It is really enjoyable to watch when one of your clients self-initiates a game. Today, one of our members brought in a deck of cards and was asking his friends to play Go Fish with him. He is a real charmer, although his form of dementia makes it a struggle for him to determine things that are appropriate. So, in the middle of a group activity, he pulls out his cards and loudly asks his friend to play with him. And, he doesn’t take “no” for an answer, he just deals you a hand of seven cards and waits for you to join!
The other members didn’t really want to sidebar themselves from the group, so I decided to jump in so he would have someone to play with. As we started, I realized I didn’t know what rules he was using for the game, so I asked him to explain it to me. Here’s what he said:
“Well, its a real good game, you’re gonna like it,” his southern drawl was soft but always genuine. “You get seven cards each, and you ask the other player for a card, and if he doesn’t have it you draw from the pile. When you get rid of all your cards you are the winner.” He gave me seven cards and then put the rest in a stack, so you could only draw from the top.
Almost a year ago we started a men’s club at our program because our male enrollment increased quite significantly. I can’t say I have definitive proof, but I do believe having a male on the activity staff (me!) helped attract families looking after their husband and fathers.
Anyways, this meant I had to look into what kind of activities our men’s club would be interested in. At first, I think I was trying too hard. I spent more than a couple hours scouring the internet for a great idea or two, but I ended up pretty much where I started. So I got to thinking, what was it that these guys would do for fun before their dementia set in?
One morning, I decided we were going to try Blackjack. I was a little skeptical at the time, I mean these men had trouble telling time and would reach for words they couldn’t remember. But, I figured if we never tried, we’d never really know, and if they couldn’t really play we’d at least have fun trying.
I was quite excited when I received a large manila envelope in the mail yesterday. It was from the NCCAP (National Certification Council for Activity Professionals) and I was going to hear whether my application for activity director provisional certification was accepted.
The envelope seemed to be somewhat thick, so I was optimistic. I opened it up and saw a nice certificate with a shiny seal and an official signature! I especially enjoy certificates with large, shiny seals on them. I guess it makes me feel important!
Anyway, I am now officially an ADPC, and upon completion of the MEPAP 2nd edition course I’m currently taking, I will be eligible for ADC (Activity Director Certified).
Why become certified? Well, I can’t tell you how many phone calls I’ve taken from families that ask about our staff and their background and training. Usually I try to hype up the years of experience I’ve put in, but I could tell with some families they wanted to hear something a little more official. I wasn’t about to go back to school to get a Bachelor’s degree in therapeutic recreation, I just graduated with a B.A.! Also, I wasn’t interested in becoming an Occupational Therapist, not that they’re not necessary, but I really enjoy enhancing people’s lives through what I can do in the activities department.
We’ve been working with a gentleman who recently began worrying in the afternoon that he needed to get to his job, and that he had a ton of things he needed to do that day. Sound familiar? This sort of behavior can be awfully difficult to redirect, since he is focused on the tasks he believes he needs to accomplish. And, it is compounded with the notion that he spent all day playing games and needs to play catch-up.
If you’ve been working with dementia, I’m sure you’ve heard that often a person’s thinking reverts to an earlier period in their life. Hopefully, it was a nice period that they feel comfortable in. Sometimes, if a person’s early life was rather difficult, this symptom of dementia can be hard to live with.
In trying to help our gentleman we employ a few different strategies. First, we try reassurance. I tell him that he had the day off or that all his work is taken care of. We also try to pre-empt his sudden realization he should be at work by playing cards or dice games beforehand. Inevitably, he looks at his watch and sees the day is almost over and starts to worry. So, we may try to redirect him with an activity or take him on a walk to the restroom to take his mind off of it. Usually between these methods we could keep him stable.
During the MEPAP course I’m currently taking (MEPAP stands for Modular Education Program for Activity Professionals, and is part of the requirements to become a certified activity director) we occasionally have a chance to share experiences and stories from our facilities. One of our classmates shared this true gem.
At her facility, they have a resident to believes that he is Jesus Christ. One day, another person who was admitted to the facility also began claiming that he was Jesus Christ. Fearful of the outcome if Jesus ever met Jesus, they made sure their two rooms were in far apart units.
Medical interventions can happen quite frequently when working with the elderly population. Sometimes, they are very necessary. Other times, they inadvertently lead to a really poor outcome for the person.
For instance, my wife and I were planning a natural childbirth, one with as small amount of medical interventions as necessary. Why would one want to forgo the wonders that modern medicine can provide? It was because of the cascade of interventions during labor.
I was so glad when I came in to work today and a bunch of our members were decked out in their Tigers’ shirts and hats! Today was the first day of the regular season for Major League Baseball and we planned a theme day around rooting for the Detroit Tigers. In the past, we haven’t had many members who talked about the the Tigers but lately a lot of our folks are very interested, so I thought it’d be fun to throw a theme day. I sometimes get a little nervous because there’s nothing worse than throwing a theme day and have no one actually dress up or do anything for it!
Anyways, I wanted to plan a baseball game that we could do with our group that everyone could participate in and I started brainstorming about how a dice baseball game could work. I previously read a couple ways to play baseball with dice but they seemed too complicated or uninteresting. Here’s what I came up with:
At the end of a long day, some of our members will get tired and yesterday a woman who has been with us for many years turned to me and said, “Oh, I could just take a nap right now.” I’ll call her Ms. Montana.
So I told her she looked sleepy, but sitting next to me was another member, let’s call him Dr. Singer, and he said, “You know, if you come visit me in my office, we could diagnose the problem and help you to not be so sleepy.” Of course, Dr. Singer no longer practices, but often he talks as if he’s still in the prime of his career. Somtimes he can be a little rude about diagnosing people (”You may have sephilus.”), but today he was very respectable, like an earnest physician that I hope he once was.
“You see, we can do the blood work, and find out what is making you sleepy. There may be some obesity in the blood.” I love hearing him talk because he has a Count Dracula type accent.
Ms. Montana was a little astonished. “Are you saying I’m fat?!!”
At our facility today, we had to call 911 for one of our members. Everything is okay and our member is doing well. However, it caused me to wonder what roles an activity staff should take during and after an emergency situation.
Every facility has a plan in place in cases of emergency, but often these plans are limited in scope to the medical side of things. This is not a bad thing, though. An emergency requires quick action, teamwork, and an understanding of chain of command; adding too many other details may get in the way, causing us to lose precious minutes that could be used to save someone’s life.
After thinking through how our staff reacted today, I wanted to share five roles that I would encourage my staff to keep in mind in case of emergency.
 She turned 93! Today we celebrated one of our members’ 93rd birthday! She’s been with our program for at least the past 4 years that I’ve been working. Although she’s one of the oldest members we have, there aren’t that many others still with us from four years ago when I started.
We had a great day of celebration. We only sang Happy Birthday to her about four times. An hour after the first time we sang someone saw the balloon and asked if it was indeed her birthday. “So why haven’t we sung for her yet?!!!” So we sang again, and again, but it was no chore, we all celebrated the achievement of this small, frail, elderly woman battling dementia. I’ve named some of our other members so I might as well ascribe one for her. I think Ms. Determination will do.
What struck me most today is how much our staff and volunteers have emotionally attached to Ms. Determination. Of course, this includes myself, and I was trying to weigh the pros and cons of becoming attached to the people we care for throughout the day. Is it a good thing? Should we be more or less involved on an emotional level?
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