Shake that Schedule Up

I attended an ombudsman session at a conference a few years ago.  He told all the activity professionals in the room that their calendars were repetitive and there was no excitement in them. He suggested that we needed to shake things up. I did manage to listen past this statement, but I could tell the rest of the room had shut him off.  I believe he had some good things to say, however they fell on deaf ears.  After the session I approached him and asked him some questions.

Before I tell you about my conversation with him, I’m going to give you some experiences I have had over the years. Not all my experiences will be healthcare related, but life related.  I hope by the end of this article you will understand where I am coming from and be able to determine whether your calendar needs shaking up or if you need to find a way to defend your calendar.

When I was in the military, I worked what they called a 2 on, 1 off, 2 on, 3 off. Now I know I’m not the best at math, however, anyone who adds those numbers realizes that they equal 8 not 7.  The last time I checked there are only 7 days in a week.  The way this “schedule” worked was; you work 2 twelve hour days, have 1 day off, work 2 twelve hour mid-watches  and then have 3 days off.   It didn’t help that most of the time I went to work in the dark and left work in the dark.  I never knew what day of the week it was without looking at a calendar.  Someone asked me what day of the week it was, and I replied it’s my Friday.  It was really Sunday, but it was my second mid-watch and I was about to have 3 days off. This was my schedule for several years. I really struggled when I was given a day job. It took me a while to adjust to working 5 days in a row.

One facility I worked in decided to change the dining times.  We would serve meals to the high functioning residents at 11 am and 4:30pm.  The lower functioning residents would eat at 12 pm and 5:30pm.  I cannot remember the reason for changing.  We had to have 2 different times due to the size of the dining room.  We did not have enough room to serve everyone at the same time. We had several meetings with the residents, staff and their families to let them know about the changes coming. I had to rearrange my entire calendar to accommodate this change. Corporate wanted to make sure there were activities for the higher functioning to make sure they had something to do to redirect them with this change. I am sure right now everyone reading this already knows what I’m about to say.  This change DID NOT go well at all.  It didn’t matter what was on the calendar they were eating at their normal time, and it was their right to do so. It took months to finally get them acclimated to the new meal times.  And yes Residents and their families called the state board of health and the ombudsman multiple times.  We were never cited, but that didn’t keep them from calling.

I interviewed for a position at an Assisted Living and Independent living.  I got the job. The first thing my boss tells me after I’m hired is “I need you to get rid of Bingo everyday.  It needs to be 3 days or less.” They were playing bingo every single day.  The first thought that went through my head was, “I might as well sign my own death certificate.”  Anyone who has been in this field any amount of time, knows you do not mess with bingo. I explained I needed to be here at least 6 months before I made any changes.  After six months, I went to resident council and asked them what they wanted.  They told me more parties so I started with replacing BINGO on Fridays with parties like they wanted. This was fine on paper, but when it came to the change it wasn’t all roses.  To the credit of my boss, there were only about 10-15 people attending bingo and there were about 80 residents. There was an uprising, but slowly those complaining actually started to enjoy what was being put in the place of bingo.  It took me about 18 months, but I was able to get bingo down to 3 days a week and we saw more residents being involved in activities.

I was a member of a church that had church first and then Sunday School after the church service.  The church had done this for years.  I mean like 30 years.  They had been talking about changing it since the reason it was started was no longer an issue.  You would have thought the church was moving to another state.  It did not go well. There were people threatening to leave if they changed the times. They did change the times and it took almost a year for members to quit complaining about the change.

Every church I have ever been to has assigned seats.  Well not actually in writing, but it is understood that we always sit in the same places.  One Sunday we came to church and there were people sitting in the seats we normally sit in.  So, my husband said let’s go sit on the other side.  We normally sat on the left side of the church, that Sunday we sat on the right side of the church since those were the only open seats left. (I guess that’s what you get for being late to church.) We went to church that night and the Pastor came up and asked us if we were feeling ok.  We assured him we were. He then asked us why we weren’t in church that morning. So even the Pastor expects people to sit in the same seats. We have actually seen church members tell visitors to move because they were sitting in their seats.

Now for the conversation with the ombudsman.   I thanked him for his time and information and then I said “can I ask you a question without offending you?”  He said “sure.”  I said “do you go to church?”  He said “Yes, I do.  I said “do you sit in the same seat every Sunday?”  He said “Yes I do” and then I asked “how do you feel when someone else sits in your seat?”  He started to answer and then he looked at me and said “oh.”  My comments to him were, you want us to shake up our calendars, which are the residents’ schedules.  They have already had their lives turned upside down by having to leave their homes, their furniture, their neighborhoods, and in some cases their friends/family. No one likes to have their routine shaken up.  Well, maybe a few people do, but most people like to know what is coming and what time it’s coming. He understood what I was saying, but he said that a lot of facility calendars have the exact same thing every month.  I explained I knew what he was talking about as well.  We need to have a schedule, but that doesn’t mean we never try something new or change up what we are doing.

An example of a schedule but changing it up is this, I had exercise on the schedule every day at 10 am. We did not always do the same exercises. We would have someone come in and do Yoga one day a week.  On other days we would put music on and exercise to the music.  The residents would pick out what music they wanted to listen to as they exercised.  Every month we tried to match the music with the theme of the month or week. We always had parties on Friday.  Each Party would be around some National day of that month. I cannot remember what month it was, but it was National Cow-chip throwing day.  We had gathered some cow-chips so we could have our own cow-chip throwing contest. Just so you know, infection control had us wrap them in saran-wrap. My farming residents had a blast and it brought back a lot of memories.  You can play football with them as long as you make sure the centers are dry.  I found that out the hard way as a kid.

All this to say, yes our calendars are the residents schedules.  My residents would carry their calendars around and if something didn’t start on time or wasn’t in the location their calendar said, they were hunting me down wanting to know what was going on. Years ago, when we had the state board of health in our building, they would schedule the resident meeting.  They didn’t ask me or the residents when would be a good time for it, they just scheduled it and expected me to get the residents to the meeting.  One such time, the meeting was scheduled during the time bingo was supposed to be taking place. To put this in perspective, this is the same facility that rebelled against the dining time changes.  I tried to explain to the state surveyors that they may need to change either the time or the day.  They refused.  I let the residents know about the meeting with the surveyors.  They acknowledged the meeting time, but I knew what was going to happen.  They all came down and set up for bingo and when the surveyors came in for the meeting the residents promptly told them they could wait.  This is their home, and they would meet with them when bingo was done.  My office was outside the room where bingo was, and I heard them yell for me to come call bingo.  The state surveyors came to my office and asked when bingo would be done.  I told them and they said they would be back then. The next time state was in, they asked me what would be a good day and time for a resident meeting.

We can shake up our calendars without shaking up the schedule. We also must make sure that as our population changes that our calendar reflects the likes and interests of the current residents. According to agingcare.com creating a daily routine helps keep residents with memory issues calm and focused. Most of the residents in our facilities have some form of dementia. As dementia progresses, the schedule we have for them will help them keep going.  This schedule may need to be tweaked as they progress downward, but it could help keep them grounded with something familiar.

We all have schedules and when they get thrown off it throws our whole day off. I can’t count on one hand how many times I’ve said after a vacation, “I can’t wait to get home and get back to normal.” I think I’ve said that about the holidays, I couldn’t wait to get to January where things would go back to normal.

Tammy Point NAAP Leadership Team