Day: May 30, 2024

Welcoming New Talent: Engage with® Skills Training Program Expands Its Team

Posted on | by Keri Boyer | Leave a Comment on Welcoming New Talent: Engage with® Skills Training Program Expands Its Team

In a significant move to bolster its mission of enhancing the lives of older adults through equipping those that care for and engage with them the necessary skills of empathy, respect, and effective communication, the Engage with® Skills Training Program has welcomed four new Certified Skills Trainers. This strategic expansion is set to increase the program’s capacity to meet the growing training needs of partnering organizations, particularly the Maryland Department of Aging and their State Longevity Ready Initiative. With their extensive experience and diverse backgrounds, these new trainers are poised to make a substantial impact on the program’s effectiveness and reach.

Building a Stronger Foundation for Older Adult Care

The Engage with® Skills Training Program, a national non-profit initiative of the Mental Health Association of Maryland (MHAMD), focuses on equipping direct care workers and service providers with crucial skills that improve the lives of older adults they serve. As Amanda Krisher, Senior Director of the program, emphasized in a recent podcast interview, the program’s core values are rooted in empathy, respect, and effective communication. The integration of these values into training modules helps create a more compassionate and understanding workforce, ultimately enhancing the quality of care provided to older adults and improving the overall job satisfaction for the staff members.

“Our training is conducted on a virtual platform built on a gaming system, where participants create and customize avatars to represent themselves. Our Certified Skills Trainers guide them through interactive conversations in real-time.
Unlike many traditional long-term care and aging services training curricula, which often rely on brief videos and quizzes, our unique approach focuses on providing a comprehensive experience. Our Certified Skills Trainers ensure that participants have ample opportunities to practice the skills we teach, which is crucial for effective learning and understanding how to respectfully engage with older adults. The success of this program would not be possible without the team of talented skills trainers that we’ve developed here at Engage with!“

Amanda Krisher, LCSW-C, Senior Director,
     Engage with® Skills Training Programs

Meet the New Certified Skills Trainers

Jill Kluesner, MA, CRC, Certified Skills Trainer (Contractor)

With over 15 years of experience in public health programming, Jill Kluesner brings a wealth of knowledge to the Engage with® team. Her expertise spans curriculum development, public health education, and program implementation. Jill has worked with the National Council for Mental Wellbeing to create and pilot diverse training experiences, including Mental Health First Aid (MHFA) programs. Her commitment to advancing public health education and supporting instructor development is evident in her role as a mentor and national trainer. Jill’s background in Rehabilitation Counseling and Public Health, combined with her practical experience, makes her a valuable asset to the team.

Soumya Palreddy, PhD, Certified Skills Trainer (Contractor)

Soumya Palreddy is a licensed psychologist and restorative justice practitioner with a passion for promoting transformative change in communities. Her experience includes facilitating restorative justice implementation, addressing inequities, and fostering cultures of care in various settings. As a National Trainer for MHFA, Soumya has been instrumental in updating training programs and developing train-the-trainer initiatives. Her previous roles, including Associate Director at University Health Services at the University of Wisconsin-Madison, highlight her leadership and expertise in mental health education.

Suzanne Perlman, MA, Certified Skills Trainer (Contractor)

An expert in curricula development and training program facilitation, Suzanne Perlman has over 20 years of experience in promoting equity and access. Her work focuses on designing innovative curricula for diverse communities, including Indigenous, older adult, and rural populations. Suzanne’s national training efforts have reached thousands, providing mentorship and technical assistance to ensure programs meet the evolving needs of various groups. Her background in behavioral health system transformation further underscores her ability to drive meaningful change in public health education.

Rachel Taube, MSW, Certified Skills Trainer (Contractor)

Rachel Taube’s dedication to mental health education and community engagement is reflected in her extensive experience as a national facilitator. With a strong foundation in social work, Rachel specializes in bridging the gap between theory and practice, connecting communities with evidence-based tools. Her educational journey, which includes degrees from Valparaiso University and Washington University in St. Louis, has equipped her with the skills to effectively translate knowledge into practice, enhancing the overall impact of training programs.

