| Activities Directors Quarterly ® | ||||||||||||||||||||||||
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Publications American Journal of Disaster Medicine Opioid Management
Society Journal of Neurodegeneration & Regeneration Activities Directors' Quarterly for Alzheimer's & Other Dementia Patients American Journal of Recreation Therapy |
Winter 2002; pages 5-8 Abstract For activities professionals who are new to the nursing home or acute care setting, working with people suffering from Alzheimer’s disease or other dementias is a new and daunting challenge. As the old adage says, knowing what to expect is half the battle. The purpose of this article is to give you a brief and straightforward overview of Alzheimer’s disease as well as its signs, symptoms, and effects. It is important for you to understand common behaviors, cognitive and physical decline, personality changes, and the so-called “co-morbidities” that result (such as wandering, disorientation, incontinence, depression, and catastrophic reactions). Remember that placement in extended care often follows a period when the patient was at home in care of a loved one, and so represents the later
Winter 2002; pages 9-16 Abstract The goals of the “Memories in the Making”® program are (1) encouraging communication through art; (2) exploring the process of creating; (3) increasing self-esteem through the creation of something of value; (4) sensory stimulation for the participants; and (5) socialization. A person with diminished verbal and organizational skills can still communicate through creating a drawing or picture. The Memories in the Making program differs from traditional “arts and crafts” because the process is tailored to the needs and limitations of people affected by dementia and relies primarily on decreased censorship of symbolic expression.
Winter 2002; pages 17-22 Abstract The objective of art therapy is to benefit people with dementia of varying functioning levels by providing an opportunity for self-expression, life review, reducing depression or other psychological problems, building self-esteem, increasing concentration, improving fine motor skills, and socialization. Remember, the emphasis is on the process, not the product!
Winter 2002; pages 27-32 Abstract Grief is a common emotional reaction of newcomers in a residential care home. For persons with dementia, their sense of loss is heightened by their memory difficulties. It is important for activity professionals to expect newcomers to present feelings of grief and loss, and to understand the symptoms (including confusion, disorientation, anxiety, agitation, anger, denial, fatigue, feeling lost or not belonging, relief, and excitement). There are ways in which activity professionals can work through these common emotional reactions in one-to-one activities and getting acquainted with newly arrived residents. As your interactions with the newcomer help him or her adjust to the new environment, his or her problem behaviors will lessen. However, some newcomers may adjust more quickly and smoothly than others, while a few new residents may not adapt at all. The activity professional who interacts with newcomers, gets to know them, and understands what to expect will be able to help the residents and their families as well as other staff deal with these difficult, but normal, emotional reactions.
Winter 2002; pages 33-40 Abstract Caring Connections is a sensory stimulation program for late stage dementia persons that tries to “reach” their remaining sensory appreciation through body awareness, connection to the outside world, and enhanced quality of life by using gentle sensory experiences, positive social contact, and use of their remaining abilities.
Winter 2002; pages 41-48 Abstract Music has a long history of applications to soothe and quiet.4 The music applications suggested here were developed over a 10-year period through music therapy clinical research and practice in special-care units. They are designed expressly for use by caregivers and professionals that do not have a background in music. Activities Directors Quarterly Spring 2002, Volume 3, Number 2
Spring 2002; pages 5-7 Abstract It is important for activities professionals to have a basic understanding of the medications prescribed for Alzheimer’s patients at your facility. In addition to being aware of common side effects, how these medications work gives important clues about the effects of Alzheimer’s disease (AD) at all stages. Also, it is important for us to understand the limits of these medications, which can help professionals know what to expect from their patients, residents, or clients with AD.
Spring 2002; pages 9-16 Abstract Long-term care facilities need effective intervention strategies to assist residents who, out of confusion, frustration, or anger, seek to exit the facility, which can result in their becoming lost or injured. This article describes some of the factors that lead to exit-seeking behavior, and offers proven methods for educating staff to intervene during these episodes, enabling them to deal with the exit-seeker in a calm, compassionate, and dignified manner.
