ongoing story and that almost all of us are capable of determining our quality of life in our final days, no matter where we live.

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SAVEZ-VOUS QUE… ?

WHAT IS RELAXOLOGY?

• A relaxation session begins with an interview to help the instructor adapt his or her practice to the participant’s needs.

• This is followed by a few deep, full breaths to release tension and loosen the muscles.

• Participants perform specific exercises to relax their muscles and soothe the body. This also helps to calm the mind.

• Finally, the participant will be encouraged to visualise the images of his or her choice (landscapes, relaxing and sending the breath to different parts of the body, etc.) to improve well-being and let go of tension.

• The session ends with an open-ended dis-cussion on how the person feels and what they experienced.

Practicing relaxation:

• Relieves physical and emotional tension;

• Improves concentration;

• Improves sleep;

• Boosts self-confidence;

• Helps participants become more aware of their own bodies, which is especially important for seniors, including those with disabilities or bodily discomfort.

Studies have also shown that relaxation plays a role in activating the immune system and the digestive system.

RELAXOLOGY uses various relaxation methods that can help anyone to become calm and relaxed, in addition to combating stress and anxiety.

DID YOU KNOW?

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A relaxation exerciseAfter taking several calm breaths, lie down and listen quietly to the following exercise (you can record it, taking care to speak slowly as you read):

You will now visualise a place that you may already know, it may be the beach, the country-side, or somewhere else, or maybe another place that you have never seen before that you can create in your imagination.

The weather is perfect, just the right tempera-ture. You are watching the scene unfold….

You welcome any shapes or colours that may float into view. There may be softer or more intense colours, areas that are brighter or dark.

You are enjoying what you see. Suddenly, you start to hear a noise close by…and as you listen, you hear the noise go farther and farther away.

You are listening to the sounds of nature. You start to become more sensitive to the smells around you, perhaps a unique scent that you love or a combination of scents.

And in this place, you may find something deli-cious that you’d like to taste…or perhaps you brought something yummy with you. You lift it up to your mouth and smell the aromas, taking your time to chew and swallow slowly.

Then, you look around and start to touch something close to you. You touch it softly, gently, and pick it up in your hand.

And now all your senses are stimulated: you are aware of all of them. Notice your breath…notice how you have left all your worries behind.

Now, let this scene fade away. You are now back where you started. You can feel the weight of your body. You gently become aware of the

feeling of your breath in your stomach…and the feeling of your body being supported by the ground. When you feel it’s time, once you’re ready, you can gently stretch your body and open your eyes.

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DID YOU KNOW?

WHAT IS MINDFULNESS MEDITATION?

• Mindfulness meditation does not mean thinking of nothing at all but rather redirecting our attention. Since thoughts have a major impact on our feeling of well-being and our daily decisions, mindfulness meditation makes us aware of our feelings at a given point in time, which has a calming effect on our minds.

• Mindfulness meditation is a technique used for greater well-being and personal development.

• Mindfulness meditation should be prac-ticed for at least twenty minutes a day for better results.

It consists of bringing our attention to whatever is happening in the present moment and exa-mining the feelings that arise, how long they last, and their disappearance. As this happens, we should remain neutral, without judging ourselves, and without trying to hold on to any pleasant thoughts or push away any uncomfor-table feelings. This teaches us to detach from our emotions and gradually let go of any men-tal distractions.

Mindfulness meditation is used successfully in two ways:

• ‘Stress reduction through mindfulness’ was developed by Jon Kabat-Zinn. This method is now offered in 200 American hospitals.

• Mindfulness meditation is effective at preventing relapse for patients suffering from depression. A study from the University of Oxford published in The Lancet in April 2015 shows that therapy based on mindfulness meditation is as effective as antidepressants at preventing depressive relapse.

MINDFULNESS refers to the conscious awareness of our own thoughts, actions, and motivations. It plays an essential role in Buddhism. In the Western world, mindfulness is used as a therapy to reduce stress and prevent depression.

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DID YOU KNOW?

Hypnosis can also reduce anxiety, whether caused by care procedures or something else. It is known to be an effective treatment for mental health and can be used for stress-related disorders, panic, and pho-bias (including agoraphobia and claustro-phobia). Finally, it is a useful tool for treating addiction and dependency, which is why it is often used to help patients stop smoking or recover from bulimia.

Hypnosis provides:• A feeling of mental calmness and relaxation;

• A total focusing of one’s attention;

• A lack of judgment and self-analysis.

Patients are better able to focus on a feeling or task to be accomplished, even an imaginary one (such as visualising a landscape or taking a walk), than in an ordinary state of consciousness. We are more receptive to suggestions when under hypnosis. The hypnotist accompanies the patient by helping him or her ‘descend’ into a state of hypnosis and then by giving appropriate suggestions that the patient can apply to improve his or her well-being.

The first references to hypnosis in medicine go back to ancient Greece. Throughout human history, we can find aspects of medical hypnosis in certain rituals (including those of the Druids).

