Tuning In to the Intelligence of the Heart to Change Lives

Did you know that there is a simple way to measure and reduce the stress response in our bodies? The variability in the heartbeat from beat to beat is called heart rate variability (HRV), and HRV is a powerful indicator of overall health. HRV essentially measures the stress response in our bodies, and through the use of biofeedback, we can actually train our stress response and improve our health! Dozens of our therapy programs across the country are using sophisticated biofeedback devices developed by our partners at HeartMath® in order to reduce personal stress, and to help our patients improve function and reduce anxiety. Here are a few examples of our success stories!

Angela Anderson at Gateway in Pocatello, Idaho, used the power of HeartMath technology to help a patient who was experiencing anxiety that would lead to cardiac arrhythmias resulting in multiple hospital readmission. Angela began biofeedback training using the HeartMath app and Bluetooth device, and the patient responded immediately with reduced anxiety. Angela set up the patient in her room with a portable device for her to use anytime she felt the anxiety and panic starting to occur. The results have been life-changing for the patient. She is now able to manage her anxiety and no longer is discharged to the hospital with panic attacks. The physicians and staff have been amazed!

Matt Zweig, Occupational Therapist at Park View Post-Acute Care, utilized HeartMath with a patient who came to the facility following a CABG. Even though the patient had just undergone extensive cardiac surgery, he had limited understanding of blood pressure and the anatomy and function of the heart. Matt used HRV training as an opportunity to educate the patient about the overall function of the heart. Matt hooked up the biofeedback device and instructed the patient on the techniques to regulate his autonomic nervous system. The patient was fascinated with the ability to see the results of the techniques through biofeedback and reported greatly reduced anxiety as a result of being able to regulate his heart.

Tyler Johnson, DOR at Northbrook, utilized the HeartMath biofeedback device with a patient with pneumonia, atrial fibrillation and anxiety. The patient was struggling to complete therapy sessions and quickly becoming short of breath (SOB). When the patient became SOB, he became more anxious and O2 saturations would quickly decrease. He was unable to complete functional mobility or ADLs due to SOB and O2 sat decline was also sent to the ER three times in a one-week period with these symptoms. HRV training was implemented with the use of the HeartMath emWave Pro to decrease anxiety, control rate of breathing and improve functional performance. The patient was able to maintain O2 saturations above 90 percent following HRV training and able to participate in training for functional transfers and ADLs with SBA.

Stephanie Winkler is a DOR at Wellington Rehab in Temple, Texas. Stephanie and her staff have multiple personal and patient success stories.

Mrs. T’s story:

Mrs. T had a variety of tests run as she was presenting with LE and UE weakness, but without any diagnosis to support the weakness. She was discharged from the hospital and was initially not making progress with therapy. We introduced the HRV training using HeartMath to see if we could help with focus and reduce her anxiety and depression. After only two sessions, she was able to focus better, participating in therapy and improving each day. She didn’t initially understand that she had underlying anxiety and fear, but with the use of HeartMath, she was able to control her anxiety and ambulate over 300 feet on even and uneven surfaces as well as shower and dress independently, and she was discharged home independently.

Mrs. S’s story:

Mrs. S came to us following a total knee replacement. She was exhibiting high anxiety and fear during her therapy. On the third day, we introduced the HRV training using HeartMath. Through the use of this program, she was able to begin to help with bed mobility and begin her rehabilitation with fewer episodes of yelling. She also was able to overcome her fear of standing and ambulate over 300 feet independently with the use of an assistive device, and she achieved excellent knee range of motion. The use of HRV biofeedback training allowed her to participate with therapy so that she quickly achieved independence with a short length of stay.

Mrs. B’s story:

Mrs. B came to us due to a hip fracture. She had a tremendous amount of fear and anxiety that was limiting her ability to participate in therapy. HRV training using HeartMath was introduced, and she was then able to fully participate in her therapy session, was following one-step commands, and was able to perform functional transfers and gait training with the assistance of therapy within the first week of HeartMath implementation.

Jon Anderson, Texas therapy resource, utilizes HRV and HeartMath both in trainings with therapy staff and also for his own health. One of the most profound changes that Jon has seen personally is his ability to sleep at night. He also has noticed an improved ability to focus and listen to others, reduced muscle tension, and overall reduced pain and fatigue after implementing the biofeedback techniques. Jon has also introduced the technology to his mother to help her with her anxiety and health challenges.

North Mountain Medical and Rehab Introduces “The SPOT”

The North Mountain Therapy Department specializes in Pulmonary Rehab, encouraging a multi-disciplinary approach to meet our respiratory patients’ goals of being decannulated, which typically is dependent upon the patient’s ability to return to a regular diet. In an effort to contribute to the greater independence of our patients, the Therapy Department created the SPOT (Speech Pathology Occupational Therapy), a holistic approach to a specialized dining experience to facilitate independence with safe swallow techniques and self-feeding.