Spring 2002; pages 17-21 Abstract This article presents an overview of the organization, implementation, and results of social dancing as an intervention with persons with dementia in a long-term care facility. Positive results of the intervention, including increased communication, self-expression, and feelings of togetherness and fellowship among persons with dementia, are discussed. Specific techniques staff can employ to enhance patients’ feelings of security and self-assurance are outlined, as well as ideas for providing physical and emotional support to enhance patients’ enjoyment of the dance sessions.
Spring 2002; pages 27-39 Abstract Aware that low-functioning Alzheimer’s patients within long-term care facilities are sometimes dismissed as unable to engage in daily activities and relegated to receiving custodial care, Eileen Eisner has developed an approach that builds activities around patients’ remaining abilities. Her concept of providing interventions based on the strengths that still exist within each individual can lead to enhanced comfort and self-expression among patients, and an increased quality of life for both patients and staff. This article includes a discussion of the process of identifying these individual strengths as well as activities that build on them.
Spring 2002; pages 40-44 Abstract From her work in medicine, psychiatry, hygiene, pedagogy, and anthropology, Maria Montessori devised teaching methods that can be used at both ends of the age spectrum. Her philosophy is inherently respectful of the individual; her terminology sheds a positive and analytical perspective on Alzheimer behaviors. Montessori claimed that play was the child’s work. For the Alzheimer patient, work has become play. When skills used in former roles are performed, however slowly and imperfectly, the person with Alzheimer’s is riveted and reassured. Activities that merely resemble useful work increase concentration. Sweeping, washing, and kitchen tasks stir muscle memory and a sense of worth.
Spring 2002; pages 45-48 Abstract The purpose of this article is to suggest activities and discuss the advantages of using copying and tracing during supportive, educational, and therapeutic sessions with patients who have Alzheimer’s disease or other dementias. Originality and inventiveness are sometimes pursued to such an extent that this population, for whom spontaneous creativity is not always possible, may be forgotten. Copying and tracing are perfectly legitimate and often productive forms of operation for these clients. Activities Directors Quarterly Summer 2002, Volume 3, Number 3
Summer 2002; pages 4-10 Abstract The Adapted Work Program (AWP), developed by Theressa Burns and Brenda Ebbitt, is based on the principle that engagement, not entertainment, is often more effective in reducing boredom and frustration among persons with dementia. It was initially developed as a task-oriented, sheltered workshop for veterans in a VA hospital setting. The program’s basic concept of adapting tasks as an individual’s functional abilities decline also has potential for implementation in other adult care facilities for residents with dementia. The underlying theme of providing repetitive-type work for persons at all levels of functioning has successfully reduced agitation, even among late-stage dementia patients in long-term care. Veterans’ scores on the Geriatric Depression Scale (GDS) showed marked improvement following participation in the AWP.
Summer 2002; pages 11-14 Abstract The dismantling of language characteristic of people with Alzheimer’s disease and related disorders has a profound affect on their quality of life and on their interactions with family, staff, and peers in the nursing home environment. Recognizing that the ability to articulate our experiences enables us to sustain connections with other people and ourselves, this innovative social program was developed to foster sustained interaction with peers in a home-like environment.
Summer 2002; pages 15-22 Abstract Nursing homes and assisted-living facilities increasingly are adapting kitchens for resident and staff use through remodeling efforts or new construction. In this article, practical and innovative ideas are offered for the design and arrangement of a kitchen that supports recreational group activities for residents with early and middle-stage dementia, based on findings from a recent survey and a subsequent research study by the authors. Specific design suggestions address the configuration of the kitchen, appliances, work surfaces, cabinetry or storage areas, décor, and safety features. Many of the design suggestions are appropriate for those that are planning renovations or new construction, but facilities with existing on-unit kitchens may be able to implement some of the suggestions easily and cost-effectively.
Summer 2002; pages 27-32 Abstract Standard memory techniques, including external aids (note cards, pictures, signs, or reminder notes), repetition, retrieval practice, and reality orientation (RO), can be effectively employed for people in the early and middle stages of dementia due to Alzheimer’s disease (AD) to compensate for their cognitive deficits. The later stages of AD are characterized by more severe dementia, and newer cognitive techniques can be used because they are not dependent on the person’s ability to learn new information, but rather his or her capacity to respond to internal and external storage of implicit and explicit memory.
