2015 Annual Report - Schmieding Center
Transcription
2015 Annual Report - Schmieding Center
2015 Annual Report A program of the Donald W. Reynolds Institute on Aging and the Arkansas Aging Initiative A program of the Donald W. Reynolds Institute on Aging and the Arkansas Aging Initiative in partnership with Northwest Health System in partnership with Northwest Health System 2015 Annual Report TABLE OF CONTENTS LETTER FROM DIRECTOR OF EDUCATION ................................................................................................... 3 DESCRIPTION AND BACKGROUND OF ORGANIZATION ........................................................................... 5 2015 SCHMIEDING CENTER STAFF .................................................................................................................. 6 2015 ORGANIZATIONAL CHART ...................................................................................................................... 7 2016 ORGANIZATIONAL CHART ...................................................................................................................... 8 SCHMIEDING EDUCATION ................................................................................................................................ 9 HEALTH PROFESSIONAL PROGRAMS ............................................................................................................ 9 PARAPROFESSIONAL EDUCATION ............................................................................................................... 11 IN-SERVICE PROGRAMS .................................................................................................................................. 19 COMMUNITY EVENTS ...................................................................................................................................... 21 UAMS MEDICAL STUDENT CLERKSHIP ....................................................................................................... 29 AGING RESOURCE CENTER REPORT ............................................................................................................ 33 RESEARCH & DEVELOPMENT ........................................................................................................................ 34 AGING SERVICES .............................................................................................................................................. 35 PARTNERSHIPS .................................................................................................................................................. 40 LEVERAGING ..................................................................................................................................................... 43 COMMUNITY ADVISORY COMMITTEE ........................................................................................................ 44 2015 FACILITY, AUDIO VISUAL AND INFORMATION SYSTEMS ............................................................ 47 OUTREACH AND PROMOTION ....................................................................................................................... 48 NORTHWEST SENIOR HEALTH CLINIC REPORT ........................................................................................ 53 OUTREACH SITE – BELLA VISTA .................................................................................................................. 55 APPENDIX A – EXAMPLES OF ARTICLES .................................................................................................... 60 APPENDIX B – EXAMPLES OF ADVERTISEMENTS .................................................................................... 68 APPENDIX C – EXAMPLES OF PROMOTIONAL FLYERS ........................................................................... 72 APPENDIX D – 2015 COMMENTS ................................................................................................................... 76 APPENDIX E – SUPPORTING DOCUMENTS .................................................................................................. 81 CNA APPROVAL................................................................................................................................................ 81 EVIDENCE BASED APPROVAL ............................................................................................................................ 82 HOME CARE SPECIALIST AGREEMENT WITH NTI .............................................................................................. 83 1 2 Letter from Director of Education February 1, 2016 Dear Friends of the UAMS/Schmieding Center: As I draft this introduction, I find that I have a great sense of nostalgia. The Merriam-Webster dictionary defines “nostalgia” as a wistful or excessively sentimental yearning for return to some past period or condition. With the following sentence the beginning of Dr. Larry D. Wright’s career at the Schmieding Center for Senior Health and Education (SCSHE) was marked in the 1999 Annual Report; it read “Implementation of the administrative structure was initiated with the appointment [on] January 1, 1999, of Larry D. Wright, MD as Director of the SCSHE.” It is my task with the 2015 Annual Report to mark the end of Dr. Wright’s 16 year journey. On October 26, 2015, our founding Executive Director, Dr. Larry D. Wright, resigned his position with the SCSHE. It seems too simple a statement for such a distinguished career at the Schmieding Center. During my five years of service at the Center, I have been impressed by the passion of this organization in pursuing the health and well-being of older adults through our education programs, our aging services, and our clinical services. In each of these areas, Dr. Wright embodied the best of who we were, who we are, and who we hope to be. His kindness, compassion, skill, professionalism, and knowledge established a firm foundation for the Schmieding Center and set a high standard of achievement that is obvious to all who encounter our organization. I invite friends and colleagues, past and present, of the Schmieding Foundation, the University of Arkansas for Medical Sciences, the Northwest Health System, the Area Agency on Aging of Northwest Arkansas, and especially the staff of the Schmieding Center, to join me in expressing sincere gratitude to Dr. Larry D. Wright for his stellar service and outstanding contribution toward keeping older adults in northwest Arkansas and around the world healthy, happy, and at home. Thanks for the memories Dr. Wright! 3 Now as I look to the particulars of this report, I hope that you will take the time to review each section. Some areas of particular accomplishment during 2015 include: Designation of the Schmieding Home Caregiver Training Program by the Arkansas Department of Human Services Division of Aging and Adult Services as an intermediate level evidence based health promotion program. Approval of our newly designed Nursing Assistant Training Program by the Arkansas Department of Human Services Division of Medical Services Office of Long Term Care. The Schmieding Center became a site that is certified by the Arkansas Lifespan Respite Coalition to offer free respite training for volunteer respite providers, family caregivers, and community and faith-based groups. Entered into a cooperative agreement of affiliation with Northwest Technical Institute for acceptance of Schmieding Certified Home Care Specialists for admission into their Practical Nursing Program. Collaborated with LPN students and nurse educator staff from Northwest Technical Institute to offer our first 3-day Family Caregiver Event free to the public. Implemented our Smart Aging-Living Well series to offer information from local experts on a variety of aging issues. Continued growth and popularity of the Bella Vista Senior Health Fair which garnered 800 participants and over 70 vendors. The above information, along with the rest of this report, represents the efforts of our dedicated staff to maintain and enhance the vision of Mr. Lawrence H. Schmieding by providing quality health education and services to northwest Arkansas communities. Thank you for your continued support! Sincerely, Gary McHenry, EdD Director of Education 4 Description and Background of Organization The Schmieding Center for Senior Health and Education (SCSHE) was established January 1, 1999, as the first satellite Center on Aging affiliated with the Donald W. Reynolds Institute on Aging (DWR-IOA) at the University of Arkansas for Medical Sciences (UAMS). Located in Springdale, Arkansas, the SCSHE represents a cooperative effort by the DWR-IOA and Northwest Health System. From temporary quarters in 1999 to the 27,500 square foot, state-of-the-art facility at 2422 North Thompson Street in Springdale, Arkansas, the Schmieding Center for Senior Health and Education stands as a visible tribute to the generosity of the late Lawrence H. Schmieding. When Mr. Schmieding made the contribution in 1999, he envisioned a center that would “improve the quality of life for older adults.” The first twelve years of the Schmieding Center’s existence saw the development, presentation, and refining of the Schmieding Certified Home Caregiver Training Program, which was Mr. Schmieding’s foremost reason for his generous gift. “Educating more people as home caregivers is important for keeping seniors happy and in their homes,” Mr. Schmieding said. One of his favorite sayings was, “Where there’s home, there’s hope.” The realization of his vision for educational programs as well as clinical and support services for older adults has continued to serve residents of northwest Arkansas and beyond. His desire to enrich the lives of others is his legacy to all who have been served by their experiences at the Schmieding Center. 