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California is unique in many ways. We have the best weather in the entire country, we are cultural trendsetters, and we are the only state to host the residential care facilities for the elderly (RCFEs) model. You may wonder what RCFEs are and how they differ from other senior housing models. We will answer that question and more in this article.

RCFEs, commonly referred to as Care Homes or Residential Care, include Assisted Living, Continuing Care Retirement Communities (CCRCs), and Memory Care to seniors who are age 60 and over. Aside from housing, RCFEs deliver care to senior residents along with assistance with daily living, activities, and general supervision as needed. Plans are custom-tailored to meet the needs of each individual and folded into the medical services provision of special care plans.

How Is the RCFE Environment?

A good Residential Care Facilities has an atmosphere that is warm and inviting, just like home, and  promotes maximum possible independence and dignity. RCFEs encourage the involvement and support of family and community members to maintain or improve the quality of life for their residents. Residents have access to a host of supportive services, such as housekeeping, personal care, dressing, bathing, and the safekeeping and distribution of medications to its residents for self-administration.

One of the benefits of an RCFE is that it acts as an intermediary between independent living and 24-hour nursing care. RCFEs can act as a bridge for the person who is no longer able to live independently but does not require round-the-clock assistance and supervision. They are not medical facilities, which means they don’t necessarily have nurses or doctors on staff (or at least there’s no requirement to have them staffed). Think of them more as assisted living and less as nursing homes.

RCFEs provide safe and healthy living accommodations and services. Some of the ancillary services include but are not limited to:

•         Consistent monitoring of the resident’s mental and physical state of being
•         Regular, healthy meals and snacks with diet modifications
•         Recreational activities and social engagement in a fun environment
•         Transportation and outings

Comparatively, Skilled Nursing Facilities provide 24/7 skilled professional medical services. This includes more specialized care that can only be treated by qualified, credentialed health care workers. Skilled Nursing Facilities are medical facilities as opposed to a housing option that includes services.

What Regulations Are in Place for RCFEs?

RCFEs are designed to promote independence and self-direction to the greatest extent possible in a residential setting. An RCFE license is issued by the Department of Social Services in California. They are governed by robust regulations and must meet quality, care, and safety standards as defined by the State. They also require an inspection by the Department of Social Services and the local Fire Inspector.

To open and operate an RCFE, one must submit a license application to the Community Care Licensing Division. Applicants must provide evidence that demonstrates they are of upstanding, reputable, and responsible character in addition to all the other application requirements with which they must comply. Additional items in the application include medication policies and procedures, sample menus, how and when their staff will be trained and a sample budget. Assisted Living Education can prepare your license application for you. 

Should I Be Concerned About Covid-19 and RCFEs?

Many of the deaths that have occurred in the U.S. due to Covid-19 have occurred in the elderly population and nursing homes are a part of that equation. Like hospitals, Skilled Nursing Facilities are medical environments where viruses and other illnesses can spread especially among the elderly. RCFEs are not medical facilities and have not experienced the outbreak of SARS-CoV-2 to the extent that medical facilities have. Still, it is always important for the elderly and those with underlying health issues to take every precaution necessary to protect against the virus. A well-run RCFE that has opened properly will have the right protocols in place to protect both the residents and themselves to the greatest extent possible.

Hopefully, this answers some of the questions you have about RCFEs. If you are worried about sending a loved one to this type of facility, don’t worry. They are a great first and gradual step back from full independent living with qualified staff that will serve your loved one well.

The close-quarters spread of the Coronavirus Disease (COVID-19) in residential care facilities poses a significant health threat to the vulnerable senior population, and the time to take action is now. RCFE Administrators and licensees in California and beyond are being encouraged by the CDC and Departments of Social Services to have a plan in place in the event of an outbreak in their community.  Assisted Living Education is here to assist you in managing  your RCFE and staying informed. 

