Joyce Bennett’s Resource Page
Welcome to your personalized Cognitive Concierge Resource Page! We appreciate the opportunity to work with you on your individual priorities. This document will be updated to reflect any changes in needs or preferences and we will post all relevant strategies here for easy access. We will notify you when we update your Resource Page.
Becky Khayum, M.S., CCC-SLP Becky.firstname.lastname@example.org
Erin Cecchi, MSW, LCSW Erin.email@example.com
Hannah Caron, SLP.D, M.S., CCC-SLP Hannah.firstname.lastname@example.org
Maureen O’Neil Brown, MS, OTR/L, CBIS Maureen.email@example.com
Life Participation Goals and Strategies
The following activities have been identified as overarching priorities:
- Ensure best quality of life for Joyce. Different family members have varying ideas on the best approach to achieve this.
- Allow identified meaningful and organized life participation goals to guide supportive services.
- Provide guidance and education regarding aphasia (communication challenges) to family members.
- Prioritize therapist and staff training in assisted living environment.
- Collaboration with Joyce’s medical team to coordinate care.
Cognitive Concierge To Do List-In Process
- Recommend templates for creating visual aids and picture boards
- Engage Joyce in a conversation about her care preferences (eg, what care she would/wouldn’t want, where she wants to receive care, who she wants to receive care from, etc) which would be beneficial for everyone.
- Connect with Teddy, Joyce’s occupational therapist (OT) at Brookdale Lisle
- Collaborate with Teddy on functional testing and goal setting for Joyce
- Assist with addressing mental health challenges by
- working together to create “coping cards” and phrases that Joyce’s family members/caregivers can use if she is experiencing moments of anxiety and stress (coping cards are simple, small cards with brief prompts or phrases on them to facilitate use of a specific coping strategy or idea)
- connect to a local therapist if this is advisable
- Assist family with keeping Joyce’s overarching priorities at the center of all decisions by:
- discussing family dynamics and how this impacts Joyce
- talking about Joyce’s personal, relationship, and familial history
- Create and share a “ground rules”/tip sheet that highlights best ways we can interact with Joyce. This could include what topics to avoid discussing (unless Joyce wants to talk about it), how to respond in certain situations (eg, providing reassurance, redirecting, changing topic), etc
- Continually discuss and assess support needed for different family members
Cognitive Concierge To Do List-Completed
- Send Suzanne introduction information on the Resource Page
- Connect with Elizabeth O’Brien Gallagher, MHS, CCC-SLP at Joyce’s Assisted Living Facility (ALF)
- Collaborate with Elizabeth on functional testing and goal setting for Joyce
- Send resource kits (general aphasia kit and assisted living kit) to Suzanne and Elizabeth
- Maureen shared information about Angel Sense
- Suzanne and Terry placed airtags on all of Joyce’s shoes.
- Suzanne and Terry worked with Joyce so she knows to always tell the front desk staff when she is leaving the building.
- Whenever Suzanne and Terry take Joyce out for walks, they have her point out her building, repeat the name of her building (Brookdale), etc.
Suzanne and Terry’s To do list-In Process
- Share this Resource Page, as you feel appropriate, with family, friends, team members
- Assist with addressing mental health challenges by:
- working together with the team to create “coping cards” and phrases that her family members/caregivers can use if she is experiencing moments of anxiety and stress (Coping cards are simple, small cards with brief prompts or phrases on them to facilitate use of a specific coping strategy or idea)
- Schedule meeting between Erin and Joyce to discuss engagement with and location of appropriate mental health professional to work with, when she feels ready to connect
Suzanne and Terry’s To do list-Completed
- Send pictures of visual aids in Joyce’s apartment
- Connect Elizabeth, Joyce’s speech therapist, with the Cognitive Concierge team so we can communicate via email and/or phone.
