Dementia Capable Care enhanced with RESTORE

By Ian Oppel, CCO of RESTORE, occupational therapist, and 20-year Dementia Capable Certified Therapist

While residents in skilled nursing facilities continue to struggle in the fourth month of this new normal, those with Alzheimer's disease and dementia have the added challenge of communication barriers, decreased engagement, and the struggle to maintain cognitive function now even more. These are people who depend on a familiar routine, secure connections with loved ones, and group activities to slow the progression of a cruel disease. 

In honor of this June's Alzheimer's and Brain Awareness Month, I want to raise awareness of how RESTORE's interactive gaming therapy software is key to supporting long term care's most vulnerable residents.

Those at the highest risk for deterioration of the disease process with COVID-19 are dementia patients.

Individuals with dementia function best with routine. They need the familiarity of a caregiver and a consistent environment. But because of COVID-19, regular routines are completely disrupted. Like everyone in skilled nursing facilities, those with dementia are spending most of the day in their rooms, often alone and isolated. They aren't able to socialize in group activities and with loved ones, which usually keeps them engaged and able to pattern behavior after others. 

The goal when working with individuals living with Alzheimer's and dementia is to promote their best ability to function to slow or delay the deterioration of a progressive disease. It starts with gaining agreement, followed by making changes to the environment, activity, and/or care partner approach. After working with this population, I know firsthand this takes time and patience because helping residents with Alzheimer's can be so much faster than supporting them to be independent. It's a good intention to want to jump in and help, but supporting these residents too much can leave them more helpless. This is a challenge always, but no doubt, it's even harder now that facilities are staffing challenged.

This is why I consider RESTORE the perfect medium to slow the progression of memory care patients. I've seen patients find engaging games connected to their life history, interests, and abilities. The games support cognitive and behavioral skills, and of course, physical skills. 

Take the WWII pilot I met at our client's facility before COVID-19 hit. He didn't want to work on the motion of lifting his arm to reach for a cone; his therapist was extending in front of him. When I learned that he was a pilot in World War II, I offered to show him our Take Flight game. He ended up getting really engaged and even told me the highlight of his life was meeting General Patton. By the end of our session, he had held his arm and sustained action several times for over two-minute intervals, something that's hard even for me but necessary for completing activities of daily living. And this is just one example of so many.

I'm seeing therapists and even activities staff customize RESTORE to support patients' cognitive and physical abilities, as well as their interests, preferences, habits, tendencies, professions, and family history. Players can golf, pull a slot machine lever, ski in a race, or fly a plane. RESTORE's 30+ games keep players engaged, as well as help with issues such as attention span, concentration, problem-solving, decision-making, and sequencing. Every game exercises cognitive functioning, helping patients with dementia to maintain attention, concentrate, and tap into procedural, working, and long term memory centers. 

Add to this personalization feature the fact that RESTORE is portable and works on any device with a webcam. It's easy to set up and allows every staff member to support skill-building therapy. It's one thing to bring a dementia patient an iPad to play a sensory game or call a family member, but how much more impactful is software that lets patients actively play without handling a device, get immersed in the activity, and invite loved ones to participate virtually?

Connect to family and friends

Just as COVID-19 hit, we added a feature to invite loved ones to join therapy sessions virtually. Having family interaction takes engagement to a whole different level. This is something that we just really haven't ever had the ability to do as therapists. It's incredible to share active treatment sessions with family members who can offer support, encouragement, and help build trust.

While family members are not able to come to the facilities these days, RESTORE can connect family members from where they are and bring them into the room virtually. Once you gain a patient's trust, now they can play RESTORE and have their family members come up on the screen and be able to interact. 

If the family video is too distracting, we can always hide their video, and players can continue with just their loved one's voices. 

I hear clients' stories every day of how RESTORE is keeping residents happy, active, and engaged during this new normal. It's keeping them connected to their families and able to do meaningful therapy work together with their loved ones' support.  And for Alzheimer's and dementia patients, who are the most at risk right now, RESTORE is helping to slow down deterioration even amid the COVID-19 pandemic.

video communication

RESTORE helps facilities enhance the new video communication needs and laws

As New York State moves to require all nursing homes to provide no-cost access to teleconferencing services, we at RESTORE Skills are seeing just how auspicious a time it is for skilled nursing facilities to adopt the best of technology.

New York announced on Monday of this week that the state would require long-term care facilities to implement a set of permanent legal updates to its nursing home laws within 90 days. Facilities will need to develop a pandemic preparation plan that must be updated annually, which includes a specific initiative to update families of each facility's status and no-cost access to teleconferencing services to keep in touch with loved ones.

