Tag Archives: skill practice

RESTORE Self-Feeding Skills

Q&A: Self-Feeding Goals

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Question: 

How can RESTORE help therapists to support self-feeding goals with patients?

Answer:

Great question. To start we have to consider the physical and cognitive components required for self-feeding:

  • Ability to bring hand to mouth
  • Ability to apply and sustain proper grasp or prehension to a utensil or finger food item
  • Activity tolerance for posture, movement for anticipated feeding duration
  • Sustained attention, concentration, problem-solving, sequencing

RESTORE can be used in support of each component. Progress can be accelerated by combining functional skill-building with immersive, interactive content (preferably person-centered based on the expressed interests of the player). Let’s consider the following:

  • Game controllers calibrate to most red, green, blue objects. 
    • If working on up/down movements with hands for finger food, select objects to replicate prehension or grasp
    • You may even consider real food items in the color family such as grapes, tomatoes, apples, candy, etc.
    • If working with utensils, select a spoon that is red, blue, green or can have a colored sticker attachment
  • Game settings and webcam settings can be graded based on the current physical and cognitive abilities of your player:
    • Backgrounds can be adjusted for greater contrast or to simplify visual display
    • Speeds and difficulty can be ranged from easiest to most difficult
    • Music and effects can be varied for appropriate encouragement and engagement
    • Range of motion capture can be reduced for players with limitations or expanded for those with full range capabilities
  • Almost every RESTORE game has upper extremity motor compatibility. A few to consider with default game duration:
    • Take Flight (plays based on lives, duration not limited). Players can control a plane in flight with up and down movement to avoid obstacles and obtain coins and gems.
    • Jackpot (default is 5 minutes). Players can have the slot machine handle alternating sides after each pull or remain on one a single side for more concentrated motion
    • Bullseye (default 2 minutes). Players can control a bow and arrow to hit various targets and bonus items, while avoiding penalty items such as dynamite
    • Ladybugs or Car Cross (rounds of play). Players practice up/down movements to assist ladybugs or cars to cross a bridge, while avoiding allowing pests or undesirables to cross

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 in trying to bring food to mouth, if only working on this during self-feeding. When a player demonstrates appropriate control, sustained action, adequate activity tolerance, and desired cognitive function that is when it is most beneficial to follow up a RESTORE session with an actual self-feeding session.  

Practice Self Feeding with RESTORE
nursing home with physical therapy

How to deal with therapy refusals

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Know when it’s a clinical indicator or wake up call

Standard in every skilled nursing therapist’s day is dealing with patients’ refusal of therapy. A typical SNF therapist averages 1-2 refusals of treatment each day. That can be 15-20 percent of a therapist’s day that’s canceled! 

Of all those therapy refusals, most are legitimate. But among them, there are some SNF patients who could be motivated to get up and exercise. 

Often, a motivated therapist can cajole a patient to join the scheduled therapy session. But many times, it’s simply easier for a busy therapist to let a tired or distracted patient skip a session. 

And now with PDPM, where SNFs are no longer reimbursed for therapy minutes, therapists have even less motivation to counter patients’ refusals than they once did under the RUG-IV payment plan with CMS.

However, therapy is the key reason patients enter a skilled nursing rehab center, and its centrality to patient care is unquestionably essential. Skilled nursing therapy is key to the healing process and to slowing the physical and mental decline of aging patients. 

PDPM means therapists and SNFs are focused more on quality than quantity, but that still means that a patient who is prescribed any number of weekly therapy sessions absolutely needs to access those sessions in order to achieve the best outcome. 

The responsibility lies on the therapist to make sure refusals don’t stand in the way of accessing therapy.

3 underlying reasons skilled nursing patients refuse therapy

Patients will have a whole host of reasons for refusing therapy, and most of them are absolutely legitimate. It’s up to you as a therapist to consider how the patient is responding and determine the source of the refusal. This way, you can determine if the reason is something you can work around or if it’s a sign of a bigger issue. And sometimes, refusals just might mean that you have work to do to make therapy sessions more worthwhile.

