We also have a few ladies who really enjoy making crafts, no matter how big or small.  We’ve found that one of the crafting activities that seems to work well for a variety of independence levels is crunching up little squares of colored tissue paper and pasting them to an object or a drawing.

To get an activity like this ready all you really need are some sheets of colored tissue paper and scissors, or actually, I prefer using one of those long blades with a grid base (I forget what to call it) so you can cut up one inch squares quicker.  We put these flat squares of tissue paper into small cups, like old margarine containers, and put them around the table for our members to choose from.  They can then scrunch the paper into whatever shape they’d like and then dip it in some glue to paste it to their shape.  Also, for those who have trouble with individually dipping each piece, you can spread glue onto the shape first and then scrunch the paper up and drop them on.

To take the activity one step further for your more independent crowd, ask them to help prepare the activity.  They can help cut, sort, or even help scrunch some shapes up for those who cannot due to arthritis or paralysis.  They can also give you input as to what colors to choose and can help supervise and assist less independent residents.

After our group made their patriotic stars, we hung them up on our bookshelf to decorate the room.  They really enjoy being able to look up and see their contribution to the program, I think it adds to their self-esteem quite a bit.  Today we sent them home with them as they left so they could enjoy it for the 4th of July holiday.

One lady in particular was very concerned about not forgetting her craft this afternoon.  She asked us to take it down from the bookshelf so she could keep her eye on it.  Memory is a fascinating thing, this lady remembers her short-term memory is poor, so she tries to compensate for it!

As you may imagine, once we pull one craft down, other members wanted to hold onto theirs as well, and before you knew it we only had three stars hanging and a bunch of them on the table!  People began to be picked up and the lady who started the whole episode went to the restroom before she expected her son to arrive.

When she came back, her star was missing!  She was so worried to not forget it and now we couldn’t find it!  We feared someone took it home accidentally, but I was pretty certain that couldn’t be the case.  I asked her to check her pockets but she said they were empty.  She wore a big, baggy jacket, one that was probably three or four sizes to large for her short frame.

We looked around and tried to see if she thought if one of the stars hanging was hers, but she could tell it wasn’t; she knew her own handiwork.  My heart ached for her, of all the things she would forget during the day, she couldn’t forget about not taking this craft home.

I asked her again to check her pocket, because I was sure it had to be somewhere on her, but they were empty.  Luckily, something caught my eye on the bottom of her jacket and I asked her to hold still for a minute.   I leaned over and saw a piece of gold string around a button on the bottom of her jacket.  I pulled it, and the star appeared out from under her jacket, thankfully!

The mind is a mysterious thing, she knew she didn’t want to forget it, yet couldn’t remember she tied it to her coat.

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When you’re trying to make sure an activity is age appropriate, its a great idea to look to the real world to see what grown adults are actually used to doing.  Ask yourself what materials they are used to working with.  For what purpose do they carry out this activity?

In truth, adult beading is almost an oxymoron.  However, when you look around, jewelry making is something that some grown women have turned into a hobby.  Today, there are kits that let you piece together earrings, necklaces, and bracelets that many adults purchase for their own enjoyment.  One of my co-workers made everyone earrings for Christmas this past year!  Here are some tips to make this simple activity more comfortable and rewarding for our residents and members:

Buy Nice Looking Beads

Okay, I know we can get 1,000 cheap, plastic, multi-colored beads for $5, but is that really what you want to hand to your clients?  We found some professional looking beads at our local craft store (Michael’s) and organized them into like-colored containers.  That way someone could very easily make a piece of jewelry where all of the pieces actually matched!

Look for Charms!

This goes along with the first tip, but many women really enjoy showing off their charm piece on their jewelry.  It could be a heart, a musical note, one woman we work with has pink dice on her earrings for good luck.  A single charm makes the entire piece of jewelry much more sophisticated.

Quality Over Quantity

If your budget is tight, consider down-sizing your craft.  Instead of a three-foot long necklace, try making bracelets.  If you’re really strapped for cash, earrings require even fewer pieces.  You may also consider a broche.  Remember, would you go for a long piece of cheap jewelry for your own wardrobe, or pay the same for a really nice looking smaller piece?

Ask for Help

Well, sort of…ask your residents to help you with the project.  Some residents may not feel like wearing jewelry, but they’d be glad to help you organize the beads into like colors.  Others may get a kick out of making jewelry for one another.  Try asking, “Do you know Ms. So-and-so down the hall?  She could really use a bracelet.  Would you like to help us and make a bracelet for her?”  This is an approach that can really empower a resident and make their day.

Recycle these as an activity!

Activities in our facilities fall into three categories, supportive, maintenance, and empowerment. Supportive activities require staff or volunteer support for the member or resident to participate in. Maintenance activities help a resident maintain their physical and cognitive abilities as well as their sense of socializing, spirituality, and emotional health. Empowerment activities help the resident re-develop a sense of purpose in their own life. Often, these involve self-expression, personal responsibility, and/or self-respect.

