Information & Tips Archives - THE GRAND

Engaging and Entertaining Residents in Long Term Care

Engaging and Entertaining Residents in Long Term Care

Amanda Lilly, Director of Activities
The GRAND of Dublin

Activities in a Nursing home are an important part of a Residents day. We provide entertainment, companionship and kindness. With activities ranging from Bingo to Zumba, we design a day to help enhance the Residents life. Mentally and physically.

Seniors in a nursing facility are at risk for depression. As people age, their health declines. This may add pain or mobility issues for the Resident contributing to depression.  According to, a study found that Residents in a Nursing Home felt healthier, happier and more satisfied with their lives after being empowered to influence their surroundings. This is one of the reasons we hold a monthly Resident Council. This is a formal meeting. The Residents elect a President, we hold minutes and document all wants and needs of the Council. During the meeting Residents discuss what each department does well, and what each department can do to improve. This empowers the Resident to influence their home.

Another way to empower the Resident is to simply ask what we can do to keep them happy and feel fulfilled. We then do all we can to accommodate the request of the Resident. Often times, the request is simple. Pizza for dinner, a specific book, a certain movie played during the matinee in The GRAND of Dublin Theater. We do what we can for them. This is their home and they have a right to feel as such.

All Residents are Different

Each Resident has different likes and dislikes. Some Residents prefer group activities and some prefer 1:1 activities. At The GRAND of Dublin we offer these and more. As each Resident joins our community they are greeted and welcomed and we begin getting to know them. This helps us determine what they may like and what we may need to add to our calendar to help them feel included and encouraged to participate.

Activities engages with the Resident and gets to know them. We get to know them on a personal level and form friendships with them. The Residents know we will listen to them and that we care. Residents often just want to chat. Most have lived a full and long life by the time they choose to retire at The GRAND. They have stories and jokes and memories of the most fascinating of times. We must remember that most of our Residents have lived through The Great Depression, World Wars and The Civil Rights Movement. We have been blessed to hear stories of people who marched with Dr. King, served proudly their country and know how to make a stew using only leftovers.

The Importance of Activities

Activities also develops relationships with the family members of our Residents. This offers familiarity and comfort to our Residents loved ones. Having a relationship with the families of our Residents means the loved ones will often keep us informed of our Residents likes and dislikes. They let us know what games they like, what music they prefer. All things that help us meet the needs of the Resident. This also provides us with a gateway for bonding with the Residents.

Activities also engage and invite the Skilled Nursing Residents. Even though they are here for a short time and tend to be more independent and at times younger, we encourage everyone to participate and have fun while they are with us. We introduce ourselves to each person and get to know them also. We develop a care plan for them that helps them feel less isolated and included.

To sum it up: The Activity Department at The GRAND is honored that we get to engage and entertain the Residents every single day. It is a real privilege to be a part of their lives.

Coronavirus (COVID-19) Recovery: Breathing Exercises

Coronavirus (COVID-19) Recovery: Breathing Exercises

Jeanne R. Seliskar, MA, CCC/SLP
Corporate Director of Rehabilitation
Vrable Healthcare

Diaphragmatic Breathing (Belly Breathing)

Diaphragmatic vs. High Chest Breathing: High chest breathing is when the chest rises and falls with inhale/exhale, this does not allow for expansion of the lungs in their entirety and therefore shallow breathing. Diaphragmatic breathing is when the stomach rises and falls with inhale/exhale. The diaphragm contracts which then expands the rib cage and allows for more room for the lung to expand.

Coronavirus (COVID-19) RecoveryPhases of Diaphragmatic Breathing:

Phase I: Deep breathing while laying on your back.

Phase II: Deep breathing while laying on your stomach.

Phase III: Deep breathing while sitting in a chair.

Phase IV: Deep breathing while standing.


Pursed Lip Breathing: Inhale through nose and exhale through mouth with lips pursed as if trying to blow a kiss.

