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An Introduction to Pathways to the Past

Each month we will be highlighting programs and resources to help in planning and implementing a dementia calendar.

20 years ago, there were very few dementia units within the United States long term care facilities. Today, there are few facilities without a designated dementia unit or locked dementia unit.  Many assisted living community’s caterers only to the elderly with dementia diagnosis.  Where dementia used to be the minority diagnosis, it is now the single most recurring diagnosis in the long term care setting. We are now seeing 60- 80 percent of your population with a dementia diagnosis and Alzheimer’s leading the way as the main type of dementia you are seeing.

Due to the increase in the elderly population and the dementia diagnosis, more and more adult day care centers provide services to clients with dementia.  Additionally, we are seeing a whole range of new services that are opening all over the country to provide other options for seniors diagnosed with dementia and who do not want or can not afford CCRC, Assisted
Living or Long Term Care, such as Shared Housing. For those who wish to age in place at home, communities are providing all kinds of services to allow for seniors to stay in their homes longer.  This includes everything from in home grocery delivery, in home PT / OT services, nursing services, home health aides, in home recreation, etc.

Never before has the Activity Professional been challenged to provide therapeutic and innovative programs that are success oriented, failure free, purposeful and meaningful to all your dementia clients.  Fortunately we are working in a time where there are more resources available.  Additionally, the internet can reach other countries that have a wealth of activity resources that activity professionals will find extremely useful and beneficial to your monthly programming.  It is now imperative that Activity Professionals become educated in dementia as there are over 60 kinds of dementia.

Activity Professionals additionally need to be aware of the resources, magazines, books and tools available to implement daily programs.  Activity Professionals have to be willing and open to try new things, keep what is working and throw out those ideas that are not working. There are many new magazines that are activity and dementia specific such as Current
Activities in Long Term Care, Nursing Home Magazine of Canada and of course Creative Forecasting.  Activity professionals should be seeking out every web site that offers information and begin saving those to your computer “favorites”.

One very important aspect of a dementia program is consistency. It is important to keep the calendar consistent while at the same time incorporate seasonal programs.  The other important aspect of a dementia program is to include Exercise, Music and Reminisce programs on a daily basis.

We recommend the morning consists of Meet and Greet, Exercise (with props) and Music (with props) programs. The time spent with the CNA in ADL care is a very important part of the day and should not be rushed in order to get the clients to programs on time.  If we understand that the time spent with the CNA is an important part of the day, although not
considered activity per state and federal regulations, is an activity onto itself. It can be exhausting for the client just getting dressed.  Be aware that the dementia residents may not even want to participate in the morning program. But should they come, low impact exercise and music programs are not as mentally taxing as the early afternoon programs.

The resident can join the morning program at any time. Props should always be used for Exercise and Music programs.  Exercise props examples are streamers, scarves, parachute, top hats, etc. Props are great visuals and are therapeutic for the hands muscles.  Music props examples are maracas, drums, tambourines and bells.  It is recommended that
everyone use the same prop vs. a variety as it tends to sound like noise rather than a music program.  For those who have never conducted a Meet and Greet, this is a program where tactile items are placed on the tables that are unique to each person ability and interest.  As the residents are brought into the day room they are placed at tables with things to do and
introduced to their table mates and the activity professional.

For those who wish to wander, it is important to have areas set up to peek their interests, such as a nursery for nurturing, sewing machine with materials for hobby pursuits, rummage dresser for those who wish to sort through things. Some places have even implemented a bus stop for those seeking to go to work. Work areas that incorporate their past professions from factory work to teaching.

The early afternoon should consist of horticulture, crafts, cooking, TimeSlips, Wake Up or Murals programs. You have more time for these programs in the afternoon and don’t have to rush these types of programs because of lunch.

The dementia client is tired by the late afternoon. The late afternoon and early evening programs should consist of relaxing programs.  Examples of these types of programs would be relaxation videos, reminisce videos, short story, pet therapy, intergenerational programs, life skills, individualized activities, feeling groups, out side programs and exercise. Unless the weather is either too cold or too hot, the clients should be brought outside daily.

