Title: Fire-proof Music Therapy: Starting and then making music therapy an integral part of skilled nursing facility interdisciplinary teams.
1Fire-proof Music Therapy Starting and then
making music therapy an integral part of skilled
nursing facility interdisciplinary teams.
- Vladana Zorjan-Stubb, MA, MT-BC, NMT and Marce
Muller, MT-BC
2What do you think?
- What is skilled nursing?
- What population is being served?
- What are their specific needs?
- What role can an MT play?
- Are there regulations for daily living act?
- Tell us what you know!
3Understanding Skilled Nursing?(from MT clinical
perspective)
- Identifying needs of facilities
- Short-term Rehab
- Desire to go home no act involvement
- Youngest Res. 32 years old
- Long-term Care
- Desire to do something interesting not be bored
- Hospice
- Young adults older adults
4Understanding Title 22 (Understanding Activity
Department Requirements)
- Daily activity requirements
- Exercise
- Current Events
- Socializing (Coffee Socials)
- Evening Groups
- Religious Services
- Intergenerational Program
- Special Events
- Minimum of 5 Special Days a month (i.e.
Grandparents day, Peanut butter Lovers Day,
etc.) - Outings in Community
- Pet Therapy
- Sensory Stimulation
- See Critical Elements for Activities
- All regulations reflect what we do as MTs
anyway!
5Marketing Tips and Ideas
- Calling Facilities Activity Directors
- Pro Bono Work
- Get on their Monthly Entertainment
Schedulethen EDUCATE! - Sell selfable to include 25 people in group
music session and provide instruments for
allinteractive! - Not only entertaining but meeting goals on care
plans, completing documentation, assessments - DO NOT ask for anything 1st timeprovide own
materials - Make face contact with administrator 1st time
come, invite to the next music session invite to
see MT at other building
6 1st Presentation to the Facility of choiceget
Hired!
- Make appointment with Administrator (Selling Pts)
- Know what theyre paying current Activity
Director/Entertainers and show what theyre
getting for the - Show cost-effectivenessCompetitive Advantage
- Marketing toolMarginal Difference-extra pts
will pay for MT in building - More professional way to engage residents
- Therapy for 2 hours/day, what about other 22
hours? - Focus sell on Short-term Rehab (revenue)
- Find studies to support needscondense, provide
bibliography
7Findings continued
- MT has shown decrease in depression in residents
with Alzheimers type dementia - Study showed increased cognitive functioning from
day to day in dementia patients who participated
in MT (JMT, Winter 2007) - Showed significant increase in positive social
behavior and decrease in negative bx (i.e.
agitation) with stimulating music in background
(JMT, Winter 2007).
8Continued
- Neglect abuseno sensory stimulation
- Studies showing brain activity For late stages of
dementia - Res facing wall, no TV considered neglectEDUCATE
STAFF - Difference from MT and high school students
- Age inappropriate activities
- Entertainment based/passive
- Unable to complete required documentation(most
important to them)
9Job Description Activity vs. MT
- Activity Director
- Party Planner
- Weekend certificate
- High school diploma
- Entertainment Coordinator
- Outing Coordinator
- Games/Movies (Bingo!)
- Unfamiliar with mental illness
- Uneducated in engaging residents (doing
activities for them)
- Music Therapist
- therapeutic approach for traditional activities
(Bingo) - Completes required documentation
- Meets needs/prevents future problems/declines in
functioningsigns of depression, anxiety,
hallucination, etc.
10Pros Cons of Full-time
- Pros
- Develop therapeutic relationship with residents
- Salary/benefits/ paid time off
- Daily educating staff/doctors of MT
- Cons
- Must perform Activity Director duties
- No control over schedule
- Risk of burn-out
- Often times only MT in building--lonely
11Pros Cons of Contracted
- Pros
- May get paid more per hr
- In control of schedule
- Planning Charting on own time (not paid)
- Clear cut MT goals/care plan
- Cons
- Less time to build relationship
- Exhaustion of traveling
- Poor support of Activity Director (not
implementing goals) - Less time with families
- Dont want to pay for assessment
12You are an Interdisciplinary Team Member!