Thus far there have been 22 deaths from coronavirus in the United States, with a total of 154 cases confirmed nationwide. California reported its first death recently following a growing outbreak in the Bay Area, but it’s Washington state that has been hit the hardest, with the ten remaining U.S. deaths all happening in and around Seattle.

By now, you’ve no doubt heard about the ongoing emergency at Life Care Center in Kirkland, WA, the nursing home that now serves as an example of what we should all be trying to prevent:  an unchecked outbreak on its premises is to blame for five deaths seen thus far.

While the global mortality rate is 3.4% (WHO, March 2), among seniors and those with underlying medical conditions the fatality rate appears quite a bit higher — about 14%. Comparatively, the mortality rate of the seasonal flu is typically about 0.1% in the U.S. The reality is that it’s difficult to fully ascertain the morbidity and mortality of coronavirus. Experts suspect that the actual number of cases in the U.S. could be in the thousands, but since many people who contract the virus experience milder symptoms similar to those of other respiratory illnesses (e.g. the common cold) — they don’t isolate themselves and continue on with their daily lives. As a result, transmission rates could be much, much higher.

Per a CDC fact-sheet about how coronavirus is spread, here’s what you should know:

• The virus is thought to spread mainly from person-to-person [and] between people who are in close contact with one another (within about 6 feet).

• [It is spread] through respiratory droplets produced when an infected person coughs or sneezes.

• These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

• People are thought to be most contagious when they are most symptomatic (the sickest), [but] some spread might be possible before people show symptoms.
• It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. 

Considering these facts, the danger of COVID-19 spreading unnoticed through our communities is something we should all be concerned about, but for residential care facilities it presents a clear and present danger. The tragic situation in that Washington nursing home should serve as a wake-up call for every RCFE Administrator and licensee. There is no time to delay.

So what should senior care facilities be doing to manage the spread of coronavirus among their residents? Here’s what the California Department of Social Services and the Centers for Disease Control suggest:

• Avoid close contact with people who are sick.
• Avoid touching your eyes, nose, and mouth.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
• Follow CDC’s recommendations for using a facemask.
  • CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19.
  • Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to  others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a healthcare facility).
• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if your hands are visibly dirty.

For more specific information on how a long term care facility (LTCF) can minimize it’s risk of a coronavirus outbreak, the CDC has resources for healthcare facilities to help licensees build a more specific action plan. Pages we recommend reading include:    

• Steps Healthcare Facilities Can Take
• Interim Guidance for Healthcare Facilities
• Strategies to Prevent Spread in LTCF
• Information for Healthcare Professionals

There is a lot we do not yet know about COVID-19, and every day brings new details about the virus, it’s spread, and the risk we might face going forward. It’s not a situation that calls for an alarmist reponse — few situations do — but it is a reality that we need to prepare for. As it stands, a vaccine for the novel coronavirus is still at least a year out, and just this week China announced that it had isolated two different strains of the virus. Meaning, it’s likely going to be a while until we are all out of the woods.

For Residential Care Facilities for the Eldery, that means taking preventative measures now to ensure they can safely manage a potential outbreak among their residents. We have a long road ahead of us, and lives are at stake.

If your facility needs assistance with formulating an action plan please do not hesitate to reach out to us for help. We offer an online infection control course as well. Here at Assisted Living Education it is our core value to empower our students to care for the elderly in the most responsible and compassionate ways possible. This includes protecting them from threats like the coronavirus to the best of our ability. Together we can make a difference and help prevent further tragedy. 

Assisted Living Education is the premier provider of RCFE classes, licensing, products and services for assisted living. Our teachers are industry professionals with many years of experience that are engaging, entertaining and highly informative. They offer RCFE consulting services and share real RCFE experience that will help you be successful in this fast growing career industry.

Starting your first Resident Care Facility or RCFE can be exciting, fulfilling and daunting all at the same time. Between securing a location and getting your certifications it can be easy to overlook the basics — the essential aspects that will help ensure your RCFE is a success.

