Life Enhancing Activities
Training Program
1. Introduction
Welcome
Ground rules
Outcomes
2. Activity Knowledge
Game
3. Activity Philosophy
Handout
4. Social Activities
5. FacilityResponsibilities
6. Life Stories
7. Implementing Activities on the Neighborhoods
Care Partners Roles & Responsibilities
Activity Outline: How to set up an activity (Handout)
8. Activities that improve resident’s quality of life
Video (Compassionate Touch)
Hand & Shoulder massage
9. Activity stations
Reminiscing “Grandmother’s Pocket Book”
Puzzle time
Parachute
10. Facilitating a Small Group Activity
11. Wrap up
12. Evaluation
LIFE ENHANCING ACTIVITIES
Training Program
Welcome and Introductions:
Welcome the participants
Ask them to introduce themselves and say what brought them to the training
Share some of each of the trainers backgrounds and experiences
Give overview of how this new program was developed
“Ground Rules” (Review with participants) Ground rules for today’s training to make our time together the most productive include:
Starting on time, ending on time.
Everyone brings with them an open mind.
All participants contribute to the discussions held throughout the entire training, as well as actively contributing when we break up in to smaller groups, and participate in more interactive training.
One participant speaks at a time. No one interrupts.
To get the full benefit of the Life Enhancing Activities everyone should stay for the entire required 2 hour training.
Outcomes: (Review with participants) After completing today’s 2 hour LifeEnhancing Activities training you will:
Have a clearer understanding of the MGRNC Activity Philosophy that surrounds activity based care.
Understand the state and federal guidelines that direct the types of activities we provide, and who is responsible for providing these activities.
Be able to conduct four small group/or individualized activity programs.
Have a greater knowledge of the activity closets on each neighborhood, their contents and their purpose.
Take individual ownership of the activity closets on each neighborhood, making sure their left neat, stocked, and functional for use by all shifts to engage residents in meaningful social interactions.
Become a train the trainer, teaching new care partners how to conduct small group activities.
Activity Knowledge
(Ice Breaker)
Ask participants to divide up into three groups, with no more then five participants in each group. (This can be achieved by counting off or having participants group by neighborhoods).
Facilitator to:
Hand each group a sheet of paper.
Have participants work together in each group to write a list of as many
activity items they remember in their neighborhood activity closets.
(Award a prize to theCNA Care Partner team with the most number of correct items!)
Discuss the importance of the activity closet and how the Activity Care Partner
assigned to their neighborhood can assist in explaining the activity items and
how they are used.
Activity Philosophy
This section reviews the regulations around providing a comprehensive plan of care that addresses and meets each resident’s socialization needs.
Federal guidelines F-248, states that each facility must develop and implement an activity program that provides a system-wide approach and identifies the needs of each resident according to physical, mental, and psycho-social well being.**
When residents are admitted the facility assures that each resident activity are:
According to the resident’s interests, preferences/choices, abilities/strengths, and limitations
Individualized, ongoing and meaningful
Activities, to the extent possible, contributes to attaining, and maintaining the
highest quality of life
** What this simply means in short, is that every single resident must have an individualized activity program to fit their needs through large, and small groups, and one-on-one experiences.
Activities – Refers to any activity, other than ADL’s, in which a resident engages, that is intended to enhance his/her sense of well being. These include but are not limited to activities that promote:
Increased self-esteem
Pleasure
Comfort
Education
Creativity
Success
Independence
Spiritual wellbeing
Activities can and should occur at anytime, not limited to formal activities being provided by the Activity Care Partners. Other people may be involved in a facility activities program, including volunteers, families, and all other departments Care Partners.
“Activity Programs Should Include”:
A combination of formal, informal and self-directed activities
It is important to be mindful that although it is great to have a knowledgeable Activities professional team, it is equally important to have other Care Partners within a facility that are aware of activities as an important aspect of quality of life.Care partners need to take responsibility to initiate meaningful social interaction with residents. To provide a life-enhancing environment, opportunities for residents to participate in meaningful activities must be wherever they are: common areas such as solariums, dayrooms, and near nurses’ stations, outdoors, as well as in the community center.
Why are activities important?
Give meaning to life
Structure
Give a sense of accomplishment
Feel valued
Define who we are
Enhance life satisfaction
“Activities are meaningful when they reflect a person’s interests and lifestyle are enjoyable to the person, help the person to feel useful, and provide a sense of belonging.” 1
Social Activities
Each resident has a right to choose activities that are consistent with their interests,
abilities and plan of care.
Each resident has the right to participate in social, religious, and community activities, both inside and outside of the facility, that donot interfere with the rights of other residents in the facility.
