# Presentation: 144276

## The Color of LifeWeaving a Tapestry of  Quality of Life  and Geropsychiatry

**Notes:**
Presenter:  Larry Mc

## What Brings Us Together as People?

- Mr. Fred Rogers (of Mr. Rogers’ Neighborhood said, “If you listen carefully to another person’s life story...you can’t help but love him.”
- Being privileged to hear and share the joys, disappointments, and deliverances of another person...endears us to that one who has vulnerably shared his story.

**Notes:**
Presenter:  Larry Mc

## Spinners

- Kristine Ashley, RN MSN, Nurse Manager Geropsych
- 	Linda O’Keefe-Wood, ARNP Geropsych
- Larry Norris, Program Support Assist- Geropsych DT
- 	Larry McConnell, Chaplain
- 	Elaine Degeneffe, RN, Charge Nurse Geropsych
- 	Sheri Wight RN, Geropsych Day Treatment
-        Robert Reynolds, RN, MSM, Geropsych DT
-        Kelly Fethelkheir, RN Geropsych Day Treatment

**Notes:**
Presenter:  Larry Mc

## Program Development

- Nursing Executive promoted
-    **Patient-Focused Care**** **as a model
**Interdisciplinary Bedside Rounds** for individual patients in pain were started
**Time**** **was  set aside with no interruptions
**Emotional**, **Physical** and **Spiritual** needs of the patient were addressed
- What started out addressing pain evolved into **Quality of Life Rounds**

**Notes:**
 Presenter:  Kris A.

## Goals

**Develop** a **Patient-Centered Care**** **environment in Geropsychiatry
**Define Quality Of Life**  and what it means in Geropsychiatry
**Train Staff** about unique skills needed for interacting with geriatric patients who have dementia and other psychiatric disorders
**Educate Staff** throughout the hospital about QOL in Geropsychiatry

**Notes:**
Presenter:  Kris A.

## Structuring the Program

**Adapting and Modifying** a hospital-based QOL Program to Geropsychiatry and it’s unique environment
**Meeting** at a set time often does not work. Be flexible, meet the patient where they are physically and emotionally
**Unmasking** past emotional issues can be dangerous.  **Don’t go there**
**Allow** veterans to tell their own story
**Learning Boundaries** of Spirituality

**Notes:**
Presenter:  Elaine D.

## Creating a Nurturing Environment

**The QOL ****Session Environment**** needs to be safe, comfortable, and familiar**
**Make area ****warm and comfortable**
**Go**** where the patient is....walk with them, go to their bedside, etc **
**Promote**** a No-Fail Environment**

**Notes:**
Presenter:  Elaine D.

## The Power of Connecting

- Family/caregiver may be** ****more likely**** **to talk if in a remote location, connected by a speakerphone
- Patients feel secure and safe when they are in a** ****familiar place**** **
**Multiple Sessions**** **promote comfort and a relationship with staff
- Meet  patients** ****where they are**** **emotionally
- “Go where the patient is”
** ****Timing**** **is everything
**Speakerphone**** **allows family/caregivers to participate

**Notes:**
Presenter:  Elaine D.

## Anecdote:  Mr. “N”

**Notes:**
Presenter:  Kris A.

## Anecdote:  Mr. “T”

- “Going where he was...”
- A connection which worked
- Feeling safe and secure

**Notes:**
Presenter: Larry Mc

## Unique Aspects of QOL in Geropsychiatry

**Quality Moments** can be achieved for patients with dementia and other psychiatric conditions
**Connecting** is possible through music, reminiscing, and providing a **“No-Fail”** environment
**Utilizing all “Senses”**** **provides avenues for patients to express themselves

**Notes:**
Presenter:  Linda W.

## Identify Unique Patient Needs

**Do No Harm Our Patients are Fragile**
**Elderly**
**Chronic Psychiatric Conditions**
**Emotionally Unsophisticated**
**Few Supports Systems**
**Few Coping Skills**
**Staff seen as Strongly Influential**
**Allowing the patient to lead the discussion**
**Consequences of unwrapping past emotional issues**

**Notes:**
Presenter:  Linda W.

## Anecdote:  Mr. “W”

- Singing

**Notes:**
Presenter:  Linda W.

## Mr. “E”

- Playing organ

**Notes:**
Presenter:  Linda W.

## Connection with the Heart

- Recognizing their suffering and sacrifice
- The “bridge of heart” in truth and vulnerability
- The result:  We are strengthened as individuals and as a team.