Summer 2002; pages 33-41 Abstract This article describes practical ways for family caregivers and significant others to facilitate meaningful and reciprocal one-to-one engagement with their loved ones in late-stage dementia through social dancing or its movement adaptations. These applications can be applied in the home as an opportunity for interaction and diversion, or in a residential care facility as an opportunity for meaningful, satisfying engagement during visits. The protocols presented here are simple and do not require a background in music for successful implementation and desirable outcomes. Book review Bon Appetit! The Joy of Dining in Long-Term Care, by Jitka Zgola and Gilbert Bordillon. Baltimore: Health Professions Press, Inc., 2001; 308 pages. Sally Albrecht, MA Summer 2002; pages 43-45 Book review Montessori-Based Activities for Persons with Dementia, Volume 1, edited by Cameron J. Camp, PhD. Baltimore: Health Professions Press, Inc., 1999; 76 pages. Thaya E. Gilmore, PhD Summer 2002; pages 46-47 Activities Directors Quarterly Fall 2002, Volume 3, Number 4
Fall 2002; pages 5-8 Abstract Recreation therapists and activity directors in day- or long-term care programs for elders with dementia inevitably encounter persistent, problematic behavior in some patients. A high percentage of problem behaviors are rooted in abandonment fears.1 This article describes two women with Alzheimer’s disease in an adult day care setting who exhibited almost constant, anxiety-ridden preoccupation with being abandoned, manifested in repeated attempts to leave the facility and constant questioning of staff and other clients. Techniques for allaying anxiety and reducing associated problem behaviors are presented.
Fall 2002; pages 9-17 Abstract Snoezelen, a Dutch term, is a philosophy of care involving the stimulation of all five senses: sight, hearing, smell, taste, and touch. A Snoezelen environment can stimulate the senses, evoke familiar life experiences, heighten awareness, and improve mood, memory, and attention span in persons with dementia so they are more able to respond appropriately to the world around them.
Fall 2002; pages 18-22 Abstract This article discusses a structured music program that is appropriate for persons in all stages of dementia. The purpose of this activity is to provide each participant with a sense of camaraderie, accomplishment, and well-being. The program can be modified for one-to-one interaction at home or at the bedside of residents in a nursing facility, as a means of increasing stimulation for those unable to socialize in a group setting.
Fall 2002; pages 27-34 Abstract This article describes a therapeutic intervention called Return to Innocence (RTI), in which individuals with dementia construct collages. The collage construction process is used as a tool to focus on interacting and communicating rather than being primarily an arts activity. By using pictures and words cut out of magazines and combining them into an integrated collage, the developer of RTI found that individuals with dementia could communicate using abilities that often remain intact even as dementia progresses. The process can be used by family members as well as volunteers and can be easily taught to all staff in long-term care settings.
Fall 2002; pages 35-41 Abstract Sometimes a person with dementia who finds it difficult to converse with other people can read specifically prepared materials aloud. Reading from specially designed cards allows a dementia patient one-on-one time with a listener and offers intellectual stimulation that is different from single-word or single-sentence responses used in trivia games, fill-in the blanks, or open-ended question activities. Most important, it has been shown to be a successful vehicle for generating dialogue and establishing friendships.
Fall 2002; pages 42-45 Abstract Special considerations are needed in working with patients suffering from vascular dementia (VAD). Activity directors can be key staff members in the recognition of VAD symptoms. In their daily observations of social functioning, it is important for activity directors to learn how to differentiate VAD patients from Alzheimer’s patients and to adjust activities to the special symptoms and behaviors that they present. Book review Dementia and Wandering Behavior: Concern for the Lost Elder, by Nina M. Silverstein, Gerald Flaherty, and Terri Salmons Tobin. New York: Springer Publishing Company, 2002; 215 pages. Laura Wilson, BA, ACC, CTRS Fall 2002; pages 46-48 |
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