The following programs are not recommended for a dementia calendar such as Trivia and Bingo. If you have clients who are living on the dementia unit and you feel they would benefit from these programs, than provide supervision off the unit and allow them to attend these programs off the unit.

Unfortunately, all too often we have clients who are aging in place on the dementia unit rather than transferring the dementia client to a palliative unit. When the dementia client no longer benefit from the dementia program due to cognition the client should be transferred
to the palliative floor and special sensory activities are provided. The community should look for areas to set up a sensory room or space as this would be a beneficial program for those clients who are too low functioning to participate in planned group programs.

All programs should be properly prepared and the dementia clients should never be left unattended in the day rooms, especially when activity supplies are left out, such as sharps.   If you community does not have full cooperation of the nursing assistants, now is the time to meet with the Director of Nursing to enlist their support of the nursing assistants in the daily programs. If your long term care, it’s required. If your another type of community other than a nursing home, it only makes common sense legally, safety, and from a risk management perspective that more supervision is provided during programs.  No longer should only one activity person be providing a program to a group of clients with behavioral issues.  See upcoming April article in Advance for Long Term Care Management Magazine where we address numerous tips to involve the CNA.  Also see http://cms.internetstreaming.com and click on archives and review the web cast regarding Survey and Activities as this issue is also addressed.

The following are resources that we are highlighting this month:

 

National Council for Certified Dementia Practitioners announces New certification for dementia unit managers Certified Dementia Care Managers CDCM. Golden Living certified over 100 dementia unit managers as CDCM. The next two day class will be held in April in Orlando Florida. To qualify for the certifcation the dementia unit manager must currently supervise a dementia unit, possess a college degree, 1 year experience supervising a dementia unit and complete the two day CDCM class. Upon completion of the class, the dementia unit manager will be an approved dementia trainer, CDP Certified Dementia Practitioner and CDCM. Each student will receive dementia unit policy and procedures, job description, Dementia Unit Best Practices, Power Point disk of 7 hour dementia course, over head copies, master hand out note book, text books, tests and DVD to assist with training staff in the area of dementia care.

APPLY TO BE A CDCM.

TRAIN THE TRAINER DATES
For a complete list of seminar dates please click here.

ALZHEIMERS AND DEMENTIA SEMINAR DATES
For a complete list of seminar dates please click here.

Please contact the NCCDP if you are interested in bringing the course to your facility or organization.

CERTIFIED FIRST RESPONDER DEMENTIA TRAINER CFRDT.
Through the generous donation of the Wallerstein Foundation For Geriatric Life Improvement, the NCCDP provider 7 hour dementia training and CFRDT to all of the law enforcement trainers in Essex County NJ and Sparta NJ. The curriclum included Overview,diagnosis, prognosis, medications, behaviors, depression, wandering, Project Lifesaver, abuse and neglect in the home, hoarding, intimacy, driving concerns. Each trainer received Power Point Disk, DVD, Master Hand Out notebook. Each trainer will conduct dementia training in 24 cities in Essex County NJ. At the conclusion of the training each instructor was certified as CFRDT Certified First Responder Dementia Trainer.

For information please see http://www.nccdp.org/first-responders-dementia-training.htm

Best Friends: Staff- Building a Culture of Care in Alzheimer’s Programs

Nutrition & Dietary Products for Dementia and Alzheimer's

Outdoor Environments for People with Dementia

Spiritual Care for Persons with Dementia

Therapeutic Interventions for the Person With Dementia

The Best Friends Book of Alzheimer’s Activities, Volume One

 

 


 

Study Guides
Sensory Products
Alternative Solutions in Long Term Care provide resources and services for Health Care Professionals and Care Givers. Recreation Therapists, Activity Directors, Social Workers, Creative Arts Specialists, and other health care workers utilize this site to obtain information and purchase products for use in nursing homes and long term care facilities. Products and resources include sensory stimulation products, relaxation videos, party supplies, care plans, activity calendars, and more. For additional resources visit our associate site the Therapeutic Recreation Directory at www.recreationtherapy.com. To become certified in Dementia Care go to www.nccdp.org.

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