Tag Archives: Speech Skills

Grocery Grab

New Game: Grocery Grab

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The RESTORE-Skills market is open!

Now your patients and residents can practice food shopping with our newest game, Grocery Grab while improving their motor, cognitive, and communication skills. Talk about the perfect recipe for life readiness & cognitive skill-building.

Game Icon for new game Grocery Grab"

Use the grocery item list to begin your shopping experience in our market. Move your controller over the desired stands (Dairy, Produce, Bakery, etc.) in order to see the stocked shelves and locate your items. Hover over the item to pick it up and place it in your cart. After you've collected all items, head to the Checkout. Place your items on the counter to ring them up, then place them in the cart to bag. Finally, players will pay by selecting the most appropriate dollar amount from the options provided.

Players will have a great time putting the FUN in function while improving their motor, cognitive, and communication skills:

  • Life Skills: Money management, shopping, community reintegration
  • Cognitive Skills: Attention, concentration, memory, problem-solving, decision-making
  • Motor Skills: Visual scanning, eye-hand coordination, range of motion, and activity tolerance

Not yet a user? Contact us to schedule a live demo for your team and learn more about our subscriptions.

group and concurrent

Q&A: Group and Concurrent

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Question: 

How can we use RESTORE in the delivery of group and concurrent therapy?

Answer:

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. 

concurrent therapy

 

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

  • Group Play
    • 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 
  • RESTORE Together
    • 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 
  • Single Game
    • 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
  • Tournament Play
    • 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.

 

group_together

We RESTORE-Skills TOGETHER

Q&A: RESTORE-Together

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Question: 

Tell me more about RESTORE-Together and it’s benefits? What is the difference between a live game and a private game?

Answer:

We are very excited to be able to introduce RESTORE-Together, which for the first time allows patients/players to play interactively with their loved ones, other patients/residents in their center, and/or with other players across the country - all from the safety of their rooms or in a socially distanced setting. Our primary motivation was to advocate for older adults, vulnerable to the risks of social isolation, by providing access to a virtual community of skill-builders.

Benefits:

  • Helps mitigate the physical, cognitive, and psychosocial risks of isolation by connecting patients/residents with others they know and love
  • Fosters a sense of community to have patients, therapists, and care partners interacting in a similar skill-building fashion with their peers nationwide
  • Increases fun, engagement, and motivation to accelerate outcomes and provide a better patient experience

Live games:

  • The ability to join a desired game with others is always open and does not require a code
  • A player joins, enters a player name/identifier, indicates readiness, and waits a short time (often less than 1 minute) to see other players that join the competition
  • Players will always know the score in head-to-head games or where they rank in tournament-style games

Private games: 

  • Allow a user to send a code to designated participants who can join the action by visiting the website restoreskills.com/together, entering the code, and following the instructions
  • Adds motivation for the player as he/she will be interacting with family members, friends, or peers that they have expressed an interest in joining a fun and competitive RESTORE skill-building session
  • If an audio exchange is desired during the session, we recommend having a phone or video conference call
    • Note - we are working on a simple, emoji-based way to communicate within the game play if audio is not available or desired
    • Note - some video conferencing apps will need to have the camera turned off so that RESTORE has primary access to the camera
  • Players will always know the score in head-to-head games or where they rank in tournament-style games

Instructions for a player joining upon receiving a private game invite:

  • Open Google Chrome and go to: restoreskills.com/together
  • Secure the four (4) character code from the invitee and enter it in the text box
  • Click “Join” to enter the private game
  • If prompted, select “allow” to enable camera access
  • Have a red, green, or blue rounded object available for play (i.e., ball, apple, container lid, cup, etc.)
  • When prompted, use your mouse to select the color of your rounded object 
  • To calibrate, bring your controller to the center of the square, making sure the camera can clearly see the color of the object

 

  • Enter your name or identifier in the text box and click ‘save’

 

  • Click the ‘Ready’ button. When all players are ready, the game will start after a 20 second countdown 

When players (patients) are having fun and engaged they focus less on targeted skills and more on the game. Fostering a sense of community by connecting with others will help mitigate the physical, cognitive, and psychosocial risks of isolation.

Falls Prevention

Q&A: Falls Prevention

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Question: 

How can we utilize RESTORE with our patients in support of falls prevention?