 

Reason #1: Patient isn’t feeling well 

Patients may be adjusting to a new medication, still healing from a recent procedure or have any number of clinical challenges that can make therapy more difficult. Speak to interdisciplinary team members to see if they have also received concerns and what subsequent actions have been taken

Reason #2: Patient has concerns outside of their control 

Skilled nursing care has to be integrative for therapists to successfully treat patients. This means letting the care team know when a patient doesn’t get enough sleep because of a loud roommate or a patient didn’t eat because the food got too cold. Be an advocate for the patient if action has not been taken to address concerns/complaints. 

Reason #3: Patient is apathetic

Sometimes patients will refuse therapy without a specific reason. Statements like “Maybe tomorrow?” or “I don’t want to do it today” can mean that the patient isn’t seeing the value of the therapy sessions.

 

Reassess your approach to skilled nursing therapy for apathetic patients

If you are unable to identify the source of why your patient is refusing care, it’s time to ask yourself some hard questions.

We as therapists are taught the therapeutic use of self approach. This means we use all our faculties to meet our patients where they are, with empathy, and bring them to where we want them to be for the session. We use our creativity, attitude, and effort to make patients feel positive, motivated, encouraged, and successful. This is how we gain their trust and ensure they feel empowered.

7 questions therapists should ask when facing refusals 

  • Are you offering a care approach that has meaning to the patient?
  • Are you offering a care approach in which the patient believes they have the opportunity to experience success?
  • Can you grade your approach to gain trust and agreement?
  • Are you conveying enthusiasm and excitement in your approach or are you going through the motions and thinking about the end of the day?
  • What is your strategy to motivate? 
  • Can you modify the environment to one that will promote a more successful experience?
  • Can you modify the intended activity based on the fluctuating physical and cognitive ability output of your patient? 
Health visitor and senior

Therapists’ methods to deal with refusals

Once you’ve taken some time to ask yourself the hard questions above, you are poised to better address therapy refusals. The following are some steps you can use.

Step 1: Show empathy to patients’ needs

Your first reaction to therapy refusals should always be empathy. Most patients have legitimate hesitations to therapy, such as overall weakness, pain or emotional struggles. Of course, therapy can improve the physical and mental state of patients, but it’s a long process, and the journey can be hard. 

Listen well to your patients’ concerns and repeat what you hear them saying to you to validate their concerns. If the patient is refusing to exercise because he is in pain or needs an improvement to his care, you may need to advocate for him to the interdisciplinary team.

 

Step 2: Use a person-centered approach for therapy

One obvious solution to refusals, of course, is to have a more person-centered approach. Provide therapy on the patients’ schedule, when he is at his best. This is obviously harder to coordinate, but if it reduces refusals to offer a late sleeper a later therapy time slot, then you will have more luck cajoling him to exercise. 

It also helps to offer the patient something engaging she wants to do. Get to know her interests and goals and relate the therapy back to those goals. Your patient wants to walk her granddaughter down the aisle? Remind her that it starts with working on standing for two minutes.

Don’t be afraid to get family members involved in what a patient enjoys. Therapy is a great time to jump on a Zoom call with a patient’s loved ones. This makes the family feel connected, increases transparency, motivates the patient and helps you get to know more about the patient. This is why we included a video-conferencing tool right within our RESTORE Skills therapy gaming platform.

 

Step 3: Make therapy fun and engaging

Armed with the latest technology that makes therapy interactive, engaging and even fun, therapists can significantly reduce refusals. As the Chief Clinical Officer of RESTORE Skills, where we’ve created just this kind of therapy gaming platform, I see examples every day of patients actually requesting to play our therapy games. They are motivated by the fun they are having skiing, golfing or playing the slot machines, as well as the results they see as they improve their game scores.

To add to the joy, we are known for an “I hit the jackpot with RESTORE” t-shirt for those patients who hit “Wild, Wild, Wild” on our slot machine game. We are constantly hearing about patients relentlessly playing this therapy game until they win. Meanwhile, they are actually winning at therapy, as they push themselves to reach and stretch farther.

The right attitude, approach, and activity can make therapy easier and reduce refusals, but sometimes you need added help

 

Refusals can feel personal. Most therapists have developed conscious and subconscious defense mechanisms related to these remarks. However, simply shielding yourself from the impact is not necessarily best for your patient or your professional growth and development.