- Care Plans
- Care plan must reflect other areas that may
affect activity involvement (i.e. dietary, rehab,
wound management, etc.) - If resident prefers activities at 8am, CNAs must
have resident ready (Personal Preference) - Part B (Medicare)
- Help identify decline of functioning in residents
for nursing Rehab - Social Services
- Communicate residents who would benefit visits
with psychologist
13Starting the Music Therapy Program
- Department Goals! (long term and short term)
- Identify areas of improvement
- Create plan of action (include administrator if
appropriate) - In-services
- Build relationship with DSD
- Pick 1 issue/topic and focus on it
- Implement staff reward system/training tool
14Populations ServedShort-term Rehabilitation
- Generally
- Dont want to attend Groups
- Want to go home
- Get bored/depressed easily
- May have cognitive deficits/may not
- Care plan in alignment with therapy goalsinclude
therapist
15Long-Term, High-Functioning
- Use experience from resident Y.K.
- Feelings of loss of control
- Easily depressed/bored
- Resistive to some activities (example Dr. B.)
- Give a job in facility
- Resident Council President
- Greeter
- Store operator
- Resident of the Month
- Residents lead Bible Study
16Long-term, low functioning
- Sensory Stimulation
- Examples/Studies
- Help staff know when appropriate to bring to
activitiesexample of religious preferences - Keep tabs on functioningnotify when decline
occurs - Example of program in process
17Hospice
- Comfort for staff, residents families affected
- Prepare for grieving residents
- Refusal of family to do assessment
18Running the Program
19Assessments
- Initial, quarterly, annual, COC
- MDS nurse give calendar of due dates
- Generally 5 days to complete
- Must match care plan
- Include if veteran, voting, religion, occupation,
name preference - MDS 3.0 interviewoffensive
20Budget (fundraisers)
- Typically around 300/month
- Depends on building/occupancy
- Bake Sales
- Art Galas
- Garage Sales
21CALENDAR!
- Monthly calendar
- Different activity daily
- Special events
- High low functioning activities reflected
- Religious/Spiritual
- Exercise
- Socials
- Evening Groups
- Regulation of of act per day
- Give ways to get around it
- Revisit Title 22
22Volunteers
- Get on Volunteer Opportunity Listsprovide job
description - Community Colleges
- High Schools
- Girl/Boy Scouts
- Church Groups
- AA/Drug Rehab
- Make experience exciting/different
- Educate on MT
23Meetings
- Resident Care Conference
- Organized by SS (IDT)
- 1st 1-2 weeks in building
- Department Headdaily
- Department Meetings with Staff
- Resident Council
24Activity ideas
- High Functioning
- Around the World
- Music via Centuries
- Each Century Music
- Music Art
- Musical Styles
- Pictionary
- Computers
- Evening Groups
- Yoga
- Tai Chi/Chi Gong
- Brain Quest4 weeks
- High/Low Functioning
- Name that Tune
- Interesting Geography
- Music of the World
- Learn an Instrument
- Improvisation
- Geography/History/
- Trivia/
- Massage
- Singo
- Relaxation
- Emotional Ball
- Getting to Know You
- Alphabet Soup
25MDS 3.0
26Insurance Basics
- Medicare
- Medical
- GNP/Routine
- Medicare Part B3 day observation period
- HMO
27Starting Internship Program!
- Develop Packet
- Include administrator
- Follow guidelines of AMTA
- Represent at Internship Fair
- Network with Alumni
- Understand ALL requirements
- Set forth very clear expectations
28Improvements
- Documentation
- Getting back with Rehab
- Sensory Group
- Internship Development
- Instruments
- Personal/Professional Growth
- Grad school, Spanish tutor
29Activities
- Geriatric Song Listrefer to JMT
30Miscellaneous
- Policies Procedures
- Questions?