 Alternate nostrils breathing:

  1. After exhale, use thumb to gently close right nostril.
  2. Inhale through left nostril.
  3. Switch position of hand and close left nostril in order to exhale through right nostril.
  4. Continue alternative breath pattern for up to 5 minutes.

Lions Breath:

  1. Inhale deeply through nose and open eyes wide.
  2. At the same time, open mouth wide and stick out your tongue, bringing the tip down toward your chin
  3. Contract muscles at front of throat as you exhale out through your mouth by making a long “ha” sound

Humming Bee Breath:

Inhale through nose while putting pressure on tragus cartilage that partially covers ear canal. Keep mouth closed and make loud humming during exhale.

4-7-8 Breathing Technique: Inhale through nose for a count of 4 seconds. Hold breath for a count of 7 seconds. Exhale for a full 8 seconds through nose. Complete 5-8 cycles of this pattern.

Sitali breath:

Stick out your tongue and curl tongue to bring the outer edges together. If your tongue is unable to do this then just purse your lips. Inhale through mouth.

Kapalbhati breathing exercise: Sit with your hands on your knees and palms facing the sky. Take a deep breath in and as you exhale, contract your belly and force the breath out in a short burst. Put on a hand on your stomach to feel abdominal muscle contract if needed. As you quickly release your abdomen, your breath should flow into your lungs automatically. Complete 20 breaths.

Despite COVID 19 being on the decline, vulnerable individuals are still contracting the disease and with many residual effects lingering or only partially resolving.  One of the most common areas for impairment is breathing.  As a critical and integral element of functioning and being mobile, it has become a foundational factor in Physical, Occupational and Speech Therapy.  It has been a component consisting of several exercises to improve controlled inspiration and controlled expiration in addition to proper diaphragmatic pattern of breathing which targets increased respiratory volume.  All of these targeted exercises (a few shown above) are aimed improving activity tolerance during functional activities/mobility.  With the patient learning and independently practicing these breathing exercises, significant improvement in various facets of treatment are noted.

Posture also becomes an essential part of this process.  Using the “Y”, “T” and “W” positions with the arms in lying, sitting or standing, allow the chest cavity to open up and increase the respiratory volume.  It also helps the patient to move from shallow high chest breathing to expanding the lungs and moving the abdomen forward as in diaphragmatic breathing.  Although, patients may not achieve perfect postures, approximations ultimately result in better breathing patterns and improved recovery.

According to Physical Therapist Peiting Lien at Johns Hopkins: “Deep breathing can help restore diaphragm function and increase lung capacity. The goal is to build up the ability to breathe deeply during any activity, not just when at rest.”

What is an Activity Director and why are activities important in a Nursing Community?

What is an Activity Director and why are activities important in a Nursing Community?

Amanda Lilly
Director of Activities
The GRAND of Dublin

An Activity Director in a Nursing Community plans and oversees the recreational events and programs for the seniors residing in the care community. I create an activity schedule that helps to develop and enhance social skills, promote active lifestyles and encourages a healthier Resident. For example, The GRAND of Dublin has Happy Hour every Friday in our own Digger & Finch Pub. We have a live performer, snack foods and refreshments. The Residents come together and are able to chat with each other while listening to music and snacking. This fun activity focuses on getting the Residents out in the Community and socializing with their neighbors. Another example would be the weekly Chair Zumba classes we have. This again, gets the Resident out in the community with their neighbors and promotes an active and healthier lifestyle for them.

activities GRAND of DublinAccording to, consistently socializing residents help reduce the risk of depression. Depression can be caused by isolation and loneliness. Socialization also reduces the levels of anxiety in seniors. Socialization helps maintain self- esteem and self -worth. I plan a schedule of activities and events designed solely to make our Residents happier and healthier. Physically and mentally. The activities are also designed to allow the Residents to spend time with people similar to them, this gives them companionship and comradery.

