Heartlines Winter/Spring 2019

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Big Hearts + Inspired Talent = Clinical Excellence !

IN THIS ISSUE Enhanced Education Opportunities.............................3-8 CNA Classes........................... 9-13 Foundation News.................14-17 In Search of Clinical Talent..........18 Inspired Talent: Happy Residents..................21-27 Introducing Dementia360......... 28


t Presbyterian SeniorCare Network® we exist to make aging easier. Over the past nine decades, we have developed a deep understanding of the aging journey and have built a network of living and service options to address a lot of different needs. Our personcentered philosophy and commitment to service and clinical excellence are the foundation upon which we continue to improve, collaborate and innovate to meet the evolving needs of consumers, hospitals and insurers. Recognizing that some people are healthier than others and in different places along their life’s journey when they come to us, we tailor our support and care accordingly. This helps older adults be in control of their own journey and it reinforces our commitment to personcentered care and service. To address the broad spectrum of needs, we have built a continuum of care that includes residential living communities as well as at-home programs. Depending on each person’s health circumstances, our services, which range from education and wellness opportunities to high intensity nursing care, are distinguished by the knowledge, training and expertise of our people.

ABOUT THE COVER At Presbyterian SeniorCare Network, our person-centered care and service is led by well-educated and skilled team members with a lot of heart and passion for their work. Our commitment to education and continuous improvement helps our teams grow and achieve positive outcomes for all those we are privileged to serve.

Throughout this issue, you will find stories that speak to our passionate pursuit of clinical excellence in our care communities, where we’ve developed tools and advanced training opportunities to keep our nursing teams in-the-know and abreast of the changes and enhancements in long-term care. But our continuum isn’t only about our care communities – some of our offerings begin when a resident is healthy and well; a large part of clinical excellence is prevention, which is seen through specialized wellness programming at our independent living communities, such as Longwood at Oakmont. We’ll share how our teams work with residents to offer programming on fall prevention and education, as falls are a large contributor to unwanted clinical interventions amongst older adults. Read on to learn how our team members apply their knowledge and passion to their daily work, as well as our efforts to support residents in remaining well and as independent as possible, no matter where they are in life’s journey.




hen it comes to healthcare, I think we all appreciate the tremendous benefits of specialization. The same holds true when caring for older adults. Geriatrics is an area of specialty focused on promoting healthy aging, with attention to function and quality of life, all grounded in person-centered care and framed by each individual’s preferences and values. Our bodies change over time, and our health care needs to adapt with us. Geriatrics is the specialty focused on the highquality, person-centered care we all need as we age. “Highquality care” aims to improve health, independence, and quality of life for older people. “Person-centered care” puts our personal values and preferences at the heart of our care decisions. SOURCE: American Geriatrics Society

One of the biggest barriers to excellent care for seniors is the rampant fragmentation that has existed in health care. Progress is being made to better integrate health care services. Service integration will not only improve quality-of-care outcomes, but it also will be less costly for consumers, insurers and government. For most of this decade, Presbyterian SeniorCare Network has been driven by a vision to become an “essential partner” with hospitals, insurers and physicians. To us, essential partner means having deep collaboration with the common goal of pursuing clinical excellence while also “enriching the aging experience.” This vision is at the heart of why Presbyterian SeniorCare Network has been inspired to create “Centers of Excellence” in three areas--Dementia Care, Rehabilitation Services, and End-of-Life Care. All three of these Centers are built upon deep expertise through years of experience and intense collaboration with partners, providers and payers. Additionally, we are blessed to have access to top-notch fellowship trained geriatricians, who are providing medical services and serving as medical directors for our care communities across the Network under the extraordinary coordination of Dr. Vincent Balestrino, our Network Medical Director. They also bring to us outstanding Geriatric Certified Nurse Practitioners, who work with our nursing staff and therapists, all who have a passion for seniors and a commitment to clinical excellence. This is especially important as we see increasing need for higher acuity levels in our nursing communities, which in turn means we must be continually increasing our clinical skills. We are up to the challenge.

The MISSION STATEMENT conveys our organization’s purpose and what we do: Presbyterian SeniorCare Network is committed to enriching the aging experience through person-centered service and living options.

The VALUES STATEMENT works in tandem with the mission and highlights what we believe in and how we will behave: Grounded in Christ-like values of benevolence and love of neighbor, we pursue excellence, innovation and collaboration to ensure individuals live well and team members have meaningful work.



Life expectancy has increased dramatically over the past century. Longer life brings with it a huge opportunity to age well in community and live rich and vibrant lives with purpose and potential for continued personal growth. Unfortunately, our society often associates aging with illness, disability and dependency. Yet research has shown that 70% of aging is based upon lifestyle factors, many of which we can manage and control. A key factor in aging well is early identification of chronic illnesses such as diabetes and heart disease, and active, on-going management of those conditions. According to various studies, 81% of all seniors have at least one chronic condition. What’s more alarming is that most low-income seniors who are eligible for Medicare and Medicaid have five or more chronic conditions! At the same time, our nation is facing a huge challenge and opportunity in terms of the sheer number of Baby Boomers who are aging. Our region will see a 40% increase in the 65+ age group by 2030. Even more dramatic will be the increase of 75% in our 85+ population between 2030-2045! This is a large reason why Presbyterian SeniorCare Network is continuing to grow our continuum of senior living and care options. We are building upon research that shows that most of a person’s health is not driven by health care per se, but by other “Social Determinants of Health” such as housing, nutrition, transportation, and social engagement. We have adopted a wide array of best practices such as University of Pittsburgh Graduate School of Public Health’s 10 Keys to Healthy Aging, the Masterpiece Living wellness program, and It’s Never 2Late (iN2L) computer technology to promote brain health and engagement. To support this wellness philosophy, we are engaging all 2,000+ team members across our Network to partner with the seniors we serve to help them manage their chronic conditions. We will need to support them across time and location in order to help them attain their highest level of independence and quality of life. We are working to create the systems to be able to achieve this with the same passion for excellence and spirit of collaboration that has been our hallmark for more than 90 years. Across our western Pennsylvania region, we are blessed with an abundance of talented people, partners and resources with whom we can work together to ensure a successful aging journey for all.

Paul Winkler President and CEO




Implementing Practical Training and Educational Tools Preps Clinical Teams to Better Serve our Residents


ver the 90 years of our work in caring for older adults, we have not only survived, but thrived because of our commitment to learning and enhanced training. Education that builds clinical competency allows us to increase the value of our services to the person served.

Our nursing teams have certificates and licensures. Why do they need more training? “Training helps prepare us for what we may encounter in our daily work. We need to be ready for anything that comes up. There are a variety of scenarios that can occur in a long-term care setting, and we want to train the best we can so that our teams feel that they have the skill set and tools to manage any situation,” says Ginny Burke, director of clinical quality and education.

Acuity: measure of the care needed by a nursing community’s residents. According to LTCfocus.com, acuity is determined by the level of assistance a resident needs with various levels of activities of daily living.

She continues, “We need to be in-the-know because the acuity of our residents is changing. People are living longer and they are entering into long-term care communities with a greater number of chronic conditions. It is our responsibility to care for these residents with everything we’ve got.”



New roles create accountability Part of training is oversight to ensure that the training is happening in a timely, standard and consistent way across our Network. Knowing this, Presbyterian SeniorCare Network leveraged the strengths of two long-term team members and created Network roles that have oversight of clinical services, as well as education and training. In 2016, Kristin Henderson was appointed the senior director of clinical services and she focuses her time on creating standard, evidence-based processes and procedures to help our team members be efficient and effective in their clinical work. She regularly spends time at each campus evaluating the strengths and areas of

improvement in our clinical programs and services, and offers recommendations on how to standardize our work based on what she learned. In 2017, Ginny Burke was appointed the director of clinical quality and education. She focuses her time on ensuring that through training offered at each of our campuses, our clinical teams across the Network feel equipped and empowered to perform their daily work and provide quality care outcomes. Ginny works to develop programs that focus on enhancing practical clinical skills of our teams, using both hands-on training and online tools. Both Kristin and Ginny are registered nurses and have extensive clinical backgrounds, as well as years of experience working with older adults.

