Spring Newsletter 2005

Dietary and Nutritional Guide for Alzheimers

Wake Up! A Sensory Stimulation Program

Wilfrid Gordon McDonald Partridge

Activity Planning Workbook

Mothballs In My Attic

Care Plans for Dementia Clients

Inservices to present for staff

Sensory Inservice

Products Listing

Special Links

90 Hour Advance Management Course-Last time to be offered!

90 Hour Advance Management Course taught by Lisa Reidinger, will be offered one last time in the fall of 2005. It will be the last opportunity for those students who have completed the 90 hour basic activity course MEPAP part one but have not completed MEPAP part two. NCCAP has made changes to the curriculum and do to these changes, the courses will now be combined into one long course. This change becomes effective 2007. It is recommended strongly, that if you have not completed both courses and are pursuing certification as activity directors and activity assistants, that you now complete the mepap part 2 adance management course New Jersey at this time.

To avoid having to repeat material that you have already taken, we strongly recommend that you register now for the Advance Management Course being offered in NJ. Registration is now open and see our web site for details. www.activitytherapy.com

What About Music?

How important is music? Music has been a part of most people’s lives for as long as they can remember. Music is there in all stages of life. During childhood, teen years, young adult and senior years, music plays a role.

With the shrinking dollars for recreation, music can provide a lot of bang for the dollar. Music can make any activity more enjoyable and draw your people into the activity more successfully. The mellow sounds of music can bring in a person who seldom participates. It can make him or her into a toe-tapper.

Music can improve any activity. Holidays, birthdays and other life-changing events flow better with music. By playing appropriate music, you can make even an exercise session into an entertaining activity. Just don’t tell them it was good for them and they will ask when the next time is.

One way to find out what kind of music meets people’s fancy is to ask what they listened to when they were young. Everyone had his or her favorite 78’s and 45’s, or favorite radio station that played the top 40. People who were in their teens in the 1940’s danced to the sounds of Benny Goodman or the Dorsey brothers. Younger people remember Perry Como, Elvis Presley, the Beatles or the Rolling Stones.

Group leaders can lead discussions on music. They can encourage people to talk about where they were the last time they heard a piece of music. Or, what they think about when they hear musical pieces or even nature sounds.

Giving people back their past with music can be a real pleasurable experience. Music can be what gets someone started, keeps him or her involved, or makes an activity fun and stimulating. There is no special formula for having a successful activity. Every group is different just as every person needs to feel special. One way to reach people is through music.

There are a number of ways to find music for recreational activities. Your facility has music, although sometimes you have to search for it. Individuals can bring in their own music. Or you can call Recordings for Recovery at 1-800-798-1192. R4R is a non-profit music library with more than 1200 different musical titles. It is available to both activity directors and individuals. Our address is 5103 Eastman Place, Suite 101, Midland, MI, 48640-6723. You can also contact us on the web at www.r4r.org or by e-mailing us at staff@r4r.org.

Michael Hoy
Executive Director
Recordings for Recovery

Dementia & Nutrition: Recommendations for Activity Professionals andRecreation Therapists.

Excerpts from the new book, Dietary Concerns and Recommendations for Alzheimer’s and Dementia. A Guide for Long Term Care Facilities and Special Care Units. Sold only at www.activitytherapy.com