5 2015 Schmieding Center Staff Dr. Larry Wright Ellen Creakbaum Lynnette Bennett Nancy Galbraith Dr. Gary McHenry Brandi Schneider Fink Holloway Kathryn Sweetser Margaret Christensen Marjorie Hart Rene’ Garcia-Oliver Shaun Ratliff 6 Dianne Bufford Lalanya Carson Monique Parks Sue Ackerman 2015 Organizational Chart 7 2016 Organizational Chart 8 Schmieding Education In 2015, the Schmieding Center offered 113 educational programs with 2,284 attendees. This number includes the educational programs for health professionals, paraprofessionals, inservice training events, community education, and the geriatric rotation for medical students from UAMS. Health Professional Programs Many of the health professional programs at the Schmieding Center in 2015 were offered by video teleconference (VTC). Thirteen topics were presented by Arkansas Geriatric Education Center (AGEC) with 103 attendees. There were 100 health professional programs without AGEC with a total of 2181 attendees. This number includes 39 Geriatric Grand Rounds presentations with 167 attendees and the VTCs provided by Connecting Across Professions, Palliative Care, and Internal Medicine Grand Rounds. In addition to the VTCs, the Schmieding Center hosted several events for health professionals. These events featured more than one speaker and attendees were counted for each lecture they attended. Events included: Events Presented Attendees Pastoral Care Symposium 93 Medical Social Workers 83 Northwest Health Patient Safety Update 78 Hope for the Future Alzheimer’s Association 72 Circle of Life – Cultural Competency Training 47 9 Number of Health Professional Programs 140 116 120 113 108 100 81 80 80 60 40 20 1 1 0 CY2011 CY2012 CY2013 BELLA VISTA CY2014 CY2015 SPRINGDALE Participants of Health Professional Program 2500 2284 2000 1385 1500 1000 860 951 777 500 40 6 0 CY2011 CY2012 CY2013 BELLA VISTA 10 CY2014 SPRINGDALE CY2015 Paraprofessional Education The Schmieding Caregiver Training programs are nationally recognized evidence based methods inspired to enrich the lives of older adults through empowerment, understanding and quality home caregiver education. The Schmieding Center's mission is to improve “aging in place” for adults in the second half of life with the provision of personalized programs of education, services and healthcare for all stages of aging. Our classes have been offered in both face to face and online formats from Springdale and Bella Vista. In Home Assistant The Schmieding In Home Assistant (IHA) course is a unique program designed to teach students to care for an older adult in the home. This 40 hour course satisfies the training required by Arkansas law for caregivers who are paid to provide care in the home of a person who is 50 years of age or older. IHA training provides the caregiver with basic safety and support skills. Training skills, taught by registered nurses, are divided into 10 modules combining varied techniques that present material in a way that speaks to adult learner styles. Methods include: lecture for auditory learners, hands on practice for tactile learners and video to enhance visual and auditory learners. Graduates are prepared to work with clients who need assistance to remain in the home. The Schmieding curriculum fulfills the training requirements of the Arkansas Medicaid Personal Care Training Program, Rules and Regulations for Home Health Agencies in Arkansas and Conditions of Participation: Home Health Agencies from the Federal Register. IHA graduates from March 2015 11 The IHA evening classes were suspended during March through September to allow the evening instructor to collaborate with the University of Arkansas Global Campus to further develop the Online Family Care Advocate (FCA) and Online Alzheimer’s disease and Dementia (AD) courses. Alzheimer’s Disease and Dementia The Schmieding Alzheimer’s Disease and Dementia (AD) course describes the stages of Alzheimer’s disease and various types of dementia. The course provides valuable information about the needs and care of a person with dementia including how to manage difficult behaviors. This interactive course includes: lecture for auditory learners and hands on interactive exercises for tactile learners. Video, from leaders in this field of study, are presented to enhance the curriculum content. Graduates are prepared to work with clients, who have dementia, who require special behavioral support to remain in the home. This Schmieding curriculum pulls practical tips recommended by the “Broyles Playbook” as examples of dementia care. Family Care Advocate The Schmieding Family Care Advocate (FCA) course is a progressive program consisting of 40 hours advanced caregiver training on chronic disease management and patient advocacy. The prerequisite for this course is prior caregiver training in IHA, AD or CNA. FCA provides an opportunity for adult learners to develop critical thinking skills related to caregiving. These advanced concepts may well prevent unnecessary admissions to a hospital, nursing home or other alternative care setting. This model of care was developed to decrease health care cost and increase quality of the life for clients who desire to “age in place” at home. This innovative course includes: lecture for auditory learners, hands on interactive exercises for tactile learners and research aspects to develop ongoing critical thinking concepts. Videos are presented to engage the student and enhance the curriculum content. Graduates are prepared to support clients, which have one or more chronic diseases, and their families. These clients will require multi-faceted care to remain in the home. This Schmieding FCA curriculum brings together known concepts of adult learners and focuses them toward their caregiving goals. 12 Home Care Specialist The Home Care Specialist class included all of the skills learned in the 40-hour IHA class plus helpful information on becoming a better family care advocate and valuable information on Alzheimer’s disease and other forms of dementia. This class provided information about the physical and behavioral changes during each of the stages of dementia, plus helpful coping skills for the caregiver. Graduates of the August 2015 Home Care Specialist Online In Home Assistant The 2015 Schmieding Online In Home Assistant (OIHA) course is truly a distinct program designed to teach students to care for an older adult in the home. This 40 hour online course satisfies the training required by Arkansas law for caregivers who are paid to provide care in the home of a person who is 50 years of age or older. Online IHA training provides the caregiver with basic safety and support skills. Evidence based training skills, designed and monitored by registered nurses, are divided into 10 modules combining varied techniques that present material in a way that enhances online adult learner styles. Methods include: selfpaced lessons within the learning modules, video outside of the lessons to support visual and auditory content for self-directed practice and weekly dialog, via email and/or phone with the instructor to create a supportive learning experience. Graduates are prepared, after completing in-person or video teleconference skills demonstration, to work with clients who need assistance to remain in the home. The Schmieding curriculum fulfills the training requirements of the Arkansas Medicaid Personal Care Training Program, Rules and Regulations for Home Health Agencies in Arkansas and Conditions of Participation: Home Health Agencies from the Federal Register. 13 The Schmieding Center’s current Home Caregiver Training courses outlined in this report - In Home Assistant, Alzheimer’s/Dementia, Home Care Specialist and Family Care Advocate, offer our students a variety of training options. Our development of the Online Family Care Advocate (OFCA) and Online Alzheimer’s Disease/Dementia (OAD) courses are in line with many colleges and other higher learning institutes allowing us to bridge the gap between needs and access for working adult learners. Our online courses are designed with students’ literacy levels in mind. The first beta test of the OFCA course, by the nurse educators, was in late December 2015. The OAD beta test is scheduled for the end of January 2016. All of the online courses have potential future distribution beyond Arkansas to the national audience. This kind of evidence based training will positively impact the impending “silver tsunami” with compassionate Schmieding trained caregivers. CNA Report 2015 The Schmieding Home Caregiver Training Program curriculum which prepared students for the Arkansas CNA state certification exam was newly refashioned as a standalone CNA program. The Arkansas Office of Long Term Care (OLTC) Nursing Assistant Training Curriculum was used as a guide and the Schmieding program was approved by the OLTC on May 21, 2015. Nurse Educator, Sue Ackerman, observes a CNA student as he practices making a hospital bed. Currently the students are responsible of completing 96 hours of training within a three week period. The state only requires 90 hours of training which includes 15 hours of Barbara Broyles Alzheimer’s Disease& Dementia Caregiver Training. The Schmieding Home Caregiver Training Program has designated the remaining 6 hours to skills practice in which students indicate they need. All Schmieding Nurse Instructors are approved to teach the curriculum. Two long term care facilities that participate with the Schmieding Center as clinical sites for training have been approved as well. These two sites are Shiloh Health & Rehab in Springdale, AR and Highland Healthcare and Rehab Center in Bella Vista, AR. Students must spend 16 hours in the clinical arena in order to complete training. The association with these facilities has proved beneficial for our students and has enhanced their ability to gain meaningful employment. 14 The initial pilot class started June 12, 2015 and was filled to capacity. All 12 students graduated. There have been two additional CNA classes with a total of 8 students – all graduating successfully. Out of the 20 students who have graduated, we know of 10 who have taken the state exam that passed on their first try. Our goal is to teach evidence based theory and skills concepts. Another goal is to allow for sufficient skills practice time that enhances confidence especially in the clinical area. Ultimately our students will understand how to provide professional, elder-centered care. Thus far, with the limited amount of students testing, our program has a 100% pass rate. We will strive to maintain this at 80% or higher which is above the state requirement of 70%. CNA student practice taking vital signs. 15 Home Caregiver Training Program Graduates EP 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 16 61 49 64 83 94 96 91 98 98 87 98 90 75 44 1144 PCA 4 39 30 41 50 64 64 65 56 68 60 72 62 53 41 769 HCA 0 9 8 24 18 35 34 42 41 46 55 56 52 48 27 20 515 AD FCA * * * * * * * 39 73 69 55 64 65 61 47 40 22 513 28 8 9 36 IHA 34 138 78 172 HCS CNA OIHA Totals 8 8 20 20 29 14 14 Legend: EP – Elder Pal PCA – Personal Care Assistant HCA – Home Care Assistant AD – Alzheimer’s/Dementia Care FCA – Family Care Advocate IHA – In Home Assistant HCS – Home Care Specialist CNA – Certified Nursing Assistant OIHA – Online In Home Assistant Note: This table does not include students who enrolled that did not graduate. Fifteen hours of Dementia Care became a state requirement in July 2006 for CNAs. Forty hours of training for In Home Assistants became a state requirement in April 2014. The Family Care Advocate and In-Home Assistant courses were introduced in 2013. In Home Assistant replaced the Elder Pal and Personal Care Assistant courses in 2014. 16 20 109 87 129 151 193 194 237 268 281 257 290 269 237 221 235 151 3329 Continuing Education Programs for Nursing Assistants In 2015 a different format was used for our continuing education programs: C.E. groupings. The first series was offered July 7, 8 & 9 was about reducing stress: Music & Pet Therapies Stress & Exercise Managing Caregiver Stress with Massage Therapy. The topics discussed on July 28, 29 & 30 focused on Death & Dying issues: What to Do When Your Client is Dying Skin Care and Helping Your Client & Family Make Decisions at End of Life. September CE’s were on a bit of a lighter note: Faye Pyatt and her dog, Dwayne, demonstrate skills used in pet therapy. Protecting Your Back & Using a Hoyer Lift Temperature & Pulse Review & Practice Taking a Blood Pressure Correctly Additional CE’s were offered in April and October: Health Literacy for Seniors Finding Reliable Health Information on the Internet The total number of students who attended the above-mentioned CE’s was 40. Although these programs were offered during different times of the day, it is very difficult for working men and women to attend continuing education programs due to their many responsibilities with work and family. 