In the Know "To keep our clinical teams current and well-trained, we use a combination of competency-based education, simulation labs, one-on-one education, and we are starting to use some online methods, too," says Kristin Henderson, senior director of clinical services for the Network. To ensure that our teams are in-the-know in regards to what education is required of them, each campus employs a nurse educator who is devoted to facilitating training for our teams, as well as seeking out new training programs. The nurse educators are registered nurses who help team members take what they learned in training and apply it to their everyday work. Nursing care in long-term care settings is highly regulated by the state. Much of our annual training is dictated by regulation. As part of the annual training, team members are refreshed on everything from proper handwashing to safety tips and tools to how to recognize abnormal breathing sounds.

In 2018, our team members participated in nearly 40,000 hours of clinical training! To enhance our training offerings and to ensure our teams feel as they are getting value out of their training, we include team members in the process. “We survey our team members once a year to see what they want to learn, and if we are able, we do trainings based on their needs. For instance, we get requests to be refreshed on IV placement; historically, we do not place a lot of IVs in our communities, so our nurses frequently request a refresher so that they can stay current on their skills,� says Ginny. Requesting input from our team members allows us to be proactive in our training offerings, but also gives the clinical staff the ability to contribute their ideas to our training programs, allowing them to be more efficient and effective in their work.



Help Harbor (we call this our own Google) “Team members may have questions when a supervisor isn’t available, or in the middle of the night, and we want to ensure they get quick and accurate answers to those questions. To avoid our team members just consulting the internet and pulling answers from anywhere, we developed an online support tool called Help Harbor,” says Ginny. “It is impossible to remember everything you were taught in school and in your career, so that was the motivation behind the launch of Help Harbor last year,” says Ginny. Currently, team members can visit Help Harbor for beneficial information on common topics and questions such as wound management, behavior management and infection control. “We are finding that Help Harbor is being used and is considered a great educational support tool for all of our team members, not just our clinical teams,” says Ginny. For example, Help Harbor can be utilized by our Housekeeping team members to help control an outbreak of the flu or something like norovirus. Help Harbor lists all of the protocols and procedures that a team member would need to follow to contain the virus. Ginny continues, “Within Help Harbor, we not only provide a list of steps to take for many protocols and procedures, but there are also photos of the actual products teams should be using. So if a team member needs to use a specific dressing for a particular wound, we show the product so that there is no confusion as to what product to pick. Help Harbor is a really useful program for team members to easily find accurate information in the moment of need.”

Naturally Nursing Symposium Our person-centered culture encourages our team members to be open to new ways to treat the whole person – and sometimes that is not through traditional medicine. Alternative medicine is becoming increasingly popular to help manage pain and symptoms of disease, so it is no surprise that our nursing teams requested more education on the topic. Last year, nursing teams from around our Network gathered at Luther Lynn Campground in Butler County for a Nursing Naturally Symposium. Martha Shreffler, executive director of our Oakwood Heights campus in Oil City says,

“The use of alternative medicine is being embraced by our Oakwood Heights team as another means of improving quality-of-life for the residents. At Oakwood Heights, as well as at the other skilled nursing communities around our Network, the use of essential oils is one approach to relieve pain, decrease anxiety, increase appetite, and increase alertness or improve mood, without the need to increase prescribed medications.” At the Symposium, the team received relevant information about essential oils, massage, therapeutic touch, meditation and guided imagery.




Meet me at the Sim Lab

“Maxine” enhances quality of clinical training


am an advocate of blended learning. Learning in the classroom setting is certainly important, but learning extends way beyond sitting in a classroom. The classroom does not offer real life condition changes, so it is important to utilize training that includes real scenarios in order to enhance and refresh the confidence and skills of our caregiving teams,” says Ginny Burke, director of clinical quality and education. Ginny continues, “There is an increase in acuity of our skilled nursing residents. Hospitals are under pressure to discharge patients and long-term care communities are caring for individuals requiring higher levels of care. Our clinical teams are expected to have the skill and confidence to care for residents that are more complex, and be able to identify subtle changes that may indicate a significant change in condition.” How do we ensure that our teams are up for the challenge? With Maxine.

Fast Fact: By 2030, adults age 65 and older are projected to account for more than 20% of the population. With the population of adults age 85 and older growing to nearly 150%. Available data indicates that more than 15% of Medicare beneficiaries over the age of 65 had 6 or more reported chronic conditions in 2016. - UCSF Study, 2017.


Scenario-based training with Maxine “We have access to a simulation mannequin, or Maxine as we fondly refer to her, through our partners at Health Ventures Alliance in Erie. The simulator allows our nurse educators to set-up scenarios for our teams so that they can comfortably work through assessing a resident,” says Kristen Moore, care transition educator for our Erie campuses. While the team member is assessing Maxine, the mannequin has the capability to respond to what the team member is doing for treatment. So the “patient” changes as the scenario moves forward. “Maxine helps our clinical team members learn how to identify changes and seek interventions earlier in the treatment process. They also learn how to stabilize a patient, which in a real-life scenario, could ultimately avoid transfer to the hospital,” says Kristen. The simulation mannequin provides training on a variety of topics, including how to recognize normal and abnormal breath sounds and heart sounds, IV placement, blood draws, urinary catheterization, wound identification and care, injections, tracheotomy care, blood pressure checks and more. Another benefit of the simulator is that it offers special programming for common illnesses such as pneumonia and heart failure. “What’s great about Maxine is that she was built to have all of the common diagnoses that we see in our communities. If we find that at any given time, there are a number of residents in our care that have congestive heart failure (CHF), we are able to hold a special education session with our teams to discuss CHF, and then we program Maxine so that they can practice the proper treatments,” says Ginny. The simulation lab was created at Manchester Commons, one of our campuses in Erie, after Ginny attended a presentation where the labs were discussed. At the end of the conference, she was so inspired, she drew the Simulation Lab on a piece of paper while waiting to catch her plane home. Her dream turned into reality shortly after, and the simulation lab was set-up like a typical resident room. When Maxine isn’t on campus for training, team members are still able to practice on the variety of simulated body parts that have been purchased for training purposes; they are able to practice clinical techniques on a foot, an arm, a leg and more.


How often do we train? As part of orientation, newly hired Certified Nurses Aides (CNAs) and nurses participate in the Simulation Lab training to show that they are able to complete basic competency skills. Current nursing team members complete the training once a year as a refresher. “I have to admit, when we first started training with Maxine, it felt a little silly and awkward because she’s a mannequin. But those feelings quickly disappeared after a number of team members went through the training and thanked me for a refresher that they felt was needed. I cannot believe how many team members have told me ‘Wow, I learned how to do that procedure more efficiently,’ and ‘the lab was wonderful, can you believe I forgot how to take a manual blood pressure!’ But what gets me the most is when a team member tells me thank you and that they appreciated the time I took to show them how to do a particular procedure. That is what it’s all about – we are all in this together,” says Kristen.

“The Simulation Lab was a good refresher on a lot of different topics such as lung sounds, and I learned a lot about orthopedics as part of the simulation. Kristen was a great teacher and always willing to help, and when we didn’t know something, she just encouraged us to learn it and add something new to our skill sets. It is important to train on the simulation mannequin because it is the closest thing to a real person, which helps us in our everyday work.” ~ Jessica Bush, LPN at Manchester Commons




Expanding the reach of the Simulation Lab “We are so lucky to have access to the simulator through Health Ventures Alliance, but we could really benefit from having our own simulators so that team members from across our Network have consistent access to the tool,” says Ginny. Currently, the use of Maxine is limited to our Erie and Oil City communities, and while some team members have made special arrangements to travel to Erie to participate in the training, many are unable to make the trip. Ginny is working with Presbyterian SeniorCare Foundation, our fundraising arm, to raise money to purchase two of the simulators for use around our Network. David Dix, major gifts director explains that “the cost of one of the simulators is $42,000. So we are looking to raise $84,000 to purchase two simulators for educational purposes. Being able to purchase these is crucial to our success in providing wellrounded clinical training.” If you are interested in learning more about donating towards the purchase of a simulator, please contact the Foundation office at 412-826-6195 or email foundation@srcare.org.