When working with the dementia population, most of our activities fall into the supportive and maintenance categories.  It is for good reason, that particular population has an inevitable decline in most cases, and we’re trying to prolong, or plateau, their lives with therapeutic recreation.  Sadly, the person with dementia loses out on empowerment opportunities in our facilities because we’ve been so focused on helping them maintain what abilities they still have.  We must never forget, that the person with dementia is still a person who is conscious of themself, and therefore needs opportunities of empowerment that help maintain their sense of dignity and self-respect.

This brings us to the activity I led this morning with our dementia group.  One of our staff is on leave to be with one of her family members with a serious illness.  I wanted to give our members an opportunity to help (because they’re going to notice our staff is gone!) and I thought that making “Get Well Soon” cards would be a nice way to get them involved.  Right away, this activity is empowering all of our members by giving them the opportunity for self-expression and the responsibility to help cheer someone up.

I got together some various colors of construction paper.  Usually, our staff gets all the materials together ahead of time.  This time, however, I wanted to try involving our clients even more (I was inspired by some of our discussions in the MEPAP 2nd. Ed. course!).  It was an hour before our group activity was scheduled to begin, and some of our members were drinking coffee together at a table.  I asked them if they could fold the construction paper to help me get ready for the craft.  I was quite pleased because one lady who really doesn’t enjoy card or dice games was very eager to help in this manner.  One of our male members also brought forth an idea.  He asked if he could cut the paper into different shapes so we could have different sizes and shaped cards.  Wow, I did not expect this!  He was a tool guy throughout his life, so we quickly brought out some tools for this task, a ruler, pencil, and scissors (yes, real adult scissors!).

As the group was working on the paper, I brought out a stack of donated cards that we have in storage.  Some of them were for birthday occasions, some were holiday cards, and others were for any occasion.  I asked the group to cut out pictures they thought were appropriate from these cards to be glued onto the construction paper.  Also, I told them we were helping the environment because we were recycling old greeting cards.  If you’re looking for places to get used greeting cards try asking a local church or elementry school to hold a ‘card drive.’  This works especially well around and after the winter holidays when everybody has a zillion greeting cards they don’t know what to do with anymore!

So, our group was buzzing with activity, and the best part was that the “real” activity hadn’t even begun yet!  Instead of our staff spending one to two hours working to get this together, we extended the opportunity to our clients and we both benefitted!  They have something worthwhile and rewarding to work on, and our staff will get burned out less.

We spent about 45 minutes prepping the activity, and I gave them a 15 minute break to wash up or use the restroom before our Card Shoppe would begin.  Also, this gave our other members who planned to arrive at the scheduled time a chance to show up and chat without being distracted or feeling like they were left out.  One of our volunteers was about to clear the rulers, pencils, and glue from our male client’s seat, but I said, “Oh no!  He’s a tool guy, let’s let him keep his tools!”

The activity began, and this male member wanted to keep helping out.  He passed out construction paper around the room and asked what color each person preferred.  I could tell he was glowing inside.  To us, this may seem like a trivial task, but to him, the opportunity to be a leader in passing out the paper was the highlight of his day.

After a half an hour of working on the cards (we also brought out stickers and shapes they could glue on) I asked everyone to make sure they signed their names.  We then held an art show and everyone had a chance to display their work to the group, with applause in between.

I cannot overstate how many times we’ve held a card shoppe activity, and missed out on this great opportunity to empower our folks.  And in reality, its not us who were missing out, but those who we are responsible to care after.

- Justin Zarb, ADPC

Image by: Richard Moross (Flickr)

I like to think that planning activities is not simply a task or job, but that it is an art. It is a craft that one can hone. Just like any other craft, it is not easily mastered overnight or by working in the field for a long period of time. In fact, I still consider myself to be at the beginning of my journey to hone my craft of being an activity professional.

I’m sure that every activity director, in every facility, comes across the same problem. Namely, that activities are becoming too routine and mundane for the participants in the facility.  Of course, this is just one extra idea to spice things up, but I hope that by sharing my thought process behind this activity, I can help inspire others to innovate on their own.

Initially, our program was lacking variety in our table games. We can only play UNO and Yahtzee so many times before the staff and even those with short-term memory loss grow bored of it. In looking for a new activity, I wanted to start by investigating what sort of games our members used to enjoy. This way, I hoped to find an activity that would be readily relatable and feel comfortable for the members when we began playing. It turns out, somebody mentioned that their family played BUNCO with their neighbors and that it was a riot whenever they got together. At this point I was slightly petrified, I had never even heard of BUNCO.

