By Sarah Scott, SLP, Pointe Meadows, Lehi, Utah
About six weeks ago, my DOR asked me if I had any suggestions for therapy interventions for one of our Spanish-speaking residents who was having significant behaviors, including medication refusal, exit seeking, aggression, falls and throwing himself onto the ground. His diagnoses included Parkinson’s disease, severe anxiety, and repeated falls. We truly wanted to identify a plan that would address his needs and reduce the behaviors and anxiety.
We created, among other things, new simple Spanish communication boards, visual aids to support medication administration, functional problem solving, and protocol to prevent escalation of behaviors. With our therapeutic interventions, the patient started to demonstrate a dramatic increase in cognitive linguistic potential and decrease in adverse behaviors. His test scores increased, and he and his family also reported feeling happier. The nursing notes reported pleasant and compliant behaviors.
Our therapists are passionate about program implementation for diverse cultures, and understanding the backgrounds and stories behind the countries and cultures that our patients come from. The more we learn about and engage with our residents, the more we understand their lives that were rich with love, laughter, service, work, pleasure, pain, and purpose. Our therapists are becoming specialist in evaluating patients from culturally diverse backgrounds to help preserve abilities, maintain cognitive linguistic function, and facilitate opportunities for each unique need.
The interventions included extensive communication with and support from family to identify cultural, social, recreational, professional, familial, religious, educational, historical and experiential factors that could be utilized within a plan of including group and individual interventions. We continue to build our resources to understand and address different cultures.
For our Spanish speaking residents, we encouraged the patient’s participation in creating PowerPoint presentations on their home countries of Chile, Bolivia, Peru, El Salvador and Mexico. We created presentations of musicians, including Julio Iglesias, Jose Jose, and Armando Manzanero. Families emailed me links to YouTube videos of favorite songs with the lyrics that patients who otherwise never speak have sung out loud. We have created material on Mariachi bands, flute music from Peru, Tangos, etc. We used smells, tastes, colors, sounds, routines, pictures, objects, scarves, maracas, a guitar, etc. to facilitate engagement and participation. We have also created materials that we are using to support verbal expression and comprehension, memory, attention, reminiscing, sequencing, following directions, turn taking, following a schedule, orientation to place, TOD, and activities of choice. We have residents who previously have never left their rooms who are now tooling around looking for opportunities to interact and be involved.
The quarterly SLUMS in Spanish test scores that we administered increased between 2 and 12 points for EVERY one of these residents. We have continued progress with residents and are programming more complex goals and tasks with reading and other more complex activities because we have not yet reached the patients’ potential. COVID has slowed the generalization of our social/group programming, but we look forward to resuming the resident-created Club Espanol, which operates three times a week for half an hour. Restorative and Recreational Therapy have been highly involved and supportive of these residents and efforts maintaining the program once established.
During COVID, we have created social scripts and we’ve enabled patients to be engaged in therapy with family members via Facebook video messenger all over the state and as far as Bolivia and France, which has been fun and rewarding for all. A bright moment in a difficult time.
Here are a few pictures from these sessions.
A favorite song with Spanish subtitles
Reading large print script on Manzaneras aloud
Following social script on call to son in Bolivia.
Life Story Board for one of our residents allowing others to know him better and him to share information about himself.