Integrating Technology Into Your Culture Change Journey…

1. Integrating Technology Into Your Culture Change Journey…

2. Technology – Ready or Not…. • Technology is coming, NOW • Aimed at practical applications • MDS software, HIPPA compliance, benchmarking, telehealth, transportation, monitoring, etc. • Remember who its supposed to benefit • Need strategy that includes the person!

3. From a Housing Perspective

4. Meet Grandma This is Grace Margaret She is 83 years old. She is a mother, grandmother and a great-grandmother. She might be moving into your community next week.

5. She will be coming with more than a just a few clothes You are going to need more outlets!

6. She’s also coming with a lifetime of relationships She will expect to stay connected to all of them

7. Even if she is unable to have those expectations, her children and grandchildren will. Count on it!

8. Colorado LLC founded in 1999 Develop adaptive computer systems for older adults w/ disabilities Programs up and running in 37 states, Canada and Australia Dementia engagement driving 50% of interest

9. Examples of Customer Partnerships… • Genesis Healthcare • Volunteers of America • Good Samaritan Society • Lutheran Homes and Services • Erickson Retirement Communities • Pinon Management • Total Longterm Care (PACE) • Eden Alternative • Golden Living • Multiple CCRC’s

10. Internet Gaming – Not Just for Teens • Nearly 25% of those 55+ spend a minimum of 43 hours a week playing online games. • These games improve skills such as: • Reaction times • Spatial reasoning • Short-term memory

11. “Old People Can’t Learn New Things” • Decreased physical, psychological, and social activity combined with these perceptions add to a downward spiral of brain functioning. • Brain plasticity processes with negative impact take over as one ages.

12. Brain Plasticity • The lifelong ability of the brain to evolve with new learning or experiences. • “Plasticity-based” training engages older adults in programs targeting cognitive, physical, and sensory activities. • ACTIVE national clinical trial – appropriate training and practice improves cognitive abilities in older adults.

13. Impact of Technology on Persons with Dementia • Interactive technologies promoting reminiscing enhances communication by persons with dementia. • Cognitive stimulation activities may be as effective and more cost-effective comparing results with drug trials for dementia.

14. Impact of Technology on Persons with Dementia • Use of preferred music prompts motor functioning, memory recall, and decreased agitated behaviors among persons with dementia. • Positive reactions to “virtual reality” • Significant increase in the number of engagement behaviors in both individual and group activities.

15. How it all Works……

16. Technology Therapy Benefits Increased patient participation Increased RUGS categories and Part B caseloads Therapist Job satisfaction Family Satisfaction Individualized Activities

17. Commonly Used CPT Codes • 92507 Speech, Language, Communication Treatment • 97530 Therapeutic Activities • 97112 Neuromuscular Re-ed • 97110 Therapeutic Exercise • 97150 Group Therapeutic Procedures

18. Regulatory Benefits • Relevant F-tags • F240 – Quality of Life • Create humanizing environment • F241 – Dignity • Activities that assist resident maintain or enhance dignity • F242 – Self determination and participation • Choose activities inherent with interests • Interact with community

19. Supporting a Relationship-Based Culture with IN2L Genesis Health Care Case Study AHCA 2008 Convention

20. 2005: Two test sites • Operations “wow-ed” by IN2L at the Pioneer Network conference • Tested with two sites – selected for independent resident population (AL and ICF unit) • Trained Recreation and Rehab staff only • Least successful adoption

21. 2006: Linked to Culture Change • 3 Nursing Centers invited to participate based on progress and commitment to culture change • Leadership Team invited to presentation: Administrator, DNS, SS, Recreation, Admissions, Culture Change Coordinator • Responded to “care” presentations – I-centered care; family communiques • Genesis Rehab Services pursued independently

22. 2007-8: Expansion based on Culture Change • “Marketed” to Operations Executives by current users • Fourteen Nursing Centers and 1 Assisted Living selected • Tied to Person-Centered Care commitments and marketed in one state • Recreation & Behavior Specialist supporting in state with highest concentration • Genesis Rehabilitation Services signed agreement with IN2L

23. 2007-8: Expansion (continued) • Expanded training to two tiers, sequenced: • First, Leadership Training – 3.5 hours • Administrator, DNS, Admissions Director, Rehab Director • Led by VP and enthusiastic Center support (Rec or Rehab) • Objective: “see” the possibilities for personalizing care, engaging families and the community, expanding recreational opportunities; “know” who to send to the 2-day IN2L training

24. 2007-8: Expansion (continued) • Expanded training to two tiers, sequenced: • Second, Training for Support Team • Two days, hands-on with IN2L staff–how to use equipment, software, troubleshooting • Four-eight staff selected by the Leadership Team: a therapist, Recreation Director, nurse assistant, and others based on interest and positive relationships • Unit Manager, Weekend Supervisor, Cook, Housekeeper, Business Office Manager • Introduce and support the integration of IN2L in daily life

25. Lessons Learned… • Not just another activity on the calendar! • Supports unit-based activities and staff/resident relationships • Opportunity for meaningful volunteer/community involvement • Simulation games offering “lost” opportunities • Multi-media encourages impactful resident personal histories and care needs • Extends rehab participation

26. “Get to Know Me” Presentations • IN2L introduced the concept – from its community of users – with multimedia Powerpoint (or other photoalbum software) presentations • Adopted widely through Genesis internal culture change conferences – non IN2L users as well began • Opportunity to build positive relationships among staff and family

27. A Kid’s Perspective……

28. The Story of Nathan and Mamie…

29. The Power of the Story……

31. The IN2L roadmap • Cognitive therapy • Staff training tool • Short term rehab opportunities • Migration to “at home” systems • Web based loading of content • Customer specific experience • Integration of television / computing

32. Links • Assistive technology • http://www.loc.gov/nls/reference/circulars/assistive.html • www.resna.org • www.IN2L.com • jyork@IN2L.com