Enhancing Training through Technology and Empathy

Engage with® Skills Training Program leverages technology to create immersive and scalable training experiences. By using a virtual platform that allows participants to interact through avatars, the program provides a unique environment for older adult care workers and service providers to practice and refine their skills. This method not only enhances engagement but also ensures that training is accessible and impactful.

Looking Ahead

With the addition of these highly skilled trainers, the Engage with® Skills Training Program is well-positioned to expand its reach and effectiveness. The program’s commitment to fostering empathy, respect, and effective communication remains at the forefront of its mission, ensuring that direct care workers and service providers are well-equipped to meet the needs of the aging population. The expertise and dedication of the new skills trainers will undoubtedly contribute to the program’s continued success and its positive impact on the older adult care industry.

The Silent Crisis: Addressing Behavioral Health Challenges Among Older Adults

Posted on | by Madison Tralka | Leave a Comment on The Silent Crisis: Addressing Behavioral Health Challenges Among Older Adults

As the older generation continues to age, the demographic landscape of the United States is shifting dramatically. As of 2024, there are currently approximately 62 million adults ages 65 and older living in the U.S., according to the research released by the Pew Research Center, leading to Older adults now making up over 18 percent of the population.  Recent studies predict that the U.S. Centenarian population is expected to quadruple over the next 30 years and with this growth comes a critical need to address their behavioral health concerns. The recent SAMHSA report, “Behavioral Health among Older Adults: Results from the 2021 and 2022 National Surveys on Drug Use and Health,” sheds light on the pressing issues of substance use and mental health in this age group, revealing a silent crisis that demands our attention.

Unveiling the Statistics

The SAMHSA report provides a comprehensive analysis of substance use and mental health issues among older adults. According to the report, approximately 12.5% of older adults had a mental illness in the past year, with serious mental illness affecting around 2%. Substance use disorders were prevalent in 9.1% of this population, with 5.6% experiencing alcohol use disorder and 4.1% facing drug use disorder.

  • About 1 in 25 older adults had a drug use disorder (DUD) in the past year.
  • Fewer than 1 in 3 older adults that were classified as needing substance use treatments actually received it.
  • Of the older adults that received substance use treatments, nearly all (97%) did not think they needed it.
  • 2.7 million older adults had a major depressive episode in the past year, with females being twice as likely to experience one over their male counterparts.
  • About 1 in 50 older adults had serious thoughts of suicide in the past year.

These statistics are alarming, yet they reflect only a portion of the problem. Older adult females are more likely to suffer from mental illness, while older adult males have higher rates of substance use disorders. This gender disparity underscores the need for tailored interventions that address the specific needs of men and women in this age group.

Barriers to Treatment

Despite the high prevalence of mental health and substance use disorders, treatment remains elusive for many older adults. The SAMHSA report highlights that fewer than one-third of older adults who needed substance use treatment received it in the past year. Similarly, only about 46% of those living with any mental illness received treatment.

Several factors contribute to this treatment gap. Medical conditions associated with aging, significant life changes, and social isolation can exacerbate mental health issues. Additionally, stigma, cost, transportation difficulties, and challenges navigating the healthcare system pose significant barriers to accessing care. As noted in the report, “Older adults who might benefit from treatment also typically did not perceive that they needed it.”

The Impact of Loneliness

Loneliness is a significant concern for older adults, as highlighted in both the SAMHSA report and a study by researchers at the Indiana University School of Medicine. The study found that loneliness is significantly associated with lower mental and physical quality of life among older adults. This finding aligns with the broader themes of the SAMHSA report, which emphasizes the adverse effects of social isolation on mental health.

The U.S. Surgeon General’s 2023 report on social connection further underscores the importance of addressing loneliness. It emphasizes the need for supportive connections, including friendships, community involvement, and the mental health benefits of connecting with pets. As we celebrated the first inauguration of Older Americans Month in May, this year’s theme, “Powered by Connection,” aptly highlights the multifaceted benefits of social interactions.

Gender Differences in Behavioral Health

The SAMHSA report and other studies consistently show gender differences in behavioral health among older adults. Women are more likely to experience mental health issues, while men have higher rates of substance use disorders. Understanding these differences is crucial for developing effective interventions.

