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May 2019

How to drive inclusion in care home activities

By | Care Home

Last week brought us 2019’s Dementia Action Week, giving us time to reflect on this year’s theme of inclusion. Craig Taylor-Green, a Regional Wellbeing Coordinator at Oomph!, gives his thoughts on how care homes can ensure that all residents are involved in wellbeing activities.

As I write this, I know that there may be care home staff up and down the country scratching their heads as they attempt to inspire residents to take part in an activity. What does it take to ensure all residents have the opportunity to not just take part in an activity, but to take part and reap the benefits of health and wellbeing related outcomes which can have a positive impact on their mind, body and soul?

My focus is on the ‘adaptation of activities’ and steps we can take to increase the likelihood of positive engagement between resident, activity and carer. Our goal is to have a failure free environment! It’s a tricky balance ensuring activities are achievable – in order to avoid frustration and disappointment – but also challenging enough to avoid patronising or boring residents.

For us to stand a chance of success at ‘including’ all our residents, we need to have in place…

Life Stories & Wellbeing Plans

We need to know the person – it is absolutely crucial that as soon as someone moves into a care home, we start developing their life story. This in turn will allow us to create individual, meaningful wellbeing plans, full of activity ideas which can then be facilitated & adapted. We stand a much better chance of succeeding by including someone with an activity they love, or previously had a passion for, and our understanding of a person’s journey with dementia enables us to be more responsive to their needs. Gathering life story information can be a daunting task but it is pivotal.

Motivation

Ask yourself: ‘What motivates me?’. It might be one thing today and another tomorrow! It’s exactly the same for a person living with dementia – their needs and what motivates them will most likely change through their journey – so we must understand what might be relevant and meaningful for that individual at that time. What works one day, might not work the next. Hence the CQC KLOE ‘responsive’.

At the same time, it is important to present people with the opportunity to try new things. If a person declines to take part, then that’s fine, but please do not give up! One day, you might be surprised as when they engage with the unlikeliest of activities. Additionally, the idea of leaving the room to go to a group activity might be a scary thought for some residents. This should not be a barrier! With good planning, we can still ensure someone can live the fullest life they can live within their environment, whilst taking steps to try to build up their confidence to socialise outside of their rooms.

Adaptation of activities for someone living with dementia

So how do we break activity and exercise down for people living with dementia? Whilst it may be difficult to determine exactly what stage someone may be in their journey with dementia the following principles may apply:

Early stages

In the early stages, it should be possible to facilitate a meaningful, structured, goal orientated activity that focuses on the whole task. We may find that it is possible to focus on all of the elements, from start to finish and that the person’s interest may be maintained throughout the whole task (especially if it is something they are passionate about). A person may also have the capacity to follow instructions, and may benefit from linking with outside organisations to integrate into the community for these activities.

IDEAS: Structured activities may be boardgames such as scrabble, sports games such as bowling, structured arts and crafts, mastermind quizzes, group discussions and aqua aerobics

Middle Stages

As a person progresses through their journey with dementia, with potential consequences on their thought processes and language, this may impact their ability to follow the ‘structure’ of an activity. Their familiarity with the routine or objects used may still be in tact, with makes it beneficial to focus on the ‘steps’ and not the activity as a whole. Shorter activities may be appropriate, or 1:1 sessions that promote a safe environment where the person feels confident to express themselves. It may help to repeat instructions. The important thing is that the person still has the opportunity to accomplish something – and constant enthusiasm, excitement and acknowledgement of doing a good job by the carers should stimulate and motivate.

IDEAS: Movement to music, dance, reminiscence and expressive arts could help a resident to express themselves

Later Stages

Fact and logic continue to deteriorate rapidly during later stages and – while emotions and feelings may sometimes be jumbled up, they do remain intact, making it incredibly important to ensure all engagement with residents is driven by positivity. A person may now enjoy sensory stimulating activities and those which follow repetitive actions, using visuals to stimulate engagement. For example, the sensory aspects of a baking task could be: kneading the dough (but not with a cake baking goal in mind), tasting or smelling the ingredients where safe to do so, tasting or smelling the cake when baked.

I often found in my experience as an Activity Coordinator, that the incredible rewards from breaking through with someone in their later stages of dementia were second to none. Do not underestimate the benefits of including that person!

IDEAS: Movement to music, carpet balloon games, pairing and organising clutter drawers, quiz games such as finish the sentence, sensory stimulation such as scent bottles, folding laundry and gentle massage (if qualified and safe to do so).

Final thought

Not all superheroes wear capes! If you are currently working in a care home, know that you are part of a great team of people putting the lives of others at the forefront! You have the power to make an impact on a person’s life that in turn will impact another and another and another and – whilst thinking outside the box is greatly encouraged – sometimes it’s the simple steps that can make a difference.

 

Photo from Park View Care Home

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