Posted February 14, 2013
by Becky Lerner
The hustle and bustle from the holidays has finally died down, and you find yourself just now getting to organize all the toys your child received! On one hand, the generosity from family and friends is unbeatable. On the other, though, many of the toys don’t meet the needs of your child—with modified needs.
Afraid that returning the gifts and avoiding the follow-up, “How does he/she like the toy?” questions can be uncomfortable. But you’d also love to ensure them that their efforts are not for nothing. So The Comprehensive Group wanted to take a moment to go over a few resources for those spring birthday parties right around the corner.
For example, the classic Fischer-Price toy the See N’ Say is a great option. But the older versions came with a string the child had to pull to get the toy to activation which could be difficult. The newer version has a button in the middle or a lever to make things more accessible to more children. But even toys with buttons and levers can be a challenge to children with motor coordination issues.
One tip given by Toys R’ Us is to increase the surface area of levers or buttons. Attaching a bigger button, a foam shape, or Velcro to a button increases tactile feedback is an option. Adding an additional hand hold to levers can make an otherwise irrelevant toy relevant. It also notes that a switch and latch timer could be a great solution to battery-operated toys that require the child to hold down a switch to activate. In the “latch” mode, the toy will turn on with a simple switch of the latch; the same method is used to turn it off. In “timer” mode, the toy will stay activated for a set increment of time with a simple flick of the switch eliminating the need for constant contact from its user.
And remember, toys are great, but go beyond them. Music, computer games, cameras, even pots and pans (of course, used as drums… and did we mention some earplugs might be a nice investment as well?) can be equally as entertaining!
Resources for conscious toy-giving for special needs children:
Toys R’ Us Fall catalog for Differently Abled Kids:
Specially adapted toys: www.enablingdevices.com
Switch Latch and Timer: http://www.ablenetinc.com
Posted December 1, 2012
by Deborah Connery
edited by Becky Lerner
It’s not news that placing a loved one in a residential care setting is one of the most difficult decisions families have to make. Whether it is a Continuing Care Retirement Community, Assisted Living Facility, or nursing home, even the best-trained and most loving staff are not truly family. No one knows the resident like the family. That’s why this month, TCG wants to acknowledge the family caregivers out there.
Families need not completely leave their caregiver role behind once mom or dad is settled into the new residential community. While they may no longer be providing the direct, hands-on care, they can still be involved via collaboration with the community’s interdisciplinary team whose job it is to make sure the resident has the best possible quality of life.
In fact, collaboration between families and nursing care staff is critical. Families may be more familiar with how their loved one responds to medications, their customary routine—bed time, wake up time, meal times, and preferences for bathing—things that provide comfort and stability in the elder’s life. Sharing this background will give the nursing staff and the rest of the team a better chance of creating a schedule that is in sync with the resident’s life outside the facility and an easier transition for the resident.
Families should feel comfortable reaching out to the facility social worker for help in understanding their loved one’s adjustment to the new environment and for insight into the psychosocial challenges their senior may be experiencing. Conversely, the family can share invaluable social history information with the social worker that will help the social worker and the rest of the care team appreciate the resident as a unique individual and so tailor the care and services accordingly.
Families should also reach out to the facility staff responsible for resident activities. How the resident spends leisure time has a direct impact on wellness. Families should freely share what they know about their loved one’s interests, hobbies, skills and abilities, so that the activity staff can design a program that is meaningful and satisfying to the resident. In turn, the activity staff can give families fresh ideas for activities that they can do with their loved ones when they visit.
Reaching out to therapists and restorative staff to understand movement and mobility and the expected results from a rehab or restorative program is another way that families and staff can work together for mutual edification. Sharing their perspectives on the resident’s strengths and weaknesses will help ensure that programs are reasonable, with goals that are realistic for the resident.
When the family has been the caregivers, they can develop a natural partnership with the care team at the facility. Working together, the staff and family can minimize the sense of loss that comes with moving out of one’s home and maximize the quality of life for the resident.
Posted September 28, 2012
Ugh, headaches. Tension headaches, sinus headaches, migraines–they’re all awful. Our friends at Rehabilitex, Inc. sent us some very valuable information about potential causes and prevention of headaches from a therapy perspective, and we felt compelled to share it with you. Thanks, Rehabilitex!
