Tech Solutions for Children with Developmental Delays

Boy with tablet demonstrating tech solutions for children with developmental delays

By Tarra Boris, Child In-Home Care Supervisor

 
Technology has become the center of everyday life for many children. A majority of the population revolve their lives around one form of technology or another. Children with developmental delays, such as Attention Deficit Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder (ASD), can benefit greatly with the right apps. Apps can help them build positive coping mechanisms to assist with focus, calming, and task completion. The following website and apps can assist parents and children, including those with developmental delays in everyday life.

 

Social story creator- Lesson Pix

Yearly membership of $36 as little as $3 a month
I have been using this website to make social stories for some time. Lesson Pix is an easy-to-use online resource that allows users to create various customized learning materials. It is quite easy to navigate around,and user friendly. You can create numerous learning materials such as bingo, coloring sheets, short stories, certificates and much more! They offer a wide range of pictures to choose from and you can insert your own text. If you’re looking for ideas of a social story or want to create your own I would highly recommend this website.

Retrieved from http://lessonpix.com/

 

Sensory Magma

Free- Apple App Store
This app allows for the visual sensory system to be accommodated in a mobile way. “Sensory Magma is a simple calming and relaxing visual app for people with special/complex needs of ALL ages. Magma generates lava style slow moving effects, which when combined with music from the iPhone or iPad music player can be relaxing and also stimulating.” (Sensory Apps Ltd, 2013) If working with someone who benefits from the visual sensory stimuli, it would be a great reward to be used after accomplishing or focusing on tasks.
Retrieved from: https://itunes.apple.com/us/app/sensory-magma/id647810604?mt=8

 

Give Me 5!!!!! Social Skills Multiplayer Game

$7.99-Apple App store
This social skills multiplayer game is a fun social skills App designed by a Developmental Specialist and a mom of a child with ASD. Its video learning is embedded into a gaming format. Real children are shown in real-life social scenarios covering eight areas of social skills: verbal and nonverbal communication, manners, self-awareness, situational awareness, perspective taking, emotional regulation, and gestalt understanding. There are five videos for each of these eight categories: manners, words, no words, understanding others, understanding me, calming feelings, people and places, and the big picture. It is meant to help children analyze social situations by looking for key social cues in these scenarios.
Retrieved from http://www.friendshipcircle.org/apps/browse/give-me-5-social-skills-multiplayer-copy/

 

If you try out any of these APPS or the Website, or find anything similar to share please don’t hesitate to send your comments to me at :  tarra@helpinghandsrespite.care

 

Frustrated Seniors with Alzheimer’s

Frustrated Senior with Alzheimer's. This photo represents the dynamic between a senior with Alzheimer's and the caregiver.

Helping Frustrated Seniors with Alzheimer’s

By Adult Day Services program supervisor, Alison Sarkozy
Our lives continue full speed ahead. We may have work and family responsibilities, household chores, church activities, neighborhood gatherings and friends that continue to call our attention. But for many primary family caregivers, the first responsibility is the loved one that they offer care and guidance to while some of their competencies slip away due to Alzheimer’s disease. Under these circumstances it may be harder and harder to keep up the pace of your former life.

Here are a few practical tips to reduce frustration for your loved one who has Alzheimer’s disease.

Schedule wisely – hopefully, this will make your time doing “xyz” a pleasant/productive experience. For example: if you know your loved one takes a nap at 1 pm every day, it’s best not to schedule a doctor appointment or a visit with friends during that rest time.
Let him/her help – letting a loved one take part in what you are doing makes them feel useful. For example: Preparing for dinner. Have them help retrieve ingredients or help set the table. The task might have to be broken down into simple steps.
Limit choices – having fewer options makes deciding easier. For example: Asking him/her to get dressed. Place two shirts and two pairs of pants out for them to change into. They still have the option to choose what they want to wear and feel some sense of control. Also, it might speed up the process of getting ready in the morning.
Take more time – Expect things to take longer than they used to. Also, try to do things in a routine fashion. This can help with limiting frustrations.
Try to be flexible –  If your loved one is exhibiting frustration, redirection can be helpful. Maybe even try a hug and change the subject. If you both are getting worked up, it sometimes is a good choice to drop it and try again later.
You too, as the caregiver, may be experiencing frustration. Our best advice is to breathe deeply, slow down, and really treasure the time that you have with the one you love. They are still there…don’t let your busy life overshadow them.

