Debbie Hommel's A.D. Tips
Dedicated to helping Activity Professionals with the daily operation of their department.
by Debbie Hommel, BA, ACC, CTRS, Executive Director of DH Special Services
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DEBBIE HOMMEL
Executive Director
DH Special Services
About Debbie

Debbie Hommel, BA, ACC,
CTRS, is the Executive
Director of DH Special
Services. She is a Certified
Activity Consultant on State
and National level, with over
twenty-seven years of
experience in providing direct
care and consultation to long
term care, medical day care,
assisted living, and ICF/MR
facilities throughout New
Jersey, New York, Maryland,
and Pennsylvania. She is an
experienced trainer and
workshop presenter,
conducting a variety of
seminars throughout the
Tri-State area for the Activity
Professional, Administrator,
and allied healthcare
professional. Debbie Hommel
is an active member of Activity
Professional Associations on
State and National levels. She
is ACC certified through the
NCCAP. She is a founding
member of the New Jersey
Activity Professionals'
Association, serving terms as
Vice President and President.
She received the Weidner
Lifetime Achievement Award
in 1994 and the Monmouth &
Ocean County Activity
Professionals Life
Achievement Award in 1999.
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Diversional Activity Zones
by Debbie Hommel, ACC, CTRS

Meeting the needs of the diverse functional abilities of the elderly is a daily challenge for
the activity professional.  It is all too common for the activity professional to be faced
with a room filled with residents who need to be occupied for a specified length of time.  
To add to the challenge, the residents often have varied needs, both physically and
cognitively.  We quickly discover that gathering everyone into one single group is
ineffective in meeting the needs of the group.   Even though grouping the residents into
smaller more appropriate groups would be more appropriate, how does the activity
professional meet the needs of the many with only one group leader in the room?  

One approach which I have found effective is something called “Diversional Activity
Zones”.  We came upon this technique by accident in 1995.   I was working with a facility
who had just received a deficiency in programming for their cognitively impaired
residents.  It was an older facility and the residents were gathered daily into a large
room.  The activity staff had been providing programming daily, but of the 25-30
residents in the room, only half were participating.  The more impaired residents sat
idly on the parameter of the room, often dozing.   We introduced more cognitively
specific programming for these residents which worked to some degree.  But there still
remained a number of residents who would not or could not participate.  Additionally,
the activity staff were in the common room for almost two hours in the morning and
another two hours in the afternoon. Keeping cognitively impaired residents focused on
structured programs for that amount of time is difficult, if not impossible, as well.  

One day, out of frustration, we brought all the supplies and equipment we had available
for cognitively impaired programming to the room.  We organized the materials, by
category, onto the tables.  One table had folding tasks; another had kitchen sorting
tasks; another had the “babies” and baby clothes to fold and one table had simple craft
tasks with fabric, yarn and pompoms to sort.  We created an office area with file boxes,
note pads and coupons to sort.  We created a men’s area with sporting magazines,
pipe works, wood and sanding paper.  As the nursing assistants brought the residents
to the room, we seated them at tables which were appropriate to their needs and
interests.  By mid morning the room was filled and we were dumbfounded.  We looked
around the room and miraculously, all the residents were engaged and intent on their
tasks.    We found the residents enjoyed their smaller groups. They were sitting with
peers of similar interest and ability which provoked socialization.  The limited staff
“worked the room”, going from table to table, monitoring for safety, providing cues and
encouragement as needed. Somewhere along the way, the term Diversional Activity
Zones was used and it stuck.  

What are the benefits of this type of programming to the residents?
  • *Residents with limited attention spans and impaired cognitive skills will remain
    engaged in diversional tasks and activities for longer periods of time within the
    zones than traditional structured group programming.  
  • *Attention span will improve as residents can concentrate on familiar tasks with
    success.   
  • *Negative behaviors are reduced as self stimulating and disruptive behavior is
    diverted into familiar tasks.   
  • *Self esteem is improved through successful participation in familiar tasks.  
  • *Residents can utilize remaining skills and abilities which promote
    independence.  
  • *There is an enhanced relationship between resident and caregiver, as it allows
    the resident to be seen as a viable person as opposed to a resident diagnosed
    with dementia and afflicted by various losses.  

How do I set up a Diversional Zone Program?
  • * Assess resident population, categorize by interest and functional level.
  • * Establish area for program, ensuring privacy and ample space.  
  • * Secure appropriate materials (life skill tasks, diversional materials based on
    life history and interests) and storage containers or areas.
  • * Organize the zone activities on separate tables, by category.  For example, the
    laundry, ironing and folding type activities would be in one table.  For zones with
    a larger interest, place two tables together to allow ample space.  
  • *Residents should be seated at zones according to their past life interest,
    functional abilities and behavior.  The staff member facilitating the program
    should be aware of the residents' history and individual needs.   If necessary, a
    method to communicate history and activity preferences should be introduced.  
  • *The staff member must give the task meaning through verbal cues and
    encouragement.  It is not simply enough to say "do this" and hope the resident
    keeps busy.  Reminiscence, utilization of past skills and the significance of the
    past skills are the goal.  
  • *The worker needs to be very intuitive to the residents' behavior and response
    level.  If the resident seems to be losing interest, an alternative approach should
    be introduced.  The resident should not be forced to complete a task or remain
    at a zone.  There will be some days when they do not feel like doing anything.  
  • * It is often appropriate to integrate refreshment into the program.  The residents
    often enjoy a cup of coffee or juice midway through.  Introducing it as a “coffee
    break” is understood and appreciated.
  • * Zones should be tailored to the needs and interest of the population.  If there
    are more impaired residents, a sensory zone can be created. If there are more
    active residents, a sports zone can be created.  
  • *The goal of the activity is the process not the outcome.  Do not rush. Take your
    time to "smell the flowers".  

There have been variations on this type of programming documented in books, journals
and periodicals.  Parallel programming is a popular term used to describe multiple
activities or tasks being offered concurrently.  The residents are engaged according to
their ability and interest.  Cameron J. Camp and the Myers Research Institute have
applied Montessori Principles of learning stations to activities for persons with
Alzheimer’s disease.   They have created several manuals outlining activities which
focus on basic tasks of sound discrimination, scooping tasks, and pouring activities,
fine motor activities, care of the environment tasks and care of the person tasks.  

All these approaches are based on the belief that each person with cognitive loss
remains a person with abilities and strengths.  Through these individualized
approaches, the person can continue to utilize these abilities to function with meaning
and purpose.  Successful involvement in familiar tasks provides the resident with
opportunity to remain connected with their personal sense of self while also connecting
meaningfully with others.