Over the years we have worked with hundreds of newly minted RCFE administrators to make sure their facilities, policies, and business strategies are setting them and their residents up for the best possible experience. In that time, we’ve learned a thing or two, particularly about what you should and shouldn’t do when hiring your staff. After all, your employees are the backbone of your RCFE!

Here are the 7 Do’s and Don’ts of hiring staff for a residential care facility for the elderly.

Don’ts:

1. Warm body hiring:  hiring in desperation.

It’s one of the biggest mistakes an RCFE administrator can make. In your desperation to put together a staff, you might think that any warm body will do. Trust us, it won’t! It is completely okay to be patient and take your time to build your ideal team. After all, these are the people you’re going to be working with day in and day out, and they’re the employees you are going to rely on to care for your residents. You want to make sure they’re not only qualified in skill, knowledge, temperament (a big one!), and experience, but that they also have the capacity to grow into a larger role. Hiring anyone with a pulse out of desperation to fill the role is the perfect way to open yourself up to lawsuits. Remember that in the health and senior care industries, you aren’t just hiring an employee:  you’re potentially hiring a liability. That’s a whole lot of trust to place on the first person to walk through the door… who you now have to spend time (and money!) training and fingerprinting.

2. Only interviewing one person.

She’s the first person in for an interview, and you think she’s perfect. She’s warm, she’s qualified, she’s great with the residents, and she has experience to boot. There’s no two ways about it:  she is your dream candidate, so much so that you’re tempted to hire her on the spot.

This scenario is nothing new. It happens all the time in companies across the nation (and the world), but there are a few problems with only interviewing one person. Think about it, what are you doing when you interview someone? You’re gathering information. Additional candidates means more of this information, and thus more context. By allowing yourself the benefit of comparing a wider field of candidates, you’ll be able to make the most qualified choice.

In interviewing a bunch of people, you might also discover that you didn’t actually know what you wanted. It’s a surprising but true phenomenon, and the reason why you often see job postings with a seemingly endless list of impossible-to-meet criteria (another big no-no). Hiring managers just aren’t sure what they’re looking for. If you’ve ever gone on a date, and found yourself struck by someone totally not your type, you’ve seen this phenomenon in action. It’s human nature. We don’t always know, much as we think we do. The same can be said for job candidates, though. Hiring is a two-way street. As much as you are interviewing them, they are also interviewing you. That perfect candidate you’re crazy about might have multiple offers, and end up going somewhere else.

3. Not having updated job descriptions/responsibilities when interviewing a candidate.

The phenomenon continues! How often have you heard about a company deciding to “go a different direction?” In many places, this can be code for “the job we were originally hiring for has now evolved into something totally different.” Frequently this takes candidates by surprise, and can be super frustrating when everything is in flux — especially for candidates who appeared to be a shoe-in during the interview stage. It’s understandable that things change, but if you’re trying to find the right candidate for XYZ open position, you need to know what that role will entail. How will interviewing applicants know what responsibilities they will have if YOU don’t even know? 

4. Not asking the same questions of each candidate to gauge their answers.

This harkens back to what we said about comparisons in Don’t #2. In every interview you do for a given role, it’s important to have at least a certain number of questions that you ask consistently. By comparing and contrasting your candidate’s answers, you have a standardized way of judging who is the best fit. This doesn’t mean that every interview needs to follow the same script — the best interviews are more like conversations than question and answer sessions. Think about how awkward and stilted those Q&A’s are. Some people are great at interviews, but for most people they are incredibly stressful. (Who hasn’t completely blanked on even the simplest question?) Allowing some room for deviation (and personality) is a great way to put a candidate at ease, and allow them to give you their best answers. But even as the conversation evolves, always bring it back to your standard.

Do’s:

1. Introducing them to residents to see how they interact.

Your residents are the people they’re going to be caring for every day! It’s important to see how your candidates respond to them. If they are aloof, that tells you a lot about their attitude and how they might be as an employee. You want someone who engages with the residents, talks to them, and is open to hearing their concerns. Someone who is dismissive or disrespectful of the seniors in your care has no business being part of your RCFE staff.  