- Provide contact information to Maureen to connect with Teddy, Joyce’s occupational therapist
Speech Therapy Plan:
The speech-language pathologist (SLP) at Joyce’s ALF is Elizabeth O’Brien Gallagher, MS, CCC-SLP. She has worked with Joyce in the past and is ready to re-start services. Elizabeth is excited to collaborate with the Cognitive Concierge team on ways to facilitate testing, goals, and therapy that is functional and personalized for Joyce.
Target Goal/Intervention Areas:
- Wristband alert button: used spaced retrieval training with visual aids to increase Joyce’s recall to use the button for a staff member, instead of calling a family member for help
- Creation of Communication Station in Joyce’s room. This will be a hub for all tools related to Joyce’s aphasia. It can include an educational handout for staff members, describing Joyce’s aphasia and strategies for helping her to communicate. Her communication book, clock with time/date, and designated places for items she may misplace can be included at the station.
- Formulation of personalized communication book: use templates from aphasia resource kit to identify important topics and words to include in book. These may include pictures with captions, in addition to scripts. Cog Concierge team can help to make the communication book. Elizabeth and family can send us personal photos to include.
- Include visual aid for Joyce to use when the staff asks her what she needs (after she presses the call button). Identify Joyce’s most common requests and include pictures with captions on aids
- Personally relevant word rehearsal program
- If Joyce feels comfortable practicing words that are important to her, we can help to create personalized flashcards for her to practice with her family or on her own.
- Creation of a communication board for staff conversations and formation of a communication wallet
- Meeting with Joyce 2x week.
- Working on taking pictures of staff with Joyce and attaching names to pictures to make up a key ring for Joyce.
- Suzanne and Terry sent a nine-picture grid of wants and needs to assist Joyce when she needs help from CNA staff after using her call button.
- Deciding on a communication station in her apartment which has been started already for her.
Occupational Therapy Plan:
Teddy, Occupational Therapist
- On hold pending further guidance from the team
- Develop and manage comprehensive individualized care plan which will be summarized and modified regularly on your personal Resource Page.
- Create handouts that provide aphasia education and communication strategy training to the desired communication partners:
- Education about diagnosis of aphasia
- Useful strategies to help increase success and comfort with conversation.
- Include education about cultural considerations, such as speaking more slowly and being aware of her knowledge base/vocabulary prior to her brain tumor.
- Education regarding environmental alterations and external communication aids, which can help with success with communication.
- E.g., Communication book/wallet; “Communication Station” in her apartment
- Increase collaboration and communication with health care professionals involved in Joyce’s care.
- Provide guidance for upcoming medical appointments and reaching out to these professionals as needed (e.g., neurology, social work)
- Help Joyce be able to push the call button and ask for what she needs. Family does not mind Joyce calling them for assistance, but they want her to live as independently as possible.
- Assist Joyce to organize, plan, and initiate going to the activity room for leisure time or for a specific activity (game time, live music, happy hour, animal show, etc).
- Provide general suggestions and resources to Joyce’s speech and occupational therapists for creation of visual communication supports and external tools to enhance daily communication skills and overall independence with daily tasks. Of note: As consultants, we provide general advice and coaching. Joyce’s speech and occupational therapists at her AL community can apply use and practice of these communication tools during skilled treatment sessions.
- Dr. Lapins feels that the ALF setting is appropriate for Joyce at this time.
- Joyce is starting to learn new things involved with her daily routines at the ALF.
- She is a very active and social 80 year old who is loved by ALF residents and staff.
- Joyce is now initiating more conversations but will get frustrated occasionally when having difficulty with communication and word finding. Joyce can also become fatigued in certain situations like going to festivals with family.
- The ALF staff is responsible for medication management and administration.
- Family has recently added a shower service for Joyce at the ALF. Sometimes, Joyce can miss steps in her grooming care, like putting on deodorant.
- Joyce is working on reading and writing. These skills have improved, but she still needs help with spelling.