Plan and prepare all cooking events. Have all your products available and set up prior to beginning your program. Keep all sharps out of sight and locked up. You should have a finished sample of what you will be making. It is recommended that all cooking programs be offered in the afternoon, as you have more time in the afternoon and are not restricted by lunch hour. Offer 2 exercise programs a day, which will increase appetite, aid in digestion and increase desire for fluids. Before every activity, clean resident’s hands with wipes (if possible take the resident to the sink and wash hands) and offer scented lotions such as coconut. This is a nice way to segway into a program and offer stimulation to the resident.
Provide fluids at every activity.
> Offer fluids after all exercise programs.
> Invite to all food related activities and provide supervision.
> Offer end of day “tea socials.” Serve tea on fancy china and china cups.
Use colored cups, vs. white cups.
> Offer a weekly social. Play “Cheers” theme music. Serve non-alcoholic beverages such as Pina Coladas.
> Invite residents to assist with lunch set up and meal clean up.
> Offer home made milkshakes and prepare with the residents.
> Use bread machines and bake bread often.
> Watch your sharps. During the activity program, keep knives in your pocket at all times or out of sight. It only takes a second for an accident to happen.
> Use aromatherapy machines and electric candle warmers while setting up for programs.
> Play soft music before and after programs.
> Incorporate more cooking programs, using: Portable ovens, Otis Spunk Meyer Cookie Ovens, Blenders and Microwaves Oven.
> If you have the use of a kitchen, prepare small meals with the resident in the kitchens.
> Bring in recipe books for the resident’s to look at. Ask them to share their favorite recipes.
> Begin a recipe book of their favorite recipes.
> Offer snacks at all special events.
> Food related word games and trivia games.
> Food Bingo
> Invite to watch cooking shows on television or video, especially the 30 minute shows.
> Ask the resident to identify items such as squash and apples (many kinds) and their uses.
> Plan special events, breakfast buffets, pancake breakfasts, pizza parties, luaus, barbecues, elegant dining, cultural events, monthly parties and birthday parties.
> Plan special meals for religious holidays.
> At club meetings serve nutritious snacks.
> Offer hydration stations that are attractive, such as clear pitchers with floating fruit. Clear cups with lids at bedside. Eliminate Styrofoam pitchers and cups at bedside because they cannot do this three-step process of picking up the pitcher and pouring liquid into the cup.
> Offer nutritious snacks during reminisce and relaxation videos.
> Provide short lunch trips to restaurants such as McDonalds, Cafes and Diners.
> Offer tea samplers and unique condiments.
> Display different grocery items and have them reminisce about them. Uses and prices.
> String popcorn and cranberries for the birds to feed on outdoors. Drape over bushes.
> Make potpourri out of dried fruit.
> Roll pinecones in peanut butter and birdseed.
> Dry fruit and sample. Can also make art projects out of dried fruit.
> String cheerios and fancy macaroni.
> Make macaroni art. Place on construction paper and glue down.
> Discuss all the ways peanut butter can be used. Provide crackers, apples and bread.
> Shuck corn and snap beans.
> Offer seasonal beverages and food such as eggnog and peppermint ice cream.
> Make homemade lemonade and tea.
> Make popcorn and offer different seasonings for the popcorn. Let them season with their own individual portions.
> Fold dishtowels and napkins.
> Make easy salads, potato, coleslaw, three bean, fruit salad and corn salads.
> Share cooking stories found in reminisce magazines.
> Peel potatoes and make mashed potatoes.
> Prepare gelatin and fast setting puddings.
> Let them dry dishes, sort utensils and silverware.
> Provide history of different foods with a sampler.
> Have tea with the administrator or guest.
> Cinnamon crafts. Lots of ideas for cinnamon sticks.
> Have theme days such as Western Day.
> Have word games associated with themes; Vegetables, Breakfast items, farm stands.
> Have residents wipe the place mats clean.
> Make seasonal murals. For November draw a cornucopia. Let residents color vegetable items. Another idea is a mural about a farmers market that has pictures the resident can color of food items.
> Make simple recipes with the residents, such as fruit salad, pigs in a blanket,
Cookies and icing, ice cream pies, apple pies, etc. Offer recipes that are theme related such as Apple pies in September.

Live Instructors vs. Video’s for Training

Many nursing homes, assisted living and adult day care facilities rely on videos for training staff. Often times, staff is left unattended when watching videos and there is no test offered to verify they have learned the materials. Administration has to ask the question, if this type of training is beneficial? Federal and state guidelines require training. Each state is different on the type of training topics to be covered, the area of concentration. Length of training and who should conduct the training. Health Care staff and administrators realize that training has to be ongoing and continues. However, training programs have to be done well, with thought and planning into what the message is your trying to get across. No one tool should be used as the sole means to training. Variety in training and different types of tools and media will only make training programs more interesting for your staff. Videos are a welcome supplement, but should not be the only tool used when training.

There are benefits to using videos for training. However, the use of video should not be the only way material is covered with employees. The benefits to using videos are;
Videos are consistent when using the same one for different shifts. Provides staff with more tools to do their job and is less expensive than using live instructors. When using videos, there should be self-study manual, tests and observations of the skills learned in the video. There are excellent videos for health care topics and there are horrible ones. The in-service director before showing to the staff, should review all videos. These are questions to consider when selecting a video.
1. Does the video meet your objective?
2. Does the video present logically?
3. Are the actors used, interesting? Do they use accents that are hard to understand?
4. Is the topic presented in an easy to understand way? You have all levels of education that will be watching the video.
5. Is the video too long? If its long, does it break in between topics allowing students to answer questions?
6. Does the video summarize key points?
7. Is the video interesting? If it is boring, it will not hold their attention.
8. Is the video relevant to today’s market?
9. Does the video give examples to the topic being presented?