2. Analyzing the 3 C’s:  commitment, caring and culture.

You can’t work at a residential care facility for the elderly if you’re not a team player. Your staff is going to be working closely with one another day in and day out, so it’s important that they make a good fit for the culture. This doesn’t mean that every employee has to be BFFs, but they should be able to work together to get their jobs done. If they can’t put caring for your residents ahead of any interpersonal issues, productivity is going to suffer, and you run the risk of accidental negligence. These attitudes also go towards commitment (or lack thereof). You want someone who doesn’t just show up for work, but who actually shows up for work — someone for who this isn’t just a paycheck. Working at an RCFE doesn’t have to be their life’s calling, but it has to be something they’re committed to. The wellbeing of your residents depends on it! To put it simply, if they don’t care, how will they be able to care? Do they care about seniors, and want to do what’s right by them, or is this just going to be a job for them?

3. Remind them of the qualifications of the job.

We’re not just talking about responsibilities here. There’s more to qualifications than having the experience or abilities to perform the duties adequately (with or without reasonable accommodation).

DSS regulations require staff, persons residing in the facility, and most volunteers to have a criminal background clearance (or exemption) prior to their first day of work. This means that they will need to be electronically fingerprinted, at which point the California DOJ will conduct as background check. If the candidate has a criminal history, that won’t necessarily disqualify them. California’s Caregiver Background Check Bureau will review the transcript and decide if the conviction(s) were for crimes that may be exempted. Candidates with non-exemptible convictions will not be eligible to work in your care facility. 

The employee will also need to go to a local healthcare clinic (this is something you can arrange) for a health screening to verify their general well-being, and to demonstrate that their current health condition allows them to perform the type of work required. At the clinic, the physician will fill out and sign LIC 503, the health screening report for facility personnel. As a portion of their health screening, employees will also have test negative for TB.

Are you ready?

The process of successfully opening and staffing an RCFE in California might be a long one, but in the end it will all be worth it. The senior care industry is among the fastest growing industries in the country, and California is no different. We must be prepared to meet the needs of seniors with the best care possible. More growth means more new facilities, and more new facilities means hiring the best employees.

The need is there. Are you ready to provide it?

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Assisted Living Education is the premier provider of RCFE classes, licensing, products and services for assisted living. Our teachers are industry professionals with many years of experience that are engaging, entertaining and highly informative. They offer RCFE consulting services and share real RCFE experience that will help you be successful in this fast growing career industry.

As humans, we are all prone to error. Even in industries where a single mistake could mean life or death, errors are made. But just because “to err is human” does not make it right. In the case of our aging senior population, RCFE Administrators have a responsibility to the health and wellness of their residents, who in their final years have become wholly reliant on others to meet their needs.

If you already have an RCFE Administrator certificate — or are soon to earn one through an RCFE Administrator course — you are duty bound to provide all individuals in your care with a safe and welcoming environment compliant with all state and local regulations.

Here are numbers 1-5 of the ten biggest mistakes made by RCFE’s — mistakes that make it that much more difficult for you to fulfill your obligations as an administrator.

1.   Admitting inappropriate residents

In 2013, nearly 7,000 complaints were made to the National Ombudsman Reporting System (NORS) regarding resident on resident conflicts in care senior facilities. Admitting sexually inappropriate, offensive, or combative residents into your community is all but certain to cause headaches down the line, and will quickly lead to a hostile and uncomfortable environment for the others in your care.

Residents have a legal right to be free from verbal, sexual, physical, and mental abuse, and to be treated with dignity and respect. Admitting inappropriate residents and those who mistreat others creates an environment counter to those rights.

2.   Hiring the wrong employees

Your employees are the backbone of your RCFE. They’re the people you interact with everyday and the hands who care for each and every one of your residents. Without them, you would not have a facility. With the wrong ones, your home will suffer for it. The hiring process is a delicate one; rife with potential pitfalls.