17 Number of Paraprofessional Programs 350 315 300 248 250 200 162 161 CY2011 CY2012 241 150 100 50 7 0 CY2013 BELLA VISTA CY2014 CY2015 SPRINGDALE Participants of Paraprofessional Programs 2000 1880 1792 1570 1500 1328 1282 1000 500 45 0 CY2011 CY2012 CY2013 BELLA VISTA 18 CY2014 SPRINGDALE CY2015 In-Service Programs The Schmieding Center continues to train the trainers who will take the Schmieding Home Caregiver Training Program to other sites. This commitment was made to the Reynolds Foundation: “Because instructor qualifications, ability, knowledge, and skill are so crucial to quality outcomes, new program instructors will undergo an extensive orientation process to ensure understanding of the program content, expected outcomes, adult learning principles and interactive learner centered teaching techniques.” In 2015, Sherry White invited staff from the replication sites in Oklahoma and Fort Smith to the Schmieding Center to receive the following training: Review the Schmieding Method and teaching philosophy Review teacher manuals Observe labs Attend lectures The Schmieding staff also provided in service training off site. Lynette Bennett gave an in service on “Body Mechanics and Safety Tips” to a group of 50 at Visiting Angels. Brandi Schneider provided overviews on “Schmieding Center Service,” and “Needs and Resources for Older Adults.” The Schmieding Auditorium was also used for in service training programs by: Arkansas Health Care Association Coder Training Circle of Life Cultural Competency Northwest Community Health Coalition Northwest Health Senior Planning Meetings Northwest Health Managers Meetings Northwest Health Physicians Orientation Waco Title to train area realtors and mortgage bankers 19 Number of In-service Programs 90 80 80 70 58 60 50 43 42 40 26 30 20 10 18 23 18 16 4 0 CY2011 CY2012 CY2013 BELLA VISTA CY2014 SPRINGDALE Participants of In-Service Programs 20 CY2015 Community Events Residents of northwest Arkansas and the surrounding region had the opportunity to participate in a variety of interesting and informative community programs. Several community events brought large crowds to the Schmieding Center. Morning Brew Dianne Bufford welcomed 115 at the Morning Brew event August 6, 2015. Senior Health Beauty Pageant The Senior Health Beauty Pageant brought in 106 guests on September 25, 2015. 21 Participants of Springdale R.E.S.T. Volunteer Respite Training R.E.S.T. VOLUNTEER RESPITE TRAINING The R.E.S.T. Volunteer Respite Training project is supported, in part, under a grant from the U.S. Department of Health & Human Services. It provides 7 ½ hours of training to anyone desiring to provide volunteer respite care. Some of the topics discussed include crisis intervention, universal precautions, coping strategies for dealing with negative behaviors, confidentiality, leisure activities and more. Schmieding staff from the replication sites around the state pose with REST trainers at the UAMS Donald W. Reynolds Institute on Aging in Little Rock. 22 Heartsaver CPR The Heartsaver CPR class teaches adult CPR, rescue choking procedures, as well as how to operate an A.E.D. (automated external defibrillator.) After completing this three hour class, students received a two-year certification from the American Heart Association. The class was offered four times in 2015 in Springdale with a total of 16 attendees. Family Caregiver Workshop The family caregiver workshop series is designed for individuals who want to learn more about becoming an effective caregiver, but don’t have the time to complete one of our certified training programs. The workshops are usually taught in 4-hour sessions including topics such as home safety, caregiver stress, nutrition & hydration, body movement & mobility and behavioral issues relating to dementia. In 2015, Kathryn Sweetser taught the Family Caregiver Workshop in Arkansas and Hawaii. Type of FCW Basic Skills Location Fayetteville Basic Skills Hawaii 11 Dementia Hawaii 11 Total Attendees 9 31 23 Family Caregiver Event at Schmieding LPN students from Northwest Technical Institute partnered with the Schmieding Center to offer a Family Caregiver Event October 29, 2015. 24 The Schmieding Center also offers a number of recurring programs for the community. Recurring Community Programs Number of Sessions AARP Smart Driver Brain Games CDSMP Lunch & Learn Medicare: How Does It Work? Navigating Medicare Osher Lifelong Learning Institute Smart Aging Strong Body Attendees 11 13 6 11 8 5 16 7 98 Strong Body for Seniors Seniors meet at the Jones Center for Families for the Strong Body exercise program. 25 251 236 25 383 33 17 137 148 759 Dr. Larry Wright presented a trophy to Marjorie Hart celebrating her selection as a UAMS Phenomenal Woman! Mother! Available! Reliable! JOY! On It! Respected! Inspiration! Exceptional! Osher Lifelong Learning Institute (OLLI) offered these classes at the Schmieding Center. 1. 2. 3. 4. 5. 6. Earthquake Science and the New Madrid Seismic Zone Financial Safety Online Movie - Some Like It Hot Understanding Hatred Are We Alone in the Universe? Virtual Dementia Tours 26 2015 Springdale Lunch & Learn Topics January Hip and Knee Replacement Surgery February Vaccinations for Seniors March Breast Cancer 101 April Memory Loss May Sleep Apnea June Geriatric Health Maintenance July Managing Pain August Healthy Cooking with Dark Chocolate September Diabetes Management October Breast Cancer Awareness November Colon Health Senior Circle Lunch & Learn 27 Number of Community Educational Programs 400 339 350 291 300 252 244 250 182 200 150 183 199 196 CY2014 CY2015 160 105 100 50 0 CY2011 CY2012 CY2013 BELLA VISTA SPRINGDALE Participants of Community Educational Programs 6000 4876 5000 4000 4300 3000 3371 3493 3133 3136 2373 1978 1918 2000 2145 1000 0 CY2011 CY2012 CY2013 BELLA VISTA 28 CY2014 SPRINGDALE CY2015 UAMS Medical Student Clerkship Dr. Wright served as the Site Coordinator for fourth-year medical students who opt to complete their mandatory geriatric clerkship in northwest Arkansas. He worked closely with Priya Mendiratta, Clerkship Directors at UAMS-Little Rock. The specific goal of the Geriatrics Senior Block Course is two-fold: 1. To assist the student in developing a knowledge base in Geriatric Medicine with an emphasis on common geriatric syndromes and diseases as well as the normal aging process and 2. To introduce the student to the interdisciplinary approach of comprehensive assessment, management, and prevention techniques in the elderly. Site Description Locations and levels of care were chosen to introduce the students to patient care across the health care continuum, and to train them in inter-professional collaboration in these venues. Students are expected to learn how to assess common medical, functional, psychological and social needs of patients in these levels of care and to collaborate with non-physician providers. Students participate in various settings in northwest Arkansas, including Washington Regional Senior Health Care, as well as community-based Skilled Nursing Facilities (SNF) and Circle of Life for palliative care. In addition to participating in rounds and patient care in each setting, students may be assigned short subject presentations relating to each student’s individual patients. Ambulatory Care During their ambulatory care experience, students evaluate patients seeking primary care, second opinions and consultations in the outpatient setting. The students see models of healthy aging, as well as patients with geriatric syndromes and chronic disease burden being managed by inter-professional teams. During these visits, students evaluate new patients for their specific problems as well as learn to conduct Comprehensive Geriatric Assessments. Students will see return patients to assess progress from their previous care plan whenever possible. Students may also have the opportunity to collaborate with non-physician providers. Students gain this experience at Washington Regional Senior Health Care. 29 Post-Acute and Long Term Care Community based Skilled Nursing Facilities (SNF), Nursing Homes and Assisted Living Facilities located in northwest Arkansas are utilized to provide post-acute and long term care experience to students. The preceptors at these locations manage a wide variety of conditions, including new acute problems, acute exacerbations of chronic diseases, geriatric syndromes, functional decline and hazards of hospitalization. The preceptors assign patient-specific tasks to each student. These tasks may vary from week to week. The specific subjects for review in nursing homes will include topics such as nutritional problems, pressure ulcers, falls and restraint use, and behavior management in long term care. This experience allows students to learn the capabilities and limitations of a chronic care facility and how it differs from an acute care hospital. After this experience, students should be able to discuss the impact of chronic disease and disability in determining a patient’s environment of care. Students should be able to identify factors that lead to nursing home placement and the positive and negative aspects of nursing home care. The recognition and alleviation of pain will be stressed, as well as the atypical presentations of acute disease in the frail elderly population. Palliative Care The students are given palliative care experience through the community-based hospice programs run by Circle of Life Hospice of Northwest Arkansas. Each student is assigned hospice patients for home and inpatient visits and will present the patients to the preceptor. Teaching techniques will include role-play and small group discussions. Students primarily learn the physician’s role in hospice care. This experience will address the character and terms of advance directives and living wills, as well as skills of pain management and palliative care for the terminally ill. This experience allows the student to gain information about health care resources outside the hospital, as well as technological capabilities for providing health care in the home. In 2015 we had 17 students in our program all of whom were interested in practicing in a variety of different areas of medicine ranging anywhere from pediatrics to emergency medicine. As students evaluate the program at the end of the rotation, we consistently see very favorable evaluations of the program and preceptors who work alongside the students. As the programs expand at UAMS-NW, the Schmieding Center will continue to play a lead role in the education process. 