In a comprehensive review by the University  of St. Augustine for Health Sciences (USAHS), it was noted that “33.5% of adults with a mental illness also reported a substance use disorder in 2021.” This statistic highlights the complex interplay between mental health and substance use, particularly among older adults. Addressing these co-occurring disorders requires a holistic approach that considers both mental and physical health.

The Role of Primary Care

Primary care clinicians play a pivotal role in addressing the behavioral health needs of older adults. As suggested by the Indiana University study, clinicians should actively discuss loneliness with their older patients and provide resources to help them develop and maintain meaningful social relationships. This proactive approach can help mitigate the adverse effects of loneliness and improve overall mental health.

Moving Forward

Addressing the behavioral health challenges among older adults requires a multifaceted approach that includes increasing awareness, reducing stigma, and improving access to care. Service providers must focus on:

  1. Education and Awareness: Educating older adults about the risks of substance use and the importance of mental health care is crucial. Reducing stigma around these issues can encourage more individuals to seek help.
  2. Improving Access: Addressing barriers such as cost, transportation, and healthcare navigation is essential to ensure that older adults receive the care they need.
  3. Targeted Interventions: Developing interventions tailored to high-risk groups, particularly older males for substance use disorders and older females for mental health issues, can help mitigate these problems effectively.
  4. Support for Caregivers: Providing resources and support for caregivers is vital, as they play a key role in the well-being of older adults.

As the population of older adults continues to grow, addressing their behavioral health needs becomes increasingly urgent. By understanding and addressing the challenges highlighted in the SAMHSA report and other studies, we can improve the quality of life for this vulnerable population and ensure they receive the care and support they deserve.

References:

Navigating the Delicate Balance: Antihypertensive Medications and the Risk of Falls and Fractures in Older Adults

Posted on | by Alysia Osoff, RN, MSN | Leave a Comment on Navigating the Delicate Balance: Antihypertensive Medications and the Risk of Falls and Fractures in Older Adults


In the intricate landscape of older adult care, the management of hypertension presents a significant challenge, especially when weighed against the risks of falls and fractures. Recent studies have shed light on the delicate balance healthcare providers must maintain to safeguard the health of older adults, particularly those residing in long-term care centers and those with dementia.

Elevated Risks with Antihypertensive Medications

A comprehensive study published in JAMA Internal Medicine highlights a stark reality: aging adults in long-term care centers who start antihypertensive medications face significantly higher risks of falls and fractures. This study, involving data from over 29,000 older adults in long-term care centers in the Veterans Health Administration, revealed that the incidence rate of fractures in those initiating antihypertensive therapy was 5.4 per 100 person-years, compared to just 2.2 in those not on these medications.

Dr. Muna Thalji Canales, a researcher at the Malcom Randall VA Medical Center, emphasized the need for caution. “Ultimately, the question of how to treat blood pressure in older adults remains one that must be individualized,” she noted. The study’s findings underscore the necessity for additional monitoring and a tailored approach when managing hypertension in this vulnerable population.

Specific Vulnerabilities: Dementia and Blood Pressure Thresholds

The risks are particularly pronounced among older adults with dementia. The same study found that for those with dementia, the hazard ratio for fractures skyrocketed to 3.28. Additionally, older adults with systolic blood pressure of 140 mm Hg or higher and diastolic blood pressure of 80 mm Hg or higher faced even greater risks, with hazard ratios of 3.12 and 4.41, respectively.

These statistics are echoed in multiple other studies, including one from HCPLive, which linked antihypertensive medication with an increased fracture risk among older adults. Similarly, research published in Wiley Online Library highlighted that hypertensive older adults are at a heightened risk of falls and fractures following the initiation of these drugs.

Practical Implications for Long-term Care Centers

The practical implications of these findings are profound. As Dr. Thalji Canales suggests, healthcare practitioners in long-term care centers should avoid rapid intensification of antihypertensive medication, allowing at least a month for older adults to acclimate to new doses. Monitoring orthostatic vitals around changes in blood pressure management, particularly in the first week, is also recommended. However, these ideal practices often face the harsh reality of limited staffing and resources in many long-term care centers.