Each resident has the right to organize, and participate in resident groups’ i.e. resident council, and ask Care Partners for assistance to get to these meetings.
All residents have the right to refuse any activity, at any time.
Facility Responsibility
To make available to each resident a variety of activities in which they may participate, if they desire. These activities are designed to support their physical, mental, and social well-being.
To make available to all residents a resident council where they mayexpress concerns about the facility, and make recommendations.
All care partners should be mindful to approach residents by introducing themselves, and waiting for a response from the resident. Care partnersshould always let the resident know where they are taking them and make sure residents’ who are in wheelchairshave their legs, feet, and hands placed where they will not get injured when the wheelchair is moved.
Our residents have a variety of rights when admitted to their neighborhood, and it is
important to be mindful of this.
“We do the right things for the right reasons.”
“Life Stories”
(Bring information to show)
Because we are a dementia facility, we rely on input from our families regarding a resident’s traditional routines, leisure pursuits, and lifestyle preferences thatassists us in really tailoring each resident’s day to day experiences with us. Questionnaires that are completed by our families are transformed into a framed narrative “Life Stories” that Care Partners can utilize when they are visiting or providing care.
“The Life Stories” information sheets are wonderful opportunities to gather information which in turn will enrich the one to one interactions with our residents. We ask all Care Partners to read these life stories so that we can get to know each person we care for in a compassionate way. The better theCare Partnersknow the residents, the better they will care for them. The interactions become more personal and the individual becomes a real person, rather than just a diagnosis or a stereotypical elder.
Life Stories help everyone develop personal relationships with residents, thereby enhancing the spirit of being a neighbor in a community.
Implementing Activities onto the Neighborhood
It is our goal that residents will come together as a “community” for special occasions, and events whenever possible. Life should mirror as much as possible some normalcy prior to their admission to this facility. When we gather for special events such as birthdays, church services, holiday festivities, musicals, cookouts, etc., the use of the community center is the most appropriate setting for these types of events.
However in the neighborhoods, activities can occur simultaneously with the support of dedicated Care Partners, who have been trained to utilize activity supplies available to them, in their activity closets, and those who have been trained to facilitate specialized small group or individualized activities. There can be several interactions taking place at the same time.
It is our culture to expectCNA Care Partners will initiate resident activities on their neighborhoods, looking for opportunities to engage residents in social interactions, and mentoringtheir peers in the importance of activities in our every day lives. Each trained Care Partner will be challenged to set the bar high so that other Care Partners will be comfortable to get away from our task oriented “medical model” routines, moving more towards the “social model” of resident-centered care.
We will challenge our Leadership CNA Care Partners to problem-solve activity related issues with their peers, and the Activity assistant assigned to each neighborhood. They as well should be spear heading activities discussions about how activities are going on the neighborhoods, and how the activity closets are going. Are the items in them helpful? These discussions should take place routinely at monthly neighborhood meetings, and especially at the culture ChangeOversight Committee. Also it is each resident’s right to have opportunities that enhance their overall quality of life.
Activities Improve Resident’s Quality of Life
Show Video (Compassionate Touch)
Discuss video briefly
Activity facilitators will demonstrate how to do hand massages
Following the video, and demonstration of hand massages the participants will give hand massages to one another.
Discuss how the participants felt when they received their hand massages
Additional Comments:
In today’s society residents often feel that no one wants to be near them, let alone touch them. This adds to their increased sense of isolation, and sadness. There are many great benefits in the power of touch. Purposeful touch is very different from the touch a resident experiences during personal care.
Touch that is purposeful can be as simple as holding a resident’s hand, while sitting with them, a gentle massage to the neck or back, or simply rubbing the back of their hands. Often the results of gentle touch are impressive:
Reduced feelings of anxiety, and depression
Increased feelings of well-being, and being wanted
Simply spending time visiting, and holding hands with residents is not only rewarding, but can be one of the most effective 1:1 resident interactions of all, and it’s easy for most anyone to do!
Activity Stations *
Have participants break-up into groups, no more then 4 to a group then have them go to one of the stations where they will be instructed in that particular activity. The group will spend up to 10 minutes at each table while the activity is being explained and demonstrated.
1. Reminiscing Groups– “Grandmother’s Pocket Book” & picture books
Facilitated by Activity Care Partner
2. Puzzle time
Facilitated by Activity Care Partner
3. Parachute
Facilitated by CNA Care Partner
Handouts are provided for each participant at the end of this training which break down each activity demonstrated today into appropriate group size, appropriate duration of each activity, and benefits.
Duplicate copies of these specialized activities with simple directions on them to conduct small group activities will be available in small blue binders that will be located as reference materials in each neighborhood’s activity closets.
* Note: more sophisticated activities can be demonstrated for residents without cognitive impairments.
