The Color of Life Weaving a Tapestry of

The Color of Life Weaving a Tapestry of Quality of Life and Geropsychiatry 1 12/15/2021

What Brings Us Together as People? n Mr. Fred Rogers (of Mr. Rogers’ Neighborhood said, “If you listen carefully to another person’s life story…you can’t help but love him. ” n Being privileged to hear and share the joys, disappointments, and deliverances of another person…endears us to that one who has vulnerably shared his story. 2 12/15/2021

Spinners n n n Kristine Ashley, RN MSN, Nurse Manager Geropsych Linda O’Keefe-Wood, ARNP Geropsych Larry Norris, Program Support Assist- Geropsych DT Larry Mc. Connell, Chaplain Elaine Degeneffe, RN, Charge Nurse Geropsych Sheri Wight RN, Geropsych Day Treatment Robert Reynolds, RN, MSM, Geropsych DT Kelly Fethelkheir, RN Geropsych Day Treatment 3 12/15/2021

Program Development n n n Nursing Executive promoted Patient-Focused Care as a model Interdisciplinary Bedside Rounds for individual patients in pain were started Time was set aside with no interruptions Emotional, Physical and Spiritual needs of the patient were addressed What started out addressing pain evolved into Quality of Life Rounds 4 12/15/2021

Goals n Develop a Patient-Centered Care environment in Geropsychiatry n Define Quality Of Life and what it means in Geropsychiatry n Train Staff about unique skills needed for interacting with geriatric patients who have dementia and other psychiatric disorders n Educate Staff throughout the hospital about QOL in Geropsychiatry 5 12/15/2021

Structuring the Program n Adapting and Modifying a hospital-based QOL Program to Geropsychiatry and it’s unique environment n Meeting at a set time often does not work. Be flexible, meet the patient where they are physically and emotionally n Unmasking past emotional issues can be dangerous. Don’t go there n Allow veterans to tell their own story n Learning Boundaries of Spirituality 6 12/15/2021

Creating a Nurturing Environment n The QOL Session Environment needs to be safe, comfortable, and familiar n Make area warm and comfortable n Go where the patient is…. walk with them, go to their bedside, etc n Promote a No-Fail Environment 7 12/15/2021

The Power of Connecting n n Family/caregiver may be more likely to talk if in a remote location, connected by a speakerphone Patients feel secure and safe when they are in a familiar place Multiple Sessions promote comfort and a relationship with staff Meet patients where they are emotionally n n n “Go where the patient is” Timing is everything Speakerphone allows family/caregivers to 8 12/15/2021 participate

Anecdote: Mr. “N” 9 12/15/2021

Anecdote: Mr. “T” n n n “Going where he was…” A connection which worked Feeling safe and secure 10 12/15/2021

Unique Aspects of QOL in Geropsychiatry n Quality Moments can be achieved for patients with dementia and other psychiatric conditions n Connecting is possible through music, reminiscing, and providing a “No-Fail” environment n Utilizing all “Senses” provides avenues for patients to express themselves 11 12/15/2021

Identify Unique Patient Needs n Do No Harm Our Patients are Fragile n n n n Elderly Chronic Psychiatric Conditions Emotionally Unsophisticated Few Supports Systems Few Coping Skills Staff seen as Strongly Influential Allowing the patient to lead the discussion Consequences of unwrapping past emotional issues 12 12/15/2021

Anecdote: Mr. “W” n Singing 13 12/15/2021

Mr. “E” n Playing organ 14 12/15/2021

Connection with the Heart n n n Recognizing their suffering and sacrifice The “bridge of heart” in truth and vulnerability The result: We are strengthened as individuals and as a team. 15 12/15/2021

Anecdote: Mr. “R” n The value of being fully human…even without the use of one’s speech or legs. 16 12/15/2021

What Brings these Veterans Together into a Community? n n n The bonds that bring and keep them veterans together really comes from embracing values together. Concern for another Willingness to respect one another Valuing one another Affirming one another as having made a valuable contribution in a worthwhile effort 17 12/15/2021

Name of Veteran 1943 - 1948 U. S. Navy WE APPRECIATE OUR VETERANS 18 12/15/2021

What Veterans Have In Common n Military Identity n A Shared Past n A Need for Recognition for their Service to Our Country n Spirituality/Belief System 19 12/15/2021

Anecdote: Mr. “B” n A guilt unloaded 20 12/15/2021

Anecdotal Positive spirituality outcomes from QOL intervention n In what ways can we measure that the intervention of QOL on 1 -5 is being beneficial? n Veterans want to get well in order to return to Day Treatment n n Illus…Mr. “S’s” efforts following his broken hip Veterans becoming as he is acknowledged by his peers. n n Illus…Mr. “M”… valued as Burma Road veteran following acknowledgement by Vietnam Veteran (Pete) Illus…Mr. ” Mc”… valued by peers following his showing tape of D-Day involvement as paratrooper at D Minus 6 hours. 21 12/15/2021

Anecdotal Positive Spirituality Outcomes from QOL Intervention n n Veteran knowing he is valued for who he is…not how healthy he presently is. Veterans valuing one another n n Illus…playing Taps with silence remembering WWII buddies during D-Day Program Relating to and respecting one another n n Illus…”Red” telling chaplain of two “buddies” in day treatment who had died the previous week. Illus…Many day treatment veterans attending the funeral of Angel at the National Cemetery 22 12/15/2021

What Makes This Program Successful n n n This is a patient driven event The team discusses each QOL session afterwards Each staff member brings their “whole self” to the meeting, not just their discipline Being open to change Accepting differing ideas Interdisciplinary approach 23 12/15/2021

Anecdote: Mr. “M” n n n Double Amputee Grief: Not just anger “I just want to get up and walk out of here. ” Patient driven “Timing is everything” 24 12/15/2021

Challenges n Staff acceptance Solutions n n n Spirituality in Psychiatry Time constraints Daily QOL’s Sessions mandatory Low census on unit n n n n Strong Leadership Clear Vision Staff Commitment Allocating Time Meet often as a team Allow differing views Explore spirituality Listen To Staff Multiple QOL sessions for same patient are beneficial 25 12/15/2021

Team Growth and Development n n 3 Month Training by QOL Team from Hospice and Pain Management Experts Attend Dying Healed Classes Schedule daily QOL sessions Attend Monthly QOL Educational meeting n n n Being honest, giving feedback Active listening Free to voice opinions Continuous, open discussion All team members are equals Allowing members to stay true to beliefs 26 12/15/2021

Conclusions Connecting with the heart 27 12/15/2021