A Silver Lining in Loss

Learning from Those labeled “Disabled” – John Stauffer

This has been a tough month, but I have learned to always look for the silver lining. What has been tough about this month? We have had five friends/clients pass away over the last few weeks, two young adults and three seniors that enjoyed different programs provided by Helping Hands Respite Care. Where is the silver lining in the death of a friend? It is in the memory and what you take away from the interactions with them.

 
I ask your indulgence as I share just two lessons from those who recently passed, that has had an effect in my life. The first comes from a scholarly man, who struggled for several years with dementia in his later years. While education was his forte what he left me with were more words about life rather than education, he shared that “Each new day is another opportunity to smile.” This sounds simplistic but dwell on those words for a while, let them gently float through your thoughts, and you start to see and feel the depth of these simple words. What is your day going to look like? What impact are you going to make on those you encounter? If you choose to start your day with a smile, chances are very high that you will have a memorable and positive impact on those who encounter you throughout the day, and you greatly improve your chances of having a good day. Thank You H.C. for those words of wisdom.

 
My second take away is from a young woman for whom we provided care over many years. She was non-verbal, and had limited mobility, but her “disability” did not prevent her from making her feelings and wishes known and it didn’t prevent her from getting out and about. It was clear from the first time that I met her that she was a happy person that enjoyed life and lived in the moment. Over my dozens of encounters with this young lady, what she taught me was a life lesson that is really hard for some of us and that is to “Live in the moment” to enjoy what is right in front of you now. Life is uncertain, so make the best of each opportunity. Laugh more, worry less – it is that simple, but so many of us muck it up and complicate life to the point that we can barely function. The pure joy and happiness I experienced in being in this young lady’s presence where she always enjoyed the moment has made me a better person. Laurel, Thank you for demonstrating the value and the joy that life gives by simply “being in the moment.”

 
Each of us have talents and gifts, let us each work a little harder to recognize those in others.

Family Support and Counseling

Child In-Home Supervisor Tarra Boris marking new milestones.

Family Support and Counseling Available at Helping Hands – Tarra Boris
As some of you may know, I am currently a MSU graduate level student working on my Master’s degree in social work. This is my final year in the program and I am already seeing the light at the end of the tunnel! A part of my background experience includes a bachelor’s degree in social work from Ferris State University. I have had many experiences working with individuals and families throughout the years and feel well-prepared to be of assistance.

 
Since working here at Helping Hands Respite Care, I have identified a need within our families that we serve. All of our families struggle with finding adequate care for their loved one and we couldn’t be happier to help give you the respite you need. However, the need I recognize here with our families, and the families I have come in contact with over the years with a loved one with a disability, is the lack of support. No matter what your circumstance, it is always great to have access to a listening ear.
Our mission is to “Improve the quality of life for families caring for children and adults with disabilities, chronic illness or age-related conditions.” You should know that Community Mental Health offers funds to our agency to send the in-home supervisor to visit, support and listen to our families that want the service.

 
Additionally, there are some families who are required by contract to meet with the in-home supervisor on a monthly basis but are not utilizing the service.

 
As part of my advanced studies I am taking courses to be certified as a Clinical Child and Families counselor. If you would like an occasional listening ear, or are required to meet by contract, it would be my pleasure to sit down and visit with your family. Feel free to give me a call to schedule a time that works for you. You can reach me at the office at 517-372-6671 Ext. 103, or send an email to Tarra@HelpingHandsRespite.care I look forward to meeting with you.

Things We Learn

The Things We Learn Along the Way –  by Jeff Nunham

Adult In Home Supervisor, Jeff Nunham talks about the things we learn along the way. There was clearly a bit of strain and tension on the face of the care provider who sat down in my office. He was about to explain why, after less than three months as a care provider, he was resigning from Helping Hands. He came to us as a promising student heading for medical school. His father is a prominent doctor in Grand Rapids. He was very clear when I interviewed him three months earlier that his goal was to become a great physician like his dad. However, after working with several of our families, he realized that working this close with another person did not give him the kind of reward he thought it would. This realization prompted him to make a life changing decision. Now, he was about to explain it all to me. He would no longer study to be a doctor, but would instead seek a career in medical business. This was a giant decision.
What impressed me, was the fact that his time spent with a couple of our clients helped him clarify what he really wanted to do with his life. This encounter for me was one of those “aha” moments. This is when something that previously had been obscure, suddenly becomes crystal clear. Our clients are helping our care providers.
I regularly interview, train and supervise care providers who come to us to help families by caring for a loved one with a disability. They come with great compassion and idealism, focused on extending care to another person. The direction of their thinking and effort is always toward the person. “I’m here to take care of you” is the general thought process. My “aha” moment was the realization that the person we are helping is actually having an equal or greater impact on us who are the care providers.
The wonderful people we serve, some with extreme and multiple disabilities, are teaching us how to love and be loving. By virtue of their need, they call us to a greater level of commitment, making us better men and women. They reveal the strengths and weaknesses we hide within us, thus coaching us to change toward growth and maturity. What an incredible gift. And we thought we were here to help them.
We, as an agency are always seeking ways to improve what we do. The same perseverance we see in many of our clients call us to work harder to solve problems. The creative ways some of our clients communicate, urge us to think outside the box as we are being challenged by licensing authorities to require more of our staff. When you serve people who never seem to give up, they call us to a higher standard. Aha!