Fire-drilling the process of building your team is not the way you will find competent, qualified, candidates who are not only passionate about their work, but also show up day in and day out, even when it’s challenging.

You want people who aren’t just there for a paycheck, but rather come to work every day intent on making the lives of your residents better. Bad attitudes, contemptuousness, and disregard for a resident’s well-being have no place in the care industry, let alone your RCFE.

3.   Not training their employees fully and correctly

None of us walk into work that first day completely prepared for the job we’ve set out to do. The moment you are, you’ve already moved up to the next position. The assumption that someone will be able to hit the ground running and do everything perfectly from day one, is nothing short of folly. Employees need training, always. Not only when they begin, but over time as well. Training keeps us fresh and on top of shifting best practices. Without it, employees won’t be able to do their jobs properly, and if something goes wrong, you’ll have no one to blame but yourself.

Remember, always document all training an employee has done — otherwise, it did not happen!

4.   Disrespecting the LPA

Licensing Program Analysts, or LPA’s,  are state workers whose responsibility is to manage the licensing, evaluation and investigation of RCFE’s. As employees of the Community Care Licensing Division, about 50% of their time is spent out in the field conducting site visits and inspections of care facilities. They play a vital role in making sure that every RCFE meets state standards and is living up to its mission of properly serving the needs of its residents. Disrespecting your local LPA will do you no favors with the state. They have the authority to issue citations and civil penalties should an RCFE be found to be negligent or deficient — as they should. Viewing him or her as the enemy will accomplish nothing. It is not you against them, but you both against the problem.

5.   Not befriending the Ombudsman

Just as it is important for you to get up know your local LPA, so should you befriend the Ombudsman. As advocates for the residents of assisted living facilities, the Ombudsman only wants the same things you do:  a happy, healthy, and safe resident! Since it’s difficult for an aging person to advocate for themselves, somebody must. Befriending your Ombudsman will only make the process of resolving conflicts within your RCFE easier.

6.   Failing to complete proper resident file documentation

Any time there is a resident incident, such as a fall, it must be documented. Just as incidents like the above need to be reported to the resident’s physician asap (see mistake #10), it’s imperative that these incidents also have a paper trail. Liability is a huge potential problem for any RCFE, so defensive documentation is the best way to keep ahead of any issues down the line. When properly completing resident file documentation, specificity, precision, and descriptive detail are all musts. An incomplete file is not only a possible hazard to your residents, but it’s a lawsuit and a regulatory issue waiting to happen.

7.   Failing to do annual medical assessments on residents with dementia

The seriousness of dementia has lead states to enact numerous laws regulating the facilities accepting individuals with the condition. Among those is a requirement that all RCFE’s perform annual assessments on their residents with dementia. Since changes to one’s condition and behavior are all but certain to impact their care plan or which medications they take (see #9 on this list), it’s imperative that these be noted in a timely manner by licensees. Furthermore, these changes, if severe enough, may require a resident to be moved elsewhere — not all Residential Care Facilities for the Elderly are equipped or licensed to care for people living with advanced dementia.

8.   Failing to complete proper employee file documentation

A thoroughly kept personnel file is necessary to protect an employer in the event of audits or lawsuits, or any other type of employee-employer disagreement. In the case of the later, turnover becomes a risk. If another employee witnessed the issue in question, there’s a chance they are no longer available to give their account, thus forcing an employer to rely only on the documentation available in a personnel file. If few details exist in writing, that leaves the events open to debate, which can make it more difficult for an Administrator to justify cause for termination.

For a personnel file to comply, it should include state mandated  documentation. The file should also include any coaching, known policy violations, resident complaints, any disciplinary actions taken, and whether or not they met their performance goals. This record doesn’t need to be negative alone. A personnel file also serves as a justification of raises and promotions. So any noted positives should be included as well — key contributions, rewards, special recognition, client compliments, etc.