HYPNOSIS consists of reaching a state of altered consciousness while in a state of deep relaxation between sleep and wakefulness. Unlike what we might think, people who are in a state of hypnosis can clearly hear what those around them are saying and do not forget these things once they wake up. They are also able to respond to their therapist if necessary.

WHAT IS HYPNOSIS?

In the modern history of hypnosis, it was initially used to reduce the pain of labour and childbirth before being used to treat pain from the 1970s onwards. Hypnosis can be used for acute as well as chronic pain, and studies have suggested that it has an effect on the immune system.

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DID YOU KNOW?

WHAT IS HYDROTHERAPY?

• Archaeologists have found the remains of bathrooms dating back to 1700 BC at the Palace of Knossos in Crete showing that people of that era already understood the positive effects of a long soak in warm water.

• The Greek doctor Hippocrates (460-377 BC) prescribed saltwater baths to his patients with muscular pain and arthritis.

• The Caracalla thermal springs – the crème de la crème of spa pools in the ancient Roman empire – could accommodate up to 1,600 people at a time.

It is used to treat and relax patients through the soothing effects of water.

Unlike thalassotherapy and thermal spa treat-ments, which are offered on-site at natural springs and bodies of water, hydrotherapy can be practiced in nursing homes in bathrooms that are specially equipped with massage whir-lpools and massaging shower heads. With hydrotherapy, a specific rehabilitation pro-gramme can be developed based on each individual’s care plan.

Its benefits may include:

• Physical rehabilitation, with specific move-ments adapted to the person’s condition and motor deficits;

• Increased well-being, e.g. through massages adapted to suit the patient’s needs.

Hydrotherapy offers so many benefits for our seniors:

• It can ease the pain of rheumatic disorders through a warm, massaging jet spray, which promotes joint flexibility;

• It can help patients recover from a localised injury or fall;

HYDROTHERAPY Thanks to the ongoing advances in our equipment and techniques, hydrotherapy has become a valued form of therapy in our nursing homes.

• It soothes tired legs, cramps, and oedemas by promoting blood circulation due to the pres-sure of water and air bubbles;

• It decongests certain organs such as the liver and spleen;

• It boosts morale and creates a feeling of deep relaxation and well-being.

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DID YOU KNOW?

• Gardening was prescribed for the-rapeutic purposes in many North American hospitals starting in the 1800s.

• In 1900, Drs Karl and Will Menniger used the term ‘horticultural therapy’ in their clinic in Kansas.

• In 1945 horticultural therapy was conside-red to be the official term.

Horticultural therapy focuses on specific conditions and related difficulties. It can be used with patients who have suffered a stroke, a fall, or as part of post-acute cardiac care. Horticultural therapists adapt their work to patients’ needs, coordination, and endurance, and prepare a treatment plan to help them meet their goals. For example, certain gardening tools can be adapted so that they can be used by people with disabilities.

What can we do this month?Each season and each month comes with its own gardening activities… even in the winter! Here are a few ideas for January and February.

January• Sprout seeds• Read gardening books• Make labels for trees• Clean and repair gardening tools• Build a bird feeder

Gardens are magical places where the beauty of nature unfolds in all its splendour and beauty. The soothing shades of green, and the patience we feel while waiting for plants to grow, create feelings of relaxation and happiness. Gardens help us construct, by allowing us to plant, water, and prune…and they make us feel useful and alive, surrounded by nature. HORTICULTURAL THERAPY – the practice of therapeutic gardening – promotes memory retention in residents, who are encouraged to remember the seasons and months when seeds are planted, when they flower, and when they bear fruit. Other benefits include a greater sense of responsibility, motor coordination, and maintaining a good physical condition. Horticultural therapy can be enjoyed by people with physical disabilities, can promote better mental health, and, simply put, makes us feel more connected to the world around us.

WHAT IS HORTICULTURAL THERAPY?

February• Keep discarded orange peels and make

potpourri• Trim overgrown trees and grow roots from

the cuttings• Plan a spring garden• Plant lettuce seeds outside• Make a terrarium

Can you think of any more gardening activities for the current month?

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P 88 • Wish lists prepared during interviews

P 90 • Goals for the future: Positive Care – our values in a nutshell

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Before we finish, we’d like to give our Korian staff a chance to share with us their dreams and ideas for the future of Positive Care that will undoubtedly result in meaningful experiences, enriched with knowledge, and, who knows, maybe one day will lead to new Korian achievements:

“Move towards a more family-based model

that is ever more able to be personalised.”

“Technological innovations that are in line with Positive Care.”

“For us to be able to be there at every stage of a care plan: to help people remain in their homes or return home in the best possible conditions (e.g.

after an acute Parkinson’s crisis), and to give caregivers

a break.”

“I would like to celebrate Christmas

on the right date with our residents…I

don’t want to celebrate it early!”

“I would like their stay with us to be like taking

a holiday on a cruise ship.”

“Some people may prefer to get

dressed in the afternoon since

they enjoy sleeping late in the morning – I would like to be able to allow them

to do that.”

“For Positive Care to be

self-evident.”

“Move towards prevention through

better communication of information in

terms of imaging and biological markers.”

