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Module four
Engaging in everyday
activities in a meaningful
way
4. Meaningful engagement
This section covers:
4.1 What are activities in
effective care?
4.2 Tailoring everyday activities
4.3 Assisting a person to engage
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Learning outcomes
At the end of this session you will be able to:
• define the concept of activity and its purpose
• work with families to discover meaningful
activities for people with dementia
• identify appropriate activities that
meet a person’s needs and abilities
• recognise the difference between
structured and unstructured activities
• set up the environment to encourage safe participation in
activities
• break down activities into single steps or tasks.
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4.1 What are activities in effective care?
• They are not always recreational
or diversional
• They should be part of a normal day
•
They should hold meaning & purpose
for the unique person
• They should be pleasurable & aim
• to engage the person with life
3
Activity’ covers a vast number of daily
activities
• Domestic activity
‘
• Self care
• Work
• Leisure
4
Why is engaging in meaningful
activities important?
• Feel useful
• Maintain:
– skills
– health
– independence
– self-esteem
• Experience pleasure
• Reflect spiritual & cultural identity
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4. 2 Tailoring everyday activities
Centre on the person
•
•
When we centre on the person we find activities that provide meaning and
purpose
An assessment process allows us…
• to explore retained abilities and skills
• to discover an individual’s history (likes and
dislikes, past roles and routines)
• to consider the person’s cultural and spiritual
background
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Accept the impact of brain damage
Frontal Lobe
Parietal Lobe
Planning, organizing, judging,
initiating, insight
Patterns (putting together the steps to
complete a task), communication
(written and verbal), spatial awareness
Temporal Lobe
Limbic System
Filing system, memory
(Connecting system)
Sleep, appetite, emotions
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Respect the person with
dementia
• Treat the person as an adult
• Involve the person in meaningful and purposeful activity
• Be patient, flexible, creative, reassuring and encouraging
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Enable the person through…
Our caring relationship and physical and social environment will :
• Maintain skills and abilities
• Provide opportunities for individual’s
growth
• Maintain safety and feelings of security
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4.3 Assisting a person to engage
Tools that we can use:
• Breaking things up into smaller steps –
‘Step by step’
(called Activity or Task Analysis)
• Go step by step using ‘Prompt,
Guide, and assist’
(using graded assistance)
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Step by step (task analysis)
• Break activity/task into small steps
• Give the least restrictive prompt to enable activity/task completion
• Smile, encourage and give praise
• Allow person to proceed at their own pace.
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Non-Directive Prompt
Directive Prompt
Modelling
required
action
Physical
Assist
Fully
Assist
Prompts and Guidance
Graded
assistance
REMEMBER:
Make the most of a
person’s skills and
abilities!
Task analysis
allows each person to…
• Maintain independence
• Maintain existing skills
• Maintain dignity
• Maximise the possibility of success
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Preparation for an activity – 5 ‘S’s
• Set up – make prior preparations, have things ready or set up
• Say it - explain what is about to happen
• Show it – point and demonstrate
• Start with a Smile – “can you help me?”
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Balance safety/comfort with
independence
All people have a right to…
• Be safe
• Be comfortable
• Maintain independence
• Maintain existing skills
• Make informed decisions
Finding the balance can be challenging
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Structured activities
• Assisting with makeup/hair
• Bus trips
• Church service
• Showering
• Crosswords
• Gardening
• Making a cup of tea (domestic)
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Unstructured (half done)
activities
• Chair placed to look out onto bird feeder
• Garden tools accessible to encourage gardening
• Unfinished knitting
• Open magazines
• Basket of washing left to hang on the line/fold
• Broom handy to sweep floors
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Individually tailored activity
Designing and assisting a person with an individually tailored
activity
• Personal history (centre)
• Likes and dislikes (centre)
• Culture (centre)
• Safety and comfort (accept limitations)
• Disabilities (i.e. visual impairment) (accept health)
• Communication (respect)
• Safety and comfort (accept limitations)
• Enabling environment (enable)
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Partnerships with family carers
Why are partnerships with family carers so
important in dementia care?
Partnerships with family carers are crucial for:
• Achieving our mission
(quality of life for each person)
• Meeting our core challenge
(knowing & honouring each individual’s
uniqueness through how we care)
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How family carers can help …
… you engage people with dementia
Assist with achieving high quality care through sharing what they have
LEARNED THROUGH CARING:
• the meaning of mannerisms and behaviour
• how to care well
• strategies for resolving problems
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How family carers can help you …
… engage a person with dementia
• Improve quality of life
– Create pleasure & enjoyment
– Meet emotional & individual needs
– Identify issues & problems early
• Provide vital information about the person:
– Assets (social, personal)
– Interests, routines and activities
– Shared history
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Key Messages
1. Activities are everyday not just recreational
2. Activities that engage are meaningful to the
person and tailored to their needs
3. Memory is not essential to enjoyment
4. Assist engagement by a step by step approach
5. Balance comfort/safety with independence
REMEMBER … Make the most of the client’s
abilities and go at their pace not your pace and
use all your communication skills
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