“I really liked the review of the wounds and the different dressings. The whole course was a great refresher. I think the simulator provides hands-on experience to our team members. The simulator helps us think of different scenarios and brings up discussion points, enhancing learning.” ~ Chris Plyler, RN at Oakwood Heights

In Conclusion: Training Advances our Mission With tools like our Help Harbor and the Simulation Lab, our teams are equipped to advance our mission in the best way possible. We are planning to grow each of these tools to reach even more team members; learning new things and refreshing knowledge helps us to provide care and services that enrich the aging experience, making profound impacts on the lives of those we serve.



A PASSION FOR DEVELOPING CLINICAL TALENT Entry Level CNA classes help aspiring team members "leap" into long-term care career


hen Mindy Mazur, RN and primary instructor for our onsite Certified Nurse Aide (CNA) training classes at our Oakmont campus, talks about any one of the eight CNA training classes that she leads each year, you can see her eyes welling up with tears of joy and pride as she recalls the classes she’s taught over the past three years. “We have small classes, a maximum of eight students per class, so I really get to know the students personalities and career desires. It is an absolute honor for me to be able to teach the technical information they need to create a solid foundation to become a CNA, and also some ‘lessons learned’ from my 35 years as a nurse,” says Mindy. She continues, “What’s best about being an instructor is seeing the students grow from being nervous about performing

a procedure in the classroom to excited about starting the clinical portion, which is when they get to interact with the residents. That’s the benefit of teaching the class onsite – the resident experience.”

Prepping to teach onsite “We had a journey to becoming approved to teach the classes onsite, but luckily we had the knowledge and desire to get there,” says Mindy. For several years, at each of our campuses across the Network, we have offered CNA training classes, but all were done using an outside resource such as a community college or a technical school. About three years ago, clinical leadership teams at our Oakmont campus decided it was time for us to take on the training in-house for more flexibility, consistency in training and the ability to embed the resident experience into the curriculum.

Above: Check out our most recent graduating CNA class! This class is unique as two of the graduates are current team members looking to expand their skill sets to best care for our residents. Pictured at the top of the page from L to R: Savannah Schrecengost, who came to the class from our dining services team; Tasene Carlino, who is now cross-trained as both a CNA and as a housekeeper, and newcomer Francine Marotta. Pictured in the back, Instructor Mindy Mazur!

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INSPIRED CLINICAL TALENT In order to be approved by the Pennsylvania Department of Education to teach classes onsite, we went through a rigorous process of curriculum-building, classroom design and certification processes. While this is all time consuming, we never lost sight of our primary goal: to develop clinical talent onsite. When potential team members feel as if we are invested in their future and their career, they are more likely to stay. We worked closely with members of the Department of Education to ensure we were meeting all requirements, and after an inspection, we were granted certification to teach classes. Students follow an approved curriculum recommended by the PA Department of Education, which has been tailored to meet our mission around personcentered care and service. Providing in-house training affords us the opportunity to teach our values in a home-like setting as part of the curriculum, while teaching the skills required to pass the State Registry exam. The approved curriculum is not “set it and forget it.” We go through a recertification process every two years as mandated by the PA Department of Education to ensure we continue to meet the requirements.

Employed from day one One of the neat things about our CNA classes is that we recruit with the intention that the students will stay. Those interested in the class apply online and go through the same interview process as new employees. Students selected for the class are extended a conditional offer of employment with their planned start date being the first day of orientation followed by the nurse aide class. We find that there are many different reasons why the CNA students seek out the classes. Many students have worked in personal care or home care and are looking to advance their career. Some have a desire to be registered with the State. To others, this is a stepping stone to becoming an LPN or an RN. Others have no formal experience in healthcare, but know they want to take care of people. The class gives students the opportunity to learn, become certified, enhance their skill set and knowledge, all while being compensated.

Get out your notebooks! The CNA classes are 140 hours and students must complete 54.75 hours of theory, 27.25 hours of lab/skills work and 58 hours of clinical time. Students need an 80% overall average grade to pass the class. Aside from a high school diploma or a GED, there is no formal education required to become a CNA, so Mindy wastes no time and jumps right into the curriculum! The class is fast-paced, with introductions and basic knowledge the first two days, followed by a quiz on the third day – that’s faster than many college curriculums! The class keeps the same cadence throughout all 19 days, with an intense focus on learning, practicing and then showing that you can do the work. A study guide is given that outlines each day of class. The guide, which is used for reference not only during the class, but also can be used long after the class is over as a resource. “You really do not think about how much a CNA does until you see our class curriculum. We cover everything from the role of a CNA and the responsibilities as a member of the healthcare team, privacy and confidentiality to resident rights and communicating with residents and family members to infection control and safety – and that’s just a sampling,” says Mindy. The trainees also learn basic care, such as fingernail care, how to prepare a meal tray for a resident, catheter care and vital signs. Mindy continues, “Because we have a personcentered philosophy, we focus on caring for the whole person. So there are lessons on faith, spirituality, religion and culture. We even have an entire day focused on hospice care and the stages of dying. We cover a lot of complex issues and I find that the students appreciate the well-rounded education,” she says. The students, while they have a clear desire to care for our residents, are sometimes unsure as to what that entails. All of the time that we spend learning and practicing before beginning the clinical portion of the class gives the students perspective and comfort to perform their work well. - Mindy Mazur


Learning how to be our eyes and ears Care could not happen without CNAs. They are responsible for the direct care of patients, everything from dressing to bathing to eating to safety and comfort. That’s why we refer to them as our eyes and ears. CNAs spend the most time with our residents and family members, and know them best. You need practical experience to learn how to use your senses in regards to providing care, and that is done through the clinical training portion of the class. “When we begin clinicals, students jump right in and become part of a normal day. They integrate themselves into everything from checking vitals to participating in the shift change reports and reviewing where residents are located,” says Mindy. She continues, “I get excited when a new class has their first day working directly with residents. It gives me chills to watch them put their knowledge into practice, demonstrating that they’ve successfully learned the skills and what it takes to become a CNA.” Students begin with some of the easier tasks like how to prepare breakfast and helping a resident who may not be able to feed themselves. After a few days and after the students demonstrate a comfort with the residents, they progress and move on to more difficult tasks such as assisting with personal hygiene and using lifts. Mindy says, “There are necessary progressions of skills and the level of difficulty. This helps the students become comfortable in their work and they get to know the environment. One way we help with skill-building is in how the clinical sessions are structured. For instance, students start with a partner and care for one resident together; this allows for them to have a check and balance, as well as feel more confident in what they are doing. After that, the students progress to having one resident to themselves and then two residents to three residents.” “There are so many aspects to the class that bring me joy, but my favorite part is the clinical training. While they are performing the skills, what awes me most is their interactions with the residents. You cannot teach


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Top 5 Reasons to become a CNA 1. JOB SECURITY: CNAs are in demand. The Bureau of Labor Statistics estimates an increase of 18% through 2024. That means nationwide we’ll need almost 300,000 new CNAs to meet the demand. 2. TIMING: No college degree is required and you can be trained and receive CNA certification if you put your heart into it! 3. NO TWO DAYS ARE THE SAME: residents change, medical needs change and time passes quickly. 4. CAREER GROWTH: CNA is a solid start to a career as a nurse. It is often easier to get accepted into nursing programs because you have already demonstrated that you have work experience. 5. YOU WANT TO MAKE A DIFFERENCE: as the direct caregiver, you are the one who has the privilege of holding the residents' hand and listening to their life story. You spend the most time with our residents and notice changes in their condition. CNAs are important members of the clinical team in long-term care.

relationship building, which is something that comes naturally. And we help students hone this skill,” says Mindy. At the end of each clinical day, the trainees complete journal entries, reflecting on what they learned and how they felt about the clinical experience that day. For Mindy, one heartwarming benefit is seeing her former students teaching others. “This is our third year of the classes, and when I am in our skilled nursing neighborhoods with a new class, I get to see my former students, many of whom are working to mentor the current class. It is very rewarding to see how they have grown their skills, confidence and abilities in their work,” says Mindy.

