Hey Josh. Thanks for agreeing to give our RESTORE tribe a look into your life. Let's get started.
Q: What do you do at RESTORE-Skills and in what circumstances would I come to you for something?
A: I build and maintain user interfaces, handle accessibility concerns, and help come up with development standards and practices for streamlined development workflows. You could come to me with any questions or concerns when it comes to user accessibility, the visual elements of RESTORE, or any nerdy tech questions.
Q: What led you to this career path?
A: I got into development as a hobby in high school. Being able to write code and see it do something always seemed interesting to me. Once I figured out I could do that for a living it just sort of happened.
Q: Who has influenced you most when it comes to how you approach your work?
A: Probably a combination of my parents. They’ve always been hard workers, and have always mixed humor into their daily lives.
Q. What is your favorite thing to do when not at work?
A: I like tinkering with small electronics, building stuff around the house, and trying repeatedly (i.e. failing) to create music.
Q. What's something you recently saw that made you smile?
A: My daughter's first dance recital.
Q: What's one song/artist you are embarrassed to admit you like?
A: Fergalicious - Fergie (I know every word, and I guess I’m not embarrassed about it. It was my ringtone for several years.)
Q: What’s the worst job you’ve ever had, and what did you learn from it?
A: I don’t think I’ve ever had a “worst” job. I’ve worked fast food, as a stock boy at a grocery store, at marketing and promotional agencies, in retail corporations, and even spent some time in the Army. They’ve all had their ups & downs. I guess I’ve just learned to be adaptive and roll with the punches throughout all of it.
Q: What three words would your friends use to describe you?
A: Clever, Loyal and Tenacious
Wow! Well, we definitely need all three of those things here at RESTORE. Thanks for giving us some insight into your life. Have a question for Josh? Drop us a comment and we will get you an answer.
What do you do at RESTORE-Skills and in what circumstances would I come to you for something?
- As a therapist, I have always been passionate about providing the best possible experience for my patients. In my time spent in other roles such as business development, admissions, and management, I always had a focus on customer service and problem-solving. I joined the RESTORE-Skills Customer Success team because I know the best way to help serve the elders in our communities is to ensure that our partners have the knowledge and training to maximize our platform. I would have loved to have RESTORE as a therapist and am now in a role where I can make that a reality for others.
Who has influenced you most when it comes to how you approach your work?
- My father. I grew up in a family auction business so I dealt with the public from a young age. He always taught me to treat the janitor with the same respect as the CEO. How important relationships and connections are in life.
What is your favorite thing to do when not at work?
- We love to thrift and run a part-time reselling business. I also love to attend my sons’ games. My youngest (Landon) plays basketball, my middle son (Kameron) plays soccer and Esports, and my oldest (Nathan) is killing it in the Esports circuit. He started the program at his school.
If you could snap your fingers and become an expert in something, what would it be?
- Home repairs. I am the classic Youtube repairman. I know just enough to be dangerous.
What’s one thing most people don’t know about you?
- I am a state-licensed auctioneer (yes I can talk fast).
What led you to this career path?
- It's really been a combination of my life experiences. I spent 10+ years in sales prior to going back to school to get my COTA license. I have always loved people and now I get to work on a product that directly benefits those same patients I treated in therapy.
What’s one song artist you are embarrassed to admit you like?
- I don’t really get embarrassed by artists. My playlist has anything from George Jones to Tupac.
What’s one totally irrational fear you have?
- Climbing ladders. I hate it.
Are you a dog person or a cat person (or neither)?
- I have always been a cat person but do like dogs. Our greyhound Chase helped to convert me.
What’s changed you about the COVID-19 pandemic, and why?
- I spent the last year and a half in a nursing facility and got to see how COVID affects residents firsthand. The isolation and uncertainty they experienced really opens your eyes to what's important. Family and good friends make all the difference.
How can we use RESTORE in the delivery of group and concurrent therapy?
Great question. To start we have to understand the difference between group and concurrent therapy:
- Group Therapy - One therapist/asst. providing treatment of 2-6 patients performing similar functional skill activities that are part of their plans of care regardless of payor source.