At The GRAND of Dublin we like to stay busy. The Resident favorite is Bingo. For every game won, the winner receives one BINGO BUCK. They can save the BINGO BUCK or spend it in our BINGO STORE. Playing Bingo takes concentration. Concentration promotes listening and helps maintain short term memory.

A favorite for our Memory Care Friends is noodle ball. This is simply short pool noodles and balloons. The Residents pass the balloon using the pool noodle. This fun game keeps the Residents active and helps with balance and coordination.

Arts and Crafts is always a winner for us. Varying from canvas painting to paper machete projects. We have built birdhouses and painted pumpkins. Creating art stimulates the brain, gives a sense of competence and greater self -esteem.

Every week our Memory Care unit has Music Therapy. We also have live music two to three times a week. We play games like name that tune or finish the lyric. We have sing-a-longs also. Music makes people think, feel and act a certain way. Music activates the section of the brain responsible for memory retention. Memory retention is vital for seniors.

My department also helps the Residents stay connected with their family members that live away from them. We offer Facetime and Zoom calls. We also develop relationships with the Residents. We know their likes and dislikes. We encourage them to participate. Most importantly, we listen to them.

Activities facilitates voting for the Residents. Voting is such a privilege and no one understands that better than seniors.

The goal of my department is to enrich the lives of the Residents. We aim to entertain them while also improving their well -being. This is an important role in their lives. At The GRAND of Dublin, we developed the entire place to promote a sense of community. While strolling along our Main Street, the Resident can have a coffee or snack at The Cool Beans Café. Catch a movie in The GRAND Theater. Have an ice cream at What’s the Scoop Ice Cream Parlor. Get your hair done at the Queens Gate Salon. Attend Church in The GRAND Chapel. We even have neighborhoods with their own dining rooms.  The GRAND strives to maintain a facility that helps the Residents not just live happily, but THRIVE TOGETHER.

Zoom Meeting Etiquette

Zoom Meeting Etiquette

Sacha Sanborn
Business Office Manager
The GRAND of Dublin

Zoom Meeting EtiquetteJoin the Meeting Early
You should join your meeting early to test your connection and audio.

Greet the Host
Greet your host as soon as you are on, so that they know you are there.

Eliminate Distractions
Turn off email notifications, put your cell phone on silent, put a sign on your door. If working from home put pets in another room.

Mute your Microphone
Make sure your microphone is muted, so that your background noise doesn’t distract others in the meeting. Make sure to unmute prior to speaking.

Look at the Camera when Speaking
Look at the camera when interacting and speaking, just like you would when speaking to someone in a person.

Remember You are Always on Camera
Remember to have a work appropriate background, sound and lighting

Always dress professional and or “dress casual”. If working from home, no pajamas or sweatpants. No eating or drinking, unless there is prior communication between team members stating is it acceptable.

Before the zoom meeting: host tips

  • Prepare agenda prior to the meeting.
  • Only invite those who need to participate.
  • Share any resources and or material.
  • Manage the room and address disruptive participants
  • Keep participants engaged.
  • Schedule breaks and feedback times.

Resident Valentine Messages

Send a Special Valentine’s Day Message to a Resident at The GRAND of Dublin

February and Valentine’s Day are about love. As Valentine’s Day approaches, The GRAND would like to make it easy for our community, family, and friends to send our residents and your loved ones a special message to let them know someone is thinking about them on this holiday.

We ask you to take this as an opportunity to make a person’s day feel special. We would like to invite you to send a Valentine’s Day Message to your loved one or to any resident to brighten their day.

Send a message to one of our residents letting them know someone is thinking about them by filling out the form below. If you do not a have a specific resident you want to reach, simply leave the Resident Name field blank.

Please select a valid form

COVID-19 Vaccinations

The GRAND of Dublin is pleased to announce our enrollment in the Long Term Care Pharmacy Partnership Program through the CDC.  This program will provide safe COVID-19 vaccinations for our residents and staff.  The CDC has recommended Healthcare workers and long term care residents as the highest level of priority for the first distribution of the vaccine.  These vaccinations will be offered free of charge to our residents and staff, and your loved ones.