 

Jeff Nunham is the Adult In-Home Care Supervisor at Helping Hands Respite Care. He is a former pastor and often has great inspiration and advice about how we do our work. 

Health History

Nurse Jane at Helping Hands Respite taking blood sugars to compare with health history.

Why We Take a Thorough Health History

A thorough health history and medicine list is important for our caregiver staff to best take care of your loved one. An example of how the history can be helpful might be if your loved one had a history of radiation in the abdominal region. This may cause radiation colitis, with the most apparent symptom being diarrhea. This helps to narrow down causes for the diarrhea, such as an infection source vs a prior cause.

 

Health History Can Explain Behaviors

Restlessness in our seniors is another area in which we can benefit from looking at a thorough health, medicine and lifestyle history. Using this combined information some reasons for the restlessness might be found and ways to make the senior more comfortable can be added to the care plan.
It is a good idea for families to communicate prior health history and lifestyle behaviors, and then continuing to update your professional caregivers on all health and medicine changes. Not doing so, can leave families vulnerable to having their loved one discharged from our program if we do not have thorough information to modify and deal with behaviors and health problems. And, we don’t want that to happen.
There are five reasons that could put your loved one at risk for discharge:
1. Persistent and uncontrolled incontinence
2. Persistent disruptive or violent behavior, including chronic “run-aways.”
3. Need of physical care beyond the capabilities of the program
4. Inability to feed self
5. No proof of Tb test
The above reasons/problems might be resolved if caregiver staff had your help with maintaining prior health history, and previous and current medications. If you haven’t updated your health history lately check in with Nurse Jane Rogers in our Adult Day Services program.  nursejane@helpinghandsrespite.care

Change in Policy

Weekend Respite and Weekend Shifts – Change in Policy

There has been a recent change in policy for caregivers which has been put in place to provide the best opportunity for weekend respite for families. Our former policy required every caregiver to serve a mandatory three weekend shifts per month – this has now been changed to six mandatory weekend shifts per month. We recently were forced to cancel a whole weekend at the Respite House because we did not have all of the shifts covered. This was heart-breaking for the four young people who would have attended, and their families who were looking forward to a full weekend of respite.

The Benefit of the Six Weekend Shifts Plan for Caregivers

Caregivers, you have the power to schedule your own shifts, giving you all of the control you need to coordinate your schedule around important events in your life. Additionally, when you take the six weekend shifts, you may be learning about how to care for more participants, making you a better all-around care provider.

The Benefit of the Six Weekend Shifts Plan for Families

By having more caregivers trained for your loved one, in your home, or at the Weekend Respite House means you have a deeper bench of caregivers available to tap should you have the need for more coverage. The Weekend Respite House is very important to many families, and this policy was designed to make sure that we won’t have to say no to any family seeking respite.

Advice to Caregivers on Scheduling

You should know that we schedule a month in advance. Our best advice to caregivers is to be proactive about your scheduling by looking at least six to eight weeks in advance. By doing this, you will have the best shot at getting the weekend shifts you want and still be able to attend important events in your life. Our Scheduler, Molly Fultz, can be a great help to you, but she can’t help you sort out your scheduling conflicts if you don’t respond to her calls, emails, or texts.

Community Immersion

Boys visiting museum during a community immersion activity

Community Immersion Activities at Weekend Respite House

In the past few months we have worked harder to prioritize opportunities for our Weekend Respite House guests to get out and about in the community. Sometimes this takes a bit more preparation and even a bit of resourcefulness. This usually relates to where we might be going, transportation issues and in some cases finding locations which would meet the needs/interests of all of our guests. (Sometimes with the right staffing ratio we can divide and conquer and make sure that our guests get to have an experience targeted to their ability level.)

