QUALITY OF CARE

Restraints-Free Policy
The use of restraints to eliminate the risk of falls was, at one time, commonplace in long-term care facilities. New research however, confirms that the routine use of restraints fosters depression, reduces muscle strength and mobility, increases incontinence and skin problems and leads to agitation in the individual restrained.

Maimonides, always in the forefront of change, has adopted a restraint-free policy as a gradual and careful process and has almost entirely eliminated the use of restraints amongst the resident population. The benefits are compelling. Moving about stimulates circulation, channels excess energy, reduces stress and anxiety and reduces the risk of cardiovascular problems. More importantly, it preserves dignity and allows residents to live more normally.

Abuse Prevention
Residents have the right to be treated with dignity and respect and to be free from all anxiety or acts of violence that could threaten their physical or emotional well-being. Through a comprehensive series of workshops, the publication of brochures and other promotional efforts sensitizing families, employees and administration to this issue, Maimonides has adopted a policy of zero tolerance and has established a process to report any incidents of suspected abuse.

Maimonides is committed to the elimination of abuse of any kind, be it physical, emotional, psychological, financial or sexual.

Clinical Ethics
A Clinical Ethics Committee is designated to deal with conflicts or differences of opinion that may arise between caregivers and residents' decision makers. In the case of residents at Maimonides, the most characteristic ethical issues deal with end-of-life decisions - how and when to intervene - treatment choices, etc. With some families, dying with dignity becomes the overriding concern. With others, heroic interventions are demanded. So many ethical issues are charged with emotion and subjectivity that frequently the best interests of the resident may be overlooked.

A Clinical Ethics Committee acts as a consultative or facilitative group and not for the purpose of decision-making. They help to identify the problem, to explore the possible solutions and to arrive at a decision that is satisfactory for all.

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Validation Therapy
Frequently with old age, comes an increased incidence of mental confusion and deterioration. Validation Therapy provides professional caregivers with the skills to communicate with disoriented people by tuning into the person's inner world and helping them to restore the past by reliving good times and resolving past conflicts.

This technique in caring for the elderly, has assisted caregivers at Maimonides to interact effectively with highly confused residents.

QUALITY OF LIFE

Nutrition and Food
As people age and their infirmities increase, the satisfaction derived from enjoying good food may be one of the few pleasures left to them. Accordingly, Maimonides places special importance on the quality and variety of food. The Department of Nutrition and Food Services is continually testing new menus and the massive improvement to our food delivery system currently underway, at a projected cost of $3,000,000, will ensure that food arrives on the floors at the desired temperature.

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Adult Education Program
Adult Education courses, a rarely-seen program in long-term care, focuses on the residents intellectual needs and provides an excellent opportunity for enhanced self-esteem.

Boutique Evie
Originally conceived for residents who have no family members to fulfill their needs, Boutique Evie is a small in-house boutique which allows residents or families to shop from a variety of specially adapted merchandise at very reasonable prices.

Moroccan Tea Salon
Created to provide a comfortable and familiar ambiance for those of sephardic origin, the exotic Moroccan Tea Room allows residents to connect with their cultural roots. The tea room is also used for various programs and serves the special needs of all 3rd floor residents.

Breakfast Club
This program brings residents together once a week to prepare and enjoy their breakfast thereby encouraging socialization in a normalized environment.

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Interactive Computer Games / Programs
A computer version of T.V. shows and trivia games (i.e. Who Wants to be a Millionaire?, Wheel of Fortune) that are projected on a large screen to promote group interaction and cognitive stimulation.

Community Link Programs
These programs are designed to encourage residents to maintain a connection to the community through participation in various events and celebrations.

Sensory Stimulation Palliative Care
Designated for residents who have few visitors, minimal sensory stimulation and who are at risk for isolation, this program uses various methods to encourage interaction with others and participation in activities.

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Bowling / Sports Sensation:
Plays a vital role in the general health of our residents. The two activities promotes physical conditioning, increases fine and gross motor skills, encourage eye hand coordination , overall well-being and team participation.

Music / 1:1 Music Therapy:
Provides opportunities for residents to reflect on positive memories, to engage in social interaction and to reduce stress. Music is a universal stimulant that is able to console and reach residents who are non- responsive.