“I would like to see more digital technology, with virtual reality devices to

manage pain.”

“Robotic and digital technology will surely bring a lot of new advances, like increasingly

sophisticated fitness platforms.” “Warm, friendly robots (there

are even robot cats!) to help our patients work on their abilities.”

“I would like for there to be lots

of animals, with a mini-farm in the

garden.”

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“What would I do if the sky were the limit?”

“I would like for the residents to be able to go into the kitchen and participate.”

“That tomorrow I will enter a home

where residents are walking around,

wherever and whenever they like.”

“I would like them to truly feel at home

– for them not to feel they are at my workplace, but that

it’s I who am entering their home when I

arrive.”

“Have someone at Korian whose job is to make sure that

everything is fine, meet new people, and take the time to really get

to know our residents…like a Happiness

Concierge.”

“My dream? To help make the resident’s dreams

come true! To ask them about their plans, as wild as they may be, to help

them bring their plans to life. One of our residents who had almost lost her

ability to walk was able to go paragliding, which she had always dreamed of

doing. Let’s keep that kind of thing going.”

“More robotic and automated devices so that

the surrounding environment can play an even greater role

in providing care.”

“I would like all the staff to be proud to work here, because they are taking care of people who are fragile, they are doing something for other

people.”

“I would like this to be a bright, airy

place.”

“I would like us to help make THE dream of each

of our residents come true. That we bring their wish to life. Sometimes

it’s so easy to do.”

“I would like to have a

receptionist in every facility.”

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The future as a goal: Positive Care our values in a nutshell

Through this exercise, all our values are projected in their ideal form: the result is Positive Care.

Benevolence Responsibility

Initiative Transparency

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Have you ever heard of P.A.P. (‘Projective Advance Planning’)?

P.A.P. is a technique developed by in 1956 by the psychiatrist Jean Sutter to help patients who felt stuck and unable to develop or fulfil their hopes and dreams. This exercise can be used to improve any organisation. By starting with existing values, it can be used to strive for the ‘ideal positive’, and the goals we seek to achieve for the future. We used it for our Korian values to determine where we want to focus our energy in the future: Positive Care.

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See more Korian news at: www.presse-korian.com/fr - www.korian.com

@_Groupe_Korian

Press contact: [email protected]

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‘The 1st cornerstone of the Estela clinic’(November 2017)

‘Committed to fighting Alzheimer’s disease’(January 2018)

‘Pleasure, nutrition, and a friendly atmos-phere: the ingredients for healthy dining.’(March 2018)

VIVRE A book by the Korian Foundation written in partnership with Les Atelier Henry Dougier’(March 2018)

‘Careers like no others’(October 2017)

Troyes, Les Vergers.‘Post-acute and rehabilitation care clinics: hotbeds for innovation’(February 2018)

1ÈRE PIERRE DE LA CLINIQUE DE SOINS DE SUITE ET RÉADAPTATION « ESTELA »

TOULOUSE

10 Novembre 2017

EXE_DP-1re pierre Estela-Toulouse.indd 1 06/11/2017 20:30

‘Positive Care in all of our homes’(April 2018)

CSR Report (June 2018)

Korian Foundation White Paper(June 2018)

vivreviv

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vivreTextes de Cécile Coumau Photographies de Céline Gaille et Fabrice rondon

« Les gens ne savent pas qu’il y a de la vie ici. »

Ces quelques mots de Nathalie, aide-soignante dans une maison de retraite à Paris, résument parfaitement les journées passées au sein de ses lieux trop longtemps assimilés à des mouroirs. Car il s’agit bien ici de continuer à vivre, autrement certes, mais vivre tout de même. Comment ? En tissant des liens : des liens à la vie avec les souvenirs ô combien précieux, des liens aux autres – avec la famille et les amis, évidemment –, mais aussi en créant de nouvelles attaches, et ce, en dépit de l’âge et du passé de chacun.

« Les résidents », comme on les appelle, se sont confiés sans langue de bois. Ils ont livré leurs souvenirs, leurs anecdotes, leurs difficultés à affronter la vieillesse, leur perte d’autonomie mais aussi leurs joies, leurs petits plaisirs.

En face, « le personnel » trouve les bons gestes, les bons mots, les justes regards. Aides-soignants, kinésithérapeutes, animateurs ou psychologues, ils racontent avec authenticité leur quotidien dédié au service des aînés.

Ici on entend leurs voix, on découvre leurs visages.

Ce livre s’adresse, en particulier, aux familles et aux soignants, et, en général, à tout le monde puisque nous sommes tous incontestablement concernés par ce sujet, le bien vieillir.

18,90 €

ISBN : 979-10-31204-09-3

Diffusion Volumenwww.ateliershenrydougier.com

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COUV_VIVRE_260x240_DOS_8MM.indd 1 30/11/2017 19:31

ACCOMPAGNER NOS AÎNÉS, DES MÉTIERS PAS COMME LES AUTRES

Décembre 2017

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positive care...the kitchen staff in our long-term care nursing homes continually develop new...

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