LIVEWELL COMMUNITY NEWSLETTER #2

LEARNING COLLABORATIVES BUILD BETTER TEAMS AND STRONGER COMMUNITIES

In the short video below from Rackleff House, Administrator Alex Vice sums up the essence of LiveWell: “It’s helping me slow down. Think outside the box. And use a team effort. One person can never do anything all by themselves.”

In the complicated setting of an assisted living or residential care facility, it’s true that one person can’t do everything alone. It takes teamwork and communication to get the day to day work done. And even more so during a time of an evacuation or re-entry, or managing a COVID outbreak.

The LiveWell Method creates the structure for teams to work together to make sure that residents are safe. We have found that when teams use a practice such as the Huddle, it creates a consistent and reliable way to address the issues that arise every day. The Huddle is a 7-9 minute meeting of all staff during each shift. The leader runs through a series of questions to identify any current issues in the community.

VIRTUAL LEARNING COLLABORATIVES ADVANCE THEIR SKILLS WHILE BUILDING COMMUNITY

Congratulations to Rackleff House, Adams House, Willow Place, Spring Meadows, Wildflower Lodge, and McLoughlin Place, the first group of communities who will complete the virtual LiveWell Learning Collaborative on October 27!

They have learned how to Huddle, track measures like Falls on their Quality Boards, and identify small changes in residents using the Resident Status at a Glance tool. They have also made a lot of new friends with staff from other communities and plan to keep meeting as a group going forward – because they know that they are “in this together.” They are on their way to becoming true LiveWell practitioners, enhancing the dignity of residents and fellow staff.

Quality Boards are a great way to communicate values and progress!

NEW VIRTUAL LEARNING COLLABORATIVES BEGIN NOVEMBER 10th

Please join us for the next round of virtual collaboratives, beginning November 10th with an Executive Briefing for administrators. You can complete an application on the LiveWell website. The LiveWell Method focuses on the use and practice of the key concepts of quality improvement to improve quality of life for residents and staff. The LiveWell tools empower staff and residents, build community, and enhance dignity for all. The LiveWell tools empower staff, build community, and enhance dignity for all. They create better workplaces, which in turn saves money. If you have questions, you can contact Coach Barbara by email for more details.

LiveWell is Oregon’s licensed and endorsed Quality Assurance and Performance Improvement (QAPI) method. Our team is working hard to bring LiveWell to as many communities as possible. We thank DHS/APD and the Quality Care Fund for making this training and coaching available at no cost to providers. Communities that invest in QAPI enjoy more satisfied residents and staff, better outcomes, and increased sales.

Wishing you a wonderful Fall Season from Your LiveWell Team,
— Barbara, Lisa, Ann, Cindy, Laurie, Steve, Marcus, Paula, Serena, and Judy

LIVEWELL COMMUNITY NEWSLETTER #!

WELCOME TO OUR FIRST EVER LIVEWELL COMMUNITY NEWSLETTER!

The last six months have been some of the most challenging times for all of us. The LiveWell team sends a big thank you to the many people fighting COVID-19, wildfires, and especially those who are dealing with the evacuations forced upon them by the fires. Our hearts go out to you! And, we also have some exciting news to share.

LIVEWELL HAS A NEW VISION!

People living in and working with long term care communities are treating one another with dignity, growing together as a community, and fully appreciating the unique stage of life that is elderhood.

Check out our new promotional video!

With the help of Portland State University’s Center for Public Service, we have developed a strategic plan to bring this vision to many more communities in Oregon and beyond. Our vision rests on our core values:

Dignity, Empowerment, Community, Safety, and Elderhood

LIVEWELL IS NOW VIRTUAL!

Eight communities are part of LiveWell’s first virtual learning collaborative. Together they are learning the foundations of quality improvement over a three-month period: how to improve teamwork, communicate, track, measure, and observe resident status. Information about the LiveWell Method and downloadable forms are available on our website. A warm shout out to Concept in Community Living’s Adams House, Rackleff House, Spring Meadows, and Willow Place along with Pacifica Senior Living McMinnville, Wildflower Lodge, McLoughlin Place, and Cascade Valley who are our first participants.