So, we investigated and bought a small box of BUNCO at the store. I opened the top and found three white dice, three blue dice, and three red dice accompanied by a silver bell and some rules and score sheets. Naturally, I started looking at the rule book. It turns out, BUNCO is quite a complex and fast-paced game. Without going into the entire game, it involves multiple tables throughout the room all rolling three dice trying to hit a Bunco, which you do by rolling three of a kind. It sounded quite chaotic, and the scoring was complex. First you were all rolling for one’s, and once someone hit enough points you were to run and hit the bell, then everyone was supposed to get up and change tables and start rolling for two’s. I didn’t have to read much to know that this game was going to need some serious rules adaptations for our dementia population!

First off, I knew that we’d have to have one game, at one table, with one score sheet. So, running around trying to play musical chairs between rounds was off limits. Secondly, I needed to simplify the rules so I could explain the game in a sentence or two. I decided that instead of rolling for one’s in perpetuity until someone scored enough points, we would go around the table once for each number. The first time around we would all try for one’s. The second time around we would try for two’s, and so forth up until six. Third, I knew that the bell that came with the game was going to be worth its weight in gold, I mean, who doesn’t like ringing a bell? So whenever we sit down to play, I ask one of our members to be in charge of ringing the bell. When someone rolls and scores, the bell-ringer’s job is to hit the bell. I’ve found this to be empowering for some of our members with dementia, as well as entertaining for the rest of the crowd.

How do you score? The original BUNCO rules were complicated and differentiated high Buncos and low Buncos and all sorts of quirky things to keep track of. So I simplified the rules. During the first round, when you roll the three dice you gain one point for every one that you roll. In the second round, you score for rolling a two. Also, if you roll a three-of-a-kind you gain five points, which is called a Bunco. Additionally, if the three-of-a-kind is the same number as the round (i.e. you roll three four’s in the fourth round) you rolled what I call a Super Bunco and gain ten points. Sometimes, I refer to it as a Holy Bunco just for fun.

Now on your turn, you continue to roll as long as you are scoring points. So, if on your first roll you get a one, you score one point and roll again. If you roll a Bunco you score five more points and roll again. On your third roll, if you score no points, your turn for this round is over and you gain a total of six points. It is possible that on your first roll you do not score, if this happens your turn is over.

The explanation on paper seems more complicated than seeing the game in action. I was very happy to see that this adaptation of the game was still relatable for those who played the game earlier in their lives, but was simple enough for those who had never seen it before. The bell-ringer turned out to be a great idea, and it got our members more involved in leading the game as well.

Anytime you introduce a new game you should be prepared to tweak it as you see how its being received by the participants. At first, I tried using the score sheets that were included with the game, but after trying it out a few times I decided to make my own. I made a simple sheet up with eight columns and a bunch of rows. The first column was for each player’s name. The next six columns were numbered one through six so that you could keep track of each person’s score for each round. The last column was to total up the scores at the end of the game.

We’ve been playing this new version of BUNCO for quite a while now, and to be honest, many of our members ask for us to bring it out to play! The game is easy enough to be played by pretty much all of our members with dementia (all it really requires is rolling dice). Also, I keep evaluating our activities to see how we can improve them and I’m coming to the opinion that we don’t even need to keep score for the game to be fun. One day I wanted to experiment and I asked one of our members to start the game and let the members direct each other through the steps of the game. The dice went around the circle and they started rolling for two’s during the second round. What could be better than this?

- Justin Zarb, ADPC

Image by ty_asta (Flickr)

The activity is writing a letter to soldier who does not receive very much mail, to let them know how much their sacrifice is appreciated.  How do we know which soldiers don’t receive much mail?  Well, there is a program called Any Soldier where soldiers who do receive a lot of mail volunteer to help pass mail out to those who don’t hear from back home very much.

There is nothing more engaging for some of our folks that we care for than this idea.  Many of our men served in the military in their youth and many of our women had husbands or sons serve as well.  And, when you tell your residents or members you are writing to a soldier who does not receive any other mail, you can really create a meaningful, dignified activity for them.

Part of our job as activity directors is to ensure that our residents can maintain a sense that they can interact with the world outside of the facility.  Also, this is an activity where our resident, who is is usually the one being cared for, gets to reverse the role and support someone else.  While I’m sure these letters will help our soldiers overseas, writing and sending them can also improve those we care for in our facilities.

This is an activity you might do with your men’s group, or with a single resident if you think they would really enjoy it.  You can also open up a large group activity if you have a lot of people with dementia and write the letter as a group.  This way, everyone can participate without having to articulate an entire letter.  You may want to ask the group to take their picture and send it with the letter.  And, of course, please have everyone sign their own name to the letter.

You can find all the information for sending a letter at www.anysoldier.com.  One word of caution, when you address your letter, you must address it to a real soldier and put “Attn: Any Soldier” on the second line.  The USPS will not deliver a letter if the only person on the envelope is “Any Soldier.”  You may also want to put your letter in a second envelope, underneath the official one, that way when it is received it might appear more special to the troop.