Answer:

Great question. To start we have to consider the physical and cognitive components required for a comprehensive falls prevention approach:

  • Core and lower body strengthening (squats, lunges, etc.) to improve center of gravity control, stability to support sitting and standing
  • Static and dynamic sitting and standing balance (no reaching, single extremity reach, bilateral hands-free isolated and integrated movement patterns)
  • Weight-shifting, lateral mobility, forward/backward mobility
  • Activity tolerance for posture, movement required for completion of self-care, leisure skills, home and community management
  • Sustained attention, concentration, visual scanning, sequencing, safety awareness, decision making, following commands/direction 

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 functional reaching, select objects appropriate to maintain grasp/hand control or optimized for patients with only gross motor extremity control 
  • The calibrated controller for mobility should optimally have a center of the body placement (between chest and abdomen) so the player can maintain hands-free (especially if in need of assistive device)
  • Use the controller/camera view box (camera or white box in the lower right portion of the screen which tracks controller connection) to assist with patient positioning based on desired movement patterns

    •  

    • 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
      • Best for games challenging a combination of up/down, left/right, and diagonal movement patterns
      • Best for games challenging a combination of up/down and left/right movement patterns
      • Best for game challenging left/right movement patterns in sitting, and left/right, forward/backward movement patterns in standing
    • Webcam setting options
    • Full, medium, small screen capture
    • Large, medium, small circular capture (narrows capture from square to circular configuration) 
    • Large, medium, small semi-circular capture (maintains top screen circular capture, but removes bottom screen circular capture requirement

     

    Demonstrate intended movements and explain why they are critical components to limiting or preventing falls

    • Patients are often fearful of falling. Having the ability to pattern their movements after seeing the therapist in action, can instill greater understanding and confidence 

     

    • Determine which skill areas you plan to target and match the game(s) with your plan. A few to consider with default game duration:

     

    • Ski Saga (default is 3 minutes). Players can control a skier in a race by stepping/shifting left/right and squatting, or up/down, left/right upper extremity movements to avoid obstacles, slalom between flags, and obtain coins and gems. Bonus points awarded after 10+ successful obstacle navigations
    • Ancient Temple (no set time limit). Players use both hands, sitting or standing, in an alternating up/down movement pattern to simulate rock climbing, with various integrated movement patterns included to challenge this treasure hunt adventure 
    • Spooky Spiders (default 3 minutes). Players utilize a dynamic, upper extremity or mobility, range to shoo away spiders of all sizes dropping/climbing vertically while watching out for a chance to knock a witch off her broom flying horizontally across the screen 
    • Bounce It (default 2 minutes). Players align with a silhouette, sitting or standing,  and can use their knees, feet in an upward motion to connect and juggle a soccer ball.

     

    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 overcoming gravity and a fear of falling, when not focused on that fear every second. 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 a functional activity as they will now have the confidence to complete successfully.

    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.  

    Mo Money, Less Problems

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    Who doesn’t like money?! Our guess is no one! And while money doesn’t grow on trees, you’ll find no shortage of the green stuff in our newest game Money Mania!  Our newest game requires players to complete a variety of rehab-driven tasks involving money ranging from the basic matching of bills to the collecting bills in order to reach a specified amount. Each activity has 4 levels that increase with difficulty as they are played through. To select a bill, players use the hand to hover over the bill of their choice.

    • Matching: Collect all of the bills that match the requested one in the instructions
    • Sequencing: Collect the bills and arrange them in ascending value. Check your answer or use "reset" to start over
    • Totaling: Collect the bill/s that total closest to the dollar up cost of the given amount

    Like most of our games, Money Mania! allows players to practice both cognitive and motor skills. As they work through the various tasks involving money - encourage your patients to play with one or two hands together while sitting to expand the range of motion, strengthen their upper extremities, or cross the mid-line. Players can also practice standing, with or without support, to target balance and endurance.

    How will you incorporate Money Mania! into your player's next therapy session? Let us know in the comments!

    Follow the RESTORE blog for updates on industry news, PDPM, platform upgrades, new game announcements, user experience, and much much more! To schedule an obligation free demonstration of our on-demand therapy platform with our team, please contact us at info@restoreskills.com or call (234) 303-0723. We look forward to supporting your goals!

     

    Gone Fishin’

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    Grab your fishing pole and dive into RESTORE with our recently added game, Fish Spell! This activity gives players the oppor-tuna-ty to target both cognitive and motor skills as they simply “catch” fish in order to correctly spell a given word or complete a pattern.

    Using a red, green, or blue object, hover the target over the fish displaying the correct letter until it fills up.  Be sure to catch all the fish in the correct order to complete open the treasure chest on the ocean floor. Adjust the settings to match shapes or colors instead.  Hold your hand over the snail to hear the word repeated. Play this activity in a variety of positions to strengthen the foundational skills necessary for self-care activities.

    Fish Spell aims to further develop the following skills:

    • Cognitive Skills
      • Spelling
      • Planning
      • Matching Patterns
    • Mid-line Crossing
    • Bilateral Coordination
    • Range of Motion

    Follow the RESTORE blog for updates on industry news, PDPM, platform upgrades, new game announcements, user experience, and much much more! To schedule an obligation free demonstration of our on-demand therapy platform with our team, please contact us at info@restoreskills.com or call (234) 303-0723. We look forward to supporting your goals!