Everything You (Didn’t) Know About Headaches
|The common response to a headache is “Let me pop a painkiller and hope the pain goes away”. While this isn’t necessarily a bad idea, it’s not a long-term solution for headaches, particularly the ones that that have a musculoskeletal origin.Most patients are unaware that physical therapy can play an important role in the treatment of headaches. Did you know that a physical therapist can evaluate symptoms and create a plan to reduce headache by restoring muscle balance? With certain types of headache, this has the potential to reduce or even eliminate the need for medication. For example, did you know that strengthening of the muscles surrounding the neck and jaw helps in the treatment of headache? It’s true; physical therapy can restore balance and relieve strain on muscles and joints in the head and neck region.After a complete evaluation, the physical therapist may decide to use manual therapy, which includes joint mobilizations and massage to provide welcome relief to overworked tissues. The result is relief from the pain of headache and a smile on your face.A migraine is a severe headache that may require medical attention. It is a disorder of the central nervous system involving blood vessels and nerves, resulting in intense pain. Once the cause of the migraine has been identified and treated by a physician, a physical therapist can facilitate a quick recovery to help the patient resume a normal, healthy life.|
Pain Relief at the Source
|One of the objectives of physical therapy intervention is adjustment of soft tissues and correction of mechanical dysfunction associated with the headache. There are several ways that a physical therapist can help achieve this. If sensitive tissues (blood vessels, nerves) in the neck are compressed, the physical therapist can use mechanical or manual traction procedures to facilitate decompression, improve circulation and relieve pressure around the affected tissues.The prescription of a home exercise program to improve posture and movement patterns can be another part of the treatment process. Unknown to most patients, poor posture contributes to head and neck pain.Depending on the severity of your headache, physical therapy can be a valuable adjunct to medications prescribed by a physician. While medications help control the pain of headache, a regimen of physical therapy improves the body’s inherent ability to fight factors that trigger headaches.|
Physical Therapy and Referred Pain
|One of the causes of headache is referred pain (from other parts of the body). When the muscles and joints in the upper back, neck and shoulder are under stress, they become inflamed and cause pain. Due to the complex and interconnected network of nerves and blood vessels in the upper body, this pain often spreads upwards, triggering a headache or a debilitating migraine.This is exactly where a physical therapist can help. With a precise combination of exercises, manual therapy and relaxation techniques, the therapist can facilitate pain relief. If you’ve been suffering from headaches, a viable, drug free option is available to you. You don’t have to live with pain any longer because physical therapy is a viable, scientific treatment option. Just call us and we’ll get you started. We’ll do everything we can to put that smile back on your face.|
Posted August 28, 2012
by Kelli Comise
edited by Becky Lerner
As I cruised the internet I stumbled upon an interesting fact: There were 62.8 million adults volunteering almost 8.1 billion hours in local and national organizations in 2010, service valued at almost $173 billion.
Our very own Comprehensive Cares will be part of the 2012 stats by the end of the year, but we need your help.
Comprehensive Cares is a committee that was formed in September 2011 by recognizing a greater need for social responsibility and giving back to the communities we serve. But with so many options, we had to first find missing pieces, our fellow charities.
Our first goal was to identify charitable organizations that reflected our vision and our mission. Our vision is to strive to build organizational partnerships that focus on common goals of creating a better quality of life for its recipients. Our mission is our commitment to a corporate culture that supports and encourages community involvement, volunteerism and charitable contributions. After careful consideration and employee feedback the following organizations were selected for 2012:
Honor Flight of Chicago*: a non-profit organization that sponsors flights to Washington DC to honor veterans for their service which partnered with one of our clients, Pathway Senior Living. The Pathway organization identified all of their veterans and applied for the flight to Washington.
Thumbuddy Special**: a non-profit organization that benefits children and families in need of adaptive equipment, communication devices, and adapted wheelchairs and bikes. They also offer scholarships for kids to attend camp and special recreation programs throughout the year.
Community Health Clinic in Chicago*: the state’s largest free health clinic. It offers no-cost primary care, specialty care, medications, education, and mental health support services to men and women who are poor and medically uninsured.
*: needing time donations
**: needing financial donations
Volunteering has many unexpected payoffs. It’s enlightening; it gives you the opportunity to gain first-hand insight into a whole different world that you wouldn’t otherwise experience, but it’s inspiring to see what some can achieve despite what is lacking. And it’s re-energizing; I discover something about myself and others when I volunteer or work with those less fortunate, especially those associated with Honor Flight of Chicago, Thumbuddy Special and the Community Health Clinic. I truly believe that volunteering promotes the good in yourself and others in addition to improving the quality of life of its recipients.