Operators must provide, free of charge, "remote video-conference or equivalent communication methods with family members and guardians," according to the new law, while updating families of infected residents once per day.

Whether states nationwide follow in New York's direction, one thing is clear from our view as a technology company inside this pandemic. Technology in healthcare is here to stay, and those companies that adapt the fastest will be positioned to succeed in the future. 

RESTORE Skills - can help bolster your videoconferencing touchpoints with residents' families while affording residents' valuable skill-building training at the same time.

video communication

This means that instead of keeping up with weekly video chats and care conferences for each resident, families can be invited to join therapy sessions virtually. Everyone benefits from this added touchpoint. Residents get the encouragement they need to show off newly acquired therapy skills. Families get to see their loved ones are being well cared for and meeting new goals. And therapists can customize the experience for each patient by having family input on what most interests the patients. We've created therapy games where everybody wins.

RESTORE's CEO, Eran Arden, has seen firsthand how the therapy games can support skill-building while at the same time, reassuring families that their loved ones are getting the care they need in rehab. "We are seeing facilities turn the videoconferencing touchpoints into an amazing patient-family experience with the bonus of supporting their loved ones in an important skill-building activity. And here to support more facilities to do the same."

RESTORE's platform includes a built-in communication tool that invites families virtually. But it also works with Zoom, Google Meet, or Microsoft Teams. Imagine how much more meaningful it is for families to communicate during therapy than at a predetermined time when perhaps the patient is too tired or isn't up to having a conversation? Using RESTORE therapy games as a communication tool makes it more like the patient's family is right in the room there with them.

What the future for skilled nursing looks like after the pandemic is yet to be seen. But one thing is for sure. Technology in healthcare will be part of the solution.

adopt new tech

What it takes to successfully adopt technology in skilled nursing facilities

And why you'll be left behind if you don’t--especially with COVID-19

By Ian Oppel, OTR, MBA, DCCT

After 25 years working on the therapy provider side as an occupational therapist, clinical specialist, and multiple senior operations roles, I moved in 2019 to become co-founder and chief clinical officer at RESTORE Skills. I have seen for myself the power of creativity and innovation to get better results in therapy, and I recognize the tremendous impact gaming software could bring to the 2.4 million seniors living in long term care facilities. 

RESTORE is an interactive software product for adult rehabilitation patients that uses any webcam-equipped, Wi-Fi-enabled device as a therapy tool in the gym, at the bedside, or home post-discharge. The virtual gamification tool ensures skill-building can happen anywhere, and any loved ones can join therapy sessions virtually. 

I joined the RESTORE Skills team because I saw the delight in the eyes of patients and recognized the potential breakthrough this software could make. What I didn't see coming was the unintentional resistance to technology adoption in healthcare that I encountered once I began working on the therapy technology provider side. 

RESTORE's Chief Clinical Officer, Ian Oppel, helping a SNF adopt new tech

Facility owners and therapy leaders experience our software and agree it serves patients better than reaching for cones, manipulating clothespins, or repeating the same motion to increase shoulder strength and ROM. What they struggle with is getting busy therapists to change the way they are used to working.

But, COVID-19 is forcing facilities to change or risk being left behind. Therapists, accustomed to using therapy gym equipment and keeping patients engaged with interactive group therapy, are now having to find ways to bring therapy into every patient room without sharing equipment. COVID-19 has forced all therapists and facilities to adapt and get creative. 

I've come to realize that technology is innovating faster than ever to solve problems created by those who resist technology. It's time to become an active part of this innovation and evolve with technology or risk that components of your job or maybe even all functions of your job being replaced by smart learning. 

Facilities risk being outpaced by competitors that gain a reputation for customer satisfaction, innovation, and better outcomes. 

In every industry, there will be those businesses that confront the challenges of this global pandemic, and instead of just struggling through, use this new normal as a springboard to take action. These will be the businesses that come out on top.

Champions are key to successful technology adoption

On the provider side, I always looked for innovative technologies that could both accelerate and elevate clinical outcomes, improve customer experience, reduce costs, and simplify work for our teams. Some tools were more successful than others, but the common factor in success was having champions who were committed to working through any challenges before succeeding. 

Build time into their schedules

Even before COVID-19, no one likes to take time away from therapists' productivity to allocate time for training and adoption. Hardworking therapists are busy and aren't interested in looking less than competent in front of patients and coworkers. Successfully implementing new technology requires building time for adoption into therapists' daily schedule and then supporting them through trial and error. 

Start with the right champions

Even if new initiatives are intended for everyone, the most successful adoptions start with identifying champions best suited to be early adopters. When selecting a champion, find someone with a genuine interest or understanding of the big picture goal, which will include growing your census, increasing your quality mix, improving your outcomes, and increasing customer satisfaction. 