- Joyce has a great schedule at her ALF. She goes to the dining hall for meals three times a day. She will occasionally go on morning walks with the ALF residents. In the afternoon, the ALF puts on events and games (some cognitive-focused games). Joyce usually takes an afternoon nap; family and staff encourage her to take shorter naps in the afternoon, so as not to disturb her sleep schedule.
- Family visits with Joyce in the afternoon. Terry will play a game with Joyce (UNO, shape puzzles, etc.) or watch TV. Todd will call Joyce on the phone every couple of days.
- Family provides choices when Joyce has a hard time finding words. Joyce needs extra time to communicate.
- Joyce has a wrist band with a call button. She can call the staff if she needs something (help with the TV, is hungry, etc.), but family has noticed that Joyce has a hard time communicating her needs when the responding staff enter her room. Family feels this communication difficulty is exacerbated by external pressure in these situations. Terry has made a picture board to help and plans to discuss training with Elizabeth.
- Everything in Joyce’s apartment is labeled.
- Joyce has an adaptive TV remote.
- Joyce’s phone has been programmed and adapted for ease of use.
- Joyce has a memory book containing pictures, names, and relationships for the members of her family. Joyce carries this book with her and uses it to initiate conversations with people.
Family/friends support system
Terry and Suzanne Littell-Joyce’s son and daughter-in-law
Todd and Uyen Littell-Joyce’s son and daughter-in-law. Todd is Joyce’s power of attorney
TJ, Tim, Phillip, Holly and Kyle-Joyce’s grandkids
Elizabeth Lapins, MD-Joyce’s neurologist
Elizabeth O’Brien Gallagher, MHS, CCC-SLP-Joyce’s speech therapist at Brookdale
Teddy-Joyce’s occupational therapist at Brookdale
Cognitive Concierge-Becky Khayum, MS, CCC-SLP, Erin Cecchi, MSW, LCSW, Hannah Caron, SLP.D., M.S., CCC-SLP and Maureen O’Neil Brown, MS, OTR/L, consultants
Medications/Pertinent Medical Information
- Suzanne and Terry feel Joyce is now up-to-date on her medical appointments.
- Joyce will have dental work in the future but no set appointment yet.
- Joyce and family met with a social worker. The session focused on how Joyce is feeling in her new living environment. There are no plans to see the social worker again at this time.
- Joyce has received a referral for a mental health provider, but family is considering this at a later time if needed.
- Joyce has seen an Ear, Nose, and Throat (ENT) doctor recently for some post-swallow sticking sensation with pills and carbonated beverages. Joyce started reflux medications, which has been helping alleviate symptoms when drinking carbonated beverages. The nursing staff has been crushing and/or administering pills whole with applesauce. Family feels the pill dysphagia (swallowing difficulty) is related to the large volume of pills Joyce has to take, rather than a true disorder. Family plans to monitor swallow symptoms for now.
- Joyce recently had a neurology appointment on 10/2/23. Magnetic Resonance Imaging test (MRI) results showed areas of atrophy (brain shrinkage). Electroencephalogram (EEG) results showed no seizure activity, but she is at risk for having a seizure. No further neurological testing was recommended.
- Joyce is receiving some anti-anxiety medications now. Her provider has been adjusting medications.
Questions for Medical Professionals
We will use this section to prepare for appointments.
Potential Future Needs and Concerns
We can use this section to identify long term needs.
Support for the Caregiver
Respite and a supportive community assist with preserving mental and physical health of the caregiver. Respite may come in the form of a daily, routine leisure activity in which your loved one will independently engage, a friend or relative who will spend time with your loved one, or a formal community program for engagement. Knowing your loved one is safe and content will allow you take time to care for yourself to complete necessary errands or engage in work or leisure tasks with full attention. Support groups will allow you to find a safe space to discuss common issues, problem solve with others, and create a network of resources.
We will use this section to identify any support groups that Joyce is engaged in or might benefit from.
We will use this section to discuss involvement in any medical studies