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Why take CNA classes at Presbyterian SeniorCare Network? • You have a position when you receive certification • You get paid to take the class • We pay for your certification exam (up to 3 times) • You develop a peer network with the other students • You will not only learn theory, but get hands-on training before your class is over

Test time! Prior to the State Registry Exam, students must pass quizzes and a final exam in the theory/class portion of the program. Once they pass those tests, they are able to go on to the clinical portion of the class. After the clinical portion is complete, it’s time for the state registry exam. Students do not have to go far; our Oakmont campus is a certified testing site through the Department of Education, so we can to do the test right on campus. To ensure we are meeting state regulations for the exam, we contract with Pearson VUE, a nationally recognized provider of assessment services to develop, score, and report the results of the competency examination. According to Pearson VUE, there are 23 skills that CNA trainees must master and each skill has an outlined set of steps that must be followed. At test time, the students are tested on five skills, selected at random, and can be anything from handwashing to cleaning dentures to measuring and recording weight. The students must demonstrate a satisfactory level of achievement, not missing more than two of the non-critical steps to each skill.

Do the students pass? “At the Oakmont campus, we have a 100% overall pass rate for the class. Approximately 95% of our students pass the state exam on the first try and the other 5% pass on the second try,” Mindy says. Once the students pass the State Exam, which Presbyterian SeniorCare Network pays for as part of the class, they are officially registered! “I think the CNA classes and how they are structured help the students understand how invested we are in their futures as caregivers. CNAs are critical to long-term care, and showing them that we have the tools to train them, and making them employees from the start really increases the desire for long-term growth here. To me, that ultimately leads to a reduction in turnover and increases the continuity of care for our residents,” says Mindy. In 2018, half of the CNAs that were hired to work at our Oakmont campus were provided by the CNA class – that’s quite an accomplishment!

Standardizing the classes Network-wide Based on the nearly three years of success of the in-house training classes in Oakmont, we plan to grow this offering at the other campuses around our Network. The classes will follow the proven curriculum developed by Mindy, and will recruit and compensate the students the same, as well. “This is such a great way to grow talent,” says Mindy. “I am happy that we have succeeded with the class and that it can be used as a model for the Network. When the time comes, I will be thrilled to help launch these classes at our other campuses.”


CNA Profile: Brianna Larrow


eet Brianna Larrow, a team member who benefited from the CNA Training Classes at our Oakmont campus. Learn more about her journey to becoming a CNA.

Q: How long have you worked at Presbyterian SeniorCare Network? A: I’ve worked at the Oakmont campus for about three years, working first in dining services as a hospitality aide, and now as a CNA. Q: You decided to transition from the dining department to working as a CNA. Why?

only before the exam, but before we even step out on the floor with the residents. The clinical portion just reinforces everything we learn with Mindy in the classroom. By the time we took the test, the material is second nature. Q: What did you enjoy most about the class?

A: While I worked in dining, I often received encouragement from residents and coworkers to take the CNA classes. I took their kind words to heart and eventually enrolled! I did not have caregiving experience, so I saw the CNA training classes as more than just a way to advance my career and increase my knowledge, I saw it as an opportunity to do what I love – care for others.

A: I loved the clinical portion and gaining firsthand experience with the residents. I loved seeing how things worked as part of the clinical team and helping out, especially because I’m a hands-on learner. Because of my previous work in dining services, I already knew the residents well, and now I was able to work more closely with them, which was and still is so rewarding.

Q: Did you find the class helpful in learning how to do the daily work of a CNA?

Q: As a CNA, what are some of your main responsibilities?

A: Yes. The CNA training classes taught me and my classmates the skills required to work in longterm care. I really feel that the classes taught me everything I needed to know so that I could perform my daily duties and responsibilities. I learned that I would be the eyes and ears in the skilled nursing neighborhood which made me feel like what I was training for was both needed and meaningful.

A: I take care of our residents, make sure they are comfortable and without pain. I help them with daily activities and observe any changes in condition, which I report to the nurse manager. I also keep them motivated and hope to make them smile!

Q: In order to become a CNA, you need to pass a State test. Were you prepared? A: I felt extremely prepared for the test after taking the class. Mindy (instructor) teaches us everything we need to know, going over all the material multiple times not

Q: What would you say to anyone thinking about pursuing certification to become a CNA? A: There is always a need for CNAs. If you love taking care of people and seeing them smile, consider becoming a CNA! Sometimes the job is hard, but in the end, it’s not about difficult duties, it’s about helping to make our residents feel important and cared for at this stage in their lives.

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Coming Soon: Woodside Place of Washington


n 2018, we made history when we broke ground for Woodside Place of Washington, one of the first free-standing residential care communities in Washington County that is totally focused on Alzheimer’s and dementia care. As 2018 progressed, ground was moved, walls went up and Woodside Place of Washington started to take shape! We are proud to announce that we are on track to open the community in the fall of 2019. Opening Woodside Place of Washington is another landmark in our more than 25 years of history in specialized dementia care. Woodside Place of Washington will cost approximately $9 million to build – but it will provide priceless specialized care, security and compassion for those living with dementia, and their families. To date, we have raised over $2.4 million for this very important project. There is still time to donate - I invite you to call me to learn more about the Woodside Place of Washington Capital Campaign. There are many ways you can join us in our efforts to create this much-needed care community that will benefit the residents of Washington County and beyond. Thank you for your continued support and for helping to make aging easier for older adults in our region!

Jacqueline S. Flanagan, CFRE Executive Director 412-826-6195 jflanagan@srcare.org

Fast Fact: A quick tidbit: in 1991, we opened Woodside Place of Oakmont. This milestone in our history is considered our single, biggest accomplishment and contribution to the field of aging. From Woodside Place, we developed the Woodside model of care, standards and best practices – which have been replicated more than 100 times around the world.

To celebrate the new Woodside Place of Washington, as well as to share what we’ve learned about dementia care and services over the past 27 years, our teams have created an informative Dementia Education Series for the Washington area and surrounding communities. Educational events are being held once a month through October and the topics are specific to dementia care and education. We have events ranging from music and memory, to technology and dementia care, to how your diet affects your brain, and more! To view the upcoming events and to register now, visit www.SrCare.org/EducationWash.


Save the Date: Upcoming Days of Giving! Visit www.SrCare.org/events for details! AUGUST 13 Erie Community Foundation: Erie Gives Benefits Manchester Commons and Elmwood Gardens, our Erie campuses.

SEPTEMBER 12 Washington County Community Foundation: WCCF Gives Benefits our Washington campus

DECEMBER 3 GivingTuesday #GivingTuesday is a global day of giving celebrated on the Tuesday following Thanksgiving, Black Friday and Cyber Monday. Benefits all of our campuses A HEARTFELT THANKS Thank you to the many wonderful donors who supported Oakwood Heights, our Oil City campus, by participating in the Bridge Builders Community Foundations Week of Giving, March 18-22. Your donations are helping us to transform our Woodside Neighborhood, enhancing the lives of our residents living with dementia.

Registration is Open! 2019 Walk for a Healthy Community The Highmark Walk for a Healthy Community is an annual fundraising event that supports local health and human services agencies in Pennsylvania – organizations like Presbyterian SeniorCare Network! This is our sixth year walking to raise funds for resident enrichment programs to benefit residents at our Oakmont, Washington, Longwood, Erie and Oil City campuses, as well as our more than 30 affordable and supportive housing communities. Funds raised allow us to expand our resident programming, invest in new technology and software and plan onsite and offsite engagement opportunities for our residents. The best part about participating in this event is that Highmark underwrites the cost of the Walk, so all funds raised by our Presbyterian SeniorCare Network Walk teams come directly back to us! In the past five years, we’ve raised nearly $85,000 for our residents.

REGISTRATION IS OPEN Pittsburgh Walk When: Saturday, May 11 at 9 am Where: Stage AE, North Shore, Pittsburgh Erie Walk When: Saturday, June 1 at 9 am Where: Beach 11 at Presque Isle State Park Register now for the Walk of your choice. Can't walk? Donate! Register or donate by visiting www.SrCare.org/events.