From there, you'll want to relay to them their essential role, as well as the roles of the center, regional, and company leaders in reaching these goals and your expectations for the process. 

Track and measure results compared to the status quo

Have an easy way to track and measure results so you can determine if the cost and implementation process of the new technology is worthwhile. Analyze what is working, not working, where there are success stories, and what additional recommendations will help to ultimately the establishment of best practices.

 

Don't expect to be perfect

Once your team begins using a new tool, it's important not to apply a false pressure to have to be perfect. I conducted a virtual training session recently where almost nothing went as planned, was literally sweating, and at the end heard the patient say, "That was so much fun, I haven't skied in years and can't wait to tell my grandson what I did today."

Click here to learn more about how RESTORE Skills is helping skilled nursing facilities meet therapy needs, improve patient outcomes, and keep patients engaged and connected, especially during COVID-19. Did we mention everyone is having fun while doing it?

Challenges and wins for skilled nursing therapy during COVID-19

Four leaders in the skilled nursing therapy space gathered last week to discuss the state of therapy during COVID-19. They shared challenges and even some wins that have occurred over the past three months in this new normal for long-term care facilities.

Featured panelists were Andrea Gale, VP of case management, Marquis Health Services; Michael Sciacca, CEO, Zimmet Healthcare; and Ian Oppel, OTR, CCO, RESTORE Skills; and Aaryn Crosby, CEO, Adaptive Rehab. Monitoring the discussion was RESTORE Skills CEO Eran Arden.

Highlights of the discussion included the following. Click here to watch the full webinar video. Click here to find out about our COVID-19 special for a better therapy solution during COVID-19.

The challenges for therapy in skilled nursing facilities are many. 

Among those challenges the panelists defined are the following: 

 

Andrea: Helping residents stay connected to loved ones

Mike: The skilled nursing facility industry is lean in a normal time. There's not a lot of redundancy, and the resilience of these organizations has been challenged now that a pandemic has been brought upon them.

Aaryn: Finding ways to address staffing issues and adjust workflow to accommodate for social distancing is a challenge. We’re having to find ways to figure out how to provide quality functional treatment in people's rooms in a way that's portable.

Ian: There are 2.4 million people in long-term care facilities. We have been entrusted with a great responsibility and an escalated need for transparency and accountability beyond what we have previously known.

Andrea: We're seeing an increase in depression and other comorbidities among long-term care patients. Short-term patients are worried about being in the nursing home and not having a family member to sit by their side and advocate for them.

 

What therapy looks like in skilled nursing facilities during COVID-19 

While challenges may seem insurmountable, skilled nursing facilities across the country continue to provide excellent care, and even in some cases, are improving aspects of that care in creative, new ways. Our panelists discuss what they're seeing on the ground in facilities and with patients.

 

Aaryn: In some ways, we are providing a higher quality of treatment during this pandemic. We’re using RESTORE Skills to provide therapy because it's portable and we can roll it down the hallway to bring it into patient rooms. We get them out of bed to do therapeutic activities right there in their rooms. We can connect them with loved ones and everyone feels better knowing their loved ones are okay.

 

Ian: There is truly no team better suited to mitigate the physical, cognitive, and psychosocial risks of isolation than the rehabilitation team. Therapists can add immense value in this new normal, but it is essential they are afforded the time, tools, training, and support. In return, therapists have to be open to changes in the current care delivery model. Staggering schedules to have an extended presence beyond typical 7am-5pm windows with the majority of service between 9-3, lessening resistance to change and ensuring that therapy sessions demonstrate resourcefulness, meaning, engagement, and as much as possible, fun. As therapists, we have a responsibility to connect families and friends of loved ones with video chat to build trust through transparency, allow for encouragement, and provide an opportunity for patient/family education/training. 

 

Andrea: During COVID we’re using laptops in the rooms as well as and using RESTORE Skills in a streaming mode so we can do group exercise and residents feel like they’re with a team. We even have a leader board.

Covid-19’s lasting impact on the future of SNF therapy 

Panelists also discussed how meeting therapy needs during COVID-19 may change the industry permanently. And many of these outcomes look to be positive.

 

Mike: Our goal is to get patients active. Before COVID and PDPM, we were tied to therapy minutes and a whole generation of therapists are used to working like that. PDPM gives us all the flexibility to be creative. The pandemic exacerbates this need so that by necessity we have to be creative.

 

Ian: It's becoming more about the goal and less about the role. There is a clear shift taking place from a focus on individual competence and isolated outcomes in therapy to collective competence and optimizing patient-centered outcomes. Therapists are finding new ways to add value by integrating their care approach with activities, nursing, dietary, social services, and others as their presence has increased away from the therapy gym.        

