group and concurrent

Q&A: Group and Concurrent

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

Q&A: Player Dignity

Question: 

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. 

 

Answer: 

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.

 

RESTORE Player Testimonial

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!

 

 

Get Your Game on with Grandma

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)
  • Relatable
  • Meaningful
  • 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. 

 

In-room player

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! 

We RESTORE-Skills TOGETHER

Q&A: RESTORE-Together

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

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

    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

    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.  

    Home Safety Scenarios

    New “Safely Home” Game Supports Hazard Awareness

    After several requests from therapists, we are so excited to launch our newest game designed to help players identify and resolve hazardous scenarios in & around their homes. "Safely Home" allows players to interact with different areas of the home in order to identify and reduce a variety of hazard risks in a fun, engaging, and meaningful way. 

    Home SafetySafely Home 

    Players work to recognize safety hazards they may encounter inside or outside of home. To play, move the controller to the hazard to activate solution options. Choose the best solution to resolve the safety hazard, until all hazards in the room are corrected. The player will use attention/concentration, safety recognition, problem-solving, judgment, and decision making skills to manage the hazards in the household.  The game addresses balance, activity tolerance/endurance and can be played seated, standing.

     

    Home Safety

    Adapting one’s home to accommodate the needs of seniors is vital for independence, happiness, and longevity. Therapists can launch "Safley Home" as a means to engage in important conversations with their patients, while players build upon the critical skills needed for a safe discharge. 

    We love hearing from you!

    We were built by therapists for therapists. In fact, our most popular game "Jackpot" was suggested to us by an OT in Colorado. Be sure to share your thoughts on the game "Safely Home", including any suggestions you have for additions to the game.

    Our team is always looking to improve our existing games & create new ones to address the skills you target in your sessions. So, please don't be shy! Send your tips, fixes, or ideas to info@restoreskills.com!


    Follow RESTOREskills on Facebook & LinkedIn for updates on our platform, new game announcements, testimonials, tips, 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 (330) 968-2879. We look forward to supporting your goals!

     

    New “Stop the Spread” Game Promotes Awareness of Healthy Practices

    Businesses, healthcare centers, and concerned individuals everywhere are looking for resources which reinforce the use of proper hand-washing & other health practices in response to the current COVID-19 pandemic. 

    In an effort to help promote awareness for patients & residents, we’ve launched a new game designed to educate in a fun, engaging, and non-threatening manner. "Stop the Spread" combines essential health education with cognitive skill-building for attention, concentration, memory, problem-solving, & safety awareness!

    Stop the SpreadStop the Spread

    In this game, players work to identify and match the health tip on each card. Move the controller over the cards to flip over and reveal the healthy practice on the card. Test your memory by finding all of the matches as fast as you can!  Therapists & Care Partners can change from the memory to matching setting to directly match a card to the image in the bottom left hand corner of the screen. A wonderful game to target recall, scanning, problem-solving, functional reach, and crossing the midline.

    Stop the Spread

     

    Play anytime, anywhere! 

    With 90% of therapy treatment sessions being delivered in resident rooms, now is the time to take advantage of RESTORE's portability.

    Team members can simply bring their laptops to the resident's room to address functional skills and review best health practices by playing Stop the Spread. Use the games cards as prompts for conversation to help with health education. 

    • Tip: Devices can be used on a bedside table or stand to accommodate patients whether they’re lying in bed, sitting on the edge of the bed, sitting in a chair, or standing. 

    Be sure to follow our blog for more tips & examples of how you can set up a meaningful skill-building session right in the resident’s room! 


    Follow RESTOREskills on Facebook & LinkedIn for updates on our platform, new game announcements, testimonials, tips, 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 (330) 968-2879. We look forward to supporting your goals!

    COVID-19

    AVOID the Health Risks of COVID-19 Isolation

    Now, more than ever, it is imperative to keep your residents active, happy, and healthy! In this series of posts, we will discuss the challenges & health risks that may arise due to patient isolation and restricted visitation in the wake of COVID-19

    We know your first priority is the health, safety, and well-being of everyone in your community. During this time, we want you to know we’re here for you! RESTORE can help mitigate the physical, cognitive, and psychosocial risks involved with social isolation.

     

    Physical Health Risks COVID-19Physical Risks

    • Skeletal muscle strength can decrease up to 1.5% per day of bed rest → Skill-building with RESTORE can occur bedside in the patients’ room (and may be used by multiple team members simultaneously)
    • Heightened risk of falls with fractureOur games support functional mobility, range of motion, coordination, balance, & activity tolerance
    • Increased risk for skin breakdown & pressure soresFUNctional games turn every patients’ room into a skill-building gym 

     

    Cognitive Health Risks COVID-19Cognitive Risks

    • Seniors who suffer from social isolation have a 64% higher risk of dementia → RESTORE helps dementia patients reach their best abilities
    • Potential for a shortened attention span → Games promote cognitive skill-building with attention, concentration, memory, problem-solving, & safety awareness
    • Loss of trust and self-confidence or decreased safety awareness → Players succeed with patient-centered activities individualized to their cognitive level

     

    Cognitive Health Risks COVID-19

    Psychosocial Risks

    • Increased prevalence of anxiety, depression, & unwanted behaviors → Features include leaderboards so players can compare their game scores with others
    • Heightened sense of loneliness, social isolation → Friends & family can be included during a RESTORE session via video conference with screen sharing
    • Increased thoughts of mortality → RESTORE creates an opportunity for meaningful interaction, encouragement, & education

     

    How We Can Help! 

    Players can experience the FUN of virtually pulling a slot machine handle to win a jackpot, skiing down the slopes of a world cup race, or controlling the flight path of a plane from the comfort and safety of their room. Enhance your own devices and take advantage of RESTORE’s portability to keep residents active, happy, and healthy from the comfort of their room. 

    To help you overcome these challenges, we’ve decided to dramatically reduce the cost of our platform. Now your residents and team members can enjoy RESTORE and connect family members at a special monthly cost.

    3-MONTH SPECIAL OFFER*: $199/month (MSRP $495)

    *Special offer grants three-month access to a limited version of RESTORE-Skills. Valid until 03/31/2020.

    For more details click here or if you have any questions or would like to learn more about our special offer, please email us at info@restoreskills.com.