Even the most passionate and creative therapists will still face regular refusals on the job. This is where innovative technology can fill the gap. Having access to a variety of interactive treatment content and the ability to connect loved ones for added encouragement and participation is the perfect compliment to an empathetic, positive and motivating therapist’s approach. Hope these strategies help you realize better outcomes with less refusals.  

WBOC Good Day Delmarva

NEWS: RESTORE-Skills featured on WBOC’s Good Day Delmarva

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Below is an excerpt from the story from Good Day Delmarva: 

For today's Wellness Wednesday, Sydney speaks with Joe Asseline with the Westgate Hills Rehabilitation & Healthcare Center to learn about the steps they're taking to provide contact-less care during the ongoing pandemic. 

Today with the help of Westgate Hills Rehabilitation & Healthcare Center in Baltimore, Maryland we discover ways in which they're reaching goals with a contactless approach.

Joe: I've been working at Westgate Hills Rehab for the past year and a half. My goal is to help patient's restore their function & independence through actiticties of daily living and self-care tasks. 

Sydney: How are have you noticing that certain facilities or even yours are turning to technology to help folks get the therapy and attention that they need? 

Joe: In my sesssion, I find it's very important to use video chat...we've also been able to use this really cool RESTORE virtual reality game system. RESTORE is a syetm that we are able to bring therapeutic activties and excercises into the rooms of patients. Not only that, there's a new feature that they've just rolled out that we're able to video chat in with the families so they can add words of encouragement. It's really cool! I find that they're always asking to use it because they think the games are really fun, 

Check it out the full interview with Joe Asselin, OTR/L HERE!

senoirs in long term care connecting with families

NEWS: RESTORE-Skills CEO on ABC’s Local 24 News

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RESTORE-Skills CEO interviewed on Memphis' Local 24 News (ABC)

Below is an excerpt from the story on tech in skilled nursing: 

There is a new way some Tennesseans are connecting to loved ones in facilities. Virtually.  It's called Restore-Skills.com. It's a computer-based occupational and physical therapy gaming program. All someone in a long term care facility needs is a laptop to use it. Restore has been on the market since 2019, but when the COVID-19 pandemic hit, its creators expanded its capabilities to allow family members to virtually join in.   

"We wanted to create fun and meaningful activities, so we added the ability to connect the family member to the game while doing the activity," said Eran Arden, Restore-Skills CEO.

Arden says there is a list of games a therapist can pick from, depending on what skills the patients needs to work on. During the sessions, family members can get looped in.

"Once they join they would see the patient live and the game running," said Arden. "They can see the loved ones moving their shifting balance left and right while skiing the slopes."

Arden says family members can cheer the person in the nursing home, and there are even games that can be played together.

Check it out in full HERE!

nursing home visitation

NEWS: RESTORE featured in WTBU Radio story

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RESTORE-Skills featured in a WTBU Radio (Boston) story titled, “Mass. Longterm Care Facilities Welcome Socially Distant Visitors"

Below is an excerpt from the story on visitation: 

Amanda Telesca is the Director of Rehab at the North End Rehabilitation and Healthcare Center, which has 100 beds and about 150 staff members.  Telesca estimated that the average age of the residents is between 75 and 85 years old.

In April, her facility started receiving new guidelines from the Centers for Disease Control and Prevention about limiting gatherings and visits. With the new changes, though, came tradeoffs for seniors.

The North End facility started using the RESTORE Skills therapy program, an online, web-cam based program that has a teleconferencing feature so family members can join the virtual therapy sessions.  Physical therapy exercises are incorporated into games, which RESTORE skills developers say keep residents engaged in the session.

The facility’s goal is to prepare residents to return home and Telesca said that using a technological therapy tool has benefits beyond the physical therapy aspect.

“It is a lot of fun and it’s a good tool to use, as far as coordination goes and technology-wise, training people to use their laptops and preparing for home that way,” Telesca said.

 

Check it out in full HERE!

technology in the pandemic

NEWS: RESTORE-Skills CEO interviewed by CNN

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RESTORE-Skills featured in a CNN article titled, “These seniors are turning to cutting edge technology to stay connected during the pandemic”

Below is an excerpt from the article: 

A unique feature of the program is built-in video calling so families can see their loved ones playing games. Landsman [a resident of The Jewish Home, Freehold, NJ] said he recently played the slot machine game while using the video calling feature to connect with family.

