Long-Term Care

Tip of the week: Find your nursing home's niche for success

Contemporary Long-Term Care Weekly, May 8, 2008

One facility discovers resident/community harmony in music therapy program

Create a culture of community in your nursing home and you’ll soon see how it improves your residents’ quality of life—as well as your facility’s reputation with the public.

Notre Dame Long-Term Care Center in Worcester, MA, developed a list of ways to bring community into its residents’ daily lives (see “Include community in residents’ daily lives” on p. 7). One of Notre Dame’s most prized initiatives is its music therapy program.

“I had seen similar programs work miracles in other organizations, and I wanted to try it here,” says Jadranka Grek, BS, ADC, activities director at Notre Dame.

Be flexible to launch new programs

Notre Dame had an opening for a full-time activities assistant about two years ago. Grek approached her supervisor, Katherine Lemay, RN, MS, administrator and CEO, about staffing that post with a music therapist instead.

Budget constraints wouldn’t permit a full-time music therapist, but Lemay said she could staff the new job title on a part-time basis.

“Jadranka was flexible about staffing with the new post,” Lemay says. “We reconfigured the structure of our activities program based on this new position’s hours and had complete support from the staff.”

Flexibility meant that other staff, as well as the activities director, had to pitch in to cover routine tasks that a full-time activities assistant might have handled. For example, some staff helped out with serving residents lunch.

Hire a music therapist, not an entertainer

Music therapy is not just about playing songs for residents. There’s a difference between entertainers and therapists, Grek says.

For example, therapists can perform interventions with residents to discover their needs. They know how to treat residents with end-stage dementia through music, she explains.

To find a qualified music therapist in your area, query local colleges. Ask whether they offer music therapy education and whether they have graduates looking for jobs. Or keep your cost even lower by requesting student interns.

Learn how to use music therapy

The program has sparked a tight-knit community among the residents and has fostered a kinship between the facility and the local community, Lemay and Grek say. The following list outlines the ways in which music therapy has touched both communities:

  • Children join residents for sing-alongs, which bring together different generations in a positive way. The facility invites youngsters from local schools to these sing-alongs.
  • Professional pianists, guitarists, and harpists perform for residents. Used at times that may be stressful for residents (e.g., shift changes for staff), the music helps keep them calm and provides entertainment.
  • A resident bell choir plays recitals for family, friends, and the general community. This group, a favorite of Lemay’s, uses adaptive bell instruments made for the elderly, with special handles for easier gripping.
  • Residents with dementia or behavioral issues get one-on-one assessments from the music therapist. “It’s amazing: People with no [ability to perform] activities of daily living can sing familiar songs and interact when they otherwise could not,” Grek says. Be patient, she adds, because some residents take time to get to know. Some residents with behavioral issues at Notre Dame meet with the music therapist three times per week to determine which songs they will enjoy singing.
  • Staff give PowerPoint presentations about the history of music and famous composers.

    Let the music do the talking

    Because the program yielded much success during its first two years, it earned the funds to support a full-time music therapist. Notre Dame is the only facility in the area with a full-time music therapist, Lemay says.

    Having a niche program makes your facility stand out to your potential clientele. Although the center’s Web site provides information about the music therapy program, most of the accolades come from visitors who discover the program while they’re visiting a resident.

    “People who tour our facility for placement needs or those visiting residents can hear music in the halls pretty much any day of the week,” Lemay says. “We always get a positive response to what is going on.”

    Showing off your quality programs to the community could also earn you financial supporters in the future. To supplement any philanthropic efforts from the community, consider writing grants or fundraising to build your niche programs.

    Include community in residents’ daily lives

    In addition to having a successful music therapy program, Notre Dame Long-Term Care Center in Worcester, MA, involves its residents in a culture of community in the following ways:

  • The nursing home sponsors a community member to walk for a charitable cause. You also can coordinate creative fundraising efforts at your facility by involving residents, families, employees, and others in the community.
  • The facility invites men’s or women’s clubs to have their monthly or annual meetings at the facility. Hosting the meeting may allow residents who were or still are members of the club to attend.
  • Staff ask family members who like to travel to present a slide show of their trips. The show is both educational and entertaining.
  • Notre Dame invites high school sports teams or after-school groups to do community work at the facility. Teams usually have many members, so plan to pair the students to work with residents on simple projects such as making holiday cards, painting, working on seasonal or art projects, planting seeds, or playing table games.
  • Staff suggest that high school students do their community work projects at the facility. Many high school students begin their projects by completing a required 15 hours of community service and end up continuing throughout the school year and even through summer.
  • The facility holds regular performances of middle and high school students who are advanced musicians. Students like nursing home audiences because they always give rave reviews.
  • Notre Dame encourages college students in need of community work to come to your facility. Many local colleges have community outreach requirements for first-year students that are incorporated into their coursework.
  • The nursing home offers long-term care experience to college students planning to go to medical school. Examples of experiences that students could receive include
  • communication with the elderly
  • doing simple activity tasks with memory-impaired residents in the dementia unit
  • Staff host an end-of-the-year music recital for a local music school.

    Source: Notre Dame Long-Term Care Center, Worcester, MA. Reprinted with permission.

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