One of Wildflower Lodge's Boards is a great example of communication that helps create community.

GOOD NEWS - LIVEWELL TRAINING IS EXPANDING!

Would you like your community to get involved with LiveWell? We are recruiting 12 ALF/RCFs for the next Virtual LiveWell Learning Collaboratives starting in November. We will continue every three months after that. This is a great opportunity no matter your size, specialty designation, or location!

Contact Barbara by email for more details. LiveWell is Oregon’s licensed and endorsed Quality Assurance and Performance Improvement (QAPI) method. Our team is working hard to bring LiveWell to as many communities as possible. We thank DHS/APD and the Quality Care Fund for making this training and coaching available at no cost to providers. We know that communities that invest in QAPI will have more satisfied residents and staff, better outcomes, and increased sales.

Wishing you a wonderful beginning to the Fall Season from Your LiveWell Team, Barbara, Lisa, Ann, Cindy, Laurie, Steve, Marcus, Paula, Serena, Judy, and others

A Message from your LiveWell™ Team on COVID-19.

We want to express our heartfelt wishes that you and your residents remain healthy and safe. We know that you are providing vital care for our state’s most vulnerable older adults and that your work is especially difficult when COVID-19 threatens residents in Oregon's community-based care settings. Now more than ever it is important to have strong quality tools to provide for infection safety and quality of life for residents.

The LiveWell team is closely watching all updated guidelines from DHS and the CDC. Unless otherwise specified on our calendar, please sign up for classes as usual and we will continue to monitor infection control guidelines. Please know that all classes will be held with strict infection control measures in place.

Warmly,

Barbara, Lisa, Laurie, Ann, Cindy, and our friends at PSU’s Institute on Aging and Center for Public Service

Additional Information & Resources:

The Oregon Health Authority

The Centers for Disease Control & Prevention

World Health Organization

From Fear to Growth: Grappling with Disruption

Several weeks ago, we shared this graphic. It shows how we respond to the COVID pandemic in stages, starting in fear, moving into learning, and finally into growth. How do you want to be?

Two medical directors who have been on the forefront of COVID outbreaks at nursing homes around the country recently had this advice:

1. Love one another. And be sure to say it. Tell your co workers what they did well. Tell your family and friends that you care about them.

2. Be present in the moment. Enjoy it. Say out loud what the moment is.

3. Understand that you make a difference, every day, by your example. Whether you want to or not! If you wash your hands longer, your co workers will too. If you take an extra moment to show kindness to a resident or co worker, you’ll see other people doing the same.

Please be safe and know that your LiveWell team is wishing you the best. Let us know what you’re doing in your communities to move from fear to growth during this pandemic.

We would love to hear from you. — Coach Barbara

— CHECK OUT OTHER INFO AND COVID-19 RESOURCES —

Essential Thoughts for Essential Workers

In less than two months, everyone working in long term care has had to flex, change, plan on the fly, learn many new things quickly, and deal with anxiety, stress, illness, and fears that we didn’t even know we had. We have leaned into many of the hardest aspects of leadership.

Today I wanted to highlight what leaders in long term care are saying about how to show up during this pandemic. Thank you to The Green House Project, LeadingAge, and the Jewish Home Family network in New Jersey, whose ideas I'm channeling today.

1. Believe in your strength.

2. Plan and prepare. Cross train your staff in case of staff shortages.
   • Find your PPE and be sure everyone knows how to use it.
   • Use the PPE Burn Calculator to figure out how much you need.
   • Make sure you know your organization's policies and procedures.
   • Share with staff the guidance from DHS in provider alerts — and sign up to get these if you haven't already. CDC has excellent guidance on hand hygiene and preparing for COVID.
   • Find out what communities that have been hard hit are doing now to prepare for a second wave of COVID in the fall.

3. Let your staff step up. When staff feel like a million bucks, they will take initiative. Instead of “tell me what I should do” they will say “here’s how I’m approaching this problem.”

4. Communicate. It’s not possible to over-communicate to residents, staff, and families. Explain what’s happening, what you are doing to prevent infection or to deal with infection, what’s working and what’s not. Use social media, email, newsletters, and What’s Happening Boards to make sure that everyone knows what’s going on.

