Been awhile since I’ve posted, lots of personal taking me away from focusing on the professional (although contributing to my blog is what I consider pleasure, and not business!).
Anyways, I was having one of those “water cooler” type conversations with Recreation Therapy staff at the Livermore Community Living Center (the CLC, where I am, of course, employed as their staff Geropsychologist and have been for the past 7 years). We had been discussing some strategies for how to implement “simulated presence therapy” (or SPT for short) more efficiently and effectively in our CLC (AKA VA nursing home) and as we often do, we began to discuss how technology and mobile applications could possibly help facilitate the use of non-pharmacological interventions with our veterans.
Let’s just back up and talk about SPT for a second. What is it? It’s not really therapy per se (e.g., as in a set of specialized techniques that only trained therapists can deliver). SPT is a technique, really, used with patients who have moderate to severe dementia, to help to reduce their agitation or other behavior issues, by typically playing them recordings of family members or friends voices. In the case of the veteran we were working with, we simply obtained a recording of the daughter saying to her father, “Dad, this is X, you’re doing OK,” and reportedly this calms this veteran down immediately – a big relief given this particular veteran has lots of issues with physical combativeness and psychotic behavior.
My personal belief in the many years I’ve been working at the CLC and in nursing homes is that SPT is a highly underutilized intervention, and that a big reason for this is a combination logistical and technological barriers and lack of outreach by nursing staff. It usually requires an enterprising and energetic social worker or psychologist to get something like this going with a resident. Requires that the resident be identified as having a discrete behavior problem that would actually be amenable to SPT in the first place – which, in the “throw pills at everything” culture that still remains embedded in many nursing facilities, is a difficult thing to accomplish.
As I chatted with the RT staff, it occurred to me that there’s a potential here for technology to help facilitate the use of these and other techniques in nursing homes. Not just SPT, but also via use of music therapy (e.g., offering specialized music to patients based on individualized preferences), reminiscence therapy via use of family photos and video files.
How would this be accomplished? The simplest and cheapest “fix” I considered was simply just having each nursing station be outfitted with their own tablet computer, that has its own email address where family can send sound files, pictures, and music that staff might be able to use for personalized interventions with residents.
A more expensive but comprehensive fix that I envisioned (and may become the subject of another VA Employee Innovation Proposal) is that of creating “hubs” that can be visited online (say, through a Facebook page, or via a custom-build Sharepoint site), family can sign up for with a secure account.
The idea there, as I envisioned it, would be that the family could then freely upload all of the content they wished, which would then be accessible to nursing staff for the purposes of calming or entertaining the resident – ideally via networked devices located in patients rooms (with client software loaded and enabled).
So far I’ve mentioned this idea to one or two nursing staff members here at the CLC – they have responded that in their opinion, cohort issues would prevent such a system from being widely utilized by families of our current crop of veterans. Truthfully, a majority of our veterans are from the Central Valley, have very modest means, and their average age is somewhere in the 70s. Although older adults are increasing their use of information technology and mobile computing at a faster rate than most other age groups, the increase is still from a relatively small base, AND this is a population (lower SES) where technology adoption is pretty limited anyways.
But is this idea viable and just ahead of its time, or could there be some other, more immediate way of using technology to facilitate greater use of SPT, reminiscence, or individualized music therapy with nursing home residents? Curious what you think.