 
Special challenges related to unexpected behaviors during community immersion activites are not unlike what a parent might experience when taking his or her child to the grocery store. Somehow they know when you, as the parent or responsible party, are vulnerable to public displays of misbehavior. In the case of our guests at Weekend Respite House, we know that many times their behaviors are rooted in some discomfort related to a break in a predictable routine. The good news is that with our training and the proper mindset we successfully navigate most of these potentially difficult situations.

Managing Behaviors During Community Immersion Activities

Here is our best advice on managing a public (or private) behavioral situation:
1. Be vigilant for early cues that there might be some discomfort, frustration or confusion brewing.
2. When faced with a difficult behavior make a conscious effort to take a few deep breaths and use a calm and clear response in a soft, but firm, voice.
3. Make sure you are using compassion to understand the cause of the discomfort.
4. Refrain from confronting and/or arguing with a distressed person, instead creatively and cheerfully redirect attention to something which will generate more acceptable behavior.

 
During a recent visit to the Impression Five Museum we had a chance to use our own advice on managing behaviors during a community immersion. One of our guests was totally enthralled with the fact that there was a group of children having a birthday party at the museum. It was clear that our guy was not going to be easily diverted from “crashing” this party. Because we maintained our calm the situation did not escalate and the folks from the birthday party were gracious enough to share a shiny balloon and soda.

Dementia and Wandering

Dementia and Wandering can be reduced by keeping active. Balloon volleyball

At the Adult Day Services (ADS) program we have participants that tend to wander. Dementia and wandering are common. Wandering usually occurs because the participant has an urge to “Go.” Usually, that means to “go to” the bathroom, they want “to go” home or “to go/ get away” from something that they don’t understand or find stressful (i.e. how to play a game or do a project). This is why it is very beneficial to have scheduled activities for our group. We have learned that routine keeps our group on task/busy so they do not have to wait or wonder what is going on. During small group activities and games, one might get up and go/get away from the group. If it is not a bathroom matter, we give the participant the option to switch activities or go to another group that is more to their liking. Participants also have the option to relax in the library.

 

Acknowledge and Redirect – Solutions for Managing Dementia and Wandering

 

When wandering occurs, first, the staff will see if the person needs to use the bathroom. Many times this is the reason for the “urge to go.” Another reason for wandering is the person is concerned about the whereabouts of a family member – the “urge to go home.” In order to guide the participant back to joining the group, our staff uses acknowledgement and redirection. First, the staff member acknowledges the participants concern and reassures them that their family knows they are here and will be seeing them at their discharge time. Then the staff member redirects the participant by asking him or her to help with a task, tell them what the group will be doing next and/or asking an open ended question. We have learned that wandering is a coping mechanism and allowing the participant to do just that can be a form of relief. Trying to stop the wandering may increase agitation and cause anger or frustration, so if the above suggestions don’t work, we just allow the person to take a stroll.

I have just highlighted three of the most common reasons that a participant might want to wander. Please keep in mind that there are many other possible causes for wandering.

Better Care Notes and Documentation

 

better care notes requires a positive focusLately, professional documentation of care notes has been a concern for both care providers and clients. Better care notes serve as a guide for parents and their case managers to know what our care provider and their child have done during their time together. Care notes are used as data to mark the progress of the child and/or concerns that the care provider may have for this child. As a parent, please do not hesitate to ask the care provider to go into greater detail in the care notes, or request that the care notes be rewritten.

Care providers, here are some words of advice to address some of the common concerns about care notes:

How to Write Better Care Notes

1.Make sure all your documentation is professional

2.Use proper grammar in your documentation. There should be no slang.
Write “out of,” not “outta”
Write “had snot and drool,” not “was snotty” (could be misunderstood)

3.Write your name and care notes legibly and neatly. Especially on the medication sheet.

4.Remember to write the facts about what happened, not subjective opinions.
For example, stating a client was being “testy.”  This is opinionated/labeling. Please note clear facts.

5,On shift duties and medication records, be sure to sign your initials or write “n/a” on each line if the duty did not apply to you on your shift. At the end of your shift, make sure there are no blank lines.

6.Try to “paint a picture” of what happened in your documentation so that anyone who reads it has a clear idea of what happened on your shift.
For example, “his pants are wet…as of right now they are in the washer,” should be clear and state that the care provider assisted the client by changing his pants when they were wet.
7.Document when clients get their showers: if the client assisted and with what (i.e. washing their own hair and body).
8.Document the specific activities you did with each client on your shift, where you went, what they did by themselves and what you assisted with. For example, you can state, “I drove Amy to the park and pushed her on the swings. She appeared happy because she was smiling and clapping her hands.

Remember to always include what goals are being addressed!