30 2015 Medical Students at Schmieding Center Matthew Dalke Matthew Devries Nicholas Fleming Jordan Griffin Family Medicine Internal Medicine 8-2-15 to 8-28-15 Anesthesiology 1-5-15 to 1-30-15 Neurology 3-2-15 to 3-27-15 General Surgery 10-26-15 to 11-20-15 Joshua Guindon Joseph Johnson Devon Johnston Amanda Jones Emergency Medicine 10-26-15 to 11-20-15 Family Medicine 9-28-15 to 10-16-15 Psychiatry 11-23-15 to 12-18-15 Internal Medicine 3-30-15 to 4-24-15 William Lassiter Grant Meredith Elizabeth Morgan Matthew Neoh Anesthesiology 3-30-15 to 4-24-15 Psychiatry 8-3-15 to 8-28-15 Family Medicine Psychiatry 1-5-15 to 1-30-15 Family Medicine 6-1-15 to 6-25-15 31 Kody Nichols Kara Robertson William Rogers Erik Sowell Pediatrics 2-2-15 to 2-27-15 Pediatrics 11-23-15 to 12-18-15 Family Medicine 3-2-15 to 3-27-15 Internal Medicine 2-2-15 to 2-27-15 Douglass Wallace Emergency Medicine 9-28-15 to 10-16-15 32 Aging Resource Center Report The Aging Resource Center (ARC) provides valuable resources to the community. The Center offers computers for research, books about aging, Alzheimer’s, Caregiving techniques and DVDs that can be checked out. It also has numerous pamphlets that describe products or services offered to seniors. Often the ARC is the initial point of contact where older adults and their families learn of the programs and services that are available to improve quality of life. Marjorie Hart and Lee Stepp, from Experience Works, are happy to assist patrons at the Aging Resource Center. In an effort to meet the increasing demand to access information through technology versus printed material, the ARC space was refurbished and upgraded in 2014. New iPads were mounted. Home caregiver students may use iPads to check class schedules and make a reservation to attend the class of their choice. The chart below reports the numbers for our resource centers listed in the Arkansas Aging Initiative (AAI) database for 2015. Site Calls Visits Referral Calls Totals Springdale Bella Vista Totals 2322 339 2661 1905 767 2672 1786 301 2087 6013 1407 7420 33 Research & Development The Cost Effective Delivery of Enhanced Home Caregiver Training project was awarded a partial no cost extension through June 30, 2016. It has been granted a partial extension to allow the project to close the caregiver training loan program and collect any outstanding government funds. As of June 30th, 2015 the Cost Effective Delivery of Enhanced Home Caregiver Training project Microloan Program distributed 327 student loans for a total of $142,905.00. Arkansas distributed 162 loans for a total of $56,905.00 in student loans. 54 student files have been closed due to payment obligations being satisfied. A total of $18,873.19 in student loans has been collected. 62 student files are active. Active files include files in which monthly payments have been satisfied per student loan agreement and/or communication from the student has been received indicating payment delay and intent to pay within the next 30 days. Measures collected during QR 1 thru QR 12 focused on caregiver training and workforce satisfaction. As established by UAMS, CMS, and NORC the best approach to evaluating UAMS HCIA innovation program was through the utilization of a workforce evaluation. Measurements focused on caregiver training in the workforce to determine the effectiveness of an enhanced home care training program. The workforce survey analyzed caregiver training, training satisfaction and confidence a caregiver has when providing care to a client. Data collected during this upcoming year will determine, based on our experiences, if a micro-financing model (as defined by Grameen Foundation, www.grameen-info.org) can support workforce development opportunities targeting lower socioeconomic markets in the United States where caregiver training is in high demand to meet the needs of a progressively aging society. Courses that were developed during the grant period are now in the process of being delivered on line which will increase the number of trained caregivers. Refinement of the courses developed during the grant period will continue to be refined and delivered to the public in a variety of ways during this next year. Research and development will continue seek additional grant funding for further development of existing courses as well as new courses as the demand for aging services and caregiving requirements change. Various studies and publication submissions will also enhance caregiving programs in order to meet the criteria for evidence based programs designation. 34 Aging Services In 2015, Schmieding C.A.R.E.S. became Schmieding Aging Services because of the loss of the C.A.R.E.S. grant funds. The focus of Schmieding Aging Services has not changed. We serve as the front door of the Schmieding Center and direct, patients, social work clients, caregiver training students, and people from the community to the services they need. Aging Services continues to provide one-on-one client education and assistance with resources, family education, and community outreach and education. Brandi Schneider, LMSW, also assisted teaching some components of the FCA class. In January, we honored one of the Schmieding Social workers who retired at the end of 2014. Carolyn Wheeler had served as a Certified Care Manager at the Schmieding Center for over nine years. She facilitated several support groups and helped many families through their crisis. With the retirement of Carolyn Wheeler, LSW, Brandi Schneider became the only social worker on staff at the Schmieding Center. Despite the loss of a social worker, Aging Services increased the number of clients served and maintained a high number of community outreach contacts. Aging Services served 772 clients in 2015. This number includes clients and network partners served by direct contact with Brandi Schneider, LMSW, for one-on-one support or assistance. The number of clients served was an increase of almost 200 clients from 2014. Aging Services also presented over 90 community programs to just over 775 attendees. A major focus of Aging Services also became sustainability measures and reaching out to the community to determine needs for future services and sustainability options. Social services continues to be identified as a major need for older adults in NWA. 35 Student Interns: One social work student intern, Mai Lee Lor received training through Schmieding Aging Services. Mai Lee Lor experienced the Virtual Dementia Tour and assisted at the Schmieding booth at the Alzheimer’s Walk. We also had two Schmieding Fellows: One worked with Aging Services through the University of Arkansas social work department and one worked with Aging Services and Education Eric Dean (social work fellow) Morena Valdizon (education fellow) One NWACC student, Lauren McClure, also received volunteer hours and training through Aging Services. 36 Aging Services Community Programs Support Groups The Schmieding Center hosted three support groups in 2015: Grandparents As Parents (GAP)-meets once monthly Caregivers of Persons with Dementia-meets twice monthly Early Stage Support Group for people in the early stages of dementia and their care partners-meets once a week for eight weeks. This group transitioned into Memory Café in which participants continue to meet weekly as a group without a formal facilitator or agenda. The goal of Memory Café is to allow participants an opportunity to engage with others who are experiencing the same issues and feelings they are experiencing and to form connections with others in a positive way. The Family Caregiver Support Group was discontinued due to lack of participation. Support Groups Meeting Off-Site: Clarity Point Fayetteville-meets once monthly Elder Share was discontinued because of health issues and transitions of many of the group members. The support group at Concordia Health and Rehab was also discontinued due to a change in staff at the facility. It was decided that a therapeutic activity, such as TimeSlips, would be started there instead of the support group. Type of Support Group Number of Meetings Number of Attendees Grandparents as Parents 11 53 Caregivers of Persons with Dementia 24 123 Early Stage Dementia 8 21 Clarity Pointe 11 69 Total 54 266 37 Virtual Dementia Tours: Aging Services facilitated 6 virtual dementia tours with a total of 106 participants. Schmieding Center for the public Schmieding Center for Northwest Technical Institute LPN students (2 days of VDT) Schmieding Center for OLLI (2 days of VDT) North Hills Life Care Center for staff TimeSlips: The TimeSlips program uses group storytelling to enhance the lives of people with Alzheimer’s disease and related dementia. It provides hope through meaningful communication and connection. Participants are invited to look at a picture. The facilitator asks questions that encourage them to create a story their own story about the picture. Brandi Schneider facilitated TimeSlips events at three facilities in 2015. Autumn Place-once monthly Morningside Fayetteville-once monthly Concordia Health and Rehab- every other month Sample Time Slips Story by Residents of Concordia “Dumb Goats” Charlotte asks, “What are they going to work on us now?” It looks like Granny Sadie with a billy, a nanny, and a kid. We’ll name them Herbie, Rita, and Bambi. Charlotte and Rita think one of the goats looks like Rita! Granny has a cap on, so it must be a sunny day! Martha says, “The goats took a walk and went to the beach!” The goats crossed the bridge and walked to the beach. Granny had to go get them back. She had to put her dirty work dress over her clothes to go get the dirty goats. She had to pick them up on the other side after they ran away! They were bad, bad goats! She is paddling so they must be going somewhere! Looks like they’re crossing the creek, the water is dirty. The goat says, “I’m hungry. I see a couple empty cans floating down the stream.” The goat’s going to eat the cans. …..And the story goes on and on. 38 Alzheimer’s Events Brandi Schneider welcomes participants at the Alzheimer’s Walk to the support groups that meet at the Schmieding Center. Who Is that Lady? It is our Rene’ Oliver, one of our talented nurse educators in costume singing the National Anthem at the beginning of the 2015 Alzheimer’s Walk. 39 Partnerships Establishing partnerships is vital to creating awareness of the program and obtaining additional financial, human, and physical resources. Each site successfully created and maintained partnerships this year. Lynette Bennett, RN, teaches proper use of the gait belt at the ALS event. The ALS promoted the event to families who are caring for someone with Lou Gehrig’s disease. The Schmieding Center provided the auditorium, instructors & equipment for demonstrations. 