- Concurrent Therapy - One therapist/assist. providing treatment to 2 patients simultaneously, who are performing different functional skill activities (per payor guidelines).
Next, let’s look at some of the potential benefits of these deliveries of care approaches:
- Socialization - helps mitigate the risks of isolation/loneliness and promotes social interaction skills.
- Patterning of Behavior - promotes the ability to learn from others. Players of similar or different functional ability levels can benefit from observing/demonstrating how to perform an activity that helps to improve their own performance outcomes.
- Cooperation - the ability to work together towards a common goal can be rewarding and motivating. By working together, players can achieve outcomes they may never have realized individually.
- Competition - many players are motivated by competition. They may in fact participate longer, move more, and engage more when there is an opportunity for a winning outcome.
- FUN - the most important benefit is that skill-building with others is more enjoyable than skill-building alone.
RESTORE can be used in support of both group and concurrent therapy
Progress can be accelerated by combining socialization, patterning of behavior, and functional skill-building with immersive, interactive content (preferably person-centered based on the expressed interests of each player). Let’s consider the following:
- 2-6 patients (players) who share a common interest, such as casino gaming, and have therapy plan of care goals to increase activity tolerance (sitting or standing), upper extremity range of motion, coordination, and sustained attention would enjoy participating in a Jackpot, Plinko, or Bingo competition. Players can be in the same room and remain socially distanced while set up with a device with a webcam (laptop, tablet, iPad) and simultaneously address functional skills while performing a friendly competition or just trying to achieve personal bests. Players are able to encourage one another through social interaction, while additionally patterning behavior from other players to help them better achieve their personal desired skill-building outcomes.
- 2 players who may or may not share a common interest can each be set up with a device and the therapist can facilitate concurrent activities addressing desired functional skill-building with both players. A therapist may also choose to have both players participating on the same screen at the same time while working on different functional skills. For example, one player may be pulling the handle of a slot machine on the right side with his/her upper extremity while sitting and a second player may be pulling the handle on the opposite side of the slot machine with a squat or lower extremity while standing. Although the enjoyment of the same game is appreciated, each player is working on distinctly different functional skills concurrently.
Set up & selection options for the delivery of group and concurrent therapy
- Scoring is recorded on a leaderboard. Players can attempt to beat their personal best score and even make their mark on the All-Time Leaderboard
- 2 Players - Cooperative
- Best for grouping two players playing at the same time on the same screen requiring similar functional skill-building
- Concurrent consideration in this mode is to have 2 players on the same screen at the same time requiring different functional skill-building
- 2 Players - Taking Turns
- Best for grouping two players, taking turns to encourage each other, pattern behavior, and facilitate competitive motivation
- More than 2 Players - Taking Turns
- Best for grouping more than two players, taking turns to encourage each other, pattern behavior, and facilitate competitive motivation
- Players from different devices compete in the same game, same setting competition to see who can achieve the top score.
- Private Game
- Best for facilitating a group of 2 or more players in the same location on different devices who desire to experience interactive game play. Players compete with our default settings in a competition where players are able to see their place (who is in first, second, third, etc.) and scoring outcomes in real time
- A therapist will create a private game on one device and assist players on different devices to access the private game via a unique code that is entered at app.restoreskills.com/together
- Best for group treatment with the therapist providing each player a device and:
- Addressing the same functional skill-building with different games or individualized settings for the same games
- Best for concurrent treatment with the therapist providing each player a device and:
- Addressing different functional skill-building with different games or the same game but working on a different functional skill
- Best for group treatment with the therapist providing each player a device and:
- This is created by the RESTORE team upon request. Play can be enhanced with the creation of a "same game" tournament or multi-game Olympic event-style competition. Events can occur within one location or across multiple locations simultaneously. An event can be created as a single day or multi-day event.
When players (patients) are having fun and engaged they focus less on targeted skills and more on the game. They have less anxiety or frustration when able to experience success, learn from one another, and feel a sense of accomplishment. Therapists are able to appropriately incorporate functional skill-building groups or concurrent treatment using RESTORE for more effective and efficient outcomes.
