Assessment, Detection and Treatment of Pain in Nursing Home Residents with Advanced Dementia: Development of an Evidence-Based Best Practice

The purpose of this three year project, funded through a grant from the New York State Department of Health, is to develop a best practice model that will improve the detection, assessment, and treatment of pain in nursing home residents suffering from moderately severe, severe, and very severe dementia who are unable to reliably verbalize their pain.  The primary goal of the project is to reduce the amount of pain suffered by residents with advanced dementia through 1) identifying appropriate tools to assess pain in residents with advanced dementia, 2) improving nursing home staff’s knowledge and attitudes regarding pain, and 3) implementing organizational changes to the nursing home to aid in more accurate assessment and treatment of pain.  Schervier Nursing Care Center, the lead facility, will be supported in the grant by a consortium consisting of two additional nursing homes, a research center, and an advisory committee of pain and dementia experts.

The SPOON Program: Seniors Partaking of Oral Nourishment
 
While great strides have been made in  the past few years to improve end-of-life care, many nursing home residents with dementia approach death with feeding tubes in place, despite research that advises little to no benefit from this    form of treatment.  The components of  the SPOON Program (funded by the Fan Fox and Leslie R. Samuels Foundation)                          include: 1) a comprehensive education program for physicians, clinical staff, certified nursing assistants and family members regarding the terminal nature of advanced dementia; and 2) the establishment of a volunteer assisted feeding program for advanced dementia residents. The goals of the program are:    1) to establish a new and improved standard of care for advanced dementia residents in nursing facilities;  2) to increase the number of dementia residents placed on palliative and hospice care; 3) to decrease the number of unnecessary feeding tubes for residents at the end of life; 4) to increase resident socialization and companionship; and 5) to reduce needless pain and suffering. The program will also increase family awareness about the terminal nature of dementia, empower their decision-making, and enhance their satisfaction with care. The intended outcome of the SPOON Program will be an enhanced quality of life for advanced dementia residents brought about by increasing time spent with one-on-one relationships, allowing for the pleasure of tasting food, and reducing the risk for restraints and infections due to tube feeding.  To volunteer for this program, please contact Paulette Sansone at (718) 548-1700 x334 or Paulette_Sansone@bshsi.org.

The Schervier Community Garden: Growing Together

The Schervier Community Garden is a project funded by a grant from the Bon Secours Mission Fund that is designed to provide a means to foster relationships among diverse members of the community.  The community garden, on the grounds of the nursing home, is shared by community seniors; nursing home residents, many of whom are cognitively impaired; recipients of two community kitchens; disadvantaged teens and young adults from two community organizations; and developmentally disabled youth from an occupational training center.  Education and horticultural therapy are offered to all participants. The Schervier Community Garden is a model of a sustainable, intergenerational, community partnership.

Rekindling the Spirit

In late life, many older adults experience an increasing number of losses.  With all of these losses, religiousness and spirituality take on increasing importance in old age.  Many older adults, however, are homebound and feel estranged from their spiritual community.  The Rekindling the Spirit Program, funded by the Bon Secours Mission Fund, offers pastoral home care visits to assist homebound older adults in getting in touch with God, a higher being, or their own inner strength. It will connect them with a supportive community, and with those spiritual activities that promote healing and wholeness.  For more information on the program, please contact Tom Rowan at (718) 548-1700 x585 or Thomas_Rowan@bshsi.org.

Musical Memories: A Spiritual Journey for Nursing Home Residents with Dementia

The purpose of this program, funded through a grant from the Bon Secours Ministry Fund, is to tap into the residents’ spirit through music, using old favorites and newer inspirational music. A staff member plays a number of recordings with religious, spiritual or inspirational themes and discusses their content with 15-20 residents of Schervier Nursing Care Center. Through conversation on a theme such as love, peace, joy, or light and choosing songs which relate to this theme, the residents are engaged in conversation and memory sharing. Participants are also encouraged to sway, clap and even dance to the music. All of these activities provide the residents a respite from their suffering through a relaxing environment, interaction and physical contact, and a reason to hope through inspirational themes and the rekindling of positive memories.

Recognizing Depression in Short-Term Geriatric Rehabilitation Residents (July 2007- June 2008)

Research has indicated that depression may hinder the rehabilitation process and lead to longer stays, re-hospitalization, and even death.  This research study, funded through a grant from the New York Community Trust, was designed to test the effectiveness of an evidence-based guideline for detecting depression in short term rehabilitation patients.

Achieving Best Practices in Palliative Care with Dementia Residents: Steps for Success (January 2006-June 2008)