40 Springdale Partnership Activity AARP Conducted the Smart Driver Safety Program Alzheimer’s Association Alzheimer’s Association Support Groups; Walk to End Alzheimer’s, Social Work Consult; Creative Connections Area Agency on Aging PACE planning; participated in tribute for Larry D. Wright Arkansas Geriatric Educational Consortium Offered CEU’s for health professionals Arkansas Healthcare Association District 3 Used Schmieding facility District 3 Administrator meetings and for Senior Pageant Brekelbaum, MD; Kilambi,MD : Wilson,MD Led Men’s Health Seminars Centers for Medicare & Medicaid Services Gave Health Care Innovations Award Circle of Life Hospice Used Schmieding Auditorium for CE events Clarity Pointe Comfort Keepers Crystal Bridges Concordia of Bella Vista Site for Dementia support groups & the dementia education series led by Brandi Schneider Sponsor of Caregiver Appreciation Event; provided lunch for students enrolled in home caregiver training Hosted and provided supplies for the Alzheimer’s Creative Connections Events Site for TimeSlips activities led by Brandi Sponsor for Caregiver Appreciation Event; Volunteer worker for Family Caregiver Event Donald W. Reynolds Grant for the Replication of the Schmieding Home Caregiver Training Program Train the trainer sessions are provided by the staff of the Schmieding Center for sites beginning the program ElderStay At Home Distributor of the Schmieding Home Caregiver Training Program Curriculum Grandparents As Parents Led support groups at Schmieding Center Home Instead Senior Care Humana Community Event: Family Caregiver Workshop for Alzheimer’s Disease and Other Dementia Provides prizes for Brain Games; Led seminar about Medicare at Schmieding Center Kupuna Education Center/University of Hawaii Partners in the HCIA project Jones Center for Families Provides room and equipment for Strong Body Classes Junior League of Northwest Arkansas Used our facility for meetings - Schmieding staff gave greeting and brief overview. Northwest Arkansas Clinical Pastoral Education Institute Conducted Pastoral Care Symposium 41 Northwest Health System Management and personnel of Senior Health Center sponsor Lunch and Learn programs in Springdale and Bella Vista through their Senior Circle program; NHS also uses our facility for physician orientations Northwest Technical Institute Assisted with Family Caregiver Event Pacific Gateway Center - Honolulu Kathryn Sweetser went to Hawaii to train the trainers who will be using the Schmieding curriculum. PRN Medical Services Sponsor of Caregiver Appreciation Event Schmieding Developmental Center Schmieding Foundation Used Schmieding Facility for Kids First Kindergarten Graduation Financial support of the Schmieding Center for Senior Education and physical plant Springdale Chamber of Commerce Used the Schmieding Auditorium for Morning Brew Senior Transitions Provided coffee for ARC Springdale Senior Center Provides facility and prizes for Brain Games led by Fink Holloway Shiloh Health and Rehabilitation Site for clinical rotation for students enrolled CNA program Superior Senior Care Sponsor of Caregiver Appreciation Event; student referral source Texas Area Agency on Aging Partners in the HCIA project Office of Long Term Care Used Schmieding auditorium for PASRR Training UAMS – Office of Continuing Medical Education Provided video teleconferences to provide CE and CMEs for health professionals UAMS – Northwest Campus Provided site for CDSMP classes Will Corporon Led seminars on Medicare Wise and Healthy Aging Caregiver Training Academy Partners in the HCIA project See page 59 for additional partners listed in the Outreach & Promotion report. 42 Leveraging Leveraged resources of money, time, and in-kind services all contribute to the success of the Schmieding Center and its outreach sites. The total leveraged in 2015 for Springdale and Bella Vista was $711,079.84. This includes the Schmieding Foundation grant of $617,218.84 UAMS’ Cost Effective Delivery of Enhanced Home Caregiver Training project was awarded a partial no cost extension through June 30, 2016. The partial extension will support UAMS continued efforts to close the caregiver training loan program and collect any outstanding government funds. The entire CMS award amount of $3,518,798 was reported in the 2012 annual report. In the Arkansas Aging Initiative (AAI) database, the donation column includes the value of floor space donated for programs, meals and/or products that were donated, as well as monetary gifts. Volunteer data is calculated at the rate of $8.00 per hour of service. The speaker data is calculated at $50.00 per hour of service. Although the actual funds received from our primary benefactor, the Schmieding Foundation, remain critical to our ability to succeed, the value of volunteers, speakers, and smaller donors speak volumes about the good will and acceptance our programs and services have generated in northwest Arkansas and surrounding regions. We are committed to being good stewards of the opportunities set before us in the spirit of Mr. Lawrence Schmieding. The types of leverages received by the four sites are presented in the following table. Springdale Bella Vista Totals Grants Donations 617,218.84 23,744.00 35,125.00 58,869.00 617,218.84 Volunteer Hours 5784.00 13,608.00 19,392.00 43 Professional Speakers 10,100.00 5,500.00 15,600.00 Total 656,846.84 54,233.00 711,079.84 Community Advisory Committee The Community Advisory Committee is comprised of Community Leaders who help to engage the Northwest Arkansas community by building awareness of how the Schmieding Center can serve the surrounding areas with its aging population needs. They assist the staffs with educating of the community about the programs and services that are available and by encouraging middle-aged adults to participate in helping them grow older with health, grace and dignity. The Schmieding Center is a one-stop resource for geriatric clinical health and wellness, aging services information and education. They are vital to helping meet the challenge of preparing the community to care for the growing population in the “Second Half of Life”. Dr. Fred Taylor, community and legislative liaison for the Arkansas Aging Initiative, likes to attend these meetings whenever possible either in person or via telephone conference. He provides the group with the latest news from UAMS and the Reynolds Institute on Aging. Reports from Gilda Underwood, President of The Schmieding Foundation keep the committee informed of what is happening in the other replication sites. Various Schmieding Center staff members share reports pertaining to the various activities, programs and events taking place at the center. There is always a conversational exchange between staff and committee members on what they would like to see implemented in the future of the Schmieding Center. It is always good to hear fresh new ideas, suggestions and receive support from those who represent the community Community Advisory members are: Mr. John Belew Ms. Cristie Ginther Ms. Bonnie Grimes Ms. Betsy Phillips Dr. Michael R. Platt Mrs. Clara Turnbow Dr. Jean Henry Mr. Scott Huse Mr. Carl Johnson Mrs. Lee Johnson Ms. Carolyn Long Mr. C.J. Malone Mr. Walter Turnbow Ms. Ellen Turner Ms. Gilda Underwood Mr. Jerre Van Hoose Rev. Judy Van Hoose Ms. Linda Vigil Mr. Tom O'Neal Ms. Susan Patton Ms. Natalie Wood 44 Back Row: Dr. Larry Wright, Tom O’Neal, Bonnie Grimes, Dr. Jean Henry, Jerre Van Hoose, Scott Huse, Walter Turnbow, Gilda Underwood, Brandi Schneider, Dr. Gary McHenry, John Belew Front Row: Cristie Ginther, Carolyn Long, Judy Van Hoose, Lee Johnson, Ellen Turner, Clara Turnbow In 2015, the Community Advisory Committee had a major role planning the tribute to honor Dr. Larry D. Wright, MD, FACP, AGSF who served as the founding director for the Schmieding Center from 1999-2015. Carolyn Long was the Master of Ceremonies. Shannon Fleming from UAMS expresses thanks to Dr. Larry Wright, MD on behalf of the Reynolds Institute. on Aging. 45 A Tribute to Larry D. Wright – October 26, 2015 Mayor Doug Sprouse Proclamation: Larry D. Wright Day Mary McKinney Circle of Life Dr. Beth Vaughan-Wrobel Founding Director of Education Dr. Peter Kohler UAMS – NW Gilda Underwood Schmieding Foundation Jerry Mitchell Area Agency on Aging 46 Rev. Judy Van Hoose Community Advisory Committee Dr. Robin McAtee & Dr. Claudia Beverly UAMS - Little Rock Dr. Gary McHenry Director of Education 2015 Facility, Audio Visual and Information Systems This year the Schmieding Foundation relocated to the hall between the clinic and the rehab. The move involved networking and phone equipment being installed in Shaun’s office and the phone/server room. They used the furniture from the C.A.R.E.S. offices that was being stored there. We purchased four Microsoft Surfaces Pro 3’s as a test for IPad and laptop alternatives. Outreach purchased signs to direct visitors to park in back and to the entrance doors. A new SonicWALL firewall was bought for the Bella Vista office so that a permanent VPN could be made to the Springdale location. This allowed the users in BV to access the files and resources in Springdale easier. Their files were also moved to the servers in Springdale to better manage and back them up. A SonicWALL brand firewall was purchased for Springdale also because it is what they use at UAMS in Little Rock and would make joining their network easier. The 3mb Elink line used for video teleconferences was upgraded to 100mb fiber this year in preparation of us using it to join the UAMS network. The new SonicWALL in Springdale was setup and in November we used it to join the UAMS network. This also involved us purchasing 300 GB of storage space on a server in LR to move all of our files to. During the first part of November all of our files were moved to LR and our computers joined to the UAMS domain. This will allow the retirement of the two Windows 2003 servers, which Microsoft no longer supports, that we currently have and save us the money of having to purchase new ones to replace them. By joining the UAMS network it has made it easier for our users to login and use UAMS resources along with making it easier for UAMS to assist in support. Our plans for next year include the use of ProClass as the new registration software for classes. This includes online payment capability with Cyber Source. The Caresforyou.org website is no longer used and will be retired in the middle of 2016. The resource directory used on there will be converted into another format and stored locally or put on the website: www.schmiedingcenter.org. UAMS is planning on donating some unused network switches for use in Springdale and Bella Vista. These will be faster than our current ones and should improve performance. The Summit software the controls the HVAC is running on an old Windows XP computer that Microsoft no longer supports, and will be moved to a newer computer also this year. Since we now use the updated 100mb Elink line for our internet we will be disconnecting the one we have with Cox. This will happen the first part of 2016 after UAMS is done with some testing. This new upgraded line will also allow us to look into using a phone system through UAMS, which would give us more functionality and allow us to retire the old one we currently have. 47 Outreach and Promotion Outreach initiatives continued to focus on brand awareness for the Schmieding Center as the premier Regional Center on Aging. Our main goal was to increase the recognition and demand for our Schmieding Caregiver Training Program. Other primary goals were to Increase use of our Schmieding Aging Support Services Increase participation in our community education programs Increase the use of our facility for other community events Strengthen existing relationships Develop new strategic partners, other senior providers and shareholders. Initiatives to increase demand for Schmieding Caregiver Training Programs Through our strengthening relationships with home care agencies experiencing a shortage of trained caregivers, more agencies referred students and paid tuition for IHA and Alzheimer Disease and Dementia classes than ever before. In June, a revised Certified Nursing Assistant (CNA) program was offered allowing students to complete the entire course within a three-week period. This allowed us to strengthen our partnership with the local long-term care facilities. We begin accepting sponsorships from them for tuition. This strategy also gave us a market advantage over the other schools offering CNA training. The last quarter of 2015, the Schmieding Center offered a 25% discount to home care agencies that referred one students to us. Agencies sending two or more to the same class received a 50% discount. A “Two for One” discount was also offered to individuals. If a student brought a friend who enrolled in Schmieding Home Caregiving course with them, they could both participate at half the cost. Advertising Radio We produced 60-second ads “Schmieding Minutes” that provided advice for families caring for dementia patients and to explain the importance of hiring a Schmieding trained caregiver. Other radio station schedules ran 30-second spots for student recruitment. PSAs ran to promote the Health Care Job Fair we hosted and our Family Caregiver Event on the local radio stations and NPR. KUAF also interviewed Kathryn Sweetser and Brandi Schneider on the Ozarks at Large broadcast to promote the Family Caregiver Event. 