"I just saw my sister on there," Landsman said "She's home with the kids. She cheered me on."

Landsman's sister, Linda Landsman, said that she enjoys watching him play and that it helps her stay connected with her brother, especially during the pandemic.

"He was winning the slot machines, and I was cheering him on that he won," Landsman said. "I thought it was great exercise on top of everything."

Eran Arden, CEO of Restore Skills, said that by the end of July, the company will be launching the ability for families to play along. He also said the video calling feature was new as of May in response to the pandemic.

"When we realized that's a need that we have to answer, we switched our development plan ... and just focused on adding the video conference ability to the platform," Arden said. "We understand how important it is and how patients and their loved ones need to have the ability to see each other."

The article looks at the emergence of technology in nursing homes and skilled nursing facilities during the pandemic. Noting that the use of technology can help keep older Americans connected and thriving.

Check out the full story HERE!

COVID-19 News

NEWS: RESTORE-Skills on ABC News’ WCPO-9

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RESTORE-Skills featured on ABC News' Cincinnati affiliate in a segment titled, “Concerns Over Nursing Home Visits.”

The segment notes, “Villa Georgetown in Brown County has been getting a little creative. Residents have been using a virtual therapy program called RESTORE to stay active and healthy.”

We were honored to be mentioned on Sunday evening's broadcast as a fun and creative solution to help nursing homes combat the risks of social isolation during COVID-19. 

"Keeping our families connected with their loved ones here has been vital in not only keeping their psychosocial well-being as up as we can, but I think in many degrees keeping them alive," said Daniel Wylie, Executive Director & CEO of Villa Georgetown.

The segment discussed nursing homes struggling to balance fighting loneliness and COVID-19 concerns. In the piece, RESTORE Skills is mentioned as being used at the Crown Healthcare Group facility in Georgetown, Ohio.

Check out the full story HERE!

Improving therapy outcomes especially during COVID-19

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I want to share with you positive news. On the frontlines in the battle against COVID-19 and under more public scrutiny than ever, I’m seeing nursing home professionals creatively provide therapy and engagement to patients. Patients are reaching therapy goals even in this new season of social distancing and closed therapy gyms.

How?

Our clients are using gaming software in skilled nursing facilities so that all they need is a laptop to get patients engaged in therapy. They’re reaching higher for a slot machine level or standing up and moving side to side by playing games like Jackpot and Skiing.

  • Patients are so busy playing, they forget they’re in therapy
  • Patients are connecting with loved ones back at home, who join the therapy session right there on the app
  • Facility team members on all levels are stepping in to support therapy goals

Imagine Zoom with a Wii. That’s how I’m seeing seniors reach new goals in therapy and even get discharged home where they continue using the software – even during COVID-19. Especially during COVID-19.

RESTORE Skills is the only therapy software available with no device required outside of a laptop. We are the only player in the market that allows users to take a laptop in a room and reach therapy goals. At a time when nursing homes are even more severely understaffed and patients are isolated in their rooms, RESTORE skills turns every team member into a skill-building superstar – from activities directors, to CNAs and nurses. 

It is our goal to give as many seniors access to this transformative tool as possible.

Because across the country, many nursing home patients are missing this opportunity and most likely missing out on crucial therapy sessions while isolated in their rooms. We are offering our software at an unprecedented low price during COVID-19 so that we can help many skilled nursing facilities continue to provide cutting edge therapy even amidst a pandemic.

Let’s change the trajectory of the story of skilled nursing care in the news right now and fill it with stories of positive outcomes. Because anyone familiar with this industry knows the positive outcomes are typical, even if they’re not the story in the news. 

RESTORE Remote: Invite Family to Join LIVE Therapy Sessions

Introducing RESTORE-Together: A better way to virtually connect to patients

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Introducing RESTORE-Together: A better way to virtually connect to patients

When we launched RESTORE Skills, never did we imagine that therapy gyms would close for months at a time and skilled nursing facility patients would be isolated in their rooms. Now that COVID-19 has made this a reality, with no foreseeable end in sight, we at RESTORE Skills are seeing just how transformative our tool is for providing therapy to seniors now more than ever. 

