Natalie Kunkel, Solutions Consultant, joins Greg Puklicz, President of 12 Oaks Senior Living, to discuss the Symphony of Life program, a specialized approach to care for residents with cognitive challenges. They discuss how the program was developed to improve resident engagement and independence through a holistic, community-wide strategy. Natalie explains how team members are trained through a virtual dementia experience to build empathy, and how personalized support plans help maintain resident dignity and wellness.
You’re listening to The Roots Podcast by 12 Oaks, where we’ll be joined by industry leaders to discuss and highlight the character, competency and care that is required to successfully manage senior living portfolios.
Greg 00:12
And welcome to another episode of The Roots Podcast, brought to you by 12 Oaks Senior Living. Today we’ve got an interesting topic for you. I’m here with Natalie Kunkel. Welcome, Natalie.
Natalie 00:27
Thank you.
Greg 00:28
It’s great to have you on the podcast.
Natalie 00:30
It is awesome to be here.
Greg 00:31
So Natalie works in our Solutions Group. What is our Solutions Group? What exactly are the Solutions Sisters?
Natalie 00:38
Well, I call us Swiss Army knives because we come into communities and come alongside that community and perform a number of different functions. So we can support ops, we can support activities, we can support sales and marketing. We can do just about anything in the community to support them and make our residents have a better day.
Greg 01:01
You know, we found the Solutions Group is very much that Swiss Army knife, very functional and deployable. Maybe almost like a Seal Team Six. We can send you in where you’re needed, right? To maybe put out fires, grow programming, increase sales, and most importantly help our residents thrive in community.
Natalie 01:27 Absolutely.
Greg 01:28
Thank you for everything you do. You are something of a memory care and resident care savant, I’ve heard. And, one of the more interesting programs specific to 12 Oaks Senior Living, trademarked, I believe, is our Symphony of Life. So tell me a little bit about Symphony of Life. How did that come about?
Natalie 01:48
So Symphony of Life came about a while before I came and joined 12 Oaks. And it was, I believe, birthed out of one of the 12 Oaks communities at the hand of Eileen Aldridge, who is now our VP of Solutions. And at the time, I think she was the marketing person who had come out of activities then to sales would eventually be the ED there. And that team recognized that we had a need to better serve some low participators, which turned out to be people who were having cognitive processing problems. So as this program developed, got copyrighted and came forward, we began to craft it as a company to really support that person with a dementia-causing disease.
Greg 02:34
And that was a few years back, and that was before there really wasn’t a lot of programing or things for residents with cognitive issues, right? This really helped develop and encourage wellness in our residents, right? In a way that just hadn’t been done before.
Natalie 02:53
In a way that hadn’t been done before, and in a way that isn’t done very routinely. Now, is this whole community approach. It’s not just an activities program. It isn’t just this corner of the community. We look at every corner of the community, every department to help make that resident’s day better, to help support that resident, that person to be as independent as possible.
Greg 03:18
So pull back the curtain for us a little bit on Symphony of Life. What does it involve? What are some of the kinds of things you do to install and get residents active in the Symphony of Life programming?
Natalie 03:31
Well, I have to go back to the team first. How have we prepared the team to meet that person in the journey where they are? So the first thing that we do with our new team members is give them a virtual dementia experience where they spend five, ten, 15 minutes in the shoes of what our residents might be experiencing as they’re having cognitive shifts.
Greg 03:54
And how do you do that? I mean, how do you get them to get in the shoes?
Natalie 03:57
Well, we set up a room that’s got all sorts of tasks to do in there. Our team members put on goggles that give them the experience of having a perceptual shift in the way their vision works. And we put on gloves to help cause more difficulty and how they’re going to manage, plan and handle their hands. And then we do the same thing with their feet, and then we put on our ever sound headphones with some nice noise that simulates the brain’s inability to tell foreground from background. Then after all of that is in place and all of this overstimulation is going on, we give them 4 to 6, two step commands to complete within this environment.
Greg 04:43
How do they do, usually?
Natalie 04:44
Younger brains do better than us older brains. And most people don’t complete it. Most people come back around to talk about the frustration and oh, wow, how do our residents really experience things that way? And we talk about, we have that just for a moment. We could always take the goggles off. We could always walk out. We had control and our residents don’t. So it helps to build that empathy so that whenever they’re providing care and caring going forward, that they can have that empathic memory to lean into.
Greg 05:18
That’s a great program, and it helps caregivers and family members, and others kind of feel what it’s like to be one of the residents who has dementia in our communities. So once they kind of understand that, what’s the next step? How does it help them better serve those residents?
Natalie 05:43
Great question. So the next step is to actually understand the individuals that we’re helping. So we have what’s called a personal support plan. And we also have a focus five process. Both of those are designed to really dig in and understand what this person can do and what they need help with and what that help should look like. We do a great job of not mothering our residents, of getting there and helping them be the person that they are. We want to be their friend, not their person who tells them that they can’t do this or can’t do that.
