Steven Littlehale

Grandma sure liked her bingo. She excelled at bingo and most card games. Even in games that seemed to involve no skill at all, Grandma almost always emerged the winner.

Seeing her in action during bingo or a card game was my joy — and watching my bingo card and helping me improve my hand, that was her biggest joy.

Macular degeneration challenged Grandma’s eyesight through her declining years. Thanks to devoted family, friends and caregivers, her beloved game adapted to her. The cards got bigger, the rules somewhat simplified and the lighting enhanced — all of which enabled this cherished woman to continue something she loved.

I reflected during her eulogy how cards and bingo brought Grandma so much joy throughout her entire life. The impact of her health-related obstacles was put into sharp focus when it placed bingo or cards out of reach.

Conversely, bingo and cards were a way to engage Grandma in her healthcare and wellness activities. She endured some pretty horrific treatments for her macular degeneration with the hopes of continuing the activities that brought her joy.

Of course, you have similar personal and professional experiences, but did you know there is an emerging body of literature that discusses the benefits of this type of customized engagement? Prior to the Affordable Care Act (ACA), bingo was just bingo. But in the right circumstances and for the right people, bingo is a way to engage the person in their care and wellness activities.

Prior to ACA, there was a paucity of literature on the benefits of Engagement. However, in our post-ACA-world, engagement has been linked to “Triple Aim.” The emerging literature supports that an “engaged” person is likely to participate in his or her own care, have better outcomes, be more satisfied and — wait for it, wait for it — cost less.

Drs. Hibbard and Greene adeptly discuss this concept in Health Affairs, and describe how you can engage people at higher levels to achieve these outcomes. Here you’ll realize that engagement isn’t something you say you offer when describing your excellent activities program. It’s more than a buzzword.

Engagement is the actions and interventions you take to motivate a set of behaviors in your patients and residents that result in better outcomes.

Susan Coppola, chief clinical officer at Sunrise Senior Living, shared this about engagement: “Engaging residents is critical to how our caregivers provide care and service. Every resident needs to be engaged, no matter their health or memory status. Engagement is a universal need. It is essential to get to know a person so you can learn meaningful ways to engage them, which will improve their quality of life and positively impact outcomes. Simply, individualized Engagement is a universal need as important as air and water.”

Payors have been quick to adopt specific strategies around engagement. You don’t have to look much further than your own health insurance plan to see how their complementary or discounted wellness activities, such as preventative screenings, fitness, weight loss, and smoking cessation, to name a few, are attempts to engage you to achieve better outcomes.  

Pam Gould RN, MHA, senior vice president at Happify Health, helps connect these dots.

“Our solutions directly impact stress levels and symptoms of depression and anxiety. We do this by taking evidence-based interventions from Cognitive Behavioral Therapy, Positive Psychology and Mindfulness and transforming them into a best-in-class user experience that is non-stigmatizing, highly engaging and effective. It’s so rewarding to see the progress that our users make in improving their emotional wellbeing and living happier lives. And, this translates to better health outcomes for our payor and provider clients.”

I appreciate how Charles de Vilmorin CEO of Linked Senior summarizes this concept and describe their measurable successes. He said, “There is a sense that senior care is conflicted between healthcare and hospitality; that paradigm needs to shift. Health and well-being are the products, hospitality and person-centered-care the delivery model. We need personalized experiences that sustain Engagement, well-being and measurable outcomes. This is the new frontier and this is called Resident Engagement.”

Linked Senior is about to publish preliminary results from a study that shows its provider clients increased the engagement of their residents while reducing depression, isolation, behaviors associated with dementia and medication use.

Engagement builds resilience and is a buffer against negative outcomes. Our staff and our residents benefit when they are engaged, and so do we. Formalizing your Engagement strategy and offerings is also a good way to attract referrers, as they are aware how this contributes to Triple Aim.

Looking backwards through the lens of Resident Engagement, it’s clear that bingo and cards played a huge role in Grandma’s self-esteem and ability to cope with the many challenges aging offered. I’ll forever be grateful to those who recognized this opportunity and, by accommodating for her disabilities, brought her joy and a sense of well-being.

Steven Littlehale is a gerontological clinical nurse specialist, and executive vice president and chief clinical officer at PointRight Inc.