Developing Activities that Have Meaning AND Work What s Cooking? Teepa Snow, MS, OTR/L, FAOTA

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1 Developing Activities that Have Meaning AND Work What s Cooking? Teepa Snow, MS, OTR/L, FAOTA

2 The Basics for Success Be a Detective NOT a Judge Look, Listen, Offer, Think Use Your Approach as a Screening Tool Always use this sequence for CUES Visual - Show Verbal - Tell Physical Touch Match your help to remaining abilities

3 Now for Progression think GEMS not just loss Sapphires Diamonds Emeralds Ambers Rubies Pearls

4 Now for the GEMS Sapphires True Blue Slower BUT Fine Diamonds Repeats & Routines, Cutting Emeralds Going Time Travel Where? Ambers In the moment - Sensations Rubies Stop & Go No Fine Control Pearls Hidden in a Shell - Immobile

5 What Do People with Dementia Need? DAILY Routine!!!! Help to Fill Their DAY with meaning A Balance of: Productive activity feeling valued Leisure activity having fun Self-care activity wellness, health, personal care Restorative activity sleep, rest, and re-energizing A Match-Up for Preferences: Large Group, Small Group, 1:1, Alone Active versus passive Sensory options visual, auditory, tactile, olfactory, gustatory

6 What Are We Offering People? List Your Current Activities Monday-Sunday For Each Listing: What type of activity is it? work, fun, wellness, rest Is it working well? When Do You NOT Have something happening? What is MISSING?

7 What Does It Take To Make a Day Have Meaning and Joy? Resources to succeed Manage the ENVIRONMENT! Build staff SKILLS! Know each PERSON! Understand ACTIVITIES! Make & Use a SCHEDULE!

8 Know each Person Life History Who the person has been Personal history and background Health Status medical conditions, medications, limitations & abilities Emotional status psychological condition and mental health & limitations Cognitive Status thinking, memory, processing skills and limitations Sensory Status sight, hearing, touch, balance, coordination, temperature regulation Routines and Habits patterns of behavior, daily routines, time use & schedules

9 Personal Preferences & Values Who have you been? What did you value? Who are you now? What do you value now? Why does it matter? Who gets a say? Who gets to set the priorities?

10 Personality Traits Who are you? Introvert-Extrovert Lots of Details Big Picture only Logical Emotional Planning ahead Being in the moment Who is the person you are trying to help?

11 Introvert - Extrovert Introvert Likes to be alone Likes to think it out Likes personal space Needs alone time Private Extrovert Think out loud Talk it out Seek out people Share a lot Not good with boundaries

12 Life Story Family past & present Living place(s) Work history Leisure History Music history People history Plant history Animal history Plant history Sensory Environment preferences Cultural history & concerns Food likes & dislikes Daily routines Organizations & memberships Roles & responsibilities Comforts & Irritants

13 Design Each Day Make a schedule and follow it Be structured BUT allow flexibility Create Group schedules BUT also build individual schedules Not everything is for everybody! 8 am coffee circle 8:30 songs of joy 9 am time to go 9:15 take a hike walk n roll 10 am cool down & stretch 10:30 watering hole 11 am - use your brains games 11:30 - time to go wash up 11:45 set- em up crew 12 noon let s eat 12:30 clean up crew 1 pm music and meditation 1:30 coupons clipping 2 pm time to go 2:15 let s dance Build a Foundation of Familiar and Favorite Activities Add a few special events and something different Offer a variety of activities every day Leisure, work, rest, self-care, groups and 1:1, passive and active Create a FLOW for the day Build up and then slow down Circadian rhythms

14 Understand Activities What type of activity is it??? Self-care, leisure, work, rest Spiritual, social, physical, cognitive, passive, active, solitary Analyze the Activity What do you need to do it? What skills, abilities, interests? What is the activity all about? Doing something or making something? Modify and Structure the Activity for Success Change the materials, the complexity, the setting, the help offered, the task demands, or the purpose of the activity

15 Two Examples Paying Bills Do it independently Together use a calculator Together do all of them Together do one at a time You do most, they sign and put in envelopes You do all but the signature They put on stamps Both take them to the mail box Washing dishes Do it independently only after meals Do it independently when needed to fill time Together one wash one dry Do parts Watch & guide Carry dishes to/from sink

16 Build Care Partner Skills Group Leading Skills Getting people together & having fun Practical Hands-on Skills Crafts, games, cooking, working Customer Relations Skills With families, clients, volunteers 1:1 Interaction Skills Do you work with your partner(s) Planning & Time Management Skills What to do & when to do it! Peer Relationship Skills Helping each other Documentation Skills Record keeping and reporting Environmental Management skills Using space & keeping up the place Observation skills What you see, hear, sense Problem-solving skills Figuring out what to do when it does not work right