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Donor Profile: Nancy Jane Edelman


ancy Jane Edelman, a Longwood at Oakmont resident for more than 14 years, has made a fascinating life out of travel, getting people together, and volunteering her time and talent. Nancy Jane enjoys living at Longwood at Oakmont; the community allows her to have her privacy, feel safe, and to visit her “second home” in South Carolina. She also speaks very highly of her neighbors at Longwood – she loves her cul-de-sac and the tight knit community. She is known for getting her fellow “Nancy’s” together, and has hosted them twice for dinner. Nancy Jane says,“there are 17 Nancy’s at Longwood – what a great name! And a great reason to get together for a fun time.” Before moving to Longwood, Nancy Jane lived in Fox Chapel and volunteered her time serving on many local and state Boards: as a Director of the Fox Chapel Area School District, a Director on the Allegheny Intermediate Unit, an Allegheny College Trustee, a Senior Vice-Moderator for the Pittsburgh Presbytery, as well as a board member for Harmar Rehabilitation Center (now HealthSouth), the Girl Scouts for SWPA, a National Board Member of CONTACT USA (a telephone ministry), and the Vice-Chair of the Pennsylvania School District Liquid Asset Fund. Nancy Jane also planned and led three mission trips to the Czech Republic, and hosted their group when they came to observe our work at Presbyterian SeniorCare Network. A HEARTFELT THANKS

“I was actually the first woman on a lot of these boards, which I hope opened the door for other women to contribute their time and talent.” She also served as Vice-Chair on the board for Heyl & Patterson, the company where her late husband, Harry R. “Bud” Edelman III, worked most of his career. When Nancy Jane wasn’t attending board meetings, she was raising a family that included four children, and traveling with Bud. She’s visited 129 countries every state, continent, and province! Bud served on the board of directors for Presbyterian SeniorCare Network for nearly 40 years, much of that time as the Board Chair. Bud and Sam McCune, the previous Chair, came up with the idea to build Longwood at Oakmont to fulfill a need they saw in the community. After the community was built, Bud and Nancy Jane eventually moved to Longwood. Nancy Jane’s deep roots at Longwood played an important part in her decision to create a Charitable Gift Annuity (CGA). “I knew that I wanted to donate to Longwood, and considered leaving the gift in my will. But I figured, why wait? I’ll do this now! By giving a CGA, I am able to see how my donation is helping others, while benefiting from a return on my investment. It’s really a win-win. And I really believed in their mission and the work. Plus, Presbyterian SeniorCare Network is as old as me!” If you are interested in making a planned gift like Nancy Jane, contact Nancy Hart at 412-826-6087 or nhart@srcare.org. You may also visit our website: plannedgiving.srcare.org.

I would like to extend a heartfelt thanks to all of our supporters in 2018. Your generous gifts to benevolent care, special programs and projects, truly make aging easier for our residents. We are humbled by your continued thoughtful support – which helps us to serve older adults now and into the future. Thank you! Jacqueline S. Flanagan, CFRE & Executive Director, Presbyterian SeniorCare Foundation jflanagan@srcare.org


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Planned Giving Corner

A Year in Review: 2018


e had another great year of Planned Giving, raising vital funds for programs and services for the residents of Presbyterian SeniorCare Network!

Through our planned giving efforts, we received three Charitable Gift Annuities. A Charitable Gift Annuity enables you to support a charity that you love, receive an immediate tax deduction and enjoy an annual fixed income for life. In addition, we received two bequest gifts: one from a Longwood at Oakmont resident and the other from a neighbor of our Shenango on the Green campus in New Wilmington. Bequests enable you to make a special gift in your will benefiting future residents or employees of Presbyterian SeniorCare Network. We also were notified of two will intentions; a gift of a refundable entrance fee from a Longwood resident to set up a scholarship fund to benefit Presbyterian SeniorCare Network employees furthering their nursing education, and a will remembrance from an Erie community Board Member and his wife. In the spring, Shenango on the Green residents donated two properties in New Castle, which were sold with the proceeds supporting the SeniorCARE FUND for benevolent care at Presbyterian SeniorCare Network and Shenango on the Green. We are also proud to announce that the Anderson Legacy Society, as of the end of 2018, includes 49 members. We continued our tradition of offering our popular informative luncheon series, Food for Thought, for Anderson Legacy Society and Cornerstone Society members, Longwood at Oakmont residents, and Longwood at Home members. The spring luncheon gave an informative look at the implications of the 2017 tax law changes, and the fall luncheon was a program of the Phipps Conservatory and Botanical Gardens featuring Human and Environmental Health.

We partnered with Longwood at Oakmont’s Art Committee and the Party Committee to host two art tours of resident homes. The Arty Party, as they were dubbed, received rave reviews from the residents; more are planned for 2019. In addition, we hosted the re-dedication of the Longwood at Oakmont Memorial Garden in October. A special thanks to the Memorial Garden Committee and the Garden Club of Allegheny County for their work and support on this project. I have been delighted to meet so many of you and have been thrilled by Board Members, residents, family members, friends, staff, and volunteers telling me that they have included Presbyterian SeniorCare Network in their estate plans. It is wonderful to have so many generous people supporting our work of making aging easier. Thanks for making 2018 another memorable year – I look forward to meeting many more of you in 2019! Join us at one of our events for fun and fellowship. And contact me if you wish to learn more about planned giving and how you can help the residents of Presbyterian SeniorCare Network.

Nancy Hart Planned Giving Director Phone: 412-826-6087 Email: nhart@srcare.org Website: plannedgiving.srcare.org

THE CORNERSTONE SOCIETY recognizes individuals who make a gift of $1000 or more, either as a single gift or as the sum of several donations through the calendar year, for benevolent care or for unrestricted support for the area of greatest need. THE ANDERSON SOCIETY recognizes individuals that have included Presbyterian SeniorCare Network in their will or estate plans.

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HELP WANTED: Must Have a Passion for Serving Seniors Long-term care is a clinically rich career for nurses


ong-term care, isn’t that boring?” Well, imagine this. It is 3 am, and the usually quiet night shift suddenly springs an emergency on you. As the nurse, you may be challenged to make decisions that provide the best possible outcome for all of those involved. If that sounds more like the ER than longterm care, you’d be wrong. What makes nursing in long-term care so clinically rich? We sat down with Kristin Henderson, senior director of clinical services for Presbyterian SeniorCare Network, to ask the important questions about a nursing career in long-term care. Q: Is long-term care different than say a hospital environment? A: If you are expecting the overhead paging system directing you to a “code” or sirens and medical professionals running down the hall with a crash cart, then yes. But in terms of the care provided, we are pretty competitive. The landscape of hospital care has changed. Before, a patient would stay in the hospital for a week or more and get most of the care they needed while in the hospital. But now, that is totally different. A patient is in the hospital for one to three days and then they discharge to a skilled nursing community like ours for short-term care. So the care that was once provided at the hospital is now provided in a longterm care setting, specifically in a rehabilitation setting. The majority of the time, nurses in long-term care are utilizing the same skills as those in the hospital. The bottom line is

Kristin Henderson the skill set required to be a successful long-term care nurse is very specialized and utilizes a hands-on approach. I think one of the most obvious differences in a long-term care environment is the relationship that our nurses build with their residents and their families. That relationship is key to their care plan, not only for the medical needs, but for the care of the whole person. My nursing teams tell me that this is a rewarding environment because they are able to see the resident through their entire plan of care. Q: What types of nursing jobs are available in long-term care? A: We hire at a variety of levels. Entry level team members are Certified Nurse's Aides (CNA) and they provide the direct day-to-day care. At mid-level, we hire Licensed Practical Nurses (LPN) and Registered Nurses (RN). We also hire experienced nurses directly into manager and supervisor roles. But even RNs and LPNs without manager or supervisor experience have room for career growth. We have had great success training and growing our nurses into team lead positions, supervisor positions, as well as nurse educator and nurse navigator positions. We really can accommodate a variety of skill sets and experience levels! Q: You’ve been with us for 15 years. What characteristics do you see amongst the nurses across our Network? A: All nurses get into the field because they want to care for others. Our nursing teams are passionate

...CLINICAL TALENT about caring for others, it is ingrained in their DNA. And they do this every day, even when the day is emotionally or physically demanding, the caring never stops.

Our recruitment team has a great motto: Happy caregivers = happy residents/patients = positive outcomes. I believe in that motto.