Gardening:
Gardening connects people to nature and the environment. It is a leisure activity which encourages residents to nurture a living thing, to reminisce about past involvement with plants, and to engage in decision making. It’s also a form of beautification for the home and the environment. Together, it can bring about changes, and improve quality of life.

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Baking:
Baking has been an inherent part of the participants' life; it provides an opportunity for increased autonomy and socialization.

1:1 Intervention:
This is an individual interaction between resident and Therapist. This experience reduces anxiety, restores dignity, builds trust, and validates resident’s present state of being.
 
Sensory Stimulation:
Use of massage and multimodal stimulation (aromatherapy and music) with residents who do not respond to group therapies.  The goals of the program are to: 1) elicit a purposeful response to stimuli presented and the environment, 2) decrease isolation and sensory deprivation 3) decrease agitation 4) facilitate pain management.

Masters Program:
This is a continuing education program after graduating from the Adult Education Program. Residents are directly involved in planning their own learning experience in a small group, with invited guest speakers from the community.

Social Action Committee:
This program promotes self-actualization through creative social action. To contribute in a meaningful way and create something for the benefit of others (i.e. notepads with recycled paper , t-shirts, aprons, recycling project on their floor and putting together holiday baskets for Meals on Wheels and gifts for our non-Jewish residents) .This program build a sense of belonging and sharing of their skills in a meaningful way through a volunteer experience.

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PANORAMA
Panorama is a newsletter program for residents, about residents by residents. The group meets once a week to discuss current events, personal stories, recipes, questions for the Rabbi, jokes and many other news that’s happening at Maimonides. The information that is discussed is then written onto a newsletter that is distributed to all residents at Maimonides every month.

Current Events
This provides the residents with mental stimulation by initiating discussions in current events. The program enhances social interaction, maintains a link with the community, heightens an awareness of the world, triggers decision making skills and  problem solving techniques.

Discussion Groups ( ie. Coffee & Conversation/ Yiddish 101/Tea & Trivia)
This program is a social, informal setting that will bring about conversation amongst residents. It provides the residents with an opportunity to unite and interact in a non-threatening milieu. This homelike environment sets the stage for conversation and mental stimulation by initiating in discussions about Yiddish expressions, current events or just casual conversation. The program provides the residents a feeling of belonging and acceptance, it also generates and promotes discussion among the group members.

Interactive Computer Games / Programs:
 A computer version of T.V. shows and trivia games (i.e. Who Wants to be a Millionaire?, Wheel of Fortune) that are projected on a large screen to promote group interaction and cognitive stimulation.

Nintendo - Wii Sports Games:
Residents become pro athletes; experience the virtual / realistic sports sensations with controls that are close to the actual sport motions through a video game. Promoting physical exercise and over all well being. The game brings the golf course, baseball field, tennis court and boxing arena to the residents. Residents can now resume sporting activities they once thought impossible.

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Centre Wide Events:
These events help to de-institutionalize and create opportunities for residents & family members to sit back and share in an entertaining experience.
Here are some examples:

• Birthday Parties & 100+ Birthday Recognition - Monthly center-wide parties are held to honor the residents’ birthdays. Special recognition is given to residents 100+. 
• Matinee at the Movies – Our Synagogue is equipped with the state of the art large screen and sound system where residents enjoy watching classic movies and musicals.
• Purim Casino
• Summer Carnival
• Chanukah Cantorial Concerts

Community Link Programs
These programs are designed to encourage residents to maintain a connection to the community through participation in various events and celebrations. (i.e. March to Jerusalem, Israeli Independence Day, Social Action Club)

Chaplaincy Programs:

• Daily Services in the synagogue each morning at 9:15 AM and evenings at 6:00 PM. Sabbath and holiday services start at sundown and in the mornings from 9:15 AM -12:00 noon.
• Friday Oneg Shabbat program every Friday on the floors.
• Healing Services: A program which occurs every Wednesday morning on a different floor, composed of prayers, readings, music and songs to help residents strengthen their spiritual well-being.
• Short Story discussion group – every Wednesday on the 5th floor, a reading of a short story by a Jewish author takes place with a discussion led by the rabbi.
• Chanukat Habayit/Welcome ceremony: new residents receive a personalized welcome in their rooms within 6 weeks of their arrival at Maimonides with a visit by staff. Wine and cake are served with a prayer for a pleasant stay.

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