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I was in Activities for 5 years (5 years ago) and a lot of things have changed since I was in the game. I started back in December, and I'm looking for new Activity Participation Forms to encorporate. I'm not a fan of the forms my building is using. They were created by a former director. I've looked at Med Pass forms and like them.. but feel like there should be a space to write in specific items.

 

What you are you all using? Are you creating your own? Are you using a standardized form?

 

We currently put a copy of our calendar in the chart and highlight the resident's participation, as well as fill out a form. I do want to continue the highlighting method for our use, because it makes it so easy to see who is doing what. However our "legal" charting forms, I'm not happy with.

 

Help!!

 

feel free to email me samples of what you are using!

 

mtbrighton@bellsouth.net

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Saw this on pinterest & liked it:

 
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Training and consulting in
behavior management & dementia care.

 

Life Story Questionnaire

By Kim Warchol, OTR/L | July 27, 2012

Professional Care Partners:
Use this questionnaire to learn about the clients you work with. Complete one questionnaire with each client and/or the client’s loved ones. This great resource will provide you with helpful information as you get to know your clients and encourage their interests and abilities.

Family Care Partners:
Use this questionnaire to help others learn about your loved one. Complete this questionnaire with your family member or on her behalf. With this valuable tool in hand, everyone who cares for your loved one will have the information they need to engage her likes and interests. 

 

Download a PDF of this questionnaire. 

 

Background

 

Full name

Does your name have a special significance?

Do you have a nickname?

Where did your nickname come from?
 

Where were you born? 

 

When were you born?

What was your father’s name?
 

Please describe your father.

 

What was your mother’s name?
 

Please describe your mother.

Do you have brothers and/or sisters?
 

If yes, please describe your siblings.

Did you know your grandparents?
 

If yes, please describe your grandparents.

 

Where did you grow up?
 

Please describe the house you lived in.
 

What was your neighborhood like?
 

Who were your neighbors?
 

What games did you play?
 

Are/were you married?
 

If yes, please describe your spouse.

Do you have children and grandchildren?

If yes, please describe your children and grandchildren.


Daily Routine

 

What time do you like to get up in the morning?
 

Do you prefer to stay in your pajamas for a while?

Describe your routine after waking (e.g., brushing your teeth, doing your hair, dressing).

Do you prefer showers or baths?

At what time of day do you take a shower/bath?
 

Do you eat breakfast?
 

If yes, what do you like to eat for breakfast?
 

What’s your typical lunch and afternoon routine?
 

Do you like to take naps?

Do you like a big meal at noon or in the evening?

Please describe your typical evening routine.

What time do you like to go to bed?
 

What hygiene products do you prefer?


Education

Where did you go to school?
 

How did you get there?
 

What did you like about school?
 

Also ask questions about high school and college, if appropriate.


Work

 

What was your first paid job?
 

What kind of job was it?

What were your duties/responsibilities?

What were your accomplishments?


Leisure

What are your hobbies/interests?
 

What are your favorite movies/books?

Do you enjoy music? If yes, what kind?
 

Did you have pets? If so, what kind, and what were their names?
 

Are you afraid of or allergic to any pets?
 

Did you travel, and if so, where did you go?
 

What have been some special events in your life?
 

What’s your favorite time of year?
 

Do you prefer solitary activities, small groups, or large groups?

 

Religion/Faith

 

Did you attend a place of worship?

Did you have a role in the services? If so, please describe.
 

How did you spend your day of worship?
 

Do you have a prayer book?


Emotional Needs

 

What makes you feel happy?
 

What makes you feel safe?

What makes you feel sad?
 

Is there anything that helps you alleviate this feeling?
 

What makes you feel anxious, angry, or frustrated?

Is there anything that helps you alleviate these feelings?
 

Please describe your bedroom at home.
 

Please describe the room in your home where you relaxed.  

 

 

Additional Information

 

Please note other important likes and interests.

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I was in Activities for 5 years (5 years ago) and a lot of things have changed since I was in the game. I started back in December, and I'm looking for new Activity Participation Forms to encorporate. I'm not a fan of the forms my building is using. They were created by a former director. I've looked at Med Pass forms and like them.. but feel like there should be a space to write in specific items.

 

What you are you all using? Are you creating your own? Are you using a standardized form?

 

We currently put a copy of our calendar in the chart and highlight the resident's participation, as well as fill out a form. I do want to continue the highlighting method for our use, because it makes it so easy to see who is doing what. However our "legal" charting forms, I'm not happy with.

 

Help!!

 

feel free to email me samples of what you are using!

 

mtbrighton@bellsouth.net

I will try and forward my form I use this week Melanie its pretty good 

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I've been in this field now for around 2 years and the hardest thing for me in the job is getting men to come to activities.  Does anyone have any ideas, good ideas to get them to activities?

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  • both post support for the NAAPCC Credentialing Center
     
    Comments From Students
     
     Thank you for correcting the information that was released. I recently took the test for certification with NAAPCC and it was a very comprehensive and thorough test. It was not a simple easy test to get you certified. You had to know the information in order to complete and pass. I would recommend this avenue to anyone especially if finances are a struggle for MEPAP I & II. I did purchase the book for long-term care seventh edition and without that I would have struggled.
    Connie Gangwish, AP-BC Colorado
    reprinted with permission

    To: Activity Directors Network
    Celeste is awesome!! Anytime i have a question she gets right back with me and she is very informative. At first I didn't know if i was going to like the new course just for the fact my MEPAP course was the own pace and I work Full time plus have 3 kids. But i am loving it! It is very structured and with due dates I feel like i am holding myself more accountable for completed assignments sooner than later. It has actually been a beneficial change for me.. Thanks so much!!!
    L Williams reprinted with permission

    To: Activity Directors Network
    Good Evening I wanted to let you know that I had completed mepap 1 and had only a couple weeks left of mepap 2 so I had looked at path 2 and have taken the activities test and passed so just sending in the application. I wanted to thank you for giving all your time to us even while Kathy was ill. It didn't go unnoticed, you was a great support and helpful at ideas or even different ways of changing thoughts to positive while feeling defeated. Thank You Stacey Passa AP-BC
    reprinted with permission
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