Five Steps to Greater Interdisciplinary Engagement
A common challenge for the activity professional is how to get the interdisciplinary team to see the quality of life and the participation of residents in the activities as a team responsibility. Common responses from other staff members are that they don’t have time; or they ask if we are going to start doing their homework, if they are going to help us with ours. This has been a millennial battle since I started in activities, many moons ago. The following are five tips that can propel your community toward a more integrated mindset.
1. Know your regulations. If you work in a nursing home, there are at least six pages within the guide for F-248 that address the role of the interdisciplinary staff member in promoting and providing activities. There are specific references on how to assist residents to and from programs, providing independent and fun activities when activities staff are not present, and specific methods for staff to integrate quality of life interactions within their roles. If you work in another setting, such as an assisted living or medical day care, the referrals may not be as specific, however within those levels of care the focus has always been more social and integrated. Having these regulations and highlighting specific annotations regarding the role of the IDC team is crucial. If we can refer to “the law”, which is what regulations are, we give some weight to our argument. If you need copies of the F-248 or the state regulations for your environment, please email me.
2. Create alliances. You know you’ve worked too much with the elderly when you start using the old sayings to make a point, but “you get more with honey than vinegar” works here. Attacking, complaining, and pointing out what people are not doing is seldom welcomed and puts people on the defensive. Working together as a team toward the same goal is often more effective and much more enjoyable. Most direct care staff are very focused on their duties and have the right to perform their duties. Anything or anything that deviates them from their duties is seen as a nuisance. If staff are approached with the respect that their duties are important, they are often more responsive. Mutual respect is earned over time and creates alliances.
3. Focus on the benefits. The activity professional knows the benefits of each activity and can be shared as a means of motivating staff to encourage resident participation. The benefits should be related to how you help the interdisciplinary staff in their daily tasks. For example, encouraging a resident to participate in exercise will increase range of motion and upper body strength, which may allow the resident to complete simple AVD tasks of dressing and eating. Participation in programs that address distracting behaviors will keep the resident calm and less agitated, making the day easier for everyone. The important message for staff is that when a resident is assisted into a program or offered an activity, they are not “assisting activities” but rather assist the resident, which should be the shared goal of the community.
4. Incentives. Many have tried introducing staff incentives to assist residents to and from activities. Raffle tickets or points awarded to staff when they help residents to a program, inviting staff for a snack at a party; or the creation of contests between units or neighborhoods with attendance awards has been carried out with mixed results. These are external motivators and focus on the needs of the staff rather than the needs of the residents. This approach has worked most effectively when a special program is introduced. For example, a new sensory program is introduced called “Sunshine Club.” Residents who must be assisted in this program will have a sun symbol somewhere in their room for caregivers to see during care. This will remind you to help this resident at the Sunshine Club. During the first weeks of the program, when caregivers assist the resident into the program, they receive the raffle ticket or whatever incentive is being used. However, once the program is solidified and residents receive assistance and programs as part of routine care, the incentives are suspended.
5. Be courteous. Smiling, thanking, and please go a long way. Very often we get caught up in our duties, we forget the subtleties that contribute to the quality of life of the caregiver. There are some facilities with a “grumpy” atmosphere, where a general discord can be felt. Be the first person to start changing that atmosphere and be the first to smile at others and initiate a polite approach. At first, you may be ignored, but eventually people will reciprocate.
Light is the task in which many share the work.
Homer