Greg 06:21
Yeah, a lot of times you see dementia residents often getting frustrated when they’re told they can’t do something. How do you overcome that? Let’s say they have a physical issue trying to accomplish a task as simple as cutting up their food or something like that. How do you get them to kind of allay those emotional reactions and kind of smooth out those edges to make their journey in life a little more pleasant?
Natalie 06:49
Well, I teach the teams and I teach the champions who later teach the teams because it’s a layered approach, I guess, to build cognitive ramps. So, a ramp up front where somebody wheels their wheel cheer up. Maybe they do it independently. Maybe somebody pushes, the ramp still makes it easier. So cognitive ramps are no different. So we create the way that it’s going to make it easier for that person to accomplish it, not easier for us. We’re not just going to feed them their meal because it’s easier and faster for us. We’re going to use a hand under hand, which connects to the brain differently and can even rebuild a skill. We’re going to understand what that person’s can-do is and fill in the blank after that.
Greg 07:37
And what have you seen? So we’ve installed this programing, Symphony of Life, at a number of our communities. Give me kind of an idea of the before and after picture.
Natalie 07:47
You see willful, independent engagement in life. So you’ve got residents who are maybe a 2 or 3 are clustered and spending time together doing a puzzle, a financial discussion, whatever it is of interest to those folks. You see another group, a small group of residents over here, maybe in our resident kitchen cooking. You see another group of residents maybe doing some exercise. So it’s not just a single thing. It’s this buzz that’s in the community of residents who have been given agency. They’ve been given the ability to direct their day with the support they need to do that.
Greg 08:38
Those are great outcomes for the residents and their families, and clearly for the staff. I would imagine, too. How have you seen this program impact caregiver wellness at our communities?
Natalie 08:53
This is huge, absolutely huge. So, in doing what I do for many, many years, I would go in and I would ask team members, how do you know how to care for somebody? And they say, well, we just figure it out. We just figure it out. So what you have out there are facilities that are constantly paying people to figure it out. What we’ve done differently in our communities is we have this personal support plan where the team has come together, figured it out, and we’re still growing. We’re still always learning about that person as things change, particularly in the processing category. But we have this plan written down, so a new team member coming in has a plan to help this person. They already know what the person can do and what they need help with and what that help looks like. And so knowing that decreases onboarding frustrations right off the bat.
Greg 09:48
So what other metrics or data have you collected with regard to length of stay and that type of thing with our residents?
Natalie 09:57
Probably most specifically in my time with 12 Oaks is going in and impacting falls. So looking at communities that have a high level, high number of falls and helping them through this personal support plan, focused five process to meet that person’s need, fill those cognitive ramps, reduce those falls, which in turn has that person living with us longer.
So one of the things that occurs whenever we have our program in place is our residents are able to be with us, be engaged in the way that they want to be engaged. Their highest level of independence and these cognitive ramps that we build help support that person to maintain their life. So we see less frustration, less of that hitting, failure to communicate because they are just like us, they’ve just been us longer. And if we get mad or we don’t understand what’s going on, we use our words first and for somebody who’s got a processing disorder such as a dementia causing disease, that part of the brain, that left side of the brain that has language in it is breaking down. So then we go to fist second. I mean, I don’t know about you, but if somebody approaches me in a parking lot, there’s not a whole lot of conversation there. So our residents experience that and when we have the right approach, then we don’t have to have that frustration as a medication to reduced
Greg 11:32
You know, this is something I guess we’re looking to roll out at all of our communities now. So programmatically kind of where do we stand with the 12 Oaks portfolio? And how would you kind of describe your efforts in that regard?
Natalie 11:47
So for the assisted living communities without a dementia support piece to it, the thought is: dementia is everywhere. I say, even in the break room. So we have to prepare for that throughout our portfolio and provide a way for our teams to understand what those changes look like and processing, and how we can help that person maintain their highest level of independence. So it will be a lot of team education and a lot of really knowing that person and having a plan for each individual. Just because you’ve met one person with dementia, doesn’t mean you’ve met every person with dementia.
Greg 12:29
And I understand we’ve rolled it out in Spanish now too, to help some of the Spanish speaking first language caregivers?
Natalie 12:35
And I’m super excited about that. So it’s typically not our caregivers, I mean, we do have some caregivers that Spanish is their first language, but this also shows the depth of our programing because it’s typically our kitchen staff and our housekeeping staff who are just as important to our residents as that care friend, as that caregiver. So having everybody understand how this supports and the flip side of that too, is, statistically speaking, most of our caregivers are taking care of somebody in their family as well. And so not only are we equipping our team to take care of ours, we’re equipping them to take care of theirs, too, which is in line with our character and values.
Greg 13:21
I appreciate you taking the time to join us on the podcast. It’s a fascinating topic. I think you guys, in the whole Solutions Group with the installation of our Symphony of Life at our communities is one of the real differentiators, for 12 Oaks Senior Living, right? One of the things that makes our community special and makes our residents special. So thank you. And I appreciate everything you’re doing to help move this forward.
Natalie 13:49
Absolutely. I’m honored to be able to do it. Thank you.
Greg 13:52
That wraps up another episode of The Roots Podcast, brought to you by 12 Oaks Senior Living. Keep on listening.
Speaker 1 14:01
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