48 TV Brandi Schneider did a live interview on the KNWA morning show and the Fox morning show to promote our Family Caregiver Event. Newspaper Monthly newspaper ads ran on the front page of the Food Guide that highlighted our aging support services. Weekly Sunday classifieds promoted our caregiver training program. We continued to use constant contact to promote our upcoming events and classes. Newsletter Our AgeWise newsletter was produced quarterly and distributed in constant contact. Print copies were made available to hand out at our facility versus mailing them out. Social Media We continued to regularly post on Facebook. Our page likes increased by 26% and our most popular posts were about our Caregiver Appreciation Event and our Family Caregiver Event with pictures, each receiving more than 400 views. Internet Information about upcoming Home Caregiver Training courses was posted on Craigslist. Schmieding Website The Schmieding Center website www.schmiedingcenter.org provides the schedule for upcoming events, descriptions and applications for the home caregiver training courses, a link to the Schmieding Home Caregiver Directory, the facility use form, and much more. The Schmieding website recorded 24,658 views last year. Health Fairs The Schmieding Center was represented at six health fair events in 2015: The Senior Expo in Bella Vista, The Prime of Your Life Expo in Springdale, NWA School Nurses Workshop in Farmington, Senior Health Fair in Bella Vista, the Walk to End Alzheimer’s in Bentonville, and the J.B. Hunt employee benefits fair in Lowell. 49 New Community Education Initiatives Smart Aging-Living Well Series This series was developed for the purpose of providing valuable information from area experts on a variety of aging issues to the community. The series gave us the opportunity to collaborate with the presenters/companies and provide the opportunity to have new visitors to learn about the Schmieding Center. The free sessions were held in the Schmieding Center Auditorium the second Thursday of each month beginning in April, and continued through October. The time was set from 4 until 6 p.m. to allow for those who are still in the work force to attend as well as allowing the elder attendees to arrive before and after rush hour traffic. Refreshments were provided by either the speakers or by long-term care facilities. Some of the topics were: Smart Advice-When Do You Need an Elder Law Attorney; Smart Living: De-cluttering and Downsizing Your Home; and Coping Well-How a Social Worker Can Help Your Family Cope with Aging Issues. Family Caregiver Event The free, public event, held on October 29, was co-sponsored by the Schmieding Center and Northwest Technical Institute’s Practical Nursing Program. The purpose for the event was to teach family members and friends who are caring for an older adult the skills they need to keep their loved one at home as long as possible. Skill stations for Q&A and demonstrations included transfers, wheelchair safety, fall prevention, virtual dementia experience, activities for people with dementia and more. 50 Other 2015 Outreach Events Schmieding Caregiver Appreciation Event Osher Life Long Learning Open House & Classes Schmieding Chamber Morning Brew Schmieding Foundation Sponsored Prime of Your Life Expo Health Care Job Fair in conjunction with Goodwill Schmieding Kids First Kindergarten Graduation Alzheimer’s Arkansas - Hope for the Future Event J.B. Hunt Employee Health Fair WestArk RSVP Meet and Greet Arkansas Health Care Association District 3 Senior Beauty Pageant Seth Wilkens 2015 Outstanding Caregiver 51 Strategic Partnerships, Sponsorships and Alliances In March, the City of Springdale Community Engagement hosted a Landlord Summit in our auditorium. The Mayor and city representatives from the attorney, police, fire, city building and animal services departments provided free education to landlords. Coffee for the Resource Center provided by: Senior Transitions and Comfort Keepers; coffee cups provided by Jan Phillips State Farm and Servpro. Lunches and dinners for students, provided by: Superior Senior, Comfort Keepers, Bright Star, Right at Home, Home Helpers and Good Shepherd Senior Care. Delta Medical provided lunch for the Arkansas Lifespan Respite Training. Smart Aging Living Well refreshment providers were: Arkansas Physical Health & Rehab; Brookstone Assisted Living; Springdale Health and Rehab; Todd Whatley, Elder Law Attorney, and Jeff Huff American National Insurance Agency. Partnered with NTI LPN for the Family Caregiver Alliance; agreement to accept our Home Care Specialist certification as pre-requisite for their LPN program. Single Parent Scholarship Fund of NWA offers a $500 scholarship for qualifying Schmieding CNA students. Home care agencies referring students and clients were: Visiting Angels, Home Helpers, Superior Senor Care, Kare-In-Home, Good Shepherd and Comfort Keepers. Osher Life Long Learning held classes in our facility. Health and rehabs that supported and sponsored our 2015 events were: Ashley Health and Rehab, The Highlands of Rogers, Katherine’s Place, Springdale Health and Rehab, Walnut Grove. Westwood Health and Rehab and Walnut Grove Health and Rehab sponsored students for our CNA program. Other event and food sponsors were: Morningside of Fayetteville, Maggie’s Little Oil Business, Ozarks Community Hospital, Green Acres Easy Living, Washington Regional Hospice, Debbie’s Family Pharmacy, Concordia Retirement Center, PRN Medical Services, Dr. Bilal Naeem, and Vantage Point. 52 Northwest Senior Health Clinic Report The Senior Health Centers operate as primary care clinics for adults age 65 and older in Springdale, Bentonville and Bella Vista and function as interdisciplinary team models for geriatric care. Northwest Senior Health – Schmieding Center has been in operation since July 13, 1999. The Northwest Senior Health Clinics are owned and operated by Northwest Health System (NHS), our partnering organization for clinical services at the Schmieding Center. Rehabilitative services are provided in a separate section of the clinic by staff from Northwest Medical Center - Springdale physical therapists. We are advancing our Rehab services to the Bella Vista office to provide services to the patients in different locations. Coordination of care is provided for Senior Health patients by outpatient clinic visits, medical care in nursing homes and assisted living facilities, a limited number of home visits, case management and referrals to all medical specialties. Significant events for 2015 include: An LCSW, Lindsey Myers, was hired to provide individual and group therapy A wellness team was established to provide annual Medicare Wellness visits Dr. Kristin Bosc, geriatric neuropsychologist, left the senior health clinic in December 2015 The charts below reflect the number of visits recorded in AAI for Springdale in 2015. Discipline Encounters Physician 32079 Social Worker 376 Nurse 184 Total: 32639 Clinic Visit Type Visits Senior Health Clinic 3559 Nursing Home 3111 Home Visit 2 Total: 6672 53 2015 Staff of Northwest Health Clinics SCHMIEDING SENIOR HEALTH 2422 N. THOMPSON ST, SPRINGDALE SUGAR CREEK SENIOR HEALTH 1102 NW LOWES AVE, BENTONVILLE Michelle Jameson, Practice Manager Dr. Jose Fontanilla, MD Dr. Maria Judit, MD Dr. Kristin Bosc, Neuropsychologist (through December 11, 2015) Andrea Cheader, RN Melissa Lowrimore, LCSW Isela Araujo, RMA Marie Dee, Lab Dorothy Wilson, Registration Tech Lisa Arnold, Registration Tech Michelle Jameson, Practice Manger Amy Tobin, Clinic Coordinator Dr. Arlene Nepomuceno, MD Mary Daniel, APN Carol Schwieso, LPN Beth Kardynalski, MA Lindsey Myers, LCSW Kelly Cooke, Registration Tech BELLA VISTA SENIOR HEALTH – 1801 FOREST HILLS BLVD, BELLA VISTA NURSING HOME STAFF Michelle Jameson, Practice Manager Amy Tobin, Clinic Coordinator Dr. Marjorie Renfro, MD Jeannette Mires, RN Lindsey Myers, LCSW Megan Berger, Registration Tech Dr. Kimberly Burner, MD Mary Alice Kelly, APN WELLNESS TEAM Amber Nguyen, APRN Valerie Bedwell, APRN Linda Wilkins, RN Robin Hood, RN 54 Outreach Site – Bella Vista Education – Bella Vista Program Counts for 2015 Program Type Client Encounters In-service 233 Community Education 2145 Support Groups 955 Health Resource Center CPR Classes 1299 43 In-Services held at Brookfield Assisted Living, Concordia Catered Living on a regular basis. Community Education event titles include: Planning Ahead, Senior Circle Lunch & Learn, Numerous Service Projects and Health Screenings. American Heart Association CPR Classes include: Health Care Provider, Heartsaver, and Hands only. 55 Senior Services Expo 2015 The 2015 Senior Expo was held on April 30th at Riordan Hall in Bella Vista from 9:00 a.m. – 1:00 p.m. This event was presented by the POA, The Weekly Vista and the Bella Vista Resource Advisory Council. Over 60 vendors participated in the event and they offered seniors and community members a wide variety of information on senior services. The information included medical supply services, Hospice, insurance agencies, financial services, Elder Law, adult day care agencies, senior housing, travel agencies, reality, cancer support services, Retired and Senior Volunteer Program services, DHS Division of Aging services and many more. Over 742 community members attended and participated in the event. In addition, Ozark Orthopaedic Physicians gave seminars; "Pain of the Ball of the Foot," presented by Dr. Charles Ginn and “Arthritis of the Hand," Presented by Dr. Jeff W. Johnson. Senior Expo Partners A Plus Medical Culpepper Place Mt. Carmel Community AAA Insurance DHS Adult Services NanoPac Inc. Alliance Home Health Elder Law