Fire-proof Music Therapy: Starting and then making music therapy an integral part of skilled nursing facility interdisciplinary teams. - PowerPoint PPT Presentation

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Fire-proof Music Therapy: Starting and then making music therapy an integral part of skilled nursing facility interdisciplinary teams.

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Fire-proof Music Therapy: Starting and then making music therapy an integral part of skilled nursing facility interdisciplinary teams. Vladana Zorjan-Stubb, MA, MT-BC ... – PowerPoint PPT presentation

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Title: Fire-proof Music Therapy: Starting and then making music therapy an integral part of skilled nursing facility interdisciplinary teams.


1
Fire-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

2
What 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!

3
Understanding 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

4
Understanding 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!

5
Marketing 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

7
Findings 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).

8
Continued
  • 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)

9
Job 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.

10
Pros 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

11
Pros 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

12
You 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

13
Starting 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

14
Populations 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

15
Long-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

16
Long-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

17
Hospice
  • Comfort for staff, residents families affected
  • Prepare for grieving residents
  • Refusal of family to do assessment

18
Running the Program
19
Assessments
  • 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

20
Budget (fundraisers)
  • Typically around 300/month
  • Depends on building/occupancy
  • Bake Sales
  • Art Galas
  • Garage Sales

21
CALENDAR!
  • 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

22
Volunteers
  • 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

23
Meetings
  • Resident Care Conference
  • Organized by SS (IDT)
  • 1st 1-2 weeks in building
  • Department Headdaily
  • Department Meetings with Staff
  • Resident Council

24
Activity 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

25
MDS 3.0
  • Questions?
  • Comments?

26
Insurance Basics
  • Medicare
  • Medical
  • GNP/Routine
  • Medicare Part B3 day observation period
  • HMO

27
Starting 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

28
Improvements
  • Documentation
  • Getting back with Rehab
  • Sensory Group
  • Internship Development
  • Instruments
  • Personal/Professional Growth
  • Grad school, Spanish tutor

29
Activities
  • Geriatric Song Listrefer to JMT

30
Miscellaneous
  • Policies Procedures
  • Questions?
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