15: Activity-Focused Dementia Care: Preventing Excess Disability and Difficult Behaviors

This program will:

• Teach you about excess disability
• Help you understand how activity-focused care can prevent it
• Provide strategies for using meaningful activities to reduce agitation and other difficult behaviors
• Show you how activity-focused care can enhance caregiver satisfaction and well-being

• There are no easy answer when its 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 individual 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

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

• Engaging in meaningful occupations is important
• The human body needs to engage in activities to maintain physical and mental health
• Provides a sense of usefulness, enriches daily life, and benefits physical and mental health

• Any disability or functional decline that is over and above what is expected due to dementia-related changes
• Caused by the lack of use of one’s skills
• Results when use of existing skills is repeatedly discouraged or not encouraged
• Hastens functional decline
• Associated with passivity, social withdrawal and depression

Why do you think Robert has stopped trying to dress himself?

• A. Robert has forgotten how to dress himself.
• B. Robert has become more confused about what to wear.
• C. Robert is depressed.
• D. Robert isn’t encouraged to dress himself.
• E. All of the above.

Choice A: Robert has forgotten how to dress himself, is a possibility.

• Apraxia refers to the loss of the ability to carry out automatic movements and actions

Choice B: Robert has become more confused about what to wear, is another possibility.

Choice C: Robert has become more depressed, is another strong possibility.

Choice D: Robert isn’t encouraged to dress himself is another good choice. Choice E: All of the above, is the best answer.

Activity-focused care

• Can prevent and even reverse excess disability because it is abilities-focused care

Abilities-focused care

• Encourages the use of retained skills and capacities to compensate for dementia-related limitations
• Only assist with the tasks that care recipients can’t do for themselves

• “Doing with, not for” preserves dignity and shows respect
• Doing things for someone prevents that person from using remaining skills and capacities

• When people use abilities in activities that have meaning to them, their abilities can be maintained or improved
• If people stop doing these activities, their skills grow weaker
• People with dementia are vulnerable to losing their remaining skills when they stop participating in activities

• Assess the person’s retained capacities
  • Physical and motor capacities
  • Cognitive capacities
  • Social and communicative capacities
  • Emotional skills and capacities
• Modify caregiving and plan activities to encourage and promote these capacities

Robert is very agitated. Do you think that there’s anything Mary can do to reduce his agitation?

• A. No, Mary should not try to do anything because she provoked Robert by coming into the room.
• B. No, there’s nothing that Mary can do because brain damage caused by Alzheimer’s disease has made Robert agitated.
• C. Yes, Robert could be given calming medications.
• D. Yes, Robert could be given something meaningful to do.

Choice A: No, Mary should not try to do anything because she provoked Robert by coming into the room, is not a good answer.

Choice B: No, there’s nothing that Mary can do because brain damage caused by Alzheimer’s disease has made Robert agitated, is also not a good answer.

Choice C: Yes, Robert could be given calming medications, is not the best answer.

Choice D: Yes, Robert can be given something meaningful to do, is the best answer.

• Activity-focused dementia care can help reduce restlessness, agitation and other difficult behaviors
• All behaviors have meaning
  • Learn to read non-verbal messages
  • Check for unmet needs
  • Look for environmental triggers
• Difficult behaviors
  • Physical aggression
  • Delusions
  • Agitation
  • Sleep disturbance
  • Anxiety

• Activity-focused care helps to prevent agitation and difficult behaviors from occurring
• Addresses the need to engage in meaningful activities
• Redirect towards positive and satisfying experiences

Activity-focused care

• Improves quality of life
• Helps caregivers experience greater satisfaction, reward and joy
• Support positive emotional experiences
• Shifts negative emotional states into positive ones
• Reduces difficult behaviors
• Builds strong, trusting and satisfying relationships

• Activity-focused dementia care
  • Includes activities that are meaningful to a person
  • Meets that person’s needs or wants
  • Promotes person-centered and abilities-focused care
  • Identifies and encourages the use of retained skills and capacities
  • Prevents and even reverses excess disability
  • Reduces restlessness, agitation and other difficult behaviors
  • Addresses the need to engage in meaningful activities
  • Leads to greater satisfaction and quality of life

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

Edited by:
Sasha Asdourian

www.LightBridgeHealthcare.com

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