The SPOT is a private, home-like, therapeutic dining room that allows our speech therapists and occupational therapists to provide a specialized treatment to our respiratory patients. The SPOT provides a quiet area to concentrate on safe swallow techniques, facilitate functional positioning, assess for any adaptive equipment needs to enhance the ability of our patients to regain their independence and return to the community.

The SPOT includes a small ADL kitchen and is stocked with adaptive equipment for the patients to trial during meals including a deltoid aid, weighted/built-up utensils, specialized drinking cups, and divided plates/plate guards. Additionally, ST has a quiet environment to perform vital stim or cognitive treatments.

The SPOT dining: helping North Mountain serve up independence!

Submitted by Kelly Schwarz, DOR
North Mountain Nursing & Rehabilitation, Phoenix, AZ

 

An IDT Approach to Contracture Management

We hosted the CE at our Legend West Houston facility. Nursing and rehab must be cohesive to a have a strong contracture management program. I sent an email out to our DONs and they welcomed the idea of including our RNAs. John even provided them with certificates. They loved it.

Thank you to those who were able to make it to the Contracture Management Course on Saturday. We had a great turnout from several of your therapists/assistants as well as your RNAs. The course speakers had an opportunity to visit the Katy and West Houston facilities, the day before the course, and provide face-to-face assistance. Tawaine and Brittany gave very positive reviews and stated that several patients were identified for therapy services that were previously overlooked.

Below, you will find the names and contact information of the speakers. Both are available to provide telemedicine support. What does that mean to you? If you have a patient you are considering for an orthotic and/or you need recommendations on the best splints, they are available by phone or FaceTime to provide guidance. They are also available to assist with verification of orthotics (especially for our managed care part B residents). All you need to do is send them the patient’s face sheet, and they will take care of the rest. Please take advantage of this available resource. We have several patients within our facilities with contractures, and our obligation is to provide the best quality of care available. Special Ensign pricing is available to us.

OCSI: Ongoing Care Solutions, Inc.

John Kenney: 949-702-2828 neuroflexjk@gmail.com

Regan Ponto: 970-978-1284 regancap@msn.com

Submitted by Kai Williams, Therapy Resource, Texas

Student Resource Manual for the Clinical Instructor

What was initially simply a continuing education experience for two therapists has inspired a brand-new program here at Coral Desert Rehabilitation. Recently, a Coral Desert physical therapist, Lindsay Rankin, and a physical therapist assistant, Edwin Stevenson, attended a course to become credentialed clinical instructors. They both enjoy having students, so they were excited to go. After attending the course, they came back with a desire not only to improve their own abilities, but also to help revamp the student program at Coral Desert.

The program was loosely managed before and not standardized from one therapist to the next, so the students often had varied experiences and subjective learning/feedback depending on the therapist. Lindsay and Edwin decided to set a BHAG together to create and implement a better student program based on the principles and recommendations of the course they attended.

With a lot of after-hours work and trial and error with a current student, Lindsay and Edwin were able to create a student resource manual for the clinical instructor. This manual is specific to our building, patient population, etc. and loaded from A to Z with information on how to properly supervise a student of any discipline. They didn’t stop there. They also created a manual for each incoming student, both a PDF file to have prior to arriving and a hard copy for when they get here for reference.

Once both manuals were completed, after many rough drafts, it was presented to our therapy team during an in-service to give an in-depth look at how to use this information and apply it when a student is assigned to a therapist. This has already proved to be valuable with our current students and should continue to be a great resource for students and therapists for a long time to come. Because we have seen a steady increase in the number of students coming to CDR in the past two-plus years, it is just what we have needed since our therapists are at varying levels of experience with having students. We already have seven students committed to CDR from now until November of next year! We are crazy excited about the Passion for learning combined with Ownership shown by our own therapy team, which saw the need and responded in a big way.

Submitted by Asa Gardine, DOR, Coral Desert Rehabilitation, St. George, Utah

The Power of Creativity: One OT’s take on the Dementia Care Program

Beth Brewer, OTR/ADOR at Legend Oaks Katy, is known to most of us by her acquired moniker, MacGyver. What she creates with “a little bit” of duct tape, PVC pipe and pool noodles is magical! So when we decided to make dementia care one of our focal clinical programs, it came as no surprise that she would create something great.

This is when the Dementia Care Activity Box was born. Using guidelines from Teepa Snow’s The Gems®: Brain Change Model, Beth created Dementia Care Activity Boxes based on various dementia characteristics (gems). All facility staff have received an initial in-service/training on the purpose and use of the activity boxes, which are accompanied by a matching resource binder with descriptors for each gem; dialogue cheat sheets to engage residents in eating, bathing and dressing tasks; as well as general information about dementia. In addition to the activity boxes, Beth also recently piloted a four-resident Dementia Feeding Program using red plates and bowls to increase self-feeding and po intake. So far, we’ve seen a 10 percent to 25 percent increase in po intake depending on the resident’s level of dementia.

Our Dementia Care Program is in its infancy stages; however, with “MacGyver” Beth at the helm, I know that our residents are destined for greatness!

Submitted by Tawaine Vigers, DOR, Legend Oaks of Katy, TX