**Notes:**
Presenter:  Sheri W.

## Anecdote: Mr. “R”

- The value of being fully human...even without the use of one’s speech or legs.

**Notes:**
Presenter:  Sheri W.

## What Brings these Veterans Together into a Community?

- The bonds that bring and keep them veterans together really comes from embracing values together.
- Concern for another
- Willingness to respect one another
- Valuing one another
- Affirming one another as having made a valuable contribution in a worthwhile effort

**Notes:**
Presenter:  Kelly F.

## Name of Veteran

** **
**1943 - 1948   **
**U.S. Navy**
** **
**WE APPRECIATE OUR VETERANS**

- Name of Veteran

**Notes:**
Presenter:  Kelly F.

## What Veterans Have In Common

**Military**** **Identity
- A **Shared**** **Past
- A Need for** ****Recognition**** **for their
-    Service to Our Country
**Spirituality/Belief System**

**Notes:**
Presenter:  Bob R.

## Anecdote:  Mr. “B”

- A guilt unloaded

**Notes:**
Presenter:  Sheri W.

## Anecdotal Positive spirituality outcomes from QOL intervention

- In what ways can we measure that the intervention of QOL on 1-5 is being beneficial?
- Veterans want to get well in order to return to Day Treatment
- Illus...Mr. “S’s” efforts following his broken hip
- Veterans becoming as he is acknowledged by his peers.
- Illus...Mr. “M”... valued as Burma Road veteran following acknowledgement by Vietnam Veteran (Pete)
- Illus...Mr.” Mc”... valued by peers following his showing tape of D-Day involvement as paratrooper at D Minus 6 hours.

**Notes:**
Presenter:  Larry N.

## Anecdotal Positive Spirituality Outcomes from QOL Intervention

- Veteran knowing he is valued for who he is...not how healthy he presently is.
- Veterans valuing one another
- Illus...playing Taps with silence remembering WWII buddies during D-Day Program
- Relating to and respecting one another
- Illus...”Red” telling chaplain of two “buddies” in day treatment who had died the previous week.
- Illus...Many day treatment veterans attending the funeral of Angel at the National Cemetery

**Notes:**
Presenter:  Larry N.

## What Makes This Program Successful

- This is a** ****patient driven**** **event
- The** ****team discusses**** **each QOL session afterwards
- Each staff member** brings**** **their “whole self” to the meeting, not just their** **discipline
- Being** ****open **to change** **
**Accepting**** **differing ideas
**Interdisciplinary**** **approach

**Notes:**
Presenter:  Elaine D.

## Anecdote:  Mr. “M”

- Double Amputee
- Grief:  Not just anger
- “I just want to get up and walk out of here.”
- Patient driven
- “Timing is everything”

**Notes:**
Presenter:  Elaine D.

## Challenges        Solutions

**Staff acceptance**
**Spirituality in Psychiatry**
**Time constraints**
**Daily QOL’s Sessions mandatory**
**Low census on unit**

**Strong Leadership**
**Clear Vision **
**Staff Commitment**
**Allocating Time**
**Meet often as a team**
**Allow differing views**
**Explore spirituality**
**Listen To Staff**
**Multiple QOL sessions for same patient are beneficial**

**Notes:**
Presenter:  Kris A.

## Team Growth and Development

**3 Month Training**** by QOL Team from Hospice and Pain Management Experts**
**Attend ****Dying Healed Classes**
**Schedule ****daily**** QOL sessions **
**Attend ****Monthly ****QOL Educational meeting**

**Being**** honest****, giving feedback**
**Active ****listening**
**Free to ****voice ****opinions**
**Continuous, open ****discussion **
**All team members are ****equals**
**Allowing members to stay ****true ****to beliefs**

**Notes:**
Presenter:  Linda W.

## Conclusions

- Connecting with the heart

**Notes:**
Presenter:  Larry Mc