in Longterm Care
is a bi-monthly magazine
that provides useful
therapeutic activities and
programs, feature stories,
specialized activities for
Alzheimer's patients and
other disease conditions,
medical news and much
subscription price: Only
To order yours today:
MAIL: Freiberg Press, Inc.
P.O. Box 612
Cedar Falls, IA 50613
What’s Your Answer?
The following problems provide the framework for inservice sessions or information for those
who work with the aging. If used as inservice material, first read the question and then ask
those present to come up with their own answers or solutions based on their own experiences.
After they have fully discussed the situation, you may read the solution provided.
Taking criticism in stride
I’m an activity director, and I recently had the great idea of handing out evaluation forms for
residents to fill out at my activities. I was thinking that these forms would be a quick way to get
positive feedback for my activity staff on the work that they do. Instead, the majority of the
forms came back with negative responses and suggestions for improvement written all over
them! How do we deal with this criticism?
The evaluation is a tool to create needed change, says Marge Knoth in her book How to
Thrive, Not Just Survive, in Life and in the Activity Profession. Residents, like anyone else, do
not like to spend time engaged in activities that aren’t meeting their needs. Therefore,
consider residents’ comments seriously. True, it’s never pleasant to receive criticism when you’
ve worked so hard on all your activities. Still, read the criticism carefully, and rather than get
offended, work to make the needed changes.
The residents who take the time to fill out evaluations do so because they want to help you
change the program to meet their needs and desires. In essence, they want you to succeed in
your job. So even when the evaluation forms don’t contain the praise you may have expected,
swallow your pride and use them to better your program. If you put the negative comments to
use now, you’ll reap the rewards of positive comments in the future.
Why the old pastimes are more popular than the new
I recently spent a lot of money purchasing the latest board games on the market for our
residents to use during their spare time. These games have since done nothing but collect
dust! Why aren’t my residents interested in playing these new, fresh games?
People are much more likely to get involved in something that is familiar to them than
something where the expectations are totally unknown, says Jeanne Adams, MS, CTRS, ACC
in her book Getting People Involved in Life and Activities. Participation is increased when less
effort is needed to perform a task. This is true of us all, but seems especially true of many
elderly people in long-term care facilities. If you can decrease the amount of perceived effort in
a task or project, says Adams, you will probably be able to increase the individual’s desire to
participate. She suspects that table games stand unused in activity rooms because people
simply don’t want to bother reading the directions to learn how to play them. This doesn’t mean
people are lazy. It just means that they are less likely to initiate involvement in something
unfamiliar to them.
If you display materials and supplies in a craft or hobby area, residents will tend to gravitate
toward what they already know how to do. This is yet another reason why you must get to know
your residents, so you can offer the kinds of hobbies and pastimes that they are familiar with
and have enjoyed throughout their lives.
Two ways to help someone remember
When residents come to our facility with memory problems after having a stroke, is there
something the activity department can do to help them get their memories back?
Memory retraining after a stroke should focus on practical solutions rather than memory
improvement alone, say Richard C. Senelick, MD, and Peter W. Rossi, MD, in their book Living
with Stroke: A Guide for Families. They give two such solutions, which can be easily
implemented by the activity department or by anyone who spends time with these residents:
Memory notebooks. These notebooks serve as organizers for residents, showing them what to
do and when to do it. A resident’s notebook includes names, descriptions and places important
to him or her. It should include the person’s daily schedule, rehabilitation activities and
answers to frequently asked questions. Residents can refer to their notebooks whenever their
memories fail them. Such continual reinforcement also can sharpen the memory skills still
Mnemonics. Although it sounds complicated, mnemonics is really a kind of game. It triggers
memory by associating visuals, puns or silly slang to a word, phrase or proper name. “Aunt
Josephine is a philistine” is a mnemonic; it might trigger a relative’s name in the stroke survivor’
s mind. Similarly, picturing Hungary on a world map might help him think of the word hungry
when he wants dinner. You can help residents invent mnemonics to remember the things that
tend to slip their minds.
What to do when a resident feigns helplessness
I know that one of our residents, Shirley, can do a lot of things for herself, but she’ll always ask
someone to do it for her. We always hear that independence is very important to elders, so
why does Shirley give it up at every opportunity?
Overly dependent behavior can have a lot of causes. According to Barbara Gillogly, PhD,
author of Skills and Techniques for the New Nursing Assistant 2000, Fourth Edition: Instructor’
s Guide, this type of behavior may result from our culture’s expectation that older people
depend on others. By being dependent, therefore, Shirley may only be doing what she thinks
is expected of her. Another possible cause of overly dependent behavior is that the resident is
afraid no one will be there to help her if she appears too independent. This may be her way of
asking for affection or just keeping someone close by. It’s also possible that the resident
moved into the facility after living with family members who did everything for her, and,
according to Gillogly, reinforced her tendency toward dependent behavior.
Regardless of the cause of dependent behavior, you can respond by pointing out and praising
Shirley when she does things for herself. Also, go out of your way to spend time with her when
she hasn’t asked you for help. This way, she may not feel the need to appear helpless just to