Looking inside Grandmother’s Pocketbook
“Reminiscent Activity”
Activity Purpose:
The purpose of this activity is to reduce resident behaviors such as wandering, restlessness and anxiousness. This activity can also be utilized to enhance the quality of life in resident’s exhibiting behaviors such as depression, boredom, and passiveness, by providing residents opportunities to reminisce through discussion, tactile stimulation, and sensory stimulation, interesting, and stimulating materials found in Grandmother’s Pocketbook. The activity can be facilitated as a 1:1 or small group activity.
Resident Objectives:
Increase residents sense of security by introducing familiar objects.
Increase resident’s social interactions with others in a more normalized, purposeful way.
Reduce resident’s repetitive motor movements refocusing their energies in a productive meaningful manner
Reduce negative, unproductive resident behaviors.
Increase resident affect, as evidence through their active participation, positive expressions, and increased verbalizations.
Criteria for Participation:
Residents need to have the ability to associate with objects found in the pocketbook, and a willingness to sit and focus on task.
Set-up:
It is essentially that this small group specialized activity is facilitated in a quiet environment. Make sure adequate space and seating is available. Have all participants present prior to beginning the activity. Group size should not exceed four residents to achieve positive results. The duration of group activity time should not exceed 30 minutes.
Focus Group:
Residents that will benefit from this small group activity are those who are demonstrating signs or symptoms of wandering, restlessness, anxiousness, or are passive, bored, and appear depressed.
Process
Sensory pocketbooks are put together with interesting items for residents to rummage through and reminisce. This activity should always be supervised by care partners, making sure when residents look through pocketbook that items are not small enough to be ingested. Encourage residents to open the pocketbook to see what is inside, by demonstrating first what you would like them to do. Most residents are willing to participate if they feel they are being helpful and they feel the activity is purposeful. Have residents discuss each item found in the pocketbook.
Hints for a Successful Activity:
Use cues such as “here is a pocketbook”, “let’s look and see what’s inside the pocketbook”.
Groups of this nature, are further enhanced if, care partners have an awareness of participants past hobbies, and career interests.
Have residents touch items, and talk about textures, color, use of objects and fragrances if an object includes a smell. Encourage resident to smell objects, and discuss memories associated with each.
It is important when conducting a reminiscent activity for care partners to encourage as much hands on participation by residents to enhance resident’s interactions, and socializations with others; this will in turn increase the resident’s self-esteem.
Use cues to prompt conversations like:
- Did you ever carry a pocketbook?
- What did you keep in your pocketbook?
- Did you ever misplace your pocketbook?
- Which items in your pocketbook are the most important to you?
Puzzle Time
Activity Purpose:
The purposes of this activity are to stimulate cognitive function and senses (tactile and vision), to increase the level of attention to the task which is safe and therapeutic, to maintain and increase fine motor skills, and to facilitate a sense of achievement.
Resident Objectives:
The resident will identify what shapes, colors and/or pictures of puzzle pieces are, and how it feels.
The resident will demonstrate the ability to sit and pay attention until the task is completed.
The resident will demonstrate ability to touch and grasp the puzzle pieces.
The resident will express the sense of achievement verbally or non-verbally.
Criteria for Participation:
Ability to understand the object of the puzzles (“to put them together on the board”)
Willingness to sit at the table to do the task
Total of 2-3 residents per one staff member.
Content/Process: This activity is mainly for the residents who like “to keep themselves busy.” The activity is held in the neighborhood dayroom or the common area. The leader (the care partner) takes 4-6 wooden puzzles and/or regular paper puzzles (if appropriate) out from the neighborhood activity closet, and provide to the group of residents. The residents are to sit together preferably. The leader is to sit with them to offer the assistant and supervision as needed. The activity is held for about 30 minutes.
Supervision: A CNA as the leader. A UCA could lead the group; however, the UCA will need the supervision from CNA in case of accidents such as pica.
Parachute
Activity Purpose: The purpose of this activity is to stimulate large motor skills and eye/hand coordination. This exercise gives the resident a sense of being a part of the group in a team coordinated effort. It also brings smiles and pleasure.
Resident Objectives:
The resident will demonstrate ability to hold on to the parachute, and maneuver it up and down.
The resident will demonstrate ability to pay attention when the ball comestheir way to divert the ball away from them.
The resident will demonstrate ability to keep the ball within the circle.
Criteria for participation:
Ability to understand verbal /nonverbal instructions. To demonstrate ability to be a part of the large group.
To demonstrate ability to hold parachute and ability to hit ball.
Content/Process: Residents feel a great sense of meaning and joy when the facilitator praises and recognizes their effort and identifies residents by using their name and showing a lot of enthusiasm.