“To know even one life has breathed easier because you have lived. This is to have succeeded.”
We appreciate those who have taken action with us, but need your help with increasing volunteers and donations. Invest in giving back with time, financial donations, or even just spreading the word about our efforts and helping us ask for involvement.
For more information contact Kelli Comise at email@example.com .
Posted March 13, 2012
Director of Consultation at The Comprehensive Group
Social workers are committed to helping people cope with and overcome some of life’s most difficult circumstances—physical and mental illness, disability, poverty, abuse and neglect, unemployment, marital problems, social issues, and addictions—to name a few. Understandably, it can be an incredibly challenging, yet incredibly exciting field, which is why social work is one of the fastest growing professions in the U.S., according to The National Association of Social Workers.
Professional social workers typically have Bachelor’s and/or Master’s degrees in Social Work in addition to their state’s license. Their educational background includes coursework in human development, social behavior, psychology, program development, and economic institutions. In addition, they tend to specialize in areas such as community mental health, juvenile casework, medical social work, psychotherapy, and marriage and family counseling. They are trained to observe and analyze how circumstances and environmental factors interact to impact their clients’ social functioning. As a result, there are a variety of settings in which social workers are found. They practice intervention and crisis-prevention in hospitals, clinics, nursing homes, schools, prisons, corporations, and private practices. They then develop a treatment plan designed lead the client toward optimal functioning.
Further, with the consideration of the baby boomers, the demand for social workers dedicated to working with seniors is expected to grow exponentially over the next few years. The Comprehensive Group routinely seeks out and interacts with social workers in hospitals, nursing homes, assisted living facilities and senior housing communities. Social workers who work with the elderly have expertise in aging, Alzheimer’s disease and related dementias, and psychiatric and physical rehabilitation. They help the seniors regain and maintain optimal independence wherever they may be living.
March is National Social Work Month and The Comprehensive Group is pleased to recognize our exceptional staff of social workers. This month and always, we applaud these hardworking professionals who have dedicated their careers to improving the lives of others.
Posted February 27, 2012
by Becky Lerner
Forgetting where you put your keys or why you came into a room is nothing compared to what Alzheimer’s and Dementia patients experience on a day-to-day, nay, hour-to-hour, or minute-by-minute basis. With what is arguably one of the most difficult (and possibly engrossing) set of circumstances, our Dementia and Alzheimer’s professionals go through those days with their patients: learning their patterns, living their experiences, and caring for them. It’s a tough job, but TCG employees Karen Howard, OTR/L, and Jennifer Wagner, PT, both out of Bethlehem Woods Nursing & Rehabilitation, speak with us about the rewards and challenges of their respective jobs.
“A big piece of being a caregiver is to know enough about a person—if there’s a time of day when they’re at their best, or what triggers certain behavior,” says Howard. Much of the time, she continues, Alzheimer’s and Dementia patients don’t have the words to communicate if they’re uncomfortable, so it’s the caregiver’s job to learn the patterns, learn their communication forms, and control what they can within the environment. “Familiarity, routine, and repetition are important,” she says.
“Just like you wouldn’t argue a reason with a 3-year-old, they don’t understand reasoning,” says Wagner. “They don’t understand why you need to exercise for the sake of exercise. You need to be where they are, and it’s a comfort to them to have someone with them in that moment.”
So how do the professionals, constantly adapting to their patients, keep themselves healthy, happy, and able to do their job? Balance.
Especially if family members are caring for a Dementia or Alzheimer’s patient, it’s important to set boundaries and find some separation whether that means taking some personal time or utilizing a facility like Bethlehem Woods.
“Coming into a place like this, they have a little peace,” says Wagner. “Family members can still call and come hang out whenever they want, but it’s relieving that they don’t have to worry about caring for someone who needs their full attention all the time.”
As for those who work that the facilities, Howard says that music, yoga, spending time with family and friends, and, of course, lots of laughter help her re-energize and refocus.
Wagner finds her inspiration in the small successes. “Tie a string to balloon, step aside, and let patient punch it. First their hesitant and by the end, they’re whacking the balloon and laughing,” she says. “It’s little successes that make you go back to the books and the websites and figure how you’re going to make this person’s life better. Of course you want long-term goals, but you want short-term, attainable goals. And you should want that for yourself, too.”