9.   Inadequate resident care plans

The Nursing Home Reform Act of 1987 was enacted by the federal government with the intention of advancing the rights of nursing home residents. This came after a study in 1986 showing that people living in RCFE’s at the time were not being afforded proper health care or personal treatment. In response, new laws were established that required all nursing homes accepting Medicare to develop detailed care and treatment plans for each resident, and follow them. Additionally, all residents were given the right to review their personal plans and to be given advanced notification of any changes.

Failure to comply with these regulations will not only be interpreted as neglect by regulators and the courts but does nothing but endanger your residents. Care plans exist to prevent elder abuse, minimize the potential for medication mishaps, and reduce the risk of medical mistakes leading to serious injury or even death.

10. Failing to notify the physician of a resident change of condition

The law mandates that any change of condition in the resident, no matter how small, must be communicated to their physician. A change in an individual’s condition could mean the difference between life or death, and a lapse in communication could prevent a resident from receiving critical treatment. It’s imperative that everyone on your resident’s care team is in the loop as changes occur, and it’s doubly important that these changes are noted in writing. We’ve all heard of the game “Telephone”:  word of mouth is terribly unreliable, but words on a piece of paper are far less likely to be misunderstood. Written records reduce the risk that a serious change in condition will get mixed up in the shuffle.

There you have it. Those are the top 10 mistakes that Residential Care Facilities for the Elderly make. Mistakes like the above put your residents at risk and your facility in jeopardy. Luckily, all of them are easily preventable.

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Assisted Living Education is the premier provider of RCFE classes, licensing, products and services for assisted living. Our teachers are industry professionals with many years of experience that are engaging, entertaining and highly informative. They offer RCFE consulting services and share real RCFE experience that will help you be successful in this fast growing career industry.

Joyous as the winter season can be for some — with fresh blankets of snow, a warm hearth, and the love of family surrounding them — for others it can be a time of struggle. Not only do the holidays and cold months often counterintuitively bring some people down, perhaps in part the result of past psychological drama, but they can also trigger persistent depression.

The Holiday Blues and Seasonal Affective Disorder typically manifest in similar ways, but their origins and treatment are different. In our last post we discussed the symptoms of each condition, as well as why they might befall certain residents in your care.

As caregivers, we play an important role in an individual’s day to day life; our close relationships with those we look after allow us to notice changes in mood and behavior, and alert other members of the care team. Keeping everyone in the loop, especially the psychiatric professional who will provide the diagnosis and treatment, gives a resident the best shot at recovery.

Here are some of the ways we can help our senior residents when the black dog begins to growl.

Helping Residents With Holiday Depression

With proper planning and program design, it may be possible to shift a resident’s mood throughout the holidays, and prevent the Holiday Blues from taking hold in the first place.

Well before the holiday season or particular event arrives, try to make an extra effort to engage with those residents who may be at risk for experiencing a depressive episode. One simple way to start is with a conversation.

Have Meaningful Interactions With Your Residents

Regular, casual engagements with your residents can turn into lasting relationships, with positive benefits for the residents. These relationships can help toward stabilizing emotional highs and lows that may be experienced during particular times of year, like the holidays, where residents can tend to feel more isolated and lonely.

Initiating daily conversations with each and every resident may sound like a daunting and time-consuming task, but even keeping it short and sweet can brighten a resident’s day. It’s not necessary to have a long, sit-down conversation, but try to create an ongoing dialogue whenever you see your resident either in passing, during medications administration, therapy sessions, mealtimes, or other times you may have scheduled contact with them.

Not every individual will be responsive, for various reasons. They may be shy, have trust issues, or they may have a disorder or cognitive issue that makes it difficult for them to interact openly with you. These individuals may take some time to warm up to you, or you may need to change your approach. Gauge how the individual reacts to conversation; you may need to back off and take smaller steps for them to open up. You may be doing most of the talking at first, but over time, you might find it balances out to a more even exchange.

Begin inviting them to group activities or outings, but ever push a resident into something they’re. not interested in doing. Nonetheless, always let them know they’re welcome to join if they want. These relationships might take longer to develop, but for resident and caretakers alike, they can be truly meaningful.

