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Activity Director Meaningful Memory Care Planning - by M. Celeste Chase, AC-BC, ACC, CDP ActivityDirector.org


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Meaningful Memory Care Planning
 
Individuals afflicted with Alzheimer’s and dementia complications go through a number of different stages during the disease progression. Leisure pursuits are crucial for residents living with Alzheimer’s disease, particularly those which offer and encourage engagement opportunities and much needed cognitive stimulation.  

The Approach to discovering leisure pursuits to offer engagement and stimulation is the same as any resident assessment process with one very significant distinction:
Look at what the resident can still do rather than
what they can no longer do.

Establish consistent routines. Why? The day is a little less scary when the daily pattern is predictable and somehow familiar. Many of us operate on autopilot whilst going about our daily business but memory deficits can cause a snafu in the normal retrieval process. Thus, even our firmly embedded auto pilot can malfunction.

While structure and routine is important, there are countless opportunities to do “meaningful” things in unexpected places and times. Daily everyday tasks such as bed making, sweeping, dusting, and watering plants for example are small yet simple though they can provide rich opportunities for engaging residents who perhaps show no interest in bingo, movies, or other group activities.
Planning Tips
  • Continuously adjust and accommodate to match to the changing needs of the disease progression.
  • Plan for times during the day when the resident tends to function at their best.
  • Use adaptive strategies and techniques that focus on strengths/skills in which the individual still possesses.
  • Allow the individual to retain as much control as possible to help foster a sense of personal dignity.
  • Simplify tasks: break down step by step. Move to the next step in the sequence only when the first step has been accomplished.
  • Attention span may be limited so plan programs in no more than 20 to 45 minutes segments.
  • Programs are most effective when they are multi-sensory and spanned over consecutive days (facilitate memory input) and are connected to a related theme.
Remember: Loss of memory creates an inability for the individual to remember what they did in the past for themselves to find amusement. However, this population may still have the ability to [be amused] well into the disease process.
  •  Incorporate events that “elicit” a response through use of basic sensory stimulation and awareness of his/her body movements.
    Sensory Integration would focus on any combination of the following:
    -Visual (eyes)
    -Auditory (ears)
    -Proprioceptors* (awareness of body position)
    -Vestibular (balance)
    -Tactile (touch, feel)
    -Olfaction (smell)
    -Gustatory (taste)
Proprioceptors* sensory receptors in muscles, joint capsules and surrounding tissues, that signal information to the central nervous system about position and movement of body parts.
Activity Starters
The following list has been provided as inspiration and motivation only. You will need to look at the individual resident with a Dx of Alzheimer’s to create a “person centered” care plan uniquely suited to the skills that remain and the specific stage of the disease as per nursing assessment.

Stuffed Toys
Offer stuffed animals and other soft toys to cuddle. Check for any materials that could be removed and become a choking hazard.

Baby Dolls and Baby Doll Clothes
Provides opportunity to foster nurturing characteristics. The goal is not to dress the doll properly, but rather to “elicit” the desire to change the doll’s clothing whilst working on hand eye coordination.

Pet Therapy
Animals of varying types are well documented to improve well being and boost emotional connection to something other than themselves.

Music and Movies
Foster emotional connections via music, videos, and movies. Keep the time frame brief, only watch/listen for 5 to 10 minutes but if they are engaged, keep allowing them to enjoy the experience for long as continue to be engaged.

Sensory
Sensory deprivation is one of the hallmarks of Alzheimer’s disease. Use everyday objects to arouse one or more of the five senses (hearing, sight, smell, taste and touch), with the goal of evoking positive feelings.

Exercise
Any physical activity can be beneficial, from a simple walk to yoga. Use props, such as tambourines, clappers, top hat, streamers, maracas, batons, pom poms, stretch bands, scarves, or stretch bands.

Bird Watching
Hang a bird feeder that will not allow individuals to access the food. Provide chairs or benches to stop and watch the birds.

Sunshine and Fresh Air
Plan time for the outdoors (weather permitting) for 10-15 minutes. Supply sun      protection with wide brim hats and sun lotion on arms and legs. Avoid the sun between 11 and 3 pm. Offer cool drinks.

Read Aloud
Studies reveal that those afflicted with Alzheimer's disease may be able to hear until very late into the illness. Read articles in magazines and newspapers that the person enjoyed in former times.
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Have a topic request or question for Celeste? Send them over to celestechase@activitydirector.org
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Activity Directors Network was founded in 1996 on the idea that we could help create elderly care that dramatically improved the lives of those we all serve. We envision facilities that feel like homes and that celebrate our resident’s individuality and allows them to live with dignity, purpose and joy. We believe the exchange of education and wisdom between the most talented teachers and passionate students is the way to make an impact. Each and every single one of you are the revolution that is changing everything. Thanks for being a part of The Network.
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