“Even though you might not change the condition of a person’s life, know that you have an impact. When the patient knows that you’re there and that you care about them, it really doesn’t matter whether they’re in the mildest or most advanced stages. They know. They can feel it, and they can tell,” says Howard.
As the end of February marks the end of Alzheimer’s and Dementia Awareness Month, TCG wants to take a moment to recognize those professionals who make patients’ and their families’ lives better. Thank you for all your hard work, dedication, innovation, and care!
Posted January 13, 2012
Deborah Connery, LCSW
Director of Consultation at The Comprehensive Group
Activity Professionals are key players in the world of healthcare. It is also a profession that is expected to grow exponentially over the next few years, especially in the senior housing and long-term care industry.
Through program development, Activity Professionals help seniors and persons with disabilities structure their leisure time in ways that meet their cognitive, social, emotional, physical, and spiritual needs. Programs typically include exercise, arts and crafts, cooking, games, dance, music, community outings, and religious activities; although, what is included in a program is limited only by the creativity and vision of the Activity Professional. And because work environments vary, there are plenty of opportunities to get involved. Activity Professionals work in nursing homes, hospitals, senior housing facilities, and residential care environments. Most importantly, the profession, as a whole, is dedicated to fun, exploration, and life’s pure enjoyments.
Activity Professionals come from varying backgrounds. A college degree is not necessarily required, but specialized training in therapeutic interventions for specific areas such as: older adults; adults and children with mental and physical disabilities; and adults with cognitive impairment, such as Alzheimer’s disease, is beneficial for anyone looking to work in an Activity Department. Seminars, community college courses, and workshops are readily available to potential and existing Activity Professionals.
The Comprehensive Group has special affection for the hardworking Activity Professionals we support in nursing homes, assisted living communities, senior retirement communities, and hospitals. Our consultants have worked in these various communities and so know firsthand both the thrills and operational hardships of the mission of helping seniors and disabled people realize their fullness of purpose and leisure.
We are dedicated to providing Activity Professionals with the education and resources they need to design leisure programs that engage and excite participants. We know that BINGO is here to stay, yet life can be so much more. We love to see seniors branching out into culinary programs, fine art programs, innovative exercise and social programs that promote much-needed peer relationships. We don’t see barriers when it comes to activities. We see opportunities for a quality of life residents never dreamed they could have outside their own homes.
Through our 36-hour Activity Director Courses, 6 hour Activity Assistant Workshops, Dementia Workshops for Activity Professionals and CNAs, and specialized on-site consultation services, we encourage Activity Professionals to continue to grow and remain excited about designing programs for the people they serve.
January 22-28, we send a loud “We Love You!” to the Activity Professionals in Chicagoland and beyond. You are providing a quality of life service to your residents, which makes all the difference between growing and growing older. Kudos to you from The Comprehensive Group during Activity Professionals Week and beyond!
Posted December 21, 2011
With healthcare reform taking on an urgent tone as 2011 comes to an end, this article by colleagues Polsinelli Shughart does a great job of explaining what, exactly, is on the line.
House Passes 2-Year Doc Fix and “Medicare Extenders” Package
The House on December 12 passed legislation by a vote of 234-193 that includes a 2-year “fix” to the Medicare sustainable growth rate for physician reimbursement. The bill would prevent the scheduled 27.4 cut in Medicare physician payments and instead increase the payment rates by 1 percent in 2012 and an additional 1 percent in 2013. The legislation also would extend the therapy caps exceptions process through December 31, 2013 with some modifications to the current process. The legislation would require that the physician reviewing the therapy plan of care be detailed on the claim. Claims above the spending cap that do not include the proper billing modifier would be rejected. A manual review would be required for all claims for high cost beneficiaries. The spending cap for 2012 would be $1880 and this cap would be extended to the hospital outpatient department setting. The Congressional Budget Office estimated the therapy caps provision of the legislation would reduce spending by $1.7 billion over 10 years.