- Justin Zarb, ADPC

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.

“Got any eights?” he said.

“No, sorry,” I replied.  “Got any two’s?”

“Yep,” he handed me a two, “you can also call them deuces.”

“Alrighty!  Deuces it is!”  I went to lay down my pair of two’s.

“Oh, you need to wait until you get three of a kind to put them down,” he told me kindly.  “Got any eights?” he said again.

“No, sorry, go fish.  Do you have any Kings?”

“Sure do,” and he handed me two Kings, so I laid all three of them down.”

“Have you got any eights?” he asked, once again.

“No, I haven’t got any eights.”

The game went on for a few minutes, and partway through the game he picked up a King from the pile and played it on his side.  This gave me a great sigh of relief .  If you could only play three-of-a-kind, and you could only go out if your hand was empty, I was worried you might get stuck holding an extra card and the game would never end!  However, his version of Go Fish foresaw this predicament.  I guess it was a kind of Go Fish/Rummy hybrid.

It wasn’t too long before the game was over, and he looked at me with a big smile and said, “You won!  Congratulations!”  I was impressed with the game, it was straight-forward yet dignified (because each player is allowed to make their own choices about what card to call), could be played with only two players, and would last no longer than 10 or 15 minutes at most.  To me, this makes it a very ideal one-to-one game that I will keep in my back pocket for those clients with short attention spans, but need some social interaction.

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.

We had an old green mat that said “Blackjack” on it and was pretty official looking.  I also found some poker chips, you know the ones with the checkered outline on them.  I set the table up like you’d find at a casino and had the guys gather around.

I explained the basic premise of the game, to get as close to 21 as possible without going over, and getting a better score than the dealer.  I started each hand by saying very genuinely, “The house wishes each of you gentlemen the very best of luck.”  I kept talking in this official persona througout the hand saying, “The gentlemen in the black has a King on top,” or “He chooses to hit with eleven showing,” just to keep the effect of a real casino going in our minds.  One of the gentlemen really enjoyed my persona and would tell the other guys, “He’s talking like a real dealer,” and chuckle under his breath!

I have to admit, I was caught off-guard by the level of play of our gentlemen.  Every single one of them knew almost instinctively how the game was played and needed very little direction.  I really underestimated their ability.  It made me wonder if we should stop inventing games and activities our clients have never seen before, and stick to things that are or closely resemble the things they’ve always enjoyed doing.

Also, I realized, playing blackjack is a dignified activity.  The men have the opportunity to make choices for themselves.  Do they want to hit, or stand?  How many chips would they like to bet on each hand?  They get the ability to revel in victory and know that they did it on their own!  I feel that some of the cognitive games that we do with the dementia population can be almost degrading to participate in, because they’re too dumbed-down or so foreign to their experience that they have trouble succeeding.

Be on the lookout for activities that build up your residents or members.  There’s nothing better than a dignified activity, especially for a group of men who realize they are not the breadwinners anymore, not the head of the household anymore, and have trouble feeling like someone has to take care of them.

- Justin Zarb, ADPC

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:

Baseball Big Dice

The object of the game is to throw the dice to score more runs than the other player/team.  On each turn, the player throws two dice:

Doubles equals a home run!

Any combination that adds up to an odd number is an out.  (i.e. 2 + 3)

Dice that add up to 4 is a single (one base).

Dice that add up to 6 is a double (two bases).

Dice that add up to 8 is a triple (three bases).

Dice that add up to 10 is a home run.

You can play any number of innings, so long as each team gets an equal turn to “bat” (rolling the dice).  You can write on a chalkboard, whiteboard, or piece of paper to represent the four bases, so if a player rolls a single or double you can let everyone know they are on base.

During a team’s at bat, have one player roll at a time.  After a player rolls, either mark them on base, count any runs that have come in, or declare them out (if their roll adds up to an odd number).  Then it is the next player’s turn on that team to roll the dice.  If a player rolls a hit and there is already another player on base, move the player on base an equal number of bases as the hit.  So if there is a man on second base, and a player rolls a single, the player on second will move to third base and the player who rolled will go to first base.  If a team has three players roll outs, then their turn at bat is over for that inning.

At our program, we have our members sit in a semi-circle and we use big, yellow foam dice because they’re easy to handle (and actually kinda fun because they bound all over!)  I used a white-board to represent the bases and keep track of the runs and outs.  The game could also easily be played on a table with regular dice if you had a smaller group of people.

Remember, you can be creative as you want with games like this.  If you want members or residents to come up to an actual plate to throw the dice that’s a possibility.  You can sing the national anthem before the game begins!  We also like to split the room up into two teams and have each team designate a captain and pick a mascot.  Its all about making it fun, so feel free to get creative with your group!