Five Steps to Greater Interdisciplinary Involvement

A common challenge for the activity professional is how to get the interdisciplinary team to see quality of life and engaging residents in activities as a team responsibility. Common responses from other staff are they have no time; or they ask if we will start doing their duties, if they are going to help us with ours. This has been an age old battle since I started in activities, many moons ago. The following are five suggestions which may move your community toward a more integrated mindset.

1. Know your regulations. If you work in a nursing home, there are at least six pages within the guidance for F-248 which address the role of the interdisciplinary staff member in promoting and providing activities. There are specific references about assisting residents to and from programs, providing independent and diversional activities when activities staff are not present and specific methods for the staff to integrate quality of life interactions within their duties. If you work in another setting such as assisted living or medical day care, the references may not be as specific, however within those levels of care – the approach has always been more socially based and integrated. Having these regulations and highlighting the specific notations regarding the role of the IDC team is crucial. If we can reference “the law” which is what regulations are, it does give our plea some weight. If you need copies of the F-248 or state regulations for your setting, send me an e-mail.

2. Create alliances. You know you have worked too long with the elderly when you start using the old adages to make a point but “You get more with honey than you do with vinegar” works here. Attacking, complaining and pointing out what people are not doing are rarely received well and puts people on the defensive. Working together as a team toward the same goal is often more effective and a lot more pleasant. Most direct care staff are very focused on their duties and vested in getting their duties done. Anyone or thing which diverts them from their duties is seen as a nuisance. If staff are approached with the respect that their duties are important, they often respond better. Mutual respect is earned over time and creates alliances.

3. Focus on the benefits. The activity professional knows the benefits of each activity and can be shared as a means to motivate staff to encourage resident participation. The benefits should be related to how it will assist the interdisciplinary staff in their day to day tasks. For example, encouraging a resident to participate in exercise will increase range of motion and upper body strength which may enable the resident to complete simple ADL tasks of dressing and eating. Involvement in programs which address diverting behaviors will keep the resident calmer and less agitated which will make for an easier day for all. The important message to staff is when a resident is assisted to a program or offered an activity, they are not “helping activities” but they are helping the resident which should be the shared goal of the community.

4. Incentives. Introducing incentives to the staff for assisting residents to and from activities has been tried by many. Raffle tickets or points given to staff when they assist residents to a program, inviting staff to have refreshments at a party; or creating competitions amongst the units or neighborhoods with attendance awards has been done with mixed results. These are external motivators and focus on the needs of the staff rather than the needs of the residents. This approach has worked more effectively when a special needs program is introduced. For example, a new sensory program is introduced and it is called “Sunshine Club’. The residents who should be assisted to this program will have a sunshine symbol placed somewhere in their room for the caregivers to see during care. This will remind them to assist this resident to the Sunshine club. During the early weeks of the program, when the caregivers assist the resident to the program, they receive the raffle ticket or whatever incentive being used. However, once the program is solidified and residents are assisted to and from programs as a part of routine care, the incentives are discontinued.

5. Be courteous. Smiling, saying thanks and please go a long way. So often we get caught up in our duties, we forget the niceties that contribute to quality of life for the caregiver. There are some facilities with a “grumpy” atmosphere, where you can sense an overall discord. Be the first person to begin changing that atmosphere and be the first to smile at others and initiate a courteous approach. At first, you might be ignored, but eventually people will reciprocate.

Light is the task where many share the toil.
Homer