5. End your meetings with something positive.

6. Exercise and eat well. You will feel better and do better.

7. Celebrate. When someone returns from quarantine or the hospital, be sure to celebrate.

Please be safe and know that your LiveWell team is wishing you the best. Let us know what you’re doing in your communities to lead well during COVID. W would love to hear from you. — Coach Barbara

Supportive Routines Can Help Navigate a Crisis Like COVID.

What routines in your work, with your friends, and on your own give you comfort? Send me a note. I would love to hear from you. — Coach Laurie

Food Service Staff Can Offer Calm Leadership During Crisis, COVID or Otherwise.

Imagine you are one week into the worst food-borne illness outbreak of your career. You work tirelessly in your senior living community as a Foodservice Director to prevent this exact nightmare from happening. And because you have been properly trained in sanitation and food safety you are aware seniors are most at risk. Seventy-five of your residents are sick, quarantined in their rooms, living on several different floors, now being continuously disinfected, requiring room service. Ten staff are sick and quarantined at home. The dining room has been closed temporarily because the salad bar is under suspicion for being the vehicle of the spread. Every available employee and volunteer received a quick refresher course in food safety, sanitation, hand washing, kindness and putting their best self forward to deliver meals to the sick and well residents, helping you and your team overcome this outbreak. You are confident “This too shall pass.”

Although so much is yet unknown about the Coronavirus currently, its management and prevention are like previously recognized viral outbreaks such as Norovirus. You may have heard of it, made famous by ruining cruise ship vacations. Although Coronavirus is transmitted and symptomatic in a few different ways than Norovirus, I am encouraged to report your food service staff and serving teams who have been properly trained in sanitation and food safety can be a calming force of leaders in this situation. Because they have been trained.

As I point out in the video above, our continued focus regarding dining and managing life with Coronavirus, is to not forget our humanity in the moment. We never really know what each other faces in our lives behind the scenes, and what warms our hearts and keeps us encouraged to fight another day are the small moments of courage and kindness as we reach out to one another. We can do that with a warm greeting, a moment of patience, the camaraderie of pulling together to help deliver a tray and not expect anything in return, or replace a forgotten condiment, or deliver a kind word, such as Thank you.

.What have you tried in your community? Let us know and we’ll share what other communities are doing. Just click on the name below to email us with suggestions or questions related to any of what Cindy has shared.

Coach Barbara

Using Humor for Person-Centered Care.

Ann Mcqueen, Research and Policy Integration Manager for the Aging and People with Disabilities (APD) Department  within the Oregon Department of Human Services, shares how humor can help residents feel a sense of well-being and connection with caregivers. Ann also shares this helpful tool, Sense of Humor Profile, to help staff understand a resident’s unique sense of humor.

What have you tried in your community? Let us know and we’ll share what other communities are doing. Just click on the name below to email us with suggestions or questions related to any of what Ann’s shared.

Coach Barbara

Building Community and Social + Physical Wellbeing During Times of Social Distancing.

Dealing with social isolation is one of our biggest challenges now. Coach Ann Delmar explains how important it is to stay focused on wellbeing. Also, check out this publication from the WHO: Mental Health Considerations during COVID-19 Outbreak.

The following activities can improve the social and physical wellbeing of your residents and staff even while socially distanced. Assign a staff member as the wellbeing organizer each day. They can print these ideas and lead activities to build community in ways that are fun too! 

Social Connection Wellbeing

Each day distribute a question of the day and a brain teaser for the day.  Encourage all residents to write their answers on sticky note pad and post on their doors. You can then leave them up and/or type up a compiled list. Some of the questions may generate helpful tips for how to LiveWell while practicing social distancing. Make sure staff and residents participate by inviting input by all. It might be fun to collect then create areas of community to post questions and responses on walls that all can enjoy when we are once again able to live in closer proximity to one another!

