The Requirements for Participation (ROP) emphasize person-centered care which is care focusing on individual needs, interests and preferences. The activity professional learns early in their career that the activity assessment is the foundation of the therapeutic process. It is also the foundation for person centered care. One cannot emphasize enough the importance of collecting individualized information and how it is noted within the assessment. Specific information about the resident/client’s functioning, including physical, cognitive and psychosocial needs, is helpful in designing just the right approach that can be introduced with success.
The ROP also outlines the importance of gathering very specific information about the individuals’ past and present leisure and recreational preferences with the intent to involve the elder in programs tailored to their individual likes and dislikes. Translating that information into appropriate and individualized programming is often taken for granted and sometimes overlooked. Common assessment mistakes include not collecting enough individualized information or worse yet, not translating the documented individual needs or preferences into applicable or appropriate programming.
The most common type of program approach relates identified needs to the programs that can fulfill those needs. When first learning about therapeutic activities, categories of activities are commonly utilized. For example, physical activities are active games, exercise programs and other programs encouraging range of motion and movement. To use the program therapeutically, the activity professional would recommend or encourage resident/ client involvement in the physical activity if the assessment determined a need to increase physical movement, improve circulation, improve mood, or strengthen different parts of the body. Knowing the resident/client and knowing the scope of program benefits allows the activity professional to use activities in a therapeutic way. Knowing the person’s interests can also contribute to success. Using the right type of music, supplies, resources and verbal approach – based on individual preferences can impact directly on success or failure.
Other categories of activities include:
Cognitive: Stimulate basic and past cognitive skills of memory and decision making. Sample activities would include rote trivia, matching activities, and games like “Penny Ante”.
Intellectual: Stimulates more complex cognitive skills and intellectual functioning of learning and reasoning. Sample activities include more difficult word games involving reasoning and problem solving, discussion groups requiring debate and opinion, and learning activities.
Social: Stimulating interactive and social skills in a group setting and meeting the individuals’ need to belong and be part of a group. Sample activities would include food and discussion socials, parties, and any program where conversation is fostered.
Spiritual: Stimulation of faith or religious based values and needs. Sample activities include formal church services of any kind, bible readings, hymn sing and meditative programs
Expressive or creative: Focus on creative expression and personal expression through tangible means. Sample programs would include drama, writing, painting, creative arts, crafts, cooking, or gardening.
Affective: Focus on the emotional expression or emotional connections between individuals. Sample activities would include reminiscing, life review, theme programs with familiar tasks from the past and discussions on shared life topics.
Awareness, sensory or diversional: These are some of the categories which focus on the needs of individuals with cognitive impairment. These activities offer a sensory or solace oriented approach for individuals with more impairment or a diverting approach for the more active cognitively impaired elder. Sample activities would include sensory programs of all kinds, hand massages, environmental videos or sounds, or life skill tasks.
The activity professional introduces activities in a way that contributes to the benefits the resident may derive through engagement in the particular activity. An individualized assessment provides the information we need to have this success. With experience, we learn rather quickly that many activities have multiple benefits, depending on how they are implemented and how the person is engaged. For example, a physical activity can enhance physical functioning but there are also social aspects to most physical programs which is also beneficial. It is the activity professional who uses the activity appropriately and in a therapeutic way with the right resident. It is the activity assessment which leads to an individualized person centered care plan.
By Debbie Hommel, ACC/MC/EDU, CTRS