17 Learn How to Do something new Learn a new type of exercise or activity Simplify a dance Re-look at a old skill and make it easier Share a tasks Do something without touching things Get someone to do something without words Give POSITIVE feedback and say thanks

18 Manage the Environment Pay attention to the lights, sounds, seating, work surface, space Use the space well Plan and place for BEST effect Do the right stuff in the right place Match what you do to where you are Change it around if you need to - to make it work! Create & Use Storage Make set-up & clean-up part of the activity Give out tools and materials just in time Control the activity so clients are successful not overwhelmed - not out of synch Make it look friendly Get me to want to come Keep it ADULT Make sure supplies, activities, and games are meaningful Play & laugh with folks, not at them

19 Take a look, listen, feel Lighting- Enough, non-glare, focused Sounds background, distracting, volume Feel Temperature Space how crowded intimate, personal, public Work surface Seating surface Walking surface Familiar? Friendly? Fun? Forgiving?

20 Enough Supplies & Materials The right equipment for clients needs Good quality lighting Skilled leadership for the activity Good work surfaces Seating that works Enough help for each person A BACK-UP Plan

21 Two Options DOING Filling socks rice socks, bean socks, corn socks Adding herbs lavender, citrus, eucalyptus, mint Putting a sock inside another sock Heating the socks Rubbing the socks over muscles Emptying socks out MAKING Fruit salad from fresh fruit Fruit salad - from canned fruit Fruit salad from pre-cut fruit Fruit salad one fruit and yogurt Fruit salad dried fruit & granola & yogurt Putting the fruit salad in small cups or bowls Serving the fruit salad

22 How Do We Create Meaningful Activities? How to spend the time

23 Key Activities to Consider Productive -Work Enjoyment - Leisure Wellness Personal Care Restorative - Rest

24 Productive Activities with FOOD Helping another person Helping family members or caregivers Completing community tasks Making something Sorting things Fixing things Building things Creating something Caring for things Counting things Folding things Marking things Cleaning things Taking things apart Moving things Cooking/baking Setting up/breaking down Other ideas.

25 Please Help Us Clean Up

26 Leisure Activities think FOOD Active Socials Sports Games Dancing Singing Visiting Hobbies Doing, Talking, Looking Passive Entertainers Sport Program/event Presenters Living room or Lobby sitting TV programs watched Activity watchers Being done to

27 Playmate Hey, hey, hey playmate Come out and play with me And bring your dollies three Climb up my apple tree Call down my rain barrel Slide down my cellar door And we ll be jolly friends forever more.

28 Self-Care & Wellness Activities Food & Drink? Cognitive Table top tasks Matching, sorting, organizing, playing Table top games Cards, board games, puzzles Group games Categories, crosswords, word play, old memories Physical Exercise Walking Strengthening tasks Coordination tasks Balance tasks Flexibility tasks Aerobic tasks Personal care tasks

29 BREATHE!!! Take a deep breath in BLOW it all the way out Take another breath in BLOW it out Take one final breath in AND SING IT OUT. Feel what happened to you Look at what happened to the people around you Think about how and when you might do this

30 Rest & Restorative Activities Consider the Role of Food & Drink Sleep Naps Listen to quiet music with lights dimmed Look at the newspaper Look at a calm video on TV screen Rock in a chair Swing in a porch swing Walk outside Listen to reading from a book of faith Listen to poetry or stories Listen to or attend a worship service Stroke a pet or animal Stroke fabric Get a hand or shoulder massage Get a foot soak & rub Listen to wind chimes Aroma therapy

31 Offer a Shoulder Rub & a Hand Massage

32 GOOD Activities ones that involve Plants Animals People Music Objects

33 How Does Skill Change Over Time With Dementia? Interests Helper cues that help Environmental cues that help Ability to focus & change focus Sensory awareness & processing Motor skills gross and fine Decision making & reasoning

34 Let Go: How it used to be How it should be How you should be

35 Identify What you re good at and what you re not Who can help and how they can help What really matters

36 Care Partners Be a partner, not a boss Be an advocate, build a team Do with me, not for me or to me Learn the SO WHAT? philosophy Learn to let go not give up Learn what you are good at, & what not These ideas are for you TOO!

37 Final Note Evaluate How is it going? What s working? What s not working? Is it time to change? Dementia is progressive Activities will need to change Its about letting go NOT giving up

38 I Will Change! (to the tune of This Little Light of Mine) By Teepa Snow

39 I am gonna meet and greet Before I start to treat I am gonna meet and greet Before I check your feet I am gonna meet and greet Before I help you eat How I start sets us up to succeed!

40 No more just Getting it Done I m gonna DO with you No more just Getting it Done I m gonna help you thru No more just Getting it Done We re gonna work, we two Cause if I do it ALL, we BOTH LOSE!

41 I m gonna laugh and dance with you Not just watch and frown I m gonna laugh and dance with you Not just stand around I m gonna laugh and dance with you We ll really go to town For the POWER of JOY I have found!

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