Healthcare Training Institute - Quality Education since 1979

Section 26
Concluding Commentary:
Now... Take Action!

Table of Contents | NCCAP/NCTRC CE Booklet

So there you have it.  An entire Manual and Seminar DVD filled with Activities for your Advanced Stage Alzheimer’s and Low Functioning residents.  These can be conducted in small groups or individually.  My goal is to not only provide you with Activities that were simple enough to be appropriate for the physical and mental limitations of your residents, but to provide Activities at no cost that could be left in residents’ rooms to facilitate all staff involvement with the residents, thus providing concrete tools for CMS Culture Change implementation.  However, in addition to simple and no cost, the overriding theme of this course is teaching you the skill of observing your resident very specifically for the part of the activity that he or she can or cannot do.  In consulting, I found all too often an Activity Director would state, “She could not do it.”  However, the Director was unable to see what he or she had learned from their residents failure to successfully complete all parts of the activity.  I found one of my main goals as a consultant was to teach the Director how to observe and analyze exactly how the resident was moving her fingers, etc.  After assessing and observing them to access the creative side of their brain to answer the question, “How exactly can I change this activity to make it work?”  Finally, of course, above all to be sensitive to the activity being a positive experience for the resident.

If the activity does not appear to be appropriate, or in other words to "work" with the …
a. Ask yourself is there some way I can adapt, tailor-make, or change the idea presented in this Manual for my specific resident? 
b. Now access the creative side of your brain.  Also ask other activity staff members, volunteers, and nursing if they have any ideas on how the project may be changed to fit that particular resident.  Taller? Shorter? Bigger? Smaller? More colorful? Less colorful? Placed to the left? Placed to the right? Tried only in the mornings? Tried only in the afternoons? Used after the resident smells lemon extract? Recruit the daughter to do the Activity with the resident?

If the activity idea from this and other Manuals just does not work with that resident, ask yourself,
a. "What have I learned new about this resident from the 'failure' of this trial activity period for this activity?"
b. "Is there another resident with whom I might try this activity?"  If not, keep the idea in mind to try with your next new admission.
Ideally, I challenge you to always be actively thinking about the ideas in this Manual and the ideas in other Volumes in this Series and how you might use them with a resident who has a specific set of abilities and limitations.  Delegate a specific activity staff member, volunteer, or alert resident to conduct the activity on a regularly scheduled weekly basis with that resident. 
No magical long-term solutions… sorry!  The ideas in this Manual and other volumes in this series are not magical long-term solutions for each of your Low Functioning and Alzheimer's residents.  In short, just as you change from day-to-day, so do your residents change from day-to-day.  It goes without saying, unfortunately, because they are in healthcare facility, their change is usually downward, losing more mental and physical capability as their disease or condition progresses.  So, especially if you are new, accepting this fact may be difficult.  Thus, the activity idea that worked great today may not work at all with that same resident tomorrow.  So what do you do?  Your answer… start to formulate a progression of difficulty for these activities in your mind.  If your Mary can no longer do Weaving, perhaps she is able to do Spool Winding or Paper Balling, which require less physical and mental ability.  That is why the ideas in this Manual are arranged from least to most difficult.

Series Overview
In these first three volumes, you have almost the sum total of what was developed over ten years of consulting to activity departments.  These are just about all of the object manipulation activities that I could think of for a Low Functioning and Alzheimer's resident to do.  There are only a few remaining object manipulation ideas in Volume 4, so the piece of the puzzle you are missing is non-object manipulations, or the more common term, "motivational approaches."  You have gotten some of these.  For example, telling the resident that the project is a hand exercise, a game, etc.  However, the next course in the Series, Volume 4, totally expands upon these concepts.  You might complain, "Well… why didn't you give them all to us in one course?"  The answer is, "Well… then you would have one course that is five times as long, rather than five separate courses.”  By arbitrarily dividing all of my Low Functioning and Alzheimer's ideas into five courses, I create modules for you to pick and choose, from the varying focuses of the courses, specific to what you are interested in. The other piece of the puzzle to make everything work is efficiently running your department and getting cooperation from others.  These topics are covered in our Management Series.

Probably my two favorite activities in this course are the Yarn Winding activities and the Days Diary, because they work with so many residents.  However, your experience may be different from mine.  Look for your Nuggets of Gold via ideas that work with your residents.  When I have provided a resident with a successful experience, I feel successful.  It is my hope that you have many, many successes in your hours, days, and weeks with this segment of your resident population who possibly may not be getting too much stimulation beyond what you provide.  They may be depending on you.  They are there just down the hall.  Walk up to them, try a couple of projects, and see how you discover some little small capability that you never knew was there.  Think of what potentials are there waiting for you, perhaps undiscovered.  Maybe one resident can do Yarn Winding if provided with it in just the right way, with just the right location of materials.  Perhaps another resident is thrilled to do Paper Balling because he now feels he can do some form of exercise to help maintain the finger movement that he has.  Think of all that awaits you, and all the potential you can unlock!  It's just out there, outside your Activity Room door!  Who will you start with?  Who will you unlock first?  Your residents’ capabilities and possibilities are limitless.  Get excited about these ideas!  I am!  And I hope now, you are too!  Take care, and I wish you the best…  I certainly have given you mine in these courses!