RESTORE-Skills was featured on WINK News (Fort Myers, FL). Below is an excerpt from the segment featuring a patient & two staff members from Signature HealthCARE of Port Charlotte:
New virtual therapy technology used inside nursing homes is giving patients the care they need and giving them a way to have fun too.
Sally Connelly-Jones is a fighter. A survivor. She suffered a stroke. Beat it. Got COVID-19. Beat that too.
“I miss shopping,” Connelly said.
Jones lives at nursing home Signature HealthCARE Port Charlotte in Charlotte County.
Jones told us the loneliness has been almost as bad as her stroke.
“It was the stay in your room and not go out in the hall, not go outside and breathe some fresh air,” Jones said.
That stroke left her left side numb.
“I really hated therapy when I started because it wasn’t fun. It was very painful,” Jones said. “But you know, the more I work, the harder I got at it. And I said, you know, this is not going to say who I am. I’m going to dictate to it.”
What helped was new virtual technology. It looks and feels like a game, but it’s much more.
Check out the full news story HERE!
How RESTORE can help clinicians accelerate and optimize outcomes with stroke and brain injury patients:
RESTORE-Skills’ therapeutic gamification platform comprehensively supports clinicians by targeting the functional deficits and underlying neurological impairments most commonly presented by stroke and brain injury patients. Using a laptop or mobile device, therapists can quickly access and customize over 200 games and activities targeting the physical, cognitive, and life-readiness skills necessary to accelerate and optimize clinical outcomes.
Patients move more, stand longer, and refuse treatment less by combining skill-building with fun activities based on their personal interests such as skiing in a world-cup race, pulling a slot machine handle, flying a plane, or practicing their medication management. Every game has settings that can be adjusted to ensure the player can experience success, even if it’s their first time video gaming. A patient’s family members and friends can be invited to remotely join a therapy session via a user-friendly, video-conferencing experience to see their loved one, offer encouragement, and add motivation by playing along all from the safety of their own home.
"I feel the games have helped me to improve the movement and coordination in my arm. I'm right-handed so it's important I regain as much as I can to get back to what I used to do. My favorite game is Plinko. I use my left hand to support my right arm in getting the chips to the top of the board. We had a tournament last week and I actually got the best score on one of the days. It was a lot of fun!"
Video games are most successful when they are easy to access, easy to learn, and easy to use.
The game must also be gradable, or adaptable to an individual’s ability. The more relatable and meaningful the games are to the individual, the more the patient is excited to use the program. When players (patients) are having fun & engaged they focus less on targeted skills and more on the game. RESTORE-Skills makes rehabilitation more fun, stretching patients’ abilities playfully and diverting their attention away from discomfort, anxiety, or frustration.
Below is an excerpt from the Telehealth Best Practices interview series:
In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You” we are talking to successful Doctors, Dentists, Psychotherapists, Counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in Telehealth. As a part of this series, I had the pleasure of interviewing Ian Oppel.
Ian Oppel is a healthcare executive with over 25 years of post-acute healthcare leadership experience providing expertise in rehabilitation, fiscal and clinical operations, memory care, senior living, reimbursement, and regulatory compliance. Ian is currently the Co-Founder and Chief Clinical Officer for RestoreSkills, a leading edge therapeutic gamification and telehealth company.
Can you share the most interesting story that happened to you since you began your career?
At one of the very first skilled nursing facilities to implement RESTORE, I was introducing the gaming platform to an 88 year-old patient who was recovering from congestive heart failure. She wasn’t enthusiastic about video games, but was a good sport and willing to try with a goal to increase her standing activity tolerance. 1 minute into the game, her two great-grandchildren ran into the room shouting “Grandma, Grandma we want to play!” She sat down with a huge smile on her face. She handed over the controls to one of the grandsons, while the other sat patiently on her lap before taking his turn. The boys’ mother came over to me and softly asked “what is this and how do I get it for my home?” Before I could answer, she continued with tears in her eyes “my son sitting on her lap is autistic and this is the first time he’s ever entered the room with my grandmother let alone allowed her to embrace him.”