A study published on BMJ Open supports these recommendations, showing that older adults face an increased risk of injurious falls when initiating antihypertensive medication. The necessity for continuous and thorough medication management cannot be overstated, especially in settings where older adults safety is paramount.

Balancing Benefits and Risks

The overarching theme across these studies is the critical need to balance the benefits of antihypertensive medications against their potential risks. While controlling high blood pressure is essential to prevent strokes and other cardiovascular events, the accompanying increase in fall and fracture risks must be carefully managed.

A thought-provoking commentary in Pharmacy Times stresses the importance of reviewing older adults histories before prescribing antihypertensive medications. This step is crucial to tailor treatment plans, a primary tenet of person-centered care, that minimize risks while effectively managing hypertension.

Moving Forward: Individualized Care Plans

The path forward involves a commitment to individualized care plans, where the unique health profiles and needs of older adults are meticulously considered. Healthcare providers must be person-centered focused, and vigilant in monitoring and adjusting treatment plans, ensuring that the initiation of antihypertensive medication does not inadvertently compromise patient safety.

In conclusion, the intersection of antihypertensive medication use and fall/fracture risks in older adults, especially those living with dementia, highlights a critical area of older adult care. By embracing a patient-centric approach and advocating for the necessary resources and staffing, we can better navigate this delicate balance, ultimately enhancing the quality of life and safety for our elderly population.

References:

  1. Butt, D. A., Mamdani, M., Austin, P. C., Tu, K., Gomes, T., & Glazier, R. H. (2015). Benefits and risks of antihypertensive medications in the elderly. Journal of Internal Medicine, 278(1), 77-84. https://doi.org/10.1111/joim.12446
  2. Dhanani, S., Schultz, J., Abramowitz, M. K., & Canales, M. T. (2024). Antihypertensive medication and fracture risk in older veterans. JAMA Internal Medicine. Retrieved from https://pubmed.ncbi.nlm.nih.gov/38648065/
  3. Leipzig, R. M., Cumming, R. G., & Tinetti, M. E. (2014). Antihypertensive medications and serious fall injuries in a nationally representative sample of older adults. JAMA Internal Medicine, 174(4), 588-595. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1832197
  4. Maricic, M., & Simon, J. A. (2024). Antihypertensive medication linked to fracture risk among older adults. HCPLive. Retrieved from https://www.hcplive.com/view/antihypertensive-medication-linked-to-fracture-risk-among-older-adults
  5. Saraf, A. A., Petersen, N. J., Sargis, R. M., & Baillargeon, J. G. (2014). Antihypertensives linked to serious fall risk in elderly patients. Pharmacy Times. Retrieved from https://www.pharmacytimes.com/view/antihypertensives-linked-to-serious-fall-risk-in-elderly-patients
  6. Slattum, P. W., Johnson, C. L., & Cutson, T. M. (2023). Blood pressure meds raise fracture risks for those in nursing homes. Home News Here. Retrieved from https://homenewshere.com/national/health/article_8bed84b9-b989-5794-81c3-6d730b7802c6.html
  7. Steinman, M. A., Hanlon, J. T., & Schmader, K. E. (2014). Deprescribing. UpToDate. Retrieved from https://www.uptodate.com/contents/deprescribing
  8. Welsh, T. J., Gladman, J. R., & Gordon, A. L. (2024). Antihypertensive medication use linked to increased fracture risk in nursing home residents with dementia. Skilled Nursing News. Retrieved from https://skillednursingnews.com/2024/04/antihypertensive-medication-use-linked-to-increased-fracture-risk-in-home-residents-with-dementia/
  9. Woolcott, J. C., Richardson, K. J., Wiens, M. O., Patel, B., Marin, J., Khan, K. M., & Marra, C. A. (2009). Association between gaps in antihypertensive medication and risk of falls. BMJ Open, 9(3), e022927. https://bmjopen.bmj.com/content/9/3/e022927

Empowering Older Adult Care Through Game-Based Learning: Interview with Filament Games at CES 2024

Posted on | by Rashad Adams | Leave a Comment on Empowering Older Adult Care Through Game-Based Learning: Interview with Filament Games at CES 2024


In the bustling atmosphere of this year’s Consumer Electronics Show (CES) in Las Vegas, innovation takes center stage, showcasing the latest breakthroughs in technology. Amidst the cutting-edge displays and high-tech demonstrations, one interview stands out for its profound impact on a critical aspect of society: the care of older adults. In the premiere episode of Season 7 of the Filament Games Podcast, Jennifer Javornik, Chief Partnerships Officer, sits down with Amanda Krisher, Senior Director of the Engage with® Skills Training Programs at the Mental Health Association of Maryland (MHAMD).