 

Andrea: It’s even more important now to share positive patient outcomes. We need to produce data on what we’re doing to make people feel at ease as possible. We’re now offering live virtual tours and having to be able to explain how skilled nursing therapy, activities, and a monitored diet can support recovery and help patients avoid readmission.

 

Mike: One of the lasting impacts of this will be telehealth therapy and that this has allowed us all to be more creative in how we provide care. There’s been rapid growth in technology to make our work lives more efficient, as well as increase the connection between family and institutions. 

 

Andrea: As tech-savvy as we were, we still saw ways we can improve our use of technology for efficiency and communication. We have more Zoom and Facetime meetings for communication and care conferences with teams. Providers are moving to telemedicine and still continuing with rounds, but they are able to see more patients now that it’s virtual. And we haven’t seen a difference in outcomes, so we’ll continue to see this grow. Rounds with specialists over telemedicine have opened up avenues for multiple parties on team meetings so there’s more collaboration. 

 

How RESTORE helps therapists meet goals

While skilled nursing facilities across the country are focused on protecting residents from Coronavirus, therapists face the added challenge to keep patients progressing in physical, occupational, speech, and cognitive therapy. Nearly 200 rehabilitation companies and skilled nursing facilities across the U.S. are turning to virtual therapy solution RESTORE Skills to keep patients active and engaged in their rooms – all while having fun and staying in touch with loved ones.

RESTORE Skills is an interactive software product for adult rehabilitation patients that uses any webcam-equipped, Wi-Fi-enabled device as a therapy tool in the gym, at the bedside, or at home post-discharge. The virtual gamification tool that ensures skill-building can happen anywhere is a game-changer during this COVID-19 outbreak.

The state of therapy in our new normal

What is the state of therapy today? Join us for a lively discussion on therapy in skilled nursing facilities now that we are four months into our new normal. You’ll hear from leading experts in SNF therapy, who will provide key takeaways you can bring back to your patients to provide improved care, in spite of the new challenges you face with social isolation during COVID-19.

You’ll hear from the following panelists on how COVD-19 will bring changes to therapy:

 

Andrea Gale, VP of case management, Marquis: “The new normal presents an opportunity to redesign our approach to family and caregiver engagement in our residents’ plan of care and overall outcomes.”

Michael Sciacca, COO, Zimmet Healthcare Services Group: “This situation will change the way we operate for good because it will enhance the use of virtual connections for both short and long-term residents.”

Keith Creagh, Director of Rehab, Genesis Rehab Services: “It has been a very challenging time in healthcare with unprecedented changes to the way we all live and operate. Adversity can bring out the best in humanity and lead to innovation. With the right guidance, inspiration, and some help from technology we are more prepared than ever to deliver high-quality patient care no matter the circumstances and barriers to access.”

Ian Oppel, OTR, CCO RESTORE Skills: “In this new normal there is no team better suited to mitigate the physical, cognitive, and psychosocial risks of social isolation than the rehabilitation team. It is essential that they are afforded the times, tools, training, and support to truly put advocacy in action.”  

Aaryn Crosby, COO, Adaptive Rehab: “We need to be able to deliver functional room treatments. Many patients cannot, or are nervous to come down to the gym. Having a truly fun and interactive therapy session in the room versus a standard therapeutic exercise can increase engagement and mental well-being.”

Topics will include: 

  • What is going through the minds of patients (who are very much at risk for social isolation), families, and friends (going into month 4 of no visitation)?
  • Are therapists essential or non-essential, and how are they defining their value?
  • Census and business development significantly impacted by COVID-19 and the lack of non-COVID related procedures?
  • New messaging be to potential patients, families, and referral sources? 
  • Staffing and resource challenges - individual or collaborative approach?
  • How has your use of technology changed in everyday operations? 
  • Regulation changes, including state licensing and telehealth

 

Eran Arden, founder, and CEO of RESTORE-Skills will be moderating the discussion. Eran says, “Now that COVID-19 has changed skilled nursing facilities, we at RESTORE Skills are seeing just how transformative our tool is for providing therapy to seniors now more than ever.” 

We’ll also address how RESTORE supports current therapy challenges:

  • Turn every patient room into a therapy gym with just a laptop and a webcam
  • Employees on every level can become a skill-building superstar. 
  • Connect patients to loved ones by inviting them to therapy sessions with the click of a button
  • Keep seniors busy, active and engaged

Register for the webinar this Wednesday, June 3 at 1PM ET. Can’t join us? Register to watch it on demand from our follow up email.