To have played any part of that magical moment was incredible and to this day motivates me to do everything I can to help customers and clients to experience successes both large and small.
Can you share a few ways that Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?
I was assisting a clinician during a telehealth session with a patient who had suffered a stroke. The patient was part of a large, supportive family who lived near Atlantic City, NJ. He was an avid gambler and the family would make a monthly visit for a weekend of slot machine play. RESTORE-Skills has a game called Jackpot, which is a virtual slot machine with settings that can be adjusted based on a patient’s physical and cognitive ability level to ensure success. The therapist coordinated a virtual session to include the patient’s brother and sister. Initially they observed the session and offered encouragement to their loved one as he played his favorite game. They began to reminisce about the last time they were in the casino together. Then it clicked for the sister as she noticed an improvement in how her brother was moving his arm while pulling the lever of the slot machine (which moved to the opposite side after each pull to challenge his range of motion and coordination). “That’s great exercise and you’re doing something you love at the same time. This makes me so happy” she exclaimed. The therapist was then able to provide the family members with a code that enabled them to all play together on the same screen in a five minute slot tournament. After the session was complete, the therapist noted that it was the longest the patient had stood while performing activity and that it was clear interactivity from his family was key in providing added motivation.
Telehealth evolved out of the need for greater access, flexibility, and demand. Access to quality health providers. Access to reliable transportation. Flexibility for busy schedules/lifestyles. Providers can better meet the increasing demand for patient visits when provided virtually from a single location.
Covid-19 has certainly accelerated the use and scope of telehealth services. At RESTORE-Skills, early on we identified that perhaps an even greater risk than covid for our clients was the challenge of mitigating the risks of social isolation for patients as visitation in senior living came to an abrupt halt. We introduced a new feature, RESTORE-Together, which enabled clinicians working with a patient in their room to invite family members, friends, or even connect with other patients/residents during treatment sessions. They were able to offer visual and verbal encouragement, as well as interactively play on the same screen from the safety of their own homes or rooms.
Check out the full interview with our Chief Clinical Officer, Ian Oppel HERE!
We love the RESTORE technology; however, one concern we have is that many of the games appear “child-like” and we worry about this from a dignity standpoint with our senior population. Have you had anyone else with this concern? Any insight is appreciated.
Thank you for the feedback and important question.
Our platform takes into consideration that the majority of skilled nursing residents have a degree of cognitive impairment (in addition to any physical limitations). From my OT and Dementia Capable Care background, we have applied the theory of retrogenesis (back to birth) to our platform. That is not to say treat adults like children, but to appreciate that their developmental ability levels have regressed to the chronological age of 4-16 years old. It is important to keep simplistic themes, actions, and graphics for our population and to be able to grade the games based on the degree of difficulty settings.
The most important key is to ensure an individual is able to experience success. We do not receive concerns related to graphics when the therapists and care partners have ensured the player meets with success and not frustration. Since many have not played these types of games before, the hesitancy is more related to anxiety that they will not perform well and therefore may remark that it is stupid or for kids, but this is typically a defense mechanism.
Video games are the most popular consumed media today and have officially overtaken the sport and movie industries in 2021. We are talking about games like Candy Crush, Mario Kart, Bubble Pop, etc. I'm currently addicted to a Harry Potter Match 3 game (and not even a huge Harry Potter fan lol). If you love games and you love competition, the graphics/animations are secondary to your success and FUN!
How video games can strengthen the relationships seniors value most
While the vast majority of video gaming enthusiasts are millennials, a growing crop of older adults are accessing video gaming technology for entertainment, cognitive stimulation, physical activity, and social fulfillment. They’re even making video games a part of their health and well being.
During the pandemic, the increased adoption of video games among seniors is proving to be more important than ever. This is especially true for skilled nursing and senior living residents in need of a lifeline to counter the effects of social isolation and loneliness.