The COVID-19 vaccine is projected to be available later this month pending emergency use authorization by the FDA.  The 2 types of vaccines that are projected to be available in Ohio are Moderna and Pfizer, mRNA type vaccine).  Both will require 2 doses to be given, 3-4 weeks apart.  Trial studies have shown a 95% efficacy rate after the 2nd dose. Less than 10% of those in the trial had any side effects with fatigue being the most common.  No vaccines are 100% effective but this will greatly reduce your risk of getting sick with COVID-19 and spreading the virus.

While mRNA is new in vaccine development, this technology has been used successfully in cancer treatments. The goal of mRNA vaccines is to give your body the tools it needs to fight COVID-19 effectively and/or prevent you from getting it at all.  According to the CDC, mRNA vaccines give cells instruction for how to make proteins that are unique to the virus. Our bodies recognize the protein should not be there and it builds antibodies that will know how to fight the virus if we are infected in the future.

None of the proposed vaccines contain live or killed virus particles like many other vaccines. 2 treatments has been shown to be safe and is required to make sure your body has enough antibodies to fight off COVID-19.

Facility will continue all required precautions and use of personal protective equipment (PPE) after vaccinations are administered per CMS and CDC guidance. Current information suggests that the vaccine takes 4 weeks after the 2nd dose to generate antibodies.

Are you asking yourself, “how do I sign up myself or my loved one for the vaccine”?

As soon as the vaccines have been authorized, our pharmacy partner will contact the facility.  The facility will then begin the consent process for our staff and residents.  It is crucial to make sure that the facility has current contact information and that consents are responded to promptly.

The vaccination clinic dates and times will be announced and posted for residents and staff.  Once we have set times or know more specifics, resident families will be notified.

Day After Thanksgiving Salad

Day After Thanksgiving Salad


  • 1 tablespoon butter
  • 3/4 cup chopped walnuts
  • 1 tablespoon sugar
  • 1 package (8 ounces) ready-to-serve salad greens
  • 3 cups cubed cooked turkey breast
  • 1 small red onion, sliced
  • 1 medium sweet yellow pepper, sliced
  • 1 cup grape tomatoes, halved
  • 1 cup chow mein noodles
  • 3/4 cup jellied cranberry sauce
  • 3 tablespoons seedless raspberry preserves
  • 2 tablespoons balsamic vinegar
  • 4-1/2 teaspoons vegetable oil
  • 1 tablespoon water


  1. In a small skillet, melt butter over medium heat. Add walnuts; cook until toasted, about 4 minutes. Sprinkle with sugar. Cook and stir until sugar is melted, 2-4 minutes. Spread on foil to cool.
  2. In a large bowl, combine the salad greens, turkey, onion, pepper, tomatoes, noodles and sugared walnuts. In a blender, combine the remaining ingredients; cover and process until smooth. Pour over salad and toss to coat.

Nutrition Facts
1-1/2 cups: 464 calories, 21g fat (3g saturated fat), 78mg cholesterol, 136mg sodium, 40g carbohydrate (23g sugars, 4g fiber), 32g protein.

Answering Admissions Questions

Answering Admissions Questions

by Danielle Batdorff, BSHA/HIS
Director of Admissions
The GRAND of Dublin

If a person has never been through the process, the thought of entering a skilled nursing or rehab facility can be a little overwhelming. It’s natural to have several questions. We’ve put together a list of the most commonly asked questions to help you better understand what to expect.

What is skilled nursing?

Skilled nursing is a type of intermediate care in which the patient or resident needs more assistance than usual. This setting is designated for physical, occupational, and speech therapies, to aide in strengthening the patient who has a goal of returning to their home at baseline. Skilled nursing services are offered to patients who need IV medications administered, who may have wound care needs, or who may need teaching on medication management, an example of this would be newly diagnosed diabetics.