If videos are going to be the main tool for teaching, the in-service director should implement the following tools to insure the staff is getting the message from the video.
1. Use handouts that are relevant to the topic.
2. Introduce the video and what key points they will learn from the video
3. Summarize what they learned.
4. Lead a discussion about the topic.
5. Provide a quiz to show competency of the topic.
6. Have students fill out an evaluation about the video.
7. Ask for three key points they learned from the topic presented.
8. Observe employee competency related to what they learned.
9. Provide books related to the topic
10. Provide magazine or newspaper articles related to the topic
11. Provide information off of the internet relevant to the topic
12. Supervise staff while watching the video.

Some states require 40 hours of dementia training and have approved videos as the approved method of training in certain areas. Other states require less hours but with instructors. Some states just state that dementia training be required for dementia units but don’t state the topics to be covered.

There are many benefits to investing the time, energy and money in recruiting trained instructors. Students are able to interact with the instructor. There is time for questions and answers. Instructors may incorporate role-playing. The instructor is able to clarify points that students may not understand or just need more information. The students are able to share ideas with each other as well as problem solves resident issues.

Although the use of videos is cheaper, it cannot compare in any way to a live instructor. Administration has to look at the benefits in the long run to having staff that are well trained in the areas most crucial to resident care, areas of resident rights, dementia education, elopement, neglect and abuse. The benefits far out weigh the costs involved by using a live instructor who are trained in these areas. You can save money by using videos, but in the long run, owners of facilities will be paying in the end in state fines and litigation if videos are the only method used for training staff .

Robert’s Rules of Order:

Many health care professionals attend or participate with their local groups or state associations. This books is a must if you are actively involved in your organization.

Major Henry M. Robert first published the Robert’s Rules of Order in 1876. This is an essential reference tool that every organization that holds meetings, board meetings, committee meetings, civic groups, and churches should have with them at formal meetings. The text includes by laws and resolutions, amendments, treasurer’s reports, secretary’s minutes, nominations, elections, disciplinary actions, introduction of business, motions, officers and boards, resolutions, debates and order of business. If you are part of a board or committee, regardless of your position, it is recommended that you purchase this inexpensive book.

From time to time, there may be situations where bylaws do not clearly state what to do in every situation. This is when committees should follow the recommendations of Roberts Rules of Order. For example; there are situations when a committee member may commit an offense outside of a meeting and there may be no witnesses. When this happens, Robert’s Rules of Conduct recommends the following actions;

The Executive Committee will make a motion to investigate the action but not accuse anyone. The Executive Board would have board members or committee members volunteer for a Disciplinary Committee. At this juncture, the committee is only looking to see if the situation warrants investigation. The disciplinary committee (investigators only) would discreetly investigate the conduct and report back to the Executive Board.

The Executive Board would meet with the accused board or committee member and all accusations and documents supporting the allegations would be shown to the accused. Once the Disciplinary committee meets with the accused they determine if actions warrant a trial and charges are filed or exonerate the accused.

For each charge there will be a time, place and date set for trial and the accused is notified by registered mail, of the trial and findings of the committee. At the trial one or more members of the disciplinary committee will represent the board. The trial can be held before the disciplinary committee but not before those disciplinary members who carried out the investigation. Once notice has been given to the accused all rights as a board member or committee member are suspended.

At the beginning of the trial, charges are read by the secretary for the committee. The accused will enter a motion of guilty or not guilty for each charge. If the accused pleads guilty to one or all of the charges, the trial will then move to the penalty phase of the proceedings.

If he pleads not guilty, the board presents arguments, evidence and witnesses against the accused. Witnesses do not have to be members of the group, committee, or board. This type of trial is not bound by legal rules of evidence.

The purpose of the trial is not to prosecute the accused but to ascertain the truth. The accused is allowed to present a thorough defense. The members than consider each of the charges as separate motions, debatable, amendable and adoptable by a majority vote.

If, the accused is found guilty of any charge, the committee moves to the penalty phase. Any penalty may be imposed by a majority vote, EXCEPT FOR EXPULSION WHICH REQUIRES A TWO THIRDS VOTE. The vote should be carried out by ballot.

In any situation where there is a trial, it is recommended that you consult an attorney who is knowledge about boards and committees to avoid litigation down the road.

References: Robert’s Rules of Order by Darwin Patnode; Robert’s Rules of Order 2nd Edition by Mary A. Devries, Robert’s Rules of Order Newly Revised in Brief by Henry M. Robert III. It is available at all bookstores.