Some senior care centers are even using video games as a means of skill-building, applying newly developed therapy and wellness technologies into their clinical approach. In my work as CCO and occupational therapist at RESTORE-Skills, I regularly see seniors use gaming technology to reach therapy milestones faster and improve physical and cognitive abilities. At the same time, they’re strengthening relationships with loved ones and friends by connecting virtually via fun, therapeutic video games on our platform. This happens all from the safety of their rooms.
All of this comes as no surprise to those studying the impact of video games on seniors. A study of adults ages 60-80 published recently in Behavioural Brain Research indicated that video games may be used to enhance cognitive health in older adults. The findings suggest that both novel experiences and exposure to rich three-dimensional environments may work together to improve cognition.
Based on these findings and my own experience, skilled nursing facilities and senior living communities need to become early adopters of this new technology or be left behind.
Tournament gaming enhances social connections and fosters a sense of community
Users of RESTORE-Skills also benefit socially and emotionally by playing virtual tournaments against friends and family as part of their therapy and wellness regiment. What’s more, they’re sharing a common language with Millennial and Gen Z grandchildren outside of these sessions.
This is because there can be limits to conversation among seniors and their loved ones, especially for those in skilled nursing homes dealing with language impairments. It doesn’t help that many younger people are accustomed to rarely making phone calls, preferring text and social media apps instead.
The wider the generation gap, the harder it is today to make small talk.
Unless you’re talking about video games.
Skilled nursing and senior living residents learn a new language to share with younger relatives
Consider the following example from among skilled nursing patients we have served in therapy. A male patient, and former salesman with a gift for gab, suffered a stroke and had expressive aphasia, limiting his ability to communicate. He also had limited movement of his right upper and lower extremities. When we introduced him to our therapy video game solution, he was eager to give it a try. Although he had never played video games before, he considered it a way to impress and relate to his son and grandson, both avid video game players.
This patient is one of many.
A study published in Sage Journals revealed that sharing in video games fosters relationships and connections while producing positive emotions for both grandparents and grandchildren. “As a consequence, game designers should take into consideration ways to enhance these social aspects of gameplay.”
Seniors who play video games now have a shared language to connect with their kids or grandkids. Instead of brief conversations about what’s happening at school, they can instead play a game together and make it part of the patient’s therapy exercises.
Prior to the pandemic, one 88-year old senior living resident and great-grandmother was introduced to a virtual skill-building therapy session to improve her range of motion, coordination, and ability to perform activities of daily living. She willingly participated but wasn’t overly enthusiastic.
Ten minutes into the session, her two great-grandsons surprised her with a visit, raced into the room and asked for a turn. She shared her red ball-shaped controller, and the boys took turns sitting on her lap while they waited to play.
The staff later learned this was the first time one of the boys, who has autism, had ever entered his grandma’s room willingly and engaged physically. Such is the potential healing and connective power of this essential language and activity.
This kind of interaction makes a difference in any scenario, but especially in a season where grandkids are holding up signs at windows of skilled nursing facilities in lieu of actual visits.
Video games create generational connection while providing crucial therapy
Learning the language of video gaming gives both family members and their senior relatives a productive way to spend time together. And, the pandemic has led more seniors to be open to adopting new technology out of pure necessity.
In 2020, the pandemic propelled the video game industry to make more money than movies and North American sports combined. There’s no indication this will slow in 2021.
As more people adopt video gaming technology, the benefits are clear. Research is showing the power of video gaming, especially on cognition of older adults; making it crucial that video games are widely adopted by healthcare.
Adding therapy to video games and enabling families to connect through the technology is an incredible opportunity for post-acute rehab providers especially.
Making therapy fun with video games leads to better outcomes
Refusals are always a challenge for healthcare professionals to overcome, especially in skilled nursing and rehab facilities. However, making therapy and wellness sessions fun and engaging can lead to more positive outcomes.
One male patient who had a history of multiple falls and therefore a reluctance to leave his room was refusing physical therapy support. However, he eagerly agreed to try out the RESTORE-Skills video gaming platform as a fun way to achieve his balance goals and reduce his risk of falling.
