Debbie Hommel's A.D. Tips
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by Debbie Hommel, BA, ACC, CTRS, Executive Director of DH Special Services
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Executive Director
DH Special Services
About Debbie

Debbie Hommel, BA, ACC,
CTRS, is the Executive
Director of DH Special
Services. She is a Certified
Activity Consultant on State
and National level, with over
twenty-seven years of
experience in providing direct
care and consultation to long
term care, medical day care,
assisted living, and ICF/MR
facilities throughout New
Jersey, New York, Maryland,
and Pennsylvania. She is an
experienced trainer and
workshop presenter,
conducting a variety of
seminars throughout the
Tri-State area for the Activity
Professional, Administrator,
and allied healthcare
professional. Debbie Hommel
is an active member of Activity
Professional Associations on
State and National levels. She
is ACC certified through the
NCCAP. She is a founding
member of the New Jersey
Activity Professionals'
Association, serving terms as
Vice President and President.
She received the Weidner
Lifetime Achievement Award
in 1994 and the Monmouth &
Ocean County Activity
Professionals Life
Achievement Award in 1999.
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Activity Questions
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for Activity Professionals
in Long Term Care Settings

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Activities + Nursing = Teamwork
By Debbie Hommel, ACC/MC/EDU, CTRS

The nursing department is the largest department in most care facilities.  Even though
this department has the most staff, their staffing ratios are stretched over 24 hours and
seven days a week.   While many states have defined staff ratios for licensed and non-
licensed nursing staff, many more states have no minimum standards defined.   It is
not uncommon for a nursing assistant to be responsible for 6-12 residents during their
shift.  Knowing the total care needs of today’s nursing home resident, we can all agree
being a nursing assistant is one of the hardest jobs in long term care.  

A good employee focuses on their job and what they need to get done.    The activity
professional can build interdisciplinary team spirit by understanding and respecting the
work of each department.    The activity department needs to develop and maintain a
supportive relationship with the nursing department.  The first step toward this end is to
agree on the definition of interdisciplinary involvement with the head of the nursing
department.  If the nursing director is not supportive of interdisciplinary responsibilities,
it will be difficult to relay that message to the nursing assistants themselves.  The
activity director should meet with the director of nursing and discuss the specific
mandates in F-248 which outline the role of the nurse and nursing assistant in quality
of life and activities.  (A copy of this can be forwarded to the reader upon request.)  Clear
parameters of involvement should be agreed upon and a unified strategic plan for
implementation should be established.  

Ideas for Interdisciplinary Involvement with the Nursing Department
1.         Define a specific name for the interdisciplinary program to generate interest.   
Some program names may include the Good Neighbor Program or Friendly
Ambassador Program.  An interesting name is easier to market and creates
2.        Create written guidelines and protocols for the program.  The guidelines should
be distributed during in-services and new employee orientation.  The protocols will offer
staff clear and specific ideas for interdisciplinary engagement.  
3.        Conduct in-services to introduce the program.  Conduct the in-service with the
director of nursing and administrator by your side.  This will stress the interdisciplinary
meaning of the program.  Make the in-service fun and interactive, using role play,
games and visual demonstrations.  Check out the Interdisciplinary Quality of Life
Initiative In-service Program.
4.        Set up the common areas with diversional and leisure supplies.  This
suggestion often meets with groans from the activity department.  Unfortunately, when
supplies are left out, they often disappear.   This time consider how the materials are
introduced and organized.  Before placing them in the common areas, demonstrate
use of the supplies during the in-service.  Involve the charge nurse and more
experienced nursing assistants in where they should be stored and how they should be
organized.  If they are involved in the process, they may be more committed to the
success of the program.    Put one of the lead nursing assistants in charge of
maintaining the materials and informing activities when more items are needed.  
5.        Introduce clear means of communication regarding special needs programming
and assisting residents to the right programs.  Common practice is to provide nursing
with lists of residents and where they belong, but this often is ineffective.  Defining
specific group attendance within the nursing assistant care plan is recommended, as
the nursing assistants review this information daily.  Some facilities post special
symbols on resident closet doors or bulletin boards which associate the resident with
certain programs.  For example, if a resident is to be assisted to the daily sensory
program – a symbol associated with the program would be posted in that resident’s
room.  A sensory program may be called “sunshine club” and the resident would have a
sun symbol posted to remind the nursing assistant to assist the resident to this
6.        Involving the nursing assistants in providing 1-1 interaction for those not involved
in groups is specifically defined within the federal regulations.  The activity department
should provide individualized materials and define specific leisure pursuits (preferred
radio stations, television and music).  Mini-in-services can be conducted in the resident’
s room, demonstrating available materials.  Posting “Life Stories” which provide
individualized information about the resident’s life and interests would also provide staff
with discussion topics.
7.        Incentive programs or competition amongst the nursing units assisting the
residents to the right programs is sometimes effective.  When serving refreshments,
offer the nursing assistants a treat after they have assisted their residents to the
program.   Periodically surprise the nursing unit that is consistently supportive in
assisting their residents to programs with baked goods to show your appreciation.  
8.        Offer sincere and consistent thank you's for any involvement of the staff.  Staff
satisfaction is closely related to feeling appreciated and goes a long way in
strengthening team relationships.   

Teamwork divides the task and doubles the success.
- Unknown