Activity coordinators in the skilled nursing space have had to get infinitely more creative in the face of pandemic precautions – and residents’ resulting depression and anxiety borne from isolation.
People who fill the role must be “dynamic” in creating and executing resident programming and have the bandwidth to do more customized programs, according to Dan Strittmater, vice president of operations for Monarch Healthcare Management.
Not only do activity coordinators have to create specialized group and individual programs, they have continued to incorporate more technology, all while adhering to infection prevention protocols.
And while nursing homes face a crushing workforce crisis, bringing more technology and flexibility has helped with recruiting and retaining activity coordinators, Brenda Glonek told Skilled Nursing News. Glonek serves as executive director of recreation therapy at Monarch.
Prospective activity coordinators are excited for a mix of in-person care and incorporating new technology to improve resident quality of life, she said.
“I think that there’s been new people who’ve come into the field in the last six months to a year that are excited to work with human beings versus doing some remote job from home,” added Strittmater.
Specialization through custom content and technology has stuck around even at this point in the pandemic, Strittmater said. And despite the success of vaccination and other Covid mitigation strategies, infection prevention is still informing activities.
“They’re more deliberate … we would be more likely to go out to a parade and less likely to go do a tour of something indoors. It can just end up being more complicated,” he said.
A decrease in occupancy during the pandemic, he added, helped coordinators more easily customize activities for residents.
Barriers to the role
Masking and other infection prevention protocols have been some of the biggest barriers for pandemic-era activity coordinators, according to Julie Schwab, activity director for the Evangelical Lutheran Good Samaritan Society.
Thankfully, it seems the Centers for Disease Control and Prevention (CDC) is starting to loosen its infection prevention protocols with the latest masking changes announced late Friday – blanket mask requirements will be removed, with the exception of facilities in high Covid transmission areas.
About 73% of counties in the country still have high transmission rates, according to CDC data.
Personal touch, body language or a simple smile all go into a great activity for residents, Schwab said. Facial expressions are a “luxury” residents didn’t have for a long time during the pandemic.
“That is so much a part of activities …we’ve had to figure out ways that we can share our joy, share our laughter, share our fun and bring it to them without them being able to see the actual facial expression on our face,” she said.
Dementia patients in particular had a hard time with masked staff, Schwab said, with one resident believing staff were trying to rob her.
A closed circuit channel for in-room televisions was one way Schwab brought activities to residents without the need for masks.
“We could, through the closed circuit TV, at least somewhat share that part of ourselves, as we couldn’t when we were physically with them. That was huge during the pandemic,” said Schwab.
The role within the wider nursing home community
The role straddles the line between social work and clinical work, added Strittmater, with the right person having emotional intelligence along with being able to identify when something might be physically wrong with a resident.
Ideally, Monarch looks for a candidate licensed as a certified therapeutic recreation specialist, which traditionally requires a four-year degree.
“In Minnesota and at Monarch, we offer scholarships for people to go through that. The minimum that the state requires is a three- or four-day course,” explained Strittmater.
Good Samaritan activity coordinators are also required to be certified nursing assistants (CNAs), Schwab said, which makes day-to-day operations flow that much more easily while the sector still navigates a historic workforce crisis.
“We were having to do more of the caregiving, as far as helping with feeding, toileting,” added Schwab. “All my staff have their CNA license, so they are able to assist in that role. It goes hand in hand … if we can help the CNAs with some of these tasks, they’ll help us with transportation [to activities.]”
Monarch doesn’t make the same CNA requirement of its activity coordinators. It all depends on what the state mandates, Strittmater said, but a lot of people do come to the role through being a CNA.
“I think that the background of being a nursing assistant or activities person could make them better at both jobs,” he said. Coupled with a need to be flexible and creative, the activity coordinator has a unique perspective – the role fills gaps left by the staffing shortage, in terms of helping CNAs with meals and answering call lights.
Tech-savvy activity coordinators
Activity coordinators and directors are also on the lookout for ways to improve quality of life for residents and staff through new experiences, and finding ways to fund those experiences.
Glonek was responsible for finding state grants to incorporate virtual reality modules in Monarch homes, along with other non-tech programs that incorporate exercise with a favorite nursing home pastime – Bingo.
Through funding from the Minnesota Department of Health, Monarch was able to purchase iPads, desktop computers and equipment from Rendever.
That’s on top of the company’s partnership with the University of Minnesota Duluth Computer Sciences, to bring robots into the nursing home. The move garnered media attention earlier this year.
And, the clientele is changing. More residents are feeling comfortable with tech-heavy activities.
“People that are coming in the building know more about it already,” said Glonek. “They already have their own cell phone, they’re already playing games on their cell phones. They have tablets, everybody learned how to FaceTime and Zoom.”
A positive catalyst for change
Activity coordinators can’t schedule about half of pre-pandemic activities anymore, Strittmater estimated, which leads to resourcefulness among staff and an openness to try different activities into the future.
“Everybody’s more willing to say sure, I’m willing to try something different as long as I don’t go on lockdown again, as long as I can have my family join,” he said.
Residents are “far more receptive” to new activities – including those with an increased use of technology – out of necessity.
When it’s your only connection to the nearby community, family and loved ones outside of the nursing home, you’re more willing to learn, added Strittmater.
Glonek believes a heightened use of technology will persist in the future, along with a continued need for activity coordinators to be “extremely flexible” in their role.
“I think [the role has] changed for the better. We’re not stuck. I feel like there have been years of doing the same thing, and we’ve evolved so much from that,” said Glonek. “We’re not just playing Bingo, we’re able to bring everything to a totally different level.”
Companies featured in this article:
Evangelical Lutheran Good Samaritan Society, Monarch Healthcare Management
