trythisactivitykit 4_12_04.PDBؽRCH1DTGP@ @J@@@4@8@9v@9@ 9@ :@ :$@ @ \ l |                    "  0  >  L  Z  h  v      ces and Resources Greenwood, D., Loewenthal, D., & Rose, T., (2001). A relational approach to providing care for a person suffering from dementia. Journal of Advanced Nursing, 36 (4), 583-590. Hancock, C., K., (2001). Restraint reduction in acute care. Journal of Nursing Administration, 31 (2), 74-77. Youngstrom, M.J., et al, (2002).Occupational therapy practice framework: domain and process. American Journal of Occupational Therapy, 56, 609-639. Resources for activity materials: Alimed http://alimed.  com Geriatric Resources: http://www.geriatric-resources.com Nasco Senior Activities Catalogue, Telephone number: 1-920-563-2446 S&S Primelife, Telephone number: 1-800-243-9232 NbNo"9D0BO"o(:" xReferen( > # rN 7 7nhancing f ? H~ A Cs B Be D Fo E Ef G Jt H Hhe L Ni M Mt$ $& 6oo F V f v    $$ SS LL ~~  UU ^^ &.. 6  F V  f v*  * )).+ )*.  r 2.> N 6 O^ n "x A series provided by The Hartford Institute for Geriatric Nursing and the Alzheimers Association www.hartfordign.org x 55552cPTry This Dementia Series Volume 1, Number 4, Spring 2004 Series Editor: Marie Boltz, APRN, MSN, GNP Therapeutic Activity Kits By: Frances Conedera, RN, MS, PMHNP and Laura Mitchell, OTR/L WHY: Older adults with dementia have feelings that are often difficult to express due to cognitive impairments in: language memory, and executive function. Communicating self control, frustration, boredom, fear, loneliness, anxiety or pain can be expressed as: resistance to personal care wandering constant requests for assistance repetitive calling out. Apraxia, impaired recall, and the attendant anxiety that accompany cognitive loss often impacts the patients ability to cope with the stress of hospitalization. Caregiver impatience and rushing, being quizzed by clinicians and caregivers, unfamiliar surroundings, and an overstimulating environment may also provoke patient distress. Older adults often have periods of intense aloneness in the unfamiliar hospital environment, leading them to seek out companionship and purposeful activity. The use of an activity kit provides an opportunity for cognitive stimulation, and focused and intentional dialogue between caregiver and patient. It can also make the time spent alone, between caregiver and family visits, meaningful and less frightening. TARGET POPULATION: Hospitalized older adults with suspected or confirmed dementia whether or not they exhibit the behaviors described above, as well as patients with depression and /or limited family contact. Knowledge about the patients usual behavior and function markedly enhances the ability to individualize care. Standardized screening for cognitive impairment, including dementia, delirium and depression, should be performed upon admission and periodically. (See Try This: Mini Mental State Exam, Try This: A Brief Evaluation of Executive Dysfunction, Try This: Confusion Assessment Method, and Try This: Geriatric Depression Scale). BEST PRACTICES: The evidence suggests that non-pharmacologic methods are effective in improving mood, function and behavior in dementia. An activity kit that is a carefully selected collection of tactile, auditory, and visual items will provide: solace an opportunity for emotional expression, and relief from loneliness/boredom. Added benefits include: enhanced cognitive integration perceptual processing neuromuscular strength. The activity kit includes a wide range of items that are commonly used to provide diversion, such as: games audiotapes, and nontoxic art supplies. In addition, items such as: pieces of textured fabric cloth to fold tools, and key and lock boards are included for the person with more advanced dementia. STRENGTHS AND LIMITATIONS: Assessment and appropriate selection of activities is critical to avoid a quick fix or overstimulation. The items should reflect/match the patients preferences, cognitive capacity, and physical abilities. It is crucial to avoid items that infantilize, insult, or threaten the persons self-image. The items listed in this publication are suggestions. Families should be encouraged to individualize contents by providing audiotapes, photo albums, videotapes and activities that the patient enjoys. All kit items should be provided for the patient to keep, eliminating the need for cleaning between patient use, and infection control concerns. Enhancing Use of the Kit: Nursing staff needs to consult with family members and rehabilitation staff regarding the selection of contents, implementation, and evaluation of the activity kit. Suggested Therapeutic Activity Kit Contents ItemActivityPerformance SkillsTarget AreasPeg BoardPlace Pegs in resistive plastic boardPsycho social Cognitive Motor Vision SensorySense of purpose or relaxation Sequencing, spatial operations, categorization Coordination, crossing midline, ROM, pinch Color discrimination, depth perception, eye/hand coordination Proprioception, light touchArt supplies (Colored pencils, water colors, paper, clay)Drawing, painting, sculptingPsycho social Cognitive Motor SensoryEnjoyment/ stimulation, sense of purpose, self expression, or relaxation Attention span, spatial operations Fine motor movement Touch, visionWash ClothsFold towels Stacking towelsPsycho social Cognitive Motor Vision SensoryStimulation, sense of purpose or relaxation Sequencing, problem solving, attention span ROM, coordination, bilateral integration, pinch Depth perception Light touchFit-a- space puzzleAssemble & take apart various puzzle pieces/ shapes Lace shapes togetherPsycho social Cognitive Motor Vision SensoryEnjoyment/ stimulation, sense of purpose or relaxation Objective recognition, attention span, spatial operations Coordination, bilateral integration, visual/motor integration Form constancy, position in space, figure ground Light proprioception, touch ConesStacking ConesPsycho social Cognitive Motor Vision SensoryEnjoyment/ stimulation, sense of purpose or relaxation Sequencing, attention span, problem solving Grip, ROM Color discrimination Light touchPVC Piping (Pipe Tree)Assemble piping in patterns/ shapesPsycho social Cognitive Motor Vision SensoryEnjoyment/ stimulation, sense of purpose or relaxation Problem solving, motor planning, sustained Pinch, grip, coordination, ROM, bilateral Eye/hand coordination, visual perceptual skills Proprioception, light touchFinger FidgetsExercise Fingers with ballPsycho social Cognitive Motor Vision SensoryEnjoyment/ stimulation, sense of purpose or relaxation Attention span Pinch, coordination, bilateral integration Color stimulation Light proproception, touch Playing CardsPlay Games, sorting, shufflingPsycho social Cognitive Motor Vision SensoryEnjoyment/ stimulation Sequencing, memory, picture recognition, attention span, categorization Coordination, bilateral integration, ROM visual motor Figure ground, depth perception, visual memory Light proprioception, touch CDListen to musicCognitive Psycho- Social SensoryArousal/Relaxation Enjoyment/stimulation or relaxation AuditoryVideos Watch movieCognitive Psycho- Social Vision SensoryArousal, attention span, orientation, memory Enjoyment/stimulation or relaxation, age appropriate Visual attention Visual, auditoryNOTE: Skills required for each task vary and it is up to the professional to determine which activity is appropriate/ most therapeutic for the patient. Psychosocial= emotional wellbeing Cognitive = cognitive integration Vision = perceptual processing Motor = motor/neuromusculoskeletal skills Sensory sensory stimulation References and Resources Greenwood, D., Loewenthal, D., & Rose, T., (2001). A relational approach to providing care for a person suffering from dementia. Journal of Advanced Nursing, 36 (4), 583-590. Hancock, C., K., (2001). Restraint reduction in acute care. Journal of Nursing Administration, 31 (2), 74-77. Youngstrom, M.J., et al, (2002).Occupational therapy practice framework: domain and process. American Journal of Occupational Therapy, 56, 609-639. 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