Even for residents who have advanced dementia or Alzheimer’s, or other cognitive or verbal limitations, you making an effort to reach them can make all the difference. Singing to them, talking to them, or signing with them will help these individuals feel connected to other people. Their responses may be different, but pay close attention to their behaviors and body language for positive or negative feedback.

These are all important components of trust-building, which can help you with other times in the long-run. As a trusted staff member, the resident may look to you in times of difficulty or even non-compliance to remain calm or de-escalate a tense situation.

Involve Everyone in the Festivities

Most facilities decorate and have events correlating with the major holidays, which is a great start to creating a warm and festive environment. If possible, find out which holidays in particular your residents like to celebrate throughout the year, and make an effort to have those represented if they aren’t part of the mainstream/regular celebrations. Even decorating a common area or the hall near their room can help bring some cheer. If the resident(s) are able, they can help explain the traditions with which they’re familiar and share stories they recall from their past.

The winter holidays are also a great time of year to invite people from the community to interact with residents. Local religious organizations, youth musicians, choirs, a capella or other community groups, and even schools can come sing and/or engage with residents and bring light to their holiday experience.

If possible, outings to local community events, or even driving around looking at holiday lights in the neighborhood are great excursions as well — but if that’s not doable, reaching out to the community and requesting greeting cards for the residents is another simple way to bring your residents cheer.

Recuperation Time is Important

With all of the activities and bustle of the holiday season, down time or quiet time is crucial. Even if elderly residents are enjoying themselves with all of the festivities, it is a change from their daily routine, and may be more physically and emotionally demanding on them than expected. As we age, it can take us longer to recover from activities, especially those out of our norm, whether we realize it or not. Moreover, stress and exhaustion can depress one’s immune response, causing someone to be more susceptible to illness.

Switching things up by having partial or half-day activities with ‘regular’ days in between will allow for recovery, and help reduce the mental and physical tolls the holidays can put on elderly folks.

Treating Residents Suffering From Seasonal Affective Disorder

Many of us are familiar with the term Seasonal Affective Disorder (SAD), but may not fully understand its condition, or even that there are different kinds of SAD. While we mentioned that there is a type of spring/summer SAD, the depression varietal we’re discussing here is fall/winter — the physiological condition coming to bear in the cold months.

For the period that the resident is suffering from SAD symptoms, antidepressants can be helpful, especially if the condition’s pattern is known. If a patient has a history of SAD, the an antidepressant regimen can begin prior to the expected onset of either winter or summer SAD. By starting sooner, the medication will be more effective.

Light therapy has also proven beneficial for sufferers of fall/winter SAD, especially among seniors who dislike taking medications or whom are already on multiple medications. Light therapy is also helpful for elderly who are not as able to go outside for natural exposure to light.

For residents with executive cognitive functioning within normal range, Cognitive Behavioral Therapy (CBT) is another possible treatment as well. What works best for every patient is different, and treatment can sometimes take a while to gain a foothold. In fact, there can be a great deal of trial and error in finding the right cocktail of medications or therapies, depending on one’s personal preference and brain chemistry.

A Light Through the Fog

The resident’s attending or personal psychiatrist/psychologist can determine the best course of treatment, depending on the individual’s needs, cognitive capabilities, and severity of symptoms. Even if the resident is receiving specific treatment from their psychiatrist/psychologist, it is pertinent to keep all doctors, therapists, dieticians, and other caretakers abreast of any adjustments to the resident’s routines, medical or otherwise. This helps maintain consistency and effectiveness of the treatment and resident care.

For residents suffering from Holiday Depression or Seasonal Affective Disorder, it might be a while before they can find their way to the bright side of life again, but always remember:  with your care and compassion, you are their light through the fog.

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Assisted Living Education is the leading provider of RCFE certification classes, licensing, products and services for assisted living. Our teachers are industry professionals with many years of experience that are engaging, entertaining and highly informative.