Practice of Todd Whatley NW Medical Center Senior Circle Alzheimer's Arkansas ElDirect Nursing Consultants Autumn Place Elite Home Health Ozark Hospital Bank of Gravette Faith in Action Ozark Orthopaedic Bell Vista Senior Services Forest Hill Peachtree Bella Vista Courtesy Van Golden Living PRN Bella Vista Lion's Club Good Shepherd Rejuve Massage Bright Star HealthSouth Rehabilitation Rodan and Field Brookfield Highlands Rehab Schmieding Center Springdale BV Estate Sales Home Helpers Senior Transitions of NWA BV Hearing Home Instead Shannon's Healing Tough Massage BV Recycle Hutch Reality Smith Family Chiropractic Clinic Cancer Support Home Insurance Matters Superior Senior Care Circle of Life Jim's Old Fashion Service Inc. The Maples at Har-Ber Meadows Clarity Point Lifeline The Meadows Comfort Keepers Lisa A. Reeves Attorney The Plaza Concordia Making Memories Tour Village House Corporon Insurance Morgan Stanley WestArk RSVP 56 Bella Vista Senior Health Fair 2015 The 2015 Senior Health Fair was held on September 25th at Riordan Hall in Bella Vista, from 9 a.m. - 1 p.m. The event was presented by the POA, The Weekly Vista and the Bella Vista Resource Advisory Council. Seventy two vendors participated and over 800 community members attended and actively engaged in Health screening opportunities consisting of: blood pressure checks, BMI checks, glucose checks, dermatology, vision and hearing. In addition to the screenings, flu shots were available for those who have Medicare, Tricare, and a Federal Employee plan. There were three speakers from Ozark Orthopaedic Clinic. “Arthritis,” presented by Dr. Hanby, “How to Stop Hand and Wrist Pain,” presented by Dr. Henley, and “The Adult Degenerative Spine,” presented by Dr. Nalley. Health Fair Partners AARP ElDirect in Home ELDerly Care Ozark Community Hospital Advanced Dermatology Elite Home Health Faith in Action Parkinson’s Support Group Alzheimer’s Association Cancer Support Home Premier Dermatology Area Agency on Aging Forest Hills Church PRN Medical Services Autumn Home Care Health South Rejuve Bella Vista Hearing Center Highland Health & Rehab Right at Home Bella Vista Lions Club Highland Oncology Group Schmieding Aging Services Better Hearing and Balance Home Helpers Senior Helpers Boozman Hof Regional Eye Clinic Home Instead Senior Care Shannon’s Healthy Touch Massage BrightStar Care Hull Dermatology Superior Senior Care Caring Carriages Insurance Matters Teasley Drug Circle of Life Hospice Invision Chiropractic The Meadows Clarity Pointe Fayetteville Laser Wellness Center The Elder Law Practice Comfort Keepers Lifeline of NWA The Federal Savings Bank Concordia of Bella Vista Lifetime Wellness Chiropractic UAMS Pharmacy Students Cornerstone Pharmacy of Bella Vista Mercy Hospital NWA UV Sanitized Corporon Insurance Morgan Stanley Village Insurance Courtesy Van Mt. Carmel Community in Rogers Washington Regional for Seniors Dewitt Law Firm PLLC Northwest Medical Center Bentonville WestArk RSVP DHS Division of Aging and Adult Services Operation Good Morning and Project Lifesaver Bella Vista Westwood Health and Rehab. Dr. Yoos Eye Care Optical Ozark Orthopaedic 57 Bella Vista Health Resource Center Aging is a lifelong process that involves making healthy choices and informed decisions about your healthcare. One way to do this is to learn as much as possible about healthy aging and existing health conditions. Our Health Resource Center contains a variety of informative resources to help you stay informed and abreast of current research, trends and issues related to healthy aging. Free monthly screenings are available to the public for blood pressure checks, blood pressure equipment checks, memory screening, blood glucose testing, hearing tests, hearing aid adjustments, fall risk, and coffee with an Elder law Attorney. Our dedicated volunteers in the Health Resource Center are vital to the success of our daily programs, directory and events. They are always willing to learn new skills, share their time and talents and offer assistance to the staff and patrons in the building. In 2015, volunteers donated 1,270 hours. Partnership Bella Vista Resource Center Attorney General Leslie Rutledge Mobil Office Better Hearing and Balance Connection BrightStar Elder Law Practice of H. Todd Whatley Elite Home Health Encompass Health Highlands Health and Rehab Navigating Medicare. Schmieding Aging Services Senior Circle Smith Chiropractic 58 Additional Partners Bella Vista TV, Channel 222 Brookfield Assisted Living Churches in Bella Vista/Bentonville/Rogers Concordia Arms and Concordia Catered Living HealthCare Marketing Alliance Highlands Church Northwest Arkansas Health Providers Northwest Health Systems and Senior Circle United Lutheran Church Village House Activity Members of the Bella Vista office are regular monthly guests on Village Hi-Lites to inform the viewers of upcoming programs as well as tidbits on healthy aging. Partners with the SCEBV to provide their staff with in-service education programs every month. SCEBV works with them to meet any health related educational needs they have. Promote SCEBV programs. Partner with SCEBV to provide their staff with inservice educational programs every other month. SCEBV participates in the NWA Health Marketing group. SECBV and the church educational committee planned, promoted and participated in: “Planning ahead for the unexpected.” The programs covered topics such as medical decision making, legal issues, insurance, Medicare, Medicaid, various housing options, and death and dying. Another series is planned to begin March 2016. SCEBV participates in and hosts the Northwest Arkansas Health Providers meeting. Provides Lunch and Learn programs. Assists with informing public of these programs. Lunch and Learn sessions are well received. Provides SCEBV and Senior Circle with a free room. Set-up/tear down service and audio equipment provided. Ellen Creakbaum, RN offers Family Caregiver Class for spouses and family members of Village House 59 Appendix A – Examples of Articles UAMS News Bureau Office of Communications & Marketing 4301 West Markham # 890 Little Rock, AR 72205-7199 www.uamshealth.com/news News Release For more information: Leslie W. Taylor, 501-686-8998 Wireless phone: 501-951-7260 leslie@uams.edu Liz Caldwell, 501-686-8995 Wireless phone: 501-350-4364 liz@uams.edu UAMS/Schmieding Program Earns New Designation, Potentially Extending Caregiver Curriculum in New Avenues LITTLE ROCK – The UAMS/ Schmieding Home Caregiver Training Program has been designated as an intermediate-level, evidence-based health promotion program, making it possible for other caregiver training providers to seek federal funds to purchase the program’s curriculum materials and through them expand the program’s reach and positive influence. The Arkansas Department of Human Services-Division of Aging and Adult Services made the designation in October. Before the designation, training programs could not access federal Older Americans Act Title IIID funding to buy the materials. These funds are made available for education activities that support healthy lifestyles and reduce the need for more costly medical interventions. 60 The Schmieding program provides education and skills training to family members and paid caregivers caring for older adults in the home, allowing older adults to have choices about how they are cared for. “The Schmieding curriculum’s designation as an evidence-based program ultimately will mean more caregivers will be able to receive training and gain the knowledge they need to provide better care in the home,” said Gary McHenry, EdD, director of education in the Schmieding Center in Springdale. “Because of this, more seniors will be able to age at home for as long as possible, achieving a better quality of life and reducing the cost of care.” To receive intermediate-level, evidence-based status, the Schmieding program has: Demonstrated through evaluation to be effective for improving the health and wellbeing or reducing disease, disability and/or injury among older adults; Proven ready for translation, implementation and/or broad dissemination by community-based organizations using appropriately credentialed practitioners; Been published in a peer-review journal; and Proven effective with older adult population, using some form of a control condition. Evidence-based programs are founded on rigorous study of interventions and models of care carried out with multiple populations in a variety of settings. They are more likely to produce positive changes or outcomes for people who participate, according to the National Council on Aging. UAMS is the state’s only comprehensive academic health center, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; a hospital; a northwest Arkansas regional campus; a statewide network of regional centers; and seven institutes: the Winthrop P. Rockefeller Cancer Institute, the Jackson T. Stephens Spine & Neurosciences Institute, the Myeloma Institute, the Harvey & Bernice Jones Eye Institute, the Psychiatric Research Institute, the Donald W. Reynolds Institute on Aging and the Translational Research Institute. It is the only adult Level 1 trauma center in the state. UAMS has 3,021 students, 789 medical residents and two dental residents. It is the state’s largest public employer with more than 10,000 employees, including about 1,000 physicians and other professionals who provide care to patients at UAMS, Arkansas Children’s Hospital, the VA Medical Center and UAMS regional centers throughout the state. Visit www.uams.edu or www.uamshealth.com. Find us on Facebook, Twitter, YouTube or Instagram. 