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Activity Soldiers - Fighting for Your Residents Independence with Alzheimer's by M. Celeste Chase, AC-BC, ACC, CDP, CMDCP

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Excess Disability – Independence with Alzheimer's
by M. Celeste Chase, AC-BC, ACC, CDP, CMDCP
When someone has Alzheimer's with presenting dementia, their cognitive function continues to decline but they still possess abilities. In fact, skilled healthcare professionals know that continuing to do as much as they can do at their current ability level stimulates the brain and may even help to maintain skills longer.

However, family members unknowingly often cause "excess disability" when in their sincere earnest to be helpful, do everything for his/her loved one to make life less challenging for the dementia diagnosed individual.
Excess Disability - "Use it or lose it"
When you provide opportunities for residents to do for themselves it prevents those intrinsically rooted skills from becoming rusty and ultimately no longer usable.

It cannot be overstated how important purposeful activities are when discussing dementia and topics referencing motivation and engagement. Purposeful activities focused on interests work harmoniously to entice and elicit responses essential to maintain the "use it or lose it" concept.

As dementia progresses, older adults are capable of less and less. Helping them find self-motivated desires to participate in everyday tasks and activities can boost mood and improve quality of life and holds the power to raise self-esteem and reduce common dementia behaviors, like agitation, repeated questions, and anger.

Adapting everyday tasks with purposeful meaning for the individual diagnosed with dementia will entice and encourage mental stimulation, and provide support as needed to help older adults maintain a sense of independence and accomplishment. That is something every one of us strive to maintain for as long as it possible.
Why are Dementia Activities so Important?
1) Provides Daily Structure: A structured and consistent daily routine gives needed predictability and stability when the individual is feeling disoriented and confused.

2) Prevents Decline: Continuing to do as many activities and daily tasks as independently as possible helps to preserve innate skills for a longer period of time despite disease progression.

3) Improves Mood: The individuals capabilities continue to decline with disease progression. When individuals participate in everyday tasks can boost mood and improve overall quality of life.

4) Reduce Challenging Behaviors: Challenging behaviors present with less occurrence when opportunities are made available to engage the individual in positive oriented everyday distractions. Thereby, providing a means to release energy and unexpressed emotions.

 
Supporting Remaining Skills
Look for adaptive strategies & techniques that focus on strengths/skills that the individual still possesses.
  • Allow the individual to retain as much control possible to help foster a sense of personal dignity.
  • Integrate "chunking" methods - (break down tasks step by step) move to the next tasks in sequence only when the previous one has been completed.
  • Attention span may be limited so plan programs of no more than 20 to 45 minutes of time segments.
  • Programs are most effective when they are multi-sensory & spanned over consecutive days; first day – taste applesauce, next day – taste apple pie and so on (connects related theme to facilitate memory input).
  • Incorporate events that "elicit" a response through use of basic sensory stimulation & 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)

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.
Strategies and Techniques
Meeting the individual abilities will ensure greater success. Particularly when maintaining the overall goal to support opportunities for independence and accomplishment.

Set-up: Pre-plan what is needed in a manner that cues the resident to complete the task independently.
Example: Clothing – Place items in order of use: underwear and bra on top, shirt and pants under them.
Visual distance supervision: Remain within the line of sight to supervise and assist when needed yet distant enough to allow the individual to complete on their own.
Example: Drying dishes – stand within visual view to make sure the dishes are properly towel dried - replace the towel when it has become saturated with water.
Prompting: Minimize verbal instructions, simply point to the next task in the sequence to give guidance.
Example: Point to the place mat. When it is placed on the table, point to the plate or ask what's next?
Verbal Cues: Provide gentle verbal "cues" only as needed to prevent frustration by stating simple directions for task sequence, allow time as needed for the individual to complete one task before you offer another cue to move onto the next task.
Example: Bathing – Pick up the washcloth... turn the faucet on... wet the washcloth.
Physical Guidance: Use "hand over hand" or "mirror" techniques to help guide physical actions.
Example: Brushing teeth: Stand behind and place your hand over the individuals hand while holding the toothbrush. Gentle provide physical guidance for brushing teeth.

Note: "Excess disability" refers to the loss of an ability that comes from something other than the disease or impairment itself. In dementia care, this generally refers to the loss of abilities that go beyond the physiological changes that are caused by the dementia.
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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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Copyright © 2019 Activity Directors Network, LLC All rights reserved.

Our mailing address is:
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