What is the difference between short-term care and long-term care?

Short term care is a temporary solution that may last from a few days to a few months. Long term care is typically utilized for in-house placement for the duration of the patient’s life.

What social activities are offered?

Skilled nursing facilities offer a full calendar of social events and activities. Residents are encouraged to join in as many activities and social events as they like. Some examples include; art classes, ice cream socials, bingo and cards, game and movie night, quest performers and church services.

In addition, they offer wellness programs, exercise classes, beauty salons, small dining areas, café and restaurant style dining rooms, and outdoor sitting and walking areas.

What should I bring with me?

It is recommended that you bring comfortable clothing for working out in therapy along with good fitting shoes. Personal hygiene items (all labeled with your name), photo ID, insurance cards, advanced directive paperwork (Power of Attorney and Living Will paperwork).

What are the rooms like?

Some facilities offer both single and double occupancy rooms. Each facility has its own characteristics which make it unique and sets it apart from the other down the street. An example; The GRAND offers single occupancy rooms with walk-in showers, individual heating/cooling units, refrigerators, Wi-Fi and cable. Patient’s medications are locked securely in each patient room and we strive to provide a home like atmosphere.

What does Medicare cover?

Medicare part A covers skilled nursing care under certain conditions for a limited time.

  • You must have a qualifying hospital stay. This means you meet the minimum 3 night inpatient hospitalization requirement.
  • You have part A and days left in your benefit period.
  • Your doctor has ordered skilled services due to a medical condition which requires the need for 24/7 nursing care and therapy services offered 5 to 6 days a week.

Medicare covered services include;

  • A semi-private room
  • Meals
  • Skilled nursing care
  • Physical and Occupational Therapy
  • Speech-Language Pathology Services
  • Medical Social Services
  • Medical supplies and equipment used in the facility
  • Ambulance transportation (when other transportation endangers ones health) to the nearest supplier of needed services that aren’t available at the SNF
  • Dietary Counseling

Medicare information be obtained through

How do I find out what my insurance will cover?

Insurance benefits and eligibility will be checked prior to admission to the building, but you may also call the member services number on your card and a customer service representative will provide you with details of your coverage options.

What is the next step and what can I expect once I select a facility?

Once you have selected a facility you will notify your hospital social worker and he/she will send the referral to the building for review. You may choose to tour the building. Your clinical is then reviewed by the admissions and nursing team to make ensure the facility can clinically manage your stay, and then the hospital liaison will visit you in the hospital to answer any questions you may have. If you need an authorization from your insurance to admit, the facility will then start that process. Once authorization has been received the facility will communicate with the hospital social worker.

What are your staffing ratios?

At The GRAND skilled setting, our ration is 1:12 or 1:13, with an STNA on each hall. Our staffing ratios are significantly above average.

How often is therapy provided and will I have a schedule?

Therapy is provided at the discretion of your ordering physician, the therapy team, and your needs. You can ask for a specific schedule if that works better for you. At The GRAND, the therapy team will meet with you either the day of your arrival or the next day.  An example, some prefer mornings, some prefer afternoons and some prefer to have their therapies separated. Meaning occupational therapy may be planned for the afternoon and physical therapy planned for the mornings.

What sets your facility apart from the others?

The GRAND offers several amenities that set us apart from our competitor’s. We have Digger and Finch pub, our ice cream parlor, Movie Theater, beauty salon, pharmacy, chapel, licensed in-house therapy team and team of dedicated nurses and STNA’s and low patient/staff ratios, we offer outstanding service to our residents.

What are your visitation hours and/or restrictions?

Each facility will have set hours of operation. The most common hours of operation most facilities follow are 8am to 8pm, 7 days per week. The GRAND’s hours are 8:30am to 8pm, Monday through Friday and 9am to 8pm, Saturday and Sunday. There may or may not be restrictions on when visitors can be with their moved one. The GRAND does not have such restrictions and provides security 7 nights per week.