Our nurses are critical thinkers. They spend a lot of time with our physician groups and absorb a great deal of knowledge that they can use when a doctor is not onsite. They are comfortable offering recommendations to the doctors since they know their residents so well. They do this because they have a strong desire to quickly and accurately have proper diagnoses and treatments developed for our residents; after all, that’s what our residents deserve.

Q: The unemployment rate is low right now, making the job market very competitive and nursing jobs are always in demand. What are we doing to reach out to prospective nurses at every level?

Q: What’s your favorite memory of your 15 year tenure? A: Let me take you back to my first day at Presbyterian SeniorCare Network working as a staff nurse. I was given a stack of lab results to interpret and then report any abnormal results back to my supervisor. I had previously worked in a hospital setting where a doctor was always there and someone else read the lab results, I had not used those skills in years! What I quickly learned is that nurses in long-term care are challenged in new ways each day to pull all of those skills they learned in nursing school from the backs of their brains. It’s a really exciting environment if you like using critical thinking skills and nursing judgment. To meet these needs, we are committed to providing relevant training to refresh skills. Q: Is a career in long-term care for anyone? A: No, just like a career in a hospital setting or doctor’s office is not for everyone. It’s all about knowing your career aspirations and finding the right fit for you. Q: What do we do to ensure that those we are recruiting are a good fit? A: We want consistency of care for our residents and want to avoid as much team member turnover as possible because that impedes on that continuity of care, so we work hard in the interview process to ensure that our candidates understand the environment, and also feel that we fit into their own unique career goals. We offer tours of our campuses to prospective team members, as well as, when possible, the opportunity to shadow a current nurse and interact with our current team members.

A: We know that recruiting nurses is not a one-stopshop and that there are multiple things we need to do to engage prospective team members. Our clinical recruiters are out and about, visiting nursing schools and participating in community events to share our open positions, as well as answering any questions about working in long-term care. We also know that there is a benefit to talking with our current high school- and college-aged employees. They may already know our organization through an entry level position in housekeeping or dining services, so it’s important for us to educate them about other career paths that are available in our nursing departments. We know that not everyone wants to go to college, so we offer guidance on the positions available within our organization that do not require a degree, such as a CNA. In 2018, our recruiters Network-wide made more than 300 touchpoints with the public, so we are out there! Q: Anything you’d like to say to a prospective nurse looking to work in long-term care? A: I could go on for hours about long-term care nursing careers! For prospective nurses, I’d say that each day you come to work, you get to use not only your clinical judgment, but what’s in your heart. We have a culture of caring, not only for our residents, but for our coworkers. It is truly a privilege to care for our residents, and if you are looking for a place to work where you can make a profound difference, we’re the place for you.

Explore Careers: CareersAtSrCare.org

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A NURSE'S CALLING Megan Cunningham, RN, Assistant Director of Nursing The Willows, skilled nursing community, Oakmont campus I had been a Personal Care Aide at Westminster Place since 2000, and one evening shift in 2006, I was reading the Bible to one of my favorite residents as he was actively dying. While I held his hand, God laid it on my heart to become a nurse. I went home that night and told my husband that I wanted to go to nursing school. I applied, was accepted to Citizens School of Nursing, and I graduated with my RN diploma in 2008. I moved into skilled nursing at The Willows first as a RN, then as an evening Charge Nurse, then as the evening shift Nursing Supervisor. Now, I am working as the Assistant Director of Nursing. It is said, “When God closes a door, He opens a window.� This has been so true for me. Nursing is my calling, helping people is my passion, and I get to fulfill both to the fullest at Presbyterian SeniorCare Network.

Kathy LaVan, RN, Director of Nursing Oakwood Heights, skilled nursing community, Oil City campus I started here in 1995 as a graduate practical nurse. I never dreamed that more than 22 years later, I would still be here! The residents I provide care to became part of my family. Through the years, I have sat with residents as they passed away, held hands with family members and provided comfort to families, residents and team members during difficult times. I had wonderful nurses who mentored me and coached me when I needed it. My hope is to pass my knowledge and experience on to the next generation of nurses to instill in them the art of caring for people. I think one of the most remarkable things I have watched as a nurse has been the evolution of the long-term care world. We have grown from the institutional setting of the 1980s to a community where we care about each resident as an individual with their desires in mind. I am proud to work here and could not imagine working anywhere else.

Dawn Kauffman, CNA The Willows, skilled nursing community, Oakmont campus I have worked at Presbyterian SeniorCare Network for 31 years and have seen so many positive changes. When I first started, I worked in the "Presbyterian Medical Center," which is now "The Willows." Just the name change shows how we have changed to a person-centered culture, caring not only for the medical needs, but the whole person. Back in the 1980s, we cared for everyone exactly the same way, so when we first started talking about changing our culture, I was very doubtful as to how it would turn out. But it really has changed for the better for all of the residents in our care, and I'm proud to have been a part of that change!



Fall Prevention Education Keeps Residents Well and In-the-Know


ongwood at Oakmont in Plum is a vibrant community for independent older adults. Longwood is actually a minicontinuum; residents move in as healthy, thriving adults, and if their needs change, they are able to move through the Longwood continuum, accessing the higher levels of care they need right on campus. The goal, of course, is to help our residents remain independent; we do this by supporting them where they are, through wellness and education programs and our onsite care managers.


Laurie Lesoon, director of lifestyle engagement at Longwood at Oakmont, is inspired daily by all of the journal articles, research and books that she enjoys reading on successful aging – many which focus around remaining independent. Laurie holds a Leadership in Wellness Management certification through the International Council on Active Aging, which contributes to her strong desire to continually increase her knowledge around aging, and to learn more about a topic she is very passionate about: fall prevention. Laurie is devoted to helping our residents remain healthy and independent, so she enthusiastically implemented the “Vertical” program, offered through our partnership with Masterpiece Living, a national organization devoted to using evidence-based programs to help older adults age successfully. Vertical focuses all-around fall prevention and what independent older adults can do each day to avoid a fall. What exactly is a “fall?” A fall, in medical terms, is any kind of unintentional drop from a standing position to the ground or a lower level, whether injuries were sustained or not. An individual can fall at any age, but as we grow older, our risk for falling increases. Laurie says, “Research tells us that when an individual gets beyond age 65, the risk of falling steadily increases. And once they turn 75, the risk is even higher. Falls are a major threat to the health and independence of our residents, and older adults in general. Is your health and independence something you want to gamble with? I bet not – so get educated on fall prevention!” Knowing more about fall prevention before a fall occurs is key to preventing injuries, a possible trip to the hospital, as well as any unwanted clinical interventions. Because after all, if you are independent, you want to stay that way!

Fall Prevention “We started offering the Vertical program in 2017 as part of our partnership with Masterpiece Living,” says Laurie. Masterpiece Living has created tools and evidencebased programs based on the four components of successful living: social, intellectual, physical and spiritual. Vertical fits into the physical component by promoting ongoing movement through exercise, but it also fits into the intellectual component because the topics that are taught are exciting and participants are encouraged to ask questions and learn new things in relation to fall prevention. According to Masterpiece Living, falling is a common occurrence among older adults. The goal of the Vertical Program is to educate individuals on some simple and practical things that they can do to minimize their risk of falling. The best way to prevent falls is through education on the risk factors related to falls, and to exercise to help build strength and balance. “We get great attendance when we run the Vertical Program. This is our second year, and last year, more than 100 residents attended. This year, we’ll run two different sessions of the program for six weeks,” says Laurie. Topics stem from the risk factors associated with falling, and past speakers have included pharmacists, orthopedic doctors and specialists in the field of balance. Laurie also provides the residents with documents that they can take home, such as an environmental assessment and a listing of medications that are known to cause dizziness. There is open discussion so that the residents are able to ask questions of the specialists.

Fast Facts on Falls: • Once an older adult falls, they are two or three times more likely to fall again. • One bad fall can take away your independence. • Falls are the leading cause of injury deaths among older adults.

• Social isolation can often arise after a fall because the individual may be injured, requiring them to stay at home. Social isolation also occurs due to the decrease of self-confidence and increased fear of falling again, which leads to an inactive lifestyle.


