14: Activity-Focused Dementia Care: Person-Centered Care and Environments

This program will help you:

• Understand the importance of relating activity-focused care to a person-centered approach
• Modify environments to create the best possible occupational space

• There are no easy answers when it comes to the care of another
• Our hope is to offer you useful information and guidelines for caring for someone with dementia
• These guidelines will need to be adjusted to suit your own indivisual needs

• ACTIVITY-FOCUSED DEMENTIA CARE
• Incorporates meaningful activities into daily life
• Includes any kind of activity that is meaningful to the person
• PERSON-CENTERED CARE
• Focuses on individual needs and wants
• Considers personal preferences, habits and routines
• Considers personal preferences, habits and routines
• ABILITIES-fOCUSED CARE
• Identify and encourage use of retained skills and capacities
• Compensates for dementia-related problems and limitations
• Allows for successes at the person’s level of ability

Why did Mary want Robert to get up early in the morning?

• A. Robert likes getting up early in the morning.
• B. If Robert gets up early, he’ll sleep better at night and be more engaged during the day.
• C. Getting up early is generally helpful to people with dementia.
• D. Mary likes to start the day early.

Choice A: Robert likes getting up early in the morning, is an unlikely answer.

Choice B: If Robert gets up early, he’ll sleep better at night and be more engaged during the day, is also unlikely.

Choice C: Getting up early is generally helpful to people with dementia, is incorrect.

Choice D: Mary likes to start the day early, is the most likely answer.

• Person-centered care is individualized and considers each individual’s wants and needs
• Activity-focused care is best when customized to each individual
• Take into consideration personal preferences, characteristic habits and routines
• Respect the person’s values and beliefs
• Respect spiritual and religious practices
• Learn about each individual’s cultural norms and practices

• Caregivers should know about the person’s meaningful life experiences, past roles and accomplishments
• To learn about someone’s meaningful life experiences,caregivers can ask questions
• Use photographs, albums, and scrap books to help someone reconnect
• Post a brief life biography and supporting pictures on the bedroom door

• Person-centered care respects cultural norms and expectations
• Independence and autonomy versus interdependence and community
• May feel disrespected and embarrassed when given assistance from others
• May help explain why the exact same approach may work well on one person but not another
• Person-centered care also respects values and beliefs, including spiritual and religious preferences

What is the main reason why Robert failed to engage in putting the puzzle together?

• A. Robert failed because he became more interested in the TV rather than putting the puzzle together.
• B. Robert failed because of his cognitive problems caused by Alzheimer’s.
• C. Robert failed because of hearing and vision problems.
• D. Robert failed because his environment was not set up to increase his chances of success at the activity.

Choice A: Robert failed because he became more interested in the TV rather than putting the puzzle together, is unlikely.

Choice B: Robert failed because of his cognitive problems caused by Alzheimer’s, may be partially correct.

Choice C: Robert failed because of hearing and vision problems, may also be partially correct.

Choice D: Robert failed because his environment was not set up to increase his chances of success at the activity, is the best answer.

• Vision
• Glare
• Peripheral vision loss
• Poor central vision
• Reduced contrast perception
• Easily become visually distracted
• Hearing loss

• Remove barriers to participation
• Reduce excessive background noise
• Reduce glare
• Direct glare: occurs when light sources are not properly shielded
• Reflected glare: occurs when strong light bounces off hard, smooth surfaces

• Reduce clutter
• Set out only needed objects
• Present objects one at a time
• Put like objects with like objects
• Provide orienting signs and cues
• Ensure hearing aids are operable and being used
• Ensure eye glasses are clean and positioned properly
• Provide visual contrasts by using light letters on dark backgrounds
• Combine ambient lighting with focused task lighting

• Provide positive occupational spaces
• Places where people are meaningfully occupied
• Provide access to familiar tasks
• Call upon retained skills and abilities
• Consistent with former roles or interests
• Repetitive, large-motion activities

Creating Individual Spaces

• Spaces for individualized activity and work
  • Comfortable chairs around a small work table
  • Good task lighting
  • Favorite items within reach
• Might initiate activities on their own
  • Jigsaw puzzles
  • Handling money
  • Knitting
  • Physical activity

Creating Social Environments

• Occupational spaces encourage social interactions and gatherings
  • Allow for people to sit and interact
• Create interest points
  • Outdoor bird feeders
  • Inside aviaries
  • Aquariums
  • Religious symbols or altars
  • Tapestries and other artwork
  • Indoor plants and flowers

• Activity-focused dementia care
• Activities that are meaningful to the person
• Meets that person’s needs or wants
• Person-centered and abilities focused care
• Person-centered care
• Focuses on individual needs and wants
• Considers person’s history, preferences, habits and routines
• Respect cultural norms and values
• Incorporates personally meaningful activities
• Occupational spaces
• Adjust for vision and hearing loss and limitations due to Alzheimer’s
• Provide access to familiar tasks that use retained skills and abilities
• Consistent with former roles or interests
• Repetitive tasks with clear outcomes
• Comfortable chairs, a work table, good lighting
• Easy access to favorite items and activities
• Provide interesting objects for enjoyment and discussion

Written by:
Catherine M. Harris, PhD, RNCS.
Mindy J. Kim-Miller, MD, PhD

Edited by:
Sasha Asdourian

www.LightBridgeHealthcare.com

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