All posts by Ann Catlin

Get Ready for Trauma-Informed Care

Beginning November 28, 2019, the Centers for Medicare & Medicaid Services will require nursing homes to provide trauma-informed care. Consequently, they must  “ensure that residents who are trauma survivors receive culturally competent, hence minimizing triggers that may cause retraumatization.”

What is Trauma?

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) describes the “Three E’s of Trauma.” First of all, the person is exposed to an event such as loss, violence, a natural disaster, or abuse. Next, he experiences the situation as physically or emotionally harmful or life-threatening. Finally, she has lasting adverse effects on well-being.

People express trauma differently, and some are more resilient than others. Furthermore, the impact of trauma is often confused with other conditions, such as depression or even dementia. Symptoms may have a delayed onset and include:

  • Physical: Aches and pains, poor sleep
  • Psychological: Anxiety, poor emotional control, flashbacks
  • Cognitive: Difficulty with memory and attention
  • Social: Poor trust in others, isolation
  • Spiritual: Lacks meaning in life

What is Trauma-Informed Care?

According to SAMHSA, trauma-informed care rests on a set of critical concepts referred to as “The Four R’s. These assume that all people within an organization:

  1. Realize that trauma exists and understand the impact and consequences of traumatic experiences.
  2. Recognize signs of trauma.
  3. Respond consistently using the principles of a trauma-informed approach.
  4. Resist the re-traumatization of people with traumatic histories.

Therefore new regulations for trauma-informed care expect facilities to:

  • Assess each resident’s exposure to traumatic events in their life.
  • Train staff in the impact of traumatic experiences.
  • Incorporate trauma-informed approaches into care plans.
  • Use strength-based interventions that maximize trauma survivors’ resilience to avoid retraumatization.

Acknowledging traumatic experiences and providing care that is sensitive to each individual is essential. However, I question how realistic this new regulation is for many nursing homes faced with high staff turnover. As a result, limited resources go to basic care and training in practical approaches.

In conclusion, how do you perceive the future trauma-informed requirements?

Ann Catlin, OTR, LMT: For twenty years, Ann led in the field of skilled touch in eldercare and hospice. She has nearly forty years’ clinical experience as an occupational and massage therapist. She created Age-u-cate’s Compassionate Touch program and serves as a Master Trainer and training consultant.

Tips for Seniors Living Well

Seniors Living Well

Seniors today are living longer; however, are they living well into old age? The National Wellness Institute tells us that “Wellness is an active process through which people become aware of, and make choices toward, a more successful existence.” Indeed, the choices we make along the way determine the degree of wellness we’ll enjoy as we age. But how can cultivate a healthy, satisfying life?

The National Council for Aging Care offers some tips. First of all, develop healthy eating habits with whole foods and plenty of water. Next, keep your body and brain active. Find a physical activity you enjoy and challenge your mind in creative ways. Learn something new. Another key is to stay connected with others to avoid the pitfalls of social isolation. Reach out for help when life throws you a challenge. Also, pay attention to your appearance and keep up to date on popular culture and discover what’s buzzing with younger people. Finally, take precautions such as regular health check-ups and fall prevention measures in your home

I once was a passenger aboard a Great Lakes cruise ship. In case you’re wondering, yes, the Great Lakes are big enough to cruise on– and then some. What stood out were my fellow passengers– many of whom are in their 80′s. One woman celebrated her 94th birthday, while a couple celebrated their 60th wedding anniversary.  At nearly 60, I was almost the youngest person on board.  Now don’t get me wrong; these seniors did not run marathons. Many had physical challenges.  But they didn’t stop them from going on daily excursions and having a great time. One woman with severe scoliosis went on most tours including going down in a copper mine, complete with hard-hat! Another 92-year-old woman told me that she had recently been diagnosed with brain cancer; however, her doctor and family supported her decision to go on this trip. In spite of her illness, her attitude was sunny and positive. It seemed like she was content to stay on the ship taking in the scenery, smiling all the while.

Both of these women are examples of living well in spite of the challenges that may occur along the way. It was inspiring to be with people who didn’t stop living a fulfilling life in their senior years.

Ann Catlin, OTR, LMT: For twenty years, Ann led in the field of skilled touch in eldercare and hospice. She has nearly forty years’ clinical experience as an occupational and massage therapist. She created Age-u-cate’s Compassionate Touch program and serves as a Master Trainer and training consultant.

