SHANGRI LA SPA EXPERIENCE

SHANGRI LA SPA EXPERIENCE
SHANGRI LA SPA EXPERIENCE
Presenters: Lindsay Nersinger, Director of Activities
Charna Kay Chambers, Senior CNA
Ann Catalfano, Administrator
A special thanks to Nicole Fernandez, former
Director of Activities
Who was instrumental in the formation of the program
SHANGRI LA SPA EXPERIENCE
The Key elements of our Performance Improvement System
include the following steps:
1.) Identification of the problem
2.) Assignment of a performance improvement team and a
leader from the appropriate departments or disciplines by the
Administrator;
3.) The leader convenes the performance improvement team;
establishes ground rules for the team and begins the root
cause analysis process to ensure thorough identification of the
problem;
3.) The leader and / or facilitator utilizes techniques and tools
such as brainstorming, round robin format and fishbone cause
and effect diagram; multi-voting to identify the root cause or
causes;
SHANGRI LA SPA EXPERIENCE
The Key elements of our Performance Improvement System
include the following steps:
4.) The team sets up goals for the problem that are time
specific;
5.) The leader and / or facilitator assign team members to be
accountable for specific actions and time periods to address
the goals;
6.) The team re-convenes at a future time usually within one to
two weeks to review the action plan and assess progress;
7.) The team continues to meet until the problem has been
resolved satisfactorily and the issue is closed.
SHANGRI LA SPA EXPERIENCE
The team identified two main areas of focus:
1) Using non-pharmacological interventions, to reduce the
number of residents utilizing antipsychotic medications on a
regular basis
Penfield Place 2nd quarter 2012 Trend Tracker
Anti-psychotics(LS) – 34.7% (NYS Peer Group = 22.5%)
2) To enhance the person-centered care approach through
customization of the spa program according to individual
resident preferences.
SHANGRI LA SPA EXPERIENCE
Shangri La Spa Program
QAPI trial program – planned for 2nd quarter of 2013
Goals: To utilize the recently renovated whirlpool spa setting,
and have the residents benefit from the calming effects of a
warm water bath in a quiet environment; utilize a pampering
approach at the facility beauty salon to allow a day of peace
and harmony; promote feelings of well-being; diminish anxiety;
reduce the use of anti-psychotics
SHANGRI LA SPA EXPERIENCE
IDCP team met with representatives from Activities, Nursing, Dietary, and
Social Work to plan the program
The secondary goal is to make this an individualized, person-centered
program for each participant, and to provide pampering to reduce anxiety
and improve well-being.
The team selected residents who they believed would benefit from this oneon-one program.
Residents were chosen who exhibited heightened anxiety, frequent
elopement attempts, and/or profound sadness as well as those who may
have received anti-psychotics on a regular basis
SHANGRI LA SPA EXPERIENCE
Trial Group: Four residents chosen
A day at the Spa included: a special written invitation with appointment
times:
9am
10:15 am
1:15pm
or 2:30pm
Some elements of the Aromotherapy spa experience were a Whirlpool
bath, foot soak, hand massage, nail care and/or polish.
We chose the music included in the spa experience based upon the
preference of the individual resident (nature sounds; big band;
Broadway hits, etc.) We did the same with a special snack preference;
choices included: ginger ale/sparkling juices or hot beverage, cheese
and crackers, fruit, fancy cookies, and sherbet.
SHANGRI LA SPA EXPERIENCE
A Senior CNA was assigned to prepare the resident for the special day and
provide a relaxed Whirlpool spa bath in faux candle-lit setting with music
preference. Plush robes and slippers were provided as well.
For residents who declined the whirlpool bath option; the CNA would
provide a relaxed foot soak and hand massage in warm water
Activities team members accompanied the residents to the beauty salon
for more pampering with special nail care, hand creams, aromatherapy
infused warm water, beverages and snacks in a calm and peaceful setting
with music of their choice
SHANGRI LA SPA EXPERIENCE
The Director of Activities and Senior CNA recorded resident testimonials and
anecdotal accounts of residents’ demeanor following the spa treatments
from the chosen participating residents.
All recorded data, and residents’ responses to the treatment and ‘experience’
were shared with the IDCP team the following day in morning report.
SHANGRI LA SPA EXPERIENCE
Case Study of Resident A:
Physically fit female in her mid 80’s, with moderate dementia who is ambulatory with a
wheeled walker
Resident A exhibited:
 Daily signs and symptoms of general anxiety including; exit-seeking behaviors
 Worry, sadness, and tearfullness
 Anxiety with and around her peer group at the facility
 Frequent concern over feelings of not being accepted by others
 Perseveration regarding her personal appearance and attire – often asking “Do I look ok?”
and “Do these slacks fit me alright?”
 Frequently has impulsive behaviors and she often requires team intervention to maintain
safety during ambulation. T
SHANGRI LA SPA EXPERIENCE
Goals for Resident A for participation in the Shangri-La Spa program
included:
1) Focus on getting her to slow down and decrease her anxiety by
providing a calm atmosphere with soft tranquil music
2) Giving one-on-one attention while in the whirlpool spa
3) Providing an outlet for energy release; decreasing anxiety, and
promoting self-acceptance and reassurance of her appearance
through one- on- one attention at the beauty salon to helping her to
feel special
Resident A experiencing the
individualized spa treatments
SHANGRI LA SPA EXPERIENCE
Case Study for married couple: Mr. and Mrs. B
Residents Mr. B and Mrs. B are a married couple who
are recent LTC residents of Penfield Place. Most
activities that they enjoy are together; so the goal of
this program was to give them private, special time
together.
Mrs. B has multiple medical problems that slow her
down physically; mentally she is sharp
Mr. B is physically quite healthy, but suffers from
dementia with many trust issues, and elopement
attempts
SHANGRI LA SPA EXPERIENCE
Evaluation of spa program
April 4, 2013- July 17, 2013
Completed 17 appointments at the spa.
Initial trial group of 3-4 residents with one of the goals being to alleviate
behaviors of anxiety and agitation. Another goal of the spa program was
to reduce chronic pain; residents reported less discomfort from their usual
aches and pains following the spa treatments. The trial group of residents
showed positive effects and a more relaxed mental state following the spa
experience
July 17, 2013- November 20, 2013
Since July 17, 2013, a total of Twenty Three residents participated in the
spa experience.
Resident feedback included comments such as:
“I loved it.”
“I wish I had done this sooner.”
“This is so nice, such a blessing.”
Do you feel pampered? “Yes like a baby. I would like my feet done next
Thursday.”
The Shangra La Experience
The Shangri-La Spa experience has been expanded to a routine weekly
program and a second day has been added to the program.
On day one the team continues to focus on residents with difficult
behavioral symptoms, including those who routinely take anti-psychotic or
anti-anxiety medications.
On day two, the team focuses on those in need of physical comfort from
musculoskeletal pain, skin integrity issues or short-term rehab residents.
Feedback continues to be positive from participants of the program.
We would like to thank NYSHFA for the
opportunity to share this program.
Also, a big thank you to our team leaders at all of the Hurlbut® Care
Communities for their support and encouragement to continually try
new and innovative ways to help residents achieve
an improved level of dignity and comfort.