61 62 63 64 65 66 67 Appendix B – Examples of Advertisements 68 69 Radio Advertisements: Did you know there is an increasing shortage of skilled home caregivers? In fact, at the Schmieding Center, we often hear from home care agencies and families who are seeking to hire caregivers. If this career interests you, the Schmieding Caregiver Training program can teach you the skills to get a job! We offer basic to advanced training. Call 479- 751-3043 to enroll today! UAMS/Schmieding Center is a non-profit program of the Donald W. Reynolds Institute on Aging and the Arkansas Aging Initiative. ================================================================== Now it’s time for another Schmieding Minute brought to you by UAMS/Schmieding Center! The Schmieding Home Caregiver Training program is uniquely designed to teach caregivers how to care for an older adult in the home. Our students are taught the skills necessary to ensure a safe care environment for everyone involved. Our specialized training also teaches the skills necessary to care for those who have chronic diseases and illnesses specific to advanced aging. Schmieding students learn health literacy and communication skills that may help prevent unnecessary hospital admissions and nursing home stays. If you are looking for an advanced trained caregiver for your family member, call the Schmieding Center today at 479-751-3043. This Schmieding Minute is brought to you by UAMS/Schmieding Center, a non-profit program of the Donald W. Reynolds Institute on Aging and the Arkansas Aging Initiative. ================================================================== 70 Now it’s time for another Schmieding Minute brought to you by UAMS/Schmieding Center! This is Brandi Schneider, Social Worker and Coordinator of Aging Services at the Schmieding Center for Sr. Health and Education. I’m often asked by family members of a person with dementia about how to communicate with their loved one. Here are a few basic tips: Be patient and supportive. Offer comfort and reassurance. Remain calm. Avoid arguing, criticizing or correcting. Find a quiet place and limit distractions. If you need help with an older adult with dementia, our Schmieding Aging Resources can connect you with the support and services you need. Call us at 479-751-3043 today! This Schmieding minute is brought to you by UAMS/Schmieding Center, a non-profit program of the Donald W. Reynolds Institute on Aging and the Arkansas Aging Initiative. ================================================================== Why Is It Important to Hire a Schmieding Trained Caregiver? The Schmieding Home Caregiver Training program is uniquely designed to teach caregivers to care for an older adult in the home. Our students are taught the skills necessary to ensure a safe care environment for everyone involved. Our specialized training also teaches the skills necessary to care for those who have chronic diseases and illnesses specific to advanced aging. Schmieding students learn health literacy and communication skills that may help prevent unnecessary hospital admissions and nursing If you are looking for an advance trained caregiver for your family member, learn more at the Schmiedingcenter.org. This Schmieding Minute is brought to you by UAMS/Schmieding Center for Senior Health and Education, a non-profit program of the Donald W. Reynolds Institute on Aging and the Arkansas Aging Initiative. =================================================================== 71 Appendix C – Examples of Promotional Flyers 72 73 74 75 Appendix D – 2015 Comments I just wanted to let the Schmieding organization know that I am receiving calls monthly regarding new job offers, and it is because of my training there and my name on the Schmieding caregiver list. I also appreciate so much the Continuing Education classes. The instructors make you want to learn more. I feel so fortunate to live close enough to the Schmieding Center to be able to take classes. You are the cream of the crop! I have taken caregiver training at another agency and there is absolutely no comparison. THE SCHMIEDING CENTER TRAINING IS THE BEST!” 76 Home Caregiver Training Comments Describe the most important information you gained from this course: The most important information that I gained was learning how to properly care for my patient Potentially life-saving Heimlich Maneuver as well general comfort care for elders teaching us about different diseases and showing us how to physically help elderly people To respect the rights of clients and myself the amount of indirect care skills necessary to do the job correctly Hands on teaching of lifting the client practice of turning the client with the sheet How to move people around w/o hurting myself. How we need love the people who needs the help. The correct way to move older ones without injury to them or yourself. I found all the information I received was very important but learned about the warning signs of dementia and depression were real important. How to handle AD and how to handle my stress levels with working with people that have AD and to respect them and their families. Always treat an elder with dignity. Proper infection control. Proper positioning. Legal info I gained a stronger sense of compassion and confidence that I can use with helping anyone with basic needs. The knowledge of AD. I truly was unaware of their stages and actions. Learning about different stages of A/D and seeing the videos of real people and circumstances. Clients’ rights and my need to be always observant. Communicating for and with the elderly. Being taught how to deal with difficult situations. How to help with the client do everyday task such as moving from bed to chair, showering, bathing in bed, dressing. How to help someone without causing them undue pain How to achieve better behavior from patient by understanding the disease process Things to do with crafts or activities to make elders happy Infection control How to speak to an older person How to interact with clients in a respectful caring way while still being very observant 77 Please list ideas you have that would improve this course for future study: Maybe more physical things and less lecture I think this class is constructed very well. I have no constructive criticism Everything was great-the level of patience, understanding, professionalism, humor, lectures, and just plain knowledge was just great Maybe on a few of the skills taking the students and having them do the skills in real life situation in an old folks home. Some of the over-head forms were hard to read, see, make out. None, I would not change anything Be a little careful on the questions in books. Some are confusing & lead you a different way in answering correctly. That could be me. LOL Longer lab time! I would think about reviewing and updating the videos. Some were incorrect but the visual stays a long time in the memory. More practice time In future editions of textbooks add an index to be able to find where a particular word or abbreviation is located None. Very well done. Shorter class time, less breaks Nothing, the course is perfect the way it is. More clinical time I cannot think of one thing that would improve this course. All the tools I needed for education and training were provided. More take home materials More time with dummies and exercise I would have felt even more confident if this course lasted four weeks. More time on the hands on part It was more beneficial to practice skills with fellow students than with dummies Out loud reading and more hands on activities An excellent program. Keep it up! It was a lot of data at one time. Although in a one week course that is expected. Longer classes and more time for discussion I wish the textbook had a subject index Specific meal/menu planning for the various diet need (low sodium, diabetic, etc.).Coordination activities designed to rehab or assist weakness or balance issues. I would rather have less personal sharing. It might be better if the class was 1-2 weeks longer 78 Other Comments: Everything here at the Schmieding Center was really nice and the teachers are great. It was a very nice class. The instructors were wonderful-took time to answer questions and make learning fun. I now have thirst to continue my knowledge in this field much further. Thank you for changing my life. I enjoyed all three teachers each provided great teaching techniques. I really enjoyed this class it was extremely helpfully to me and what I have learned I will apply to when taking care of my mother thank to all. Thank you for an enjoyable educational week! Very much enjoyed the class, instructors and classmates. Lots of helpful information and we had a great time learning. The instructor showed interest and encouragement. I think the women who teach this class are amazing and have med me so much more confident in the career choice I have made. Thank you Everything was great. I learned a lot in my on line class. I felt like I learned a great deal including details that hadn’t thought about before. The learning modules and videos were very helpful and helped to emphasize the training further. I couldn’t have chosen a better place to get my education for senior health. I am impressed with your instructors Hip Hop Hooray had a great time. Learned a lot. One of the biggest things when getting any type of education is being comfortable at school and with the teachers and I was very comfortable and pleased with both. I thought Sue was great with her presentations. Katherine was fun and had some great ways to describe things that were easy to remember. Thank you for making these classed available and affordable. Really thought the instructors were great. Love them both. Love this course! Instructors are very respectful and loving people. Answers questions with good information that is clear and provided sources. Thank you for increasing my knowledge this far. These teachers were awesome, and going to the Schmieding Center was the best choice I made! Look forward to working more classes into my schedule. Look forward to working with the heath care community. “I have worked with caregivers and I know they didn’t get their training from the Schmieding Center. Kathryn wouldn’t have let us get away with doing it like that!” 79 Community Comments: To the fantastic organizers at the Schmieding Center – Thank you so very much for helping us put together our Fall Screen program. We had a good turn out and provided an excellent service for our community. Margaret, Thank you for all you do for our community. It is appreciated greatly. --Janne Norton and residents of Brookfield. Very well organized, good information. Excellent program-informative. Enjoyed the “V” lunch & the surprise lemon cookie. Appreciate the Schmieding center for hosting the Lunch & Learn-they are a blessing. Very informative, clear presentation, like the visual & questions. We are just older citizens who are interested in improving health as we continue to age. This sounds like it would be a great way to begin. Thanks for making it available. Good Program! Excellent information! Had some difficulty hearing---- my own hearing (of course) but also poor mike and her soft voice especially during Q/A. Thank you for lunch as well as a really helpful program! Thank God for Schmieding Center. Great program and great speaker. Keep up the good work! Thoroughly enjoyed this seminar. Touched on topics I hadn’t thought of before. Learned a lot about sleep apnea and how it affects your body and general health. Wonderful information! Thank you for the presentation. I had no idea Medicaid the rules were so complicated! I learned a lot & know that I need to see an attorney for estate planning! Excellent program. Thank you. Very informative! Took four pages of notes. If you plan to have these speakers back- I will definitely send friends & Clients to hear them speak. (How To Plan for Long Term Care Expenses) She kind of talked over my head. Short but to the point. Jennifer is an excellent speaker. Thanks for inviting her to help us with the emotional issues associated with downsizing. The Doctor was very thorough explaining about the problems with Diabetes, medications-etcetera, very well done. All information was most illuminating and valuable. Haven’t been so touched with emotion and gratitude by so many who inspire and willing to give their utmost best! We caregivers need the buoying up! I appreciate the program. Thank you! Programs refreshingly interesting. I did not know the music center of the brain was last affected in AD/dementia. Pet therapy course was great-a good resource to help clients in homecare or rehab. 80 Appendix E – Supporting Documents CNA Approval 81 Evidence Based Approval 82 Home Care Specialist Agreement with NTI 83 84