Ten Reasons Why Touch Matters in Nursing Homes

Comforting a nursing home resident with a compassionate touch.
  1. Touch deprivation in old age is real. Studies have shown that frail older adults are less likely to receive meaningful touch, but it’s a time when “tactile hunger is more powerful than ever,” As a result, people experience isolation, anxiety, pain, loneliness, boredom, and helplessness.
  2. Touch in caregiving is not all the same. Some touch is necessary during personal care and medical procedures while expressive touch shows care, concern, reassurance, affection, and love.
  3. Why touch matters to the person living in a nursing home. Research shows that touch improves the quality of life by:
  • Decreasing anxiety
  • Improving sleep
  • Easing physical discomfort
  • Increasing nutritional intake
  • Improving skin condition
  • Increasing social interaction
  • Reducing agitated behaviors
  • Enhancing relationship with caregivers
  1. Why touch matters to a nursing home resident’s family. They need assurance that their loved one is safe, cared for, and cared about. Family members need to relate to a loved that may not be able to communicate well because of their condition. They can use touch techniques to connect with their loved one.
  2. Why touch matters to the staff of a care facility. Care staff can learn skilled touch techniques that decrease caregiving challenges. For example, a nursing home resident became more cooperative during personal care following a five-minute skilled touch hand technique. Also, touch helps care staff to enjoy more of a relationship with those they care for.
  3. Why touch matters to the nursing home as an organization. It needs to provide excellent service. It must attract new residents and have a marketing edge in a competitive industry. It needs to retain skilled staff. As one nursing home administrator puts it: “Providing skilled touch for our residents puts us a cut above other facilities—going above and beyond what’s required.”
  4. Why touch matters to you. With a touch sensitivity to care for others grows and your ability to be a compassionate presence deepens. We share benefits of touch uplifting you while making a difference for someone else.
  5. Why touch matters to society. Healthcare in today’s high-tech world has become depersonalized. Medical care focuses on technical information.  Consequently, a person feels lost in the shuffle. We can bring together the world of medical technology with the human side of care only by reaching out and offering the gift of a compassionate touch.

Ann Catlin, OTR, LMT: For twenty years, Ann led in the field of skilled touch in eldercare and hospice. She has nearly forty years’ clinical experience as an occupational and massage therapist. She created Age-u-cate’s Compassionate Touch program and serves as a Master Trainer and training consultant.

The Case for Robotic Companion Pets in Dementia Care

A woman with dementia and her care partner interact with a robotic companion cat.

We’ve known the benefits of pet therapy for decades; however, care settings may be concerned about safety issues and commitment to maintaining an animal on site. Research on therapeutic assistive robotic pets has emerged in the last decade. Robotic companion pets offer an alternative to, or complement traditional pet therapy and have been shown to have similar positive effects.

Robotic companion pets provide a useful alternative when live animals aren’t feasible. Live pets in care settings bring both benefits and risks. Often the risk prohibits live pets or limits them to only occasional visits. Robotic companion pets have minimal risk associated with them, and research has shown that people with dementia experience similar benefits as interacting with live animals. Used on-demand, robotic pets eliminates scheduling issues. As a result, elders enjoy the benefit of a relationship with a Pet as they desire it.

Benefits of Companion Pets:

These beneficial effects were reported in research studies and observations described by care partners.

Increased Interaction with Others and the Surroundings

  • Increased social interaction between elders when sharing time with the Pet.
  • Some showed greater interest in what was happening in their surroundings.
  • The conversation became more spontaneous.

 Connection to Memories

  • The Pet stimulated sharing memories of the experience with family pets.

Increased Feelings of Self Worth

  • The Pet seemed to restore a sense of purpose while caring for it through brushing, petting, and talking to it.

Decreased Anxiety and Agitation

  • Interacting with the Pet seemed to ease anxiety and, in turn, lessened challenging behavior.

Improved Mood

  • Exhibited playfulness.
  • Facial expression brightened with a smile.

 Physical Response

  • Movement increased while reaching for, holding, and petting the Pet.
  • Elders responded to the tactile (sense of touch) stimulation of the Pet.
  • One study found oxygen saturation increased while interacting with the Pet, apparently from increased motor activity, talking and otherwise interacting with the Pet, resulting in increased respiration.

Reduced Care Partner Burden

  • Some elders cooperate more easily during routine ADL following interaction with the Pet.
  • Many enjoy lingering positive effects following interaction with the Pet and can participate in other activities with more considerable attention.

With Alzheimer’s disease and other forms of dementia on the rise worldwide, there’s a greater need for creative approaches to improve well-being and ease distressed behavior so typical in people with dementia.  Robotic companion pets could play an essential role in the emotional and social wellbeing of people living with dementia in nursing homes, home care, day memory support, hospitals, and hospice settings.

Ann Catlin, OTR, LMT: For twenty years, Ann led in the field of skilled touch in eldercare and hospice. She has nearly forty years’ clinical experience as an occupational and massage therapist. She created Age-u-cate’s Compassionate Touch program and serves as a Master Trainer and training consultant.