Longwood University



Blue Ridge PACE Program AnalysisTR ProcessAssessmentThe names of the assessment used at my agency is the Prime Suite Recreation Therapy Assessment which is a national electronic record tool for Innovage. This is an “in-house” tool used. (Sewell, 2020)It is a Lengthy process; intake enrollment coordinator determines eligibility. Then they have a center visit with all staff to have initial assessment, plan of care meeting, executive director and enrollment coordinator meet with the potential client and complete the initial signing. All disciplines have thirty days to complete the full assessments. (Sewell, 2020)UAI (Uniform Assessment Instrument) is reviewed by the enrollment coordinator to determine eligibility. (Sewell, 2020)Other- Utilization of resources (Example: dietician reaching out to see if they still need food on the weekends). Doctors will contact previous PCP, Psych records, Specialty consults (pulmonologists, oncologists, etc. anyone in treatment plan), Families and friends. (Sewell, 2020)Plan The plan of care really is the plan. The planning process is extremely individualized and is goal dependent. They identify 3-5 major goals for each person, and within 6 months we adjust goals accordingly. (Sewell, 2020)The document used in the planning process is the Plan of Care, it is a graphic/spreadsheet with goal, intervention and who is responsible Adult Protective Services, Region 10, Meals on Wheels, Mom’s Meals (Programs for food), Consultant services, Other recreation programs they were in/day programs (Sewell, 2020)In general, the programs are selective whether they need to get into the program right away or if it’s maintenance, we encourage them to check every activity out (there are nine domains) to see what they like, through social connection and through suggestion based off of what they think the patients will enjoy, play with the medium (Sewell, 2020)1358900000(InnovAge, 2014)ImplementationWhat works well is we have an activity cart, which is literally a cart full of supplies and we load it throughout the week, so we are ready for everything that is on the calendar. We also try to move people into the right room to set the mood and to make sure it is a good atmosphere for the activity. (Sewell, 2020)Blue Ridge PACE is not required to keep documentation like nursing homes, our notes are every 6 months about generalization on what happened and what types of activities people liked. We discuss objective and subjective information on each participant to the rest of the staff the following morning. (Sewell, 2020)EvaluationEvery discipline does the 6 months or an event (example: if they move or break a hip), we have the option to write progress notes if we feel necessary. Assessment, progress note, plan of care are the documents used to evaluate. (Sewell, 2020)We have general program evaluation that is used for special/big events (day, time, set up of room, number of supplies, number of participants, was everyone happy/not happy, concerns, what would you change for the next time), otherwise we usually just discuss it amongst the staff and make a list of the steps so that next time the participants can follow the activity perfectly. They tweak the process along the way. (Sewell, 2020)The therapists are evaluated by just discussing things and asking questions like “how do you think this went?”, Department notes, there is no assessment form except for the big events. (Sewell, 2020)Program OutlineProgramming- create an outline of all RT programming offered at your assigned agency/setting. PhysicalSocialCognitive/ IntellectualCreativeProductiveSensoryReflective/ContemplativeOutdoorNature/Natural WorldEntertainmentIntergenerationalHoliday EventsSelf-Esteem(InnovAge, 2014)Interventions/activities:Golf - indoor putting balls into a 3-hole mat, working on the true golfer stance and swinging the club (standard club or wheelchair club). Outcomes are physically able to take on the challenge playing the game, enhance their body awareness. Hour to hour and half session, once a month to once every other month. This activity is evidence based. (Sewell, 2020)Quality Craft Projects – Write stepped directions to follow, show demonstration, hand out materials in sequence, everyone follows along till they get to the result of craft. Outcome to follow directions successfully, work on the fine motor skills (standard supplies or adaptive equipment), social skills (participants working with each other). One-hour session, twice a week. This activity is evidence-based. (Sewell, 2020)Aromatherapy – Set up diffuser, set the calm setting, play music, and engage in breathing exercises and stretching. Outcome is to help participant relax and reduce stress. Half hour session, twice a month. This is evidence-based. (Sewell, 2020)Chair Yoga- certified yoga instructor comes in to lead the program, participants sit in a circle and watch and move with the instructor, close intervention with a self-love exercise. Outcomes to help participant relax and increase flexibility, reduce agitation, and help breathing. The session would last 45 minutes, every week. This intervention is evidence-based. (Sewell, 2020)Wheel of Fortune – Using a wheel, and dry erase board for categories, listing the amounts of “money” and letters being used, While having the whole room taking turn form one person to another and making sure to have everyone go. Outcomes is team playing and working on social skills, increase cognitive skills by guessing letters and solving puzzle and by counting money. Hour session, twice a month. Group games is evidence-based. (Sewell, 2020)Mens/Womens Group – Getting the males and females in their own groups and they talk with each other about different topics like hobbies, health education, day-to-day, etc. Outcomes are increase social interaction, awareness of the world and their environment around them. Session are one hour, once a week. This evidence based. (Sewell, 2020)TR Process Delivery Flow Chart1651000SWOT Analysis:Strengths- Run by CTRS, offer a wide range of variety of interventions, every month ask participants to see what they think should stay and go from the activity calendar, Personalized and communicating with participants frequently, Finding Strengths and interest of clients to build relationships with others, while also making sure there aren’t bad relationships (like making it too clicky). (Sewell, 2020)Weaknesses- Sounds good to all participants, however not every participant can benefit to PACE, wanting to provide to everyone even though we cannot. Communication between all departments, there is room to grow with talking and making sure everyone is connected. In RT department Not enough hours in the day to fully benefit every client., and the need for more brainstorming. (Sewell, 2020)Opportunities- Presenting at conferences/workshops for providers and caregivers. Hosting activities for senior centers/churches/community recreation/retirement communities/assisted living facilities/nursing homes. (Sewell, 2020)Threats- Adult day Care agencies, for the therapy side of PACE a competitor is ACAC. If the primary owner chooses to longer provide PACE programing, PACE could be sold or dissolved. (Sewell, 2020)References:Lloyd, R. (2013, October 7). Whiteboard: Flowchart [Video]. Institute for Healthcare Improvement. Retrieved from , L. personal communication, June 18, 2020InnovAge is. (2014, May 26). Retrieved from? ................
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