“What do you do for activities?”

When I give families a tour of our memory care homes, it is the hardest question to answer.  It is much easier to explain the intricacies of Medicaid!  Particularly if the question is phrased in a way that is more accurate for many who suffer from dementia, which is “Mom isn’t interested in doing anything, what do you do here for activities?”

First, let’s “unlearn” the term “activities.”

Facilities are desperately trying to reverse the term they created by calling their activity specialists Life Enrichment Coordinators, Lifestyle Leaders, Community Program Directors, Leisure and Well-being Coordinators and many other terms.

Societal Trends

We’ve lost the picture of our elders sitting on a porch drinking iced tea and watching cars, children and pets pass by.  We no longer watch people in airports while waiting in the gates, we look down at cell phones and furiously text, email, message or tweet.

Nobody used to ask the day care provider what the children would be doing, it was obvious they would be playing with age-appropriate toys, playing games, sliding down slides, and imitating grown-ups.

Now, we have children shuttled from school to soccer practice, violin lessons, dinner, and more…yes, activities after dinner.

Guilt

Families probably don’t realize that their elderly mother being awake 70-80 hours a week causes them consistent feelings that she needs to be constantly entertained.  

If you are reading this, your cognitive function is probably pretty good.  Imagine if someone was tending to you 10 hours a day, trying to entertain you.  You’d be exhausted.  Now imagine that you lack the cognition to process the stimulation being presented to you.  You’d be agitated.  

That’s the pattern.

So please, no more feeling guilty, and no more over-stimulating Mom.  She’s ok just “being.”  I promise.

Engagement

Here’s the new term thou shalt use:  Engagement.  We engage in things every day by choice.  Tonight, my wife and I will be engaged in eating, then we will engage in talking about our day, then we will fall asleep.  No one will stimulate us, yet we will not feel bored, left alone, or un-entertained.  In fact, when our dog pesters us after walking him and playing with toys with him, we will have to summon up the courage to provide discipline so he will stop agitating us.

Ok smart guy, define engagement in your care homes.

Um, well, uh…here’s where the stammering begins.  I have trouble defining it, but I know good engagement from bad engagement when I walk around our homes.

Here’s my best shot:  Relating to a resident in a way that is exactly how they would like to spend their day.

Now, each person will need something different on any given day.

The engagement will need to be personalized to their health, mobility, frailty and level of cognition. We then need to consider their desires for socialization, what leisure interests they had previously and the like.

In addition we need to observe them, experiment, talk to families and be reactive to each person’s mood and feelings, how they slept, the stimulation they had recently and other factors.  Did a visit from a family member last longer than usual?  Did they forget the name of a grandchild and feel badly?

Ok ok, sounds complicated.  Give me simple solutions.

Tune in for Alzheimer’s and Activities, Part 2 and I’ll give you my best effort.