Krisher, who has over a decade of experience in direct practice and program management, brings a wealth of knowledge to the Engage with® program, a national non-profit initiative. The program focuses on training older adult care workers in empathy, respect, and effective communication. Her enthusiasm for CES is palpable, noting the event’s overwhelming yet inspiring atmosphere, particularly the innovations in gaming and older adult care.

Building Empathy Through Experience

Krisher’s experiences at CES underscore the importance of empathy in older adult care. She highlights an exercise she participated in, organized by AARP and the MIT Agelab, which simulated the physical challenges faced by older adults. This hands-on experience is crucial, she explains, in understanding the unique needs of the aging population. “It’s harder to maneuver, hear things, or see things,” Krisher notes, emphasizing the necessity of designing technology with these challenges in mind.

Leveraging Technology for Scalable Training

The Engage with® Skills Training Programs have embraced technology to enhance and scale their training initiatives. Originally conducted in person, the program transitioned to an online virtual platform in 2020. This shift allowed for greater scalability and accessibility. Built on a gaming platform, the training features avatars and interactive scenarios, providing a unique and engaging learning experience. Krisher explains, “Our training takes place in a virtual platform… everyone comes in as an avatar. They have a chance to customize that avatar and find somebody that really represents them.”

This approach diverges from traditional microlearning methods, focusing instead on creating immersive experiences where participants can practice skills in a safe environment. This method allows for mistakes to be made and learned from without real-world consequences.

Game-Based Learning in Action

A standout feature of the skills training program is the “Demonstrating Respect” game, which uses a choose-your-own-adventure format to teach respect and effective care. Participants interact with virtual older adults, making choices that influence the outcome of the scenario. This interactive method helps care workers understand the diverse needs and preferences of older adults. One memorable character, Joe, a stern army veteran, requires a different approach compared to Sally, a cheerful and friendly character. This diversity in interactions teaches care workers to tailor their approach to each individual.

Impact and Results

The results of this game-based learning approach are significant. Studies conducted by independent evaluators contracted by MHAMD show a reduction in staff turnover rates and improvements in customer service skills. Krisher shares that after implementing the training, staff members felt better equipped to handle challenging situations without immediately resorting to medication. This has led to a notable decrease in PRN (pro re nata) medication use, particularly in assisted living centers.

Moreover, staff retention rates have improved dramatically. In one study, 76% of staff members who received the training were still employed over a year later, a remarkable achievement in an industry known for high turnover rates. This retention is attributed to staff feeling valued and better prepared for their roles.

Advice for Implementing Game-Based Learning

For those considering a game-based learning approach, Krisher advises balancing information delivery with interactive experiences. “Game-based training is how we move the needle,” she asserts, highlighting the importance of providing opportunities for practice and small wins. This approach not only makes training more engaging but also ensures that participants can apply what they have learned effectively.

Conclusion

Amanda Krisher’s insights from the CES interview reveal the transformative potential of game-based learning in older adult care. By leveraging technology and focusing on empathy and respect, the Engage with® Skills Training Programs are setting a new standard in the industry. As Krisher aptly summarizes, empowering care workers through innovative training methods ultimately leads to better care for older adults, fostering a culture of respect and understanding that benefits everyone.

Combatting Food Insecurity: How Medically Tailored Meals Transform Lives of Older Adults

Posted on | by Alysia Osoff, RN, MSN | Leave a Comment on Combatting Food Insecurity: How Medically Tailored Meals Transform Lives of Older Adults

In a country where food insecurity remains a persistent issue, particularly among older adults, initiatives like Mom’s Meals’ recent donation of 30,000 medically tailored meals are beacons of hope. This donation, part of the Hunger Challenge initiative, is more than a charitable act—it’s a strategic move to address a critical social determinant of health.