He was able to virtually ski in a world cup race, pull a slot machine handle to win a jackpot, and rock climb to the top of an ancient temple – all interests he had never experienced before. As soon as he finished his session, he shared how excited he was to tell his grandson all about his experience. He actually remained in the therapy clinic to watch and encourage others as they participated.
Making video gaming accessible for seniors
The key to successfully adopting video gaming technology for those in senior care centers is making the video games accessible and user friendly. Any video gaming technology for seniors must have the following features:
- Easy to access
- Easy to learn
- Easy to use
- Gradable (adaptable to an individual’s abilities)
- Have audio and video call compatibility
Access to virtual communities of friends and peers
Besides making therapy fun, video games inspire users to play and achieve more through gamification. Competition, collaboration, achievements, and a sense of community drive people to meet their goals in an enjoyable way.
Our RESTORE-Together feature allows patients and players to play interactively with loved ones and friends in a facility or across the country from the safety of their rooms. One patient’s siblings were unable to visit during a recent short-term rehabilitation admission. They worried that their phone calls didn’t provide enough meaningful connection.
The healthcare team coordinated for the patient’s siblings to join his therapy session to encourage him and participate themselves. They watched their brother stand for ten minutes at a “slot machine,” trying to win the jackpot with a weighted controller. It was a huge improvement over his previous best record of only one minute.
The therapist was then able to send a code to the patient’s siblings so they could play a slot machine tournament together, followed by a “Let it Snow Bingo” game that helped with hand-eye coordination, sustained attention, strengthening, and activity tolerance.
Being able to share this experience with others is a key to healing success.
The fact that seniors can use video games to connect to their loved ones is an added bonus to the physical, cognitive, and psychosocial benefits the technology offers. The gamification and fun aspects make programs like RESTORE-Skills appealing enough for seniors to work on skills more effectively.
Confidence to strengthen the mind, body, and social connections that matter most
When seniors have access to video game technology for skill-building, they experience greater confidence, as well as an increased desire to regain social skills and connections. Even the staff enjoys training and learning how to use this technology to benefit their patients.
Video games are most successful when they are easy to access, easy to learn, and easy to use. The game must also be gradable, or adaptable to an individual’s ability. The more relatable and meaningful the games are to the individual, the more the patient is excited to use the program.
Skilled nursing facilities and senior living communities must adapt to offer residents the opportunity to learn the language of video games. By creating virtual communities, tournaments, avatars, and immersive experiences in a world without borders, seniors can work on developing skills in a meaningful, collaborative and entertaining way.
Just don’t be surprised when grandma gets the high score!
RESTORE-Skills' CEO, Eran Arden, spoke with Jerrita Patterson on WREG News' Live at 9 about connecting seniors & their loved ones.
Patterson: More and more senior citizens are really lining up to get coronavirus vaccines across the country. But for many in nursing homes, the pandemic continues to keep them isolated from both family and friends. Now, a new platform is changing the way loved ones can interact all while staying safely apart. This morning, we're live with the CEO of RESTORE-Skills, Eran Arden, to learn more about RESTORE-Together.
Patterson: Correct me if I'm wrong, but this is a motivational therapy platform, correct? Explain what this is about.
Arden: Jerrita, thank you very much! Yeah, you are correct. RESTORE-Skills is a gaming enviornment that motivates residents in nursing homes to continue building and matain the skills they need to live independetly. We use a simple computer, so no expensive devices needed, and we have about 200 activities all designed to motivate the patients to stay active. [They can] work on their sit to stand skills, motor skills, range of motion and everything in between all while playing games.
Arden: When the pandemic started, we also realized we also want to help connect family members to their loved ones in the facilities. So, we created an enviornment where residents that are isolated [in their room] can play with their loved ones [who are] at home.
Patterson: What has been the reaction from those in nursing homes? What have you heard? What have you seen so far?
Arden: The reaction is amazing and that's what empowers us to wake up in the morning and develop the [platform] and our games.