  • Clients are using our gamified software to turn every patient room into a therapy gym
  • RESTORE-Together offers the ability to invite family members to virtually join therapy sessions with the click of a button

New communication tool in our technology

When we saw our clients setting up Zoom calls for residents and families, we quickly developed a new communication tool for our software. RESTORE-Together allows patients and therapists to invite family members to join therapy sessions right there within the games. 

RESTORE-Together is helping skilled nursing patients connect with loved ones in a powerful new way. Videoconferences with seniors can be challenging for those who struggle with new technology, but RESTORE-Together is a therapy tool seniors and therapists already know how to use. The communication tool also allows families to connect with loved ones in cognitive and speech therapy in a meaningful way.

We developed RESTORE Skills as a skill-building tool for therapy gyms, where patients can show off their new skills, compete in therapy games against one another and cheer each other on. Each player can work on their own set of skills, within their personal range of motion, but the games themselves offer a sense of competition where patients celebrate and strive to outperform one another. Users only need our software and a webcam to use RESTORE Skills anywhere, so it has always been a significant bonus that patients can continue building therapy skills on their own at home.

Now with RESTORE-Together, the audience patients enjoyed in the therapy gyms is back. Only this time, the audience is made up of loved ones.

Turns out we started getting RESTORE Skills into long term care facilities just in time. 

Our tool supports challenges facilities are facing right now. 

  • Skilled nursing facilities are struggling with staff shortages
  • Patients no longer have visitors 
  • Activity directors have limited options for keeping seniors social and engaged
  • Therapists are having to provide therapy within patient rooms
  • Skilled nursing staff are now also the IT experts, connecting residents with families over video conferences.

We at RESTORE Skills are helping SNFs meet all of these challenges. We’re working harder than ever to get RESTORE Skills into as many skilled nursing facilities as possible. Therapy and positive outcomes for our seniors in these facilities depend on it.

 

Click here to schedule a demo and find out how RESTORE-Skills can help your facility meet therapy needs during COVID-19.

 

National Nurses Day

Celebrating Nurses by Improving Patient Outcomes

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On this day and every day, all of us at RESTORE-Skills honor nurses as the healthcare heroes that they are. I see firsthand in our work with senior care facilities the demands placed on nurses. They are always on the frontlines of every patients’ battle for the best outcome possible. Perhaps during no time since World War II has this been more apparent than in the middle of our current global pandemic of COVID-19. 

This National Nurses Day my team and I are celebrating long term care nurses by improving therapy outcomes for their patients.

I’ve seen firsthand that nurses in skilled nursing facilities are among the most dedicated in the field. They get to know patients in senior care facilities over a length of time and many consider the residents like family. It takes a special soul to nurse a patient back to health at a time when there are so many compounding issues that come with aging. Sometimes the job of the nurse is to simply hold a patients’ hands and provide comfort.

 

Other times, it’s the job of long term care nurses to motivate their patients to get up and get moving for therapy. While they are not the therapy providers, nurses and their assistants are key players in ensuring that patients are ready and in the best mindset possible for therapy sessions.

What if we made that part of nurses’ jobs a lot easier? And in the process, we improved the outcomes for patients these nurses have come to love?

My team and I are doing just that with RESTORE-Skills. Here’s how I am seeing our skilled nursing facility clients benefit from our therapy software tool:

  • Our award-winning gamification technology makes therapy fun and engaging so that patients actually ask to play. 
  • Skilled nursing patients are actually playing therapy games right in their rooms during COVID-19 while therapy gyms are closed.
  • Every team member of skilled nursing facilities becomes a therapy skill building superstar with just a laptop and webcam.
  • Patients are staying busy, active and engaged while reaching therapy goals, breaking up these long days isolated in their rooms while eating meals by the door.

 

This National Nurses Day, we’re honoring these healthcare heroes by working to advance their quiet daily goal of improving each patient’s outcome. I believe in the power of this software to create positive therapy outcomes on a massive scale because we see it happen in our clients’ facilities every day. The time is now to give nurses and all dedicated employees in skilled nursing facilities a game-changing tool in their arsenal.

 

We want to get RESTORE Skills in the hands of every long term care facility possible. Click here to learn about our COVID-19 special offer.