Fall Risks A fall can happen at any time to anyone. Did you know that the beautiful rug in your living room could cause you to trip? Or that your favorite shoes may not be sturdy? Did you also know that taking more than one medication at a time could cause dizziness, which could lead to a fall? The good news is that all of the in-home risks can be easily corrected by doing a simple assessment of the home.

Assess your mess to stay independent! Here are a few things to look for room by room: • Bedroom: Nearly 50% of older adults get up in the middle of the night to go to the bathroom – some more than two times a night. Make sure you have a lamp on both or either side of the bed – and turn it on when you get up so that you can see where you are heading. Also, be sure there is a clear path to the bathroom, especially be sure your comforter isn't in the way – that’s a trip hazard! • Bathroom: Bathroom floors get wet. Have a slip-resistant mat in front of the sink, toilet and bathtub to prevent falls when water may be present on the floor. It’s also important to have anti-slip protection in the shower or tub. To reduce your risk for falls even more, install a grab bars for extra support in the shower or near the toilet.

• Kitchen: The best place to store items that you use frequently is at waist level. That eliminates unnecessary bending and reaching. If you store items overhead, be sure they are not too heavy. When getting them down, use a step stool, not a chair. Chairs were meant for sitting and not standing on, so you are taking a big gamble standing on a chair. Like bathroom floors, kitchen floors get wet. Have towels handy to wipe up liquid spills right away or have a slip-resistant mat down in front of the sink. • Living Room: Sometimes the most appropriate and safest arrangement of furniture is not always the most aesthetically pleasing. Arrange your furniture in a way that you have a clear path. Rugs should have slip-resistant backs and cords should be tucked away. It may not look the prettiest, but it could be the safest. • Hallways/Stairs: Did you know that worldwide, it has been argued that falls on stairs rival road accidents as the leading cause of accidental injury and death? And older adults are at a greater risk than any other age group to fall down stairs. Make sure stairs are clear of obstacles. Some older adults also have a hard time distinguishing where one step ends and the other begins due to vision impairment. Be sure your stairs are well lit.

Do the Brown Bag Review It’s important to know what medications you are taking and if they could interact or counteract with each other. A tip is to do a brown bag review with your physician. Gather up all of the medications and supplements you are currently taking and put them in a bag, schedule an appointment with your physician to review the medications that you are taking. This will give your physician a chance to see all of the medications you are currently prescribed, especially if you are seeing a specialist. This gives your doctor the opportunity to recommend changes to dosages or medications. Laurie noted, “To create greater awareness, we give out a list of medications that can cause dizziness. We actually had a resident participate in the Vertical program that took the list, reviewed all of her medications, and realized that it was possible that one of the medications was causing her dizziness. She took her concerns to her doctor who listened and changed the medication. It's gratifying to see how our support is helping our residents make better choices every day."


Measuring physical fitness “It is often difficult to track falls for our independent living residents. Often times, a fall goes unreported, especially if it does not result in an injury,” says Jason Klein, wellness coordinator at Longwood at Oakmont. One way to gauge how likely a resident is to fall is to encourage them to complete the Mobility Review which is a tool created by Masterpiece Living. “The Mobility Review is a physical fitness assessment that measures gait, balance, strength, flexibility and general mobility,” says Jason. “The review takes about 30 minutes to complete and we offer mini-coaching sessions after the results come in to help the residents see what they are doing well, and what can be improved on.” Laurie and Jason both emphasized that the review is not a test! Jason says, “Some of our residents are hesitant to do the review because they feel that ‘bad’ results will send them from their independent living apartment to our skilled nursing community. That is not the case. The review is designed to keep the resident where they are, for as long, and as safely, as possible. There are things we can do now to minimize the need for a clinical intervention in the event of a future fall.”

The mobility review is fun, and is made up of several parts: • Eight Foot Up-and Go: measures gait, motor ability and dynamic balance, as well as the ease and speed with which the participant is able to change directions while walking. • Arm Curl: measures upper body strength necessary for numerous daily functions, such as lifting groceries, performing housework and general lifting. • Back Scratch/Functional Reach: measures upper body shoulder flexibility, which is necessary for daily tasks such as reaching, cleaning and gardening.

• 30-second stand: measures lower body strength needed to climb stairs, walk distances, dance or any other activity that requires lower body movement. Lower body strength also helps reduce the risk of balance issues and falls. • Chair sit and reach: measures flexibility in the lower body, which is important for posture and mobility tasks like walking and climbing stairs. • Single leg balance (both legs): measures balance, which helps to reduce the risk of falls

After the Mobility Reviews are completed, Jason sits down with the resident to go over the results. For those who are at a higher risk of falling, Jason usually recommends morning exercise or an arthritis class that focuses on building strength. Some residents do not like group classes, so Jason offers one-on-one training appointments. “We have so many great classes that the residents can participate in like Tai Chi, water aerobics, kickboxing and yoga. There are plenty of opportunities to get up and get moving,” says Jason. More than 100 residents at Longwood at Oakmont took the Mobility Review in 2018. “We are seeing results. In fact, we have seen an increase in the usage of our exercise rooms, almost doubling the number of residents who use the rooms. The Wellness Center is also seeing increased usage of the pool. Pool visitors are up by 35%.”


Mind your health to stay independent! Here are a few tips you may not have known. Your home is not the only potential fall hazard, your health is, too! A contributing factor affecting balance is the number of chronic conditions you may have. It is suggested that the likelihood of falling increases if an individual has multiple chronic conditions. “Part of fall prevention education is knowing your habits,” says Jason. “If you shuffle your feet, you may not even realize you are doing it because you do it every day. Also, walking with an arched back is very common among women with osteoporosis. While we can’t change the condition, we can do exercises that help strengthen the back and promote better posture, which decreases the likelihood of falling.” Jason recommends movement, but also recommends that you check the following in regards to your health: Are your legs strong? No? Work your lower extremities! Exercise and balance activities have shown to be very effective in preventing falls. Many falls are attributed to muscle atrophy in the lower extremities, so doing strength exercises for the legs is effective in preventing falls and sustaining independence. Keep your head up. Where your head goes, your body follows. To decrease your chances of falling, try not to look down. Have your vision checked. Vision impairment, cataracts, macular degeneration, changes in depth perception can all contribute to increased falling.

How’s your blood pressure? Low blood pressure can also cause older adults to fall. It can cause the blood to rush to the head after you stand up from a sitting position which can cause dizziness or lightheadedness. How many medications do you take? If you are taking four or more prescription medications, you are at a higher risk of falling. Certain types of drugs increase that risk, particularly psychotropic drugs or the combination of drugs such as psychotropic drugs and narcotics together. This type of polypharmacy can be very dangerous and should be carefully reviewed by a physician.


Now What? “After residents take the Mobility Review and know where they stand, it’s all about small steps. Don’t self-sabotage by making big goals that may not be achievable,” says Laurie. “I’ll often tell residents to walk around their chair during a commercial break. It’s that easy to move more.” Laurie also encourages residents to collaborate with their physicians and to play a role in their own healthcare, specifically around medication management.

“We have recently started to track our falls so that we have a better understanding of why our residents fall, what time of day they fall, as well as where they fall,” says Jason. In 2019, the team has specific goals around reducing the incidence in falls in the independent living communities. Through the Vertical program, educational tools and variety of educational classes, positive results are expected.