The legislation relaxes current restrictions on physician-owned hospitals by allowing those facilities that were under construction but did not have a Medicare provider number as of December 31, 2010 to open and operate under the whole hospital exception to the Stark antitrust laws. The bill includes a reduction of $6.8 billion for hospital outpatient payments for evaluation and management and a reduction in Medicare “bad debt” payments that the CBO estimated would reduce spending by $10.6 billion over 10 years. The legislation also would increase Medicare premiums by 15 percent for high-income beneficiaries. Senate Majority Leader Harry Reid (D-NV) said the bill would not pass the Senate. Reid said, “The bill passed by House Republicans tonight is a pointless, partisan exercise. The Senate will not pass it and the president has said he will veto it.”
The American Hospital Association (AHA) and eight other hospital groups sent a letter to Congress stating their strong opposition to using reductions in Medicare payments to hospitals and Medicaid funding to offset the scheduled physician payment cut. AHA is urging its members to oppose the cuts. The letter to Congress is available here.
Posted November 9, 2011
Ashley Annen, OTR/L, CLT
by Becky Lerner
Lymphedema is one of the most poorly-understood, underestimated, and least-researched diagnoses in the medical world. That is why it is so important to increase awareness by educating all healthcare professionals as well as affected communities: patients, their families and friends, and those especially vulnerable to the condition. I first found out about Lymphedema by glancing through a continuing education course catalog and realized that I had no idea what it was. It refers to a medical condition where swelling occurs, generally, in the arms or legs, although it can technically occur anywhere in the body. This occurs when protein-rich lymph fluid accumulates in the interstitial tissue, connective tissue between our cells, as a result of a blockage in the lymphatic system.
How does this happen? The two main causes of Lymphedema are: genetics (Primary) or the result damaged lymph nodes or lymph vessels from surgery, radiation, cancer, infection, or various other causes (Secondary). Some common symptoms of Lymphedema include: swelling; heaviness, fullness, or a tight feeling in the affected area; restricted movement in the joint; abnormal difficulty fitting into clothes, shoes, or jewelry; recurring infection; hardening or thickening of the skin; and feelings of discomfort in the affected area.
Swelling may range from mild, hardly-noticeable changes in the affected area to extreme swelling that can make functionality
difficult. Unfortunately, there is no cure for Lymphedema as of yet, but there are ways to manage it.
The first step is to be properly diagnosed by a doctor. Plain and simple, a clear diagnosis must be presented in order to qualify for treatment.
The next step is to be evaluated by a Certified Lymphedema Therapist to determine an individually-tailored treatment regimen to reduce swelling and control pain.
Possible treatment techniques range from manual therapy to compression bandaging.
- Manual lymphatic drainage (MLD) is a type of gentle massage that encourages the flow of lymph fluid out of the affected limb.
- Compression Bandaging, or wrapping, helps keep the lymph fluid from returning to the affected limb by keeping pressure on the area.
- Exercises that focus on gentle contraction of the muscles in the area are common for Lymphedema in one of the limbs, the most common form.
- Compression Garments are an at-home treatment that, similar to compression bandaging, prevent the limb from swelling in the future.
To reduce the risk of developing Secondary Lymphedema, there are precautions to take. First, be careful! Avoid injury to the
affected area. If a limb is affected, elevate it as much as possible. Avoid tight clothing, and maintain good skin care to prevent infections.
Lymphedema does not need to be a life-long, debilitating condition. The sooner diagnosis and treatment begin, the better overall quality of life can be achieved. Please help us raise awareness of Lymphedema and all who are affected by it. For more information, visit The National Lymphedema Network, The Mayo Clinic, or contact us with questions.
Posted September 23, 2011
September 23 marks a new day of awareness in the state of Illinois. Governor Quinn declared this day as “Older Adult Falls Prevention Day.” Aside from coinciding with the first day of Fall, Older Adult Falls Prevention Day (OAFPD) brings to light a topic that, inevitably, will be relevant to everyone. Whether you’re in the rehabilitation field, or simply caring for a parent, grandparent, or guardian, learning how to prevent a fall could be essential to staying healthy and functional. The Comprehensive Group celebrates OAFPD not just with “Stop Falls” signage and flashing buttons, but it takes a moment to remind its employees to spread the word of how to keep our older adult population safe by using fall prevention strategies.
In addition to company-wide initiatives to raise awareness, the Centers for Disease Control and Prevention posts some great safety tips online ranging from home care to staying active. Making sure medication is updated, installing grab bars, making everyday items easily accessible are all on the list as well as implementing coordination and balance exercises such as Tai Chi and yoga.
For other ideas on falls prevention and awareness activities, visit The Center for Healthy Aging.