The Food Insecurity Challenge

Food insecurity is a widespread problem in the United States, affecting millions of households, including a significant number of older adults. According to the Food Research & Action Center (FRAC), older adults, especially those aged 50-59, face higher rates of food insecurity than those aged 65 and older. Structural factors, such as systemic racism, exacerbate these disparities, particularly among Black, Latinx, and LGBT older adults.

“Health care providers recognize the critical role of food security in patient health,” notes a FRAC survey, highlighting that nearly all respondents agreed that screening for food insecurity is important, and that it contributes to poor health outcomes among older adults.

Medically Tailored Meals: A Proven Solution

Medically tailored meals (MTMs) are designed to meet the specific dietary needs of individuals with chronic illnesses. These meals are not just about providing calories—they ensure recipients get the necessary nutrients to manage their health conditions effectively.

A study published in the Journal of General Internal Medicine showed that for food-insecure individuals with diabetes, medically tailored meals improved dietary quality, reduced food insecurity, and decreased hypoglycemia incidents. The meals were customized to the medical needs of each participant, demonstrating significant health benefits.

“Medically tailored meals go further,” says a report from Meals on Wheels, “providing nutritional support that aids in patient recovery and helps older adults maintain their independence.”

Bridging the Gap with Public-Private Partnerships

Mom’s Meals’ initiative underscores the importance of public-private partnerships in tackling food insecurity. Chris Choi, CEO of Mom’s Meals, emphasizes this point: “Private-public partnerships are really critical. We’re trying to work more closely with government leaders to provide more coverage and access to nutrition.”

Federal initiatives, like the Food is Medicine project by the Department of Health and Human Services (HHS), are pivotal in integrating nutrition into healthcare systems. These initiatives recognize that access to nutritious food is essential for health and resilience, a concept Mom’s Meals is putting into practice with their donation.

The Broader Impact on Healthcare

Addressing food insecurity through medically tailored meals has broader implications beyond individual health benefits. Research shows that food insecurity leads to increased use of health services. By providing nutritious meals, healthcare costs associated with diet-related diseases can be reduced significantly.

The FRAC survey found that healthcare providers need more support, including training on connecting patients to nutrition programs and resources, integrating screening efforts into electronic health records, and securing funding for food insecurity interventions.

A Call to Action

The commitment of Mom’s Meals to donate 30,000 meals—more than double their previous year’s contribution—highlights the growing recognition of the role nutrition plays in healthcare. It is a call to action for more stakeholders to join the fight against food insecurity.

Conclusion

Medically tailored meals represent a critical intervention for food-insecure older adults, offering a lifeline that supports their health and independence. Initiatives like those by Mom’s Meals, backed by strategic public-private partnerships and robust policy support, are essential to addressing this pressing issue. As we look towards a future where food is recognized as medicine, it is clear that these efforts are not just beneficial—they are vital.

By recognizing the profound impact of medically tailored meals, we can better support our aging population, ensuring that no one has to choose between hunger and health.

References:

  1. Food Research & Action Center. (2023). Addressing Food Insecurity Among Older Adults: Health Care Provider Beliefs, Practices, and Resources Needed. Retrieved from FRAC Report.
  2. Meals on Wheels People. (2024, February). Medically Tailored Meals Aid Patient Recovery. Retrieved from Meals on Wheels People.
  3. Berkowitz, S. A., Gao, X., & Tucker, K. L. (2014). Food-insecure dietary patterns are associated with poor longitudinal glycemic control in diabetes: Results from the Boston Puerto Rican Health study. Diabetes Care, 37(9), 2587–2592. doi:10.2337/dc14-0753.
  4. Food Research & Action Center. (2017). Hunger & Health: The Impact of Poverty, Food Insecurity, and Poor Nutrition on Health and Well-Being. Retrieved from FRAC Report.
  5. Meals on Wheels America. (2023). An Evidence-Based Solution to Senior Hunger and Isolation. Retrieved from Meals on Wheels America.