Fast Facts on Falls: The percentage of older people meeting federal physical activity guidelines decreases with age, ranging from 15% among people ages 65 to 74, to 5% among people age 85 and over. Source: agingstats.gov

UPRITE Fall Prevention Education Program in our Care Communities “Every community that serves the older population is looking for ways to reduce falls. There is no one concrete way to prevent falls. Knowing this, we take special precaution to keep our residents as safe as possible while they are in our care, and one way we do that is through the UPRITE Fall Prevention Education Program” says Ginny Burke, director of clinical education and quality. The main focus on the UPRITE Fall Prevention Education is that everyone in the community, from nursing to housekeeping to maintenance, can help prevent falls. In fact, UPRITE stands for YoU help Prevent Resident Incidents with Team Effort! “All team members who work in the neighborhoods in our skilled nursing and personal care communities know the residents just as well as a nurse does, so we have trained different disciplines to be looking, watching, and pointing out any potential fall risks,” says Ginny. “UPRITE really focuses on the importance of being aware of what’s going on around you. If a team member is passing through a neighborhood and notices someone is trying to get up alone, they assist them or get a team member that can. If they notice a call light is on, they will pop their head in – a resident may need something that is just out of reach such as the television remote or a tissue. It’s the little things like this that can prevent bigger things from happening,” Ginny says. In our care communities, we have a larger number of residents who are wheelchair bound, or who use walkers to get around. Because the mobility of some of our residents is limited, they often experience weakened legs and muscles due to inactivity. Ginny says, “In order to assist those residents who have limited mobility, we encourage our team members to frequently ask if there is anything the resident needs, even if they have just helped them or are just checking in. We have found that rounding consistently has improved resident satisfaction and safety.”


Do you exercise your toes? Tai Chi offers a multitude of health benefits – and toe exercise. FUN FACT: According to Masterpiece Living, poor balance and gait have shown to be significant contributors to falls. Their research suggests that participating in balance activities such as Tai Chi improve gait and physical balance. In fact, Tai Chi exercise helped to reduce multiple falls by 47.5%! Calm the mind. Reduce your blood pressure. Better your balance. Thanks to the Tai Chi class available at Longwood at Oakmont, residents are able to experience multiple health benefits that stem from the practice. Tai Chi, originally developed for self-defense, has evolved into a graceful form of exercise that's used for stress reduction and a variety of other health conditions. Residents are encouraged to partake in Tai Chi not only due to the health benefits involved, but because of its emphasis on stretching and balance, which can help to prevent falls. Doreen Boyce, longtime resident of Longwood at Oakmont, began taking the Tai Chi classes as soon as they were available in October 2017, and fell in love with the art. “I had read about Tai Chi and it sounded so intriguing. Dick Van Dyke even promoted it on television, crediting Tai Chi as the reason he can still tap dance in his 90s, and I thought, ‘Oh I want to be like that!’” The class, offered three times a week at the Wellness Center, is taught by Phil Jannetta, who was trained in Tai Chi in Japan. According to Doreen, Phil devotes a segment of the class to what he calls “loosening” exercises, where participants gently stretch and exercise every joint in the body, including fingers and toes. Doreen enjoys these exercises, saying, “You stretch your whole spine and you feel better for it. We older people may sit too much, so we need these loosening exercises to keep in shape!” After the loosening exercises, the class dives into the traditional portion of the Tai Chi session.

Left: Doreen Boyce, Resident of Longwood at Oakmont and Tai Chi practitioner

“It engages your mind and your body, and for Tai Chi, one’s mind and body must be in tune. That’s how one can reduce the risk of falling and stimulate the brain,” Doreen shared. She continues, “While doing the loosening exercises, you find that your feet and hands tingle because the blood gets into the joints, which is very important at my age. One of the reasons I think Tai Chi is good for not falling is because it exercises your toes, which, when strengthened, can really aid in preventing falls. Most people don’t think about that, because who exercises their toes?” Doreen has never experienced a fall. “Can I attribute this to Tai Chi? I have no idea, but the fact that the exercises claims to prevent falls further reinforces my desire to continue.” In June, Doreen underwent surgery for a knee replacement, putting her Tai Chi on hold as she recovers. She still occasionally participates in the loosening exercises, but she can’t wait to get back to full-time Tai Chi. “Although I am a Tai Chi enthusiast, I must curb my enthusiasm and discipline myself so I don’t interrupt the healing process. Complete recovery takes a year, and I’m more than halfway there!”



A comprehensive care management program We know that caregiving often can feel lonely and demanding. With Dementia360, you are not alone. A full circle of dementia care specialists will be involved to support you in your caregiving. Dementia360 is a new, comprehensive care management program designed to help you care for your loved one at home, while preparing you for the ongoing challenges of dementia. Your Dementia360 care coordinator will guide you along the way by: • Conducting an in-home assessment to better understand your home setting and support system. • Creating a personalized roadmap, based on the in-home assessment, that addresses any needs and enhances quality of life. • Connecting you with the right services at the right time. • Offering advice and empowerment through regular touch points to help you better manage the dementia and related symptoms.


1 in 3 caregivers is age 65 or older

2 in 3 caregivers are women; 1 in 3 is a daughter 1 in 4 caregivers is in the “sandwich” generation — caring for a child under age 18 as well as a senior

• Providing supportive education that includes managing chronic conditions, preventing crisis situations, self-care, coping skills, and more.

41% of caregivers have a household income of $50,000 or less

Dementia360 will help you as a caregiver to:

59% of caregivers rated their

• Better manage the disease and related symptoms.

emotional stress as high or very high

• Extend the length of time that the person you are caring for can comfortably and safely stay in the home.

30%-40% of caregivers suffer

• Experience a better quality of life for you and the person for whom you are the caregiver. As a Dementia Care Center of Excellence, Presbyterian SeniorCare Network has developed Dementia360 based on our decades of innovation and experience in caring for persons living with Alzheimer’s disease and related dementias. To learn more about program eligibility and participation in a special introductory offer, visit www.pscndementia360.org, email us at Dementia360@SrCare.org, or call 412-435-8950. Please note that at this time, the Dementia360 program is available in the surrounding Oakmont/Plum Borough area with plans to expand next year.

from depression

44% of caregivers have anxiety 41% provide care alone 6 in 10 caregivers is employed 35% of caregivers reported that their health has gotten worse due to care responsibilities

27% of caregivers reported they had delayed or did not do things they should for their own health

Source: Alzheimer's Association SOURCE: ALZHEIMER’S ASSOCIATION


Welcome, Amy Kowinsky, Executive Director, Dementia360 Amy joined our organization in December 2018 and is eager to work with our teams and the Oakmont community to provide education on our exciting new care management program, Dementia360. Get to know Amy! What is your role at Presbyterian SeniorCare Network? I am working with a great team of people to create and implement the Dementia360 program. What type of education do you have?: I received a BS in Nutrition: Dietetics at West Virginia Wesleyan College. I also completed a Certificate in Gerontology in 2017 from the University of Pittsburgh. What experience do you bring to Presbyterian SeniorCare Network? I worked at UPMC Shadyside for five years as a Patient Food Service Manager. My next job (the only other one I have had) was as a Quality/Process Improvement Specialist at UPMC, which I did for 12 years. One of the most gratifying projects I worked on was implementing a Dementia Activities Room – a safe space for people who had dementia and were also hospitalized-- on one of the inpatient units at Mercy Hospital. Why did you come to Presbyterian SeniorCare Network? I have always had a warm spot in my heart for seniors, and am very comfortable in the long-term care environment, but I always worked in a hospital. When my grandmothers both began facing the challenges of aging and dementia, and I became a caregiver, it became clear to me that there are a lot of opportunities to improve quality of life for seniors. I wanted to make a change that would allow me to use my experiences to help others on a similar journey. I feel blessed to be in a position that allows me to do just that – and get paid for it!

What are your first impressions of campus/ residents? I love it! There is a great culture here and everyone has made me feel very welcome. I love interacting with the residents. I have been here for a short time and it is already feeling like home to me. In your time at Presbyterian SeniorCare Network so far, what’s made your heart smile?: My proudest moment so far was going to the Plum Senior Center Caregivers Group and being able to sit with a small group of caregivers for people living with dementia and tell them how our upcoming Dementia360 program can help to support them. It is one thing talking to colleagues about the program, but it is very different and meaningful talking directly with the people we hope to help the most. A Few Fun Facts About Amy! Family: I live with my husband and two bad cats. Our parents, siblings, and nieces and nephews live close by, so we get the chance to spend a lot of time with them, too. What did you want to be when you grew up: I wanted to be a detective because my favorite TV show was Scooby Doo. Guilty pleasure: Winding up my nieces and nephews with my husband, and then sending them back home to their parents! Bucket list: Scuba diving in the Great Barrier Reef Hobbies: Traveling, diving, running, cooking, home improving, outdoor activities, spending time with people I love. Interesting fact about you: I have run with the bulls twice in Spain.

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