Question Suggestions:

1. What is one thing you enjoy doing while you are alone?

2. How are you demonstrating the love you feel for friends and family at this time?

3. Can you share two things that made you laugh recently?

Brain Teasers

1. It is illegal in Georgia to do what with a fork? (eat fried chicken)

2. The average person does what 13 times a day? (laughs)

3. The first puck used in the game of ice hockey was made out of what? (frozen cow manure)

Physical Wellbeing

These 4 movements can be used safely by all seniors. They can be completed while standing or sitting. If it is possible for your community to complete these exercises together, door frames could serve to stabilize those who generally use walkers. Make it fun by designating a staff member to bring some music to a hallway and demonstrate movements communally on occasion to help establish daily movement patterns. 

The most critical daily movement for seniors:

• Kicking – 3x each foot

• Marching – 3x each foot

• Pushing Up – 3 times total

• Reaching and Looking Up – 3 times total

  • Complete each movement 3 times to complete one circuit.

  • Repeat the full circuit 3 to 5 times several times a day.

What have you tried in your community? Let me know and we’ll share what other communities are doing. Just click on my name below to email me with suggestions or questions related to any of what I’ve shared.

Coach Ann

Creating a Comforting New Normal for Residents Eating in Isolation

We are living in an extraordinary and unprecedented time in the history of senior living as we battle COVID-19 to keep residents and staff healthy and safe.

Now that residents have been restricted from coming into the dining room for meals it is more important than ever for food serving teams to address the social aspect of mealtime.

I’d like to share a person-centered approach to create a comforting new normal around eating in isolation. Here are several things that I’ve learned when used consistently make a difference.

1. Introduce yourself and greet your resident by name. Let them know that you may look different wearing a mask.

2. Describe their meal as you present their plate to begin a conversation.

3. Quickly scan the tray for any missing condiments and have a backup supply close by.

4. Exit graciously after sharing a kind word, a compliment, or a community news update.

5. Make arrangements for yourself or a co-worker to circle back within 3 minutes to ask: Is there anything else we can get you?

Build your own variation on this theme but be sure to have a consistent practice. I’ve learned that keeping this kind of routine and approach can lower residents’ feelings of isolation and frustration, especially when something is missing from the tray. We must strive to get it right more often than wrong and fix any issue quickly.

Consistency in service approach improves feelings of solidarity that we are in this together. It also creates familiarity. Checking back builds a sense of trust and improves the feeling of appreciation for one another. Expect each interaction to be different but keep your response calm and consistent. We thank you for your service and the hard work you do.

What have you tried in your community? Let me know and we’ll share what other communities are doing. Just click on my name below to email me with suggestions or questions related to any of what I’ve shared.

Coach Cindy

How to Use Resident Status at a Glance.

Coach Lise explains some key ways we can support residents’ well being and health. Try the Resident Status at a Glance mentioned in the video above.

Please email us for any support you need by clicking on any of our names below.

Sincerely, your LiveWell Team:

Barbara, Lisa, Laurie, Cindy, and Ann

How Can We Best Reduce Stress in Stressful Times?

Coach Laurie explains some key ways to help our brains do better in times of high stress. Try them in your huddles. 

1. Start by asking a question of the group such as what are you looking forward to? Check in with each person.

2. Do a 1-2 minute activity to feel appreciation, humor, or creativity. For example, share a funny story or an appreciation for each person.

3. Very important: Ask the group for permission for safety feedback. For example, is everyone ok with being reminded by a colleague to keep their hands off their faces when they unknowingly touch their face? Pick a funny code word that can be said in public when your co-worker touches their face. Be sure to ask how each person likes the feedback given. Some people may prefer feedback privately, or they may prefer it with humor.

Please email us for any support you need by clicking on any of our names below.

Sincerely, your LiveWell Team:

Barbara, Lisa, Laurie, Cindy, and Ann

Using a LiveWell huddle to help your team.

When you huddle every day, try this new Huddle Guide Card that has questions to help you navigate rapidly changing news and care routines.

·      What staff are here today?

·      How are we and our families doing?

·      Are any residents showing signs of COVID-19?

·      Are any residents showing other condition changes?

·      What are our current preventative measures?

Remember to huddle for 10 minutes twice per day with all staff, keeping your distance.

Please email us for any support you need by clicking on any of our names below.

Sincerely, your LiveWell Team:

Barbara, Lisa, Laurie, Cindy, and Ann