Yes it is possible for those with severe cognitive deficits to participate in exercise and other activities programming. The process goes like this:
1. Greet warmly putting person at ease and feeling safe ( i.e. unchallenged).
2. Use body language and eye contact to keep person focused
3. Use as few words as possible giving one or two word directions and then just demonstrating
4. Always approach and direct the person from the front keeping eye contact
5. Ask permission to take the person’s hands and then guide him through the exercise gradually letting go and backing off while giving positive reinforcement for even the slightest effort. Ifise necessary repeat this process.
6. With each effort make empowering statements. For instance, “See you can do it!” or “Beautiful!” or “That’s exactly right!”
7. Watch for signs of frustration, pain or fatigue.
Let me know if this works for you and please feel free to add to this list.
Enjoy
Friday, August 7, 2009
Sunday, July 26, 2009
Follow Me
I have updated my blog with stories, tips and pictures. I hope that everyone interested in caring for the elderly will Follow Me. If you have a relevant site I'd be happy to exchange links with you.
The Wanderer,,Funny Story
Who says that those with late stage AD can't plan or make decisions? Helen was a new client at the adult day center. She was a wanderer pacing aimlessly in and out of the room where we were having class. At one point she paused and looked at me. I thought she was feeling the music. Aha! this was my chance. I said "Come on Helen. Lets dance."I take her hands and begin to dance with her. After reluctantly moving with me she starts to lead and I'm thinking "Oh this is good". Helen then very purposely leads me to the couch and sits me down! Her attitude was "I'll show You!" Well, she showed me alright and put me in my place!
Friday, July 17, 2009
“I feel like I could fly!”
I didn’t feel much like teaching today. The air conditioner had died and I was drained. But a job is a job and the show must go on. As always I psyched myself and plunged in. It turns out that the class at the adult day care went well with good humor and participation. We always end with improvisation using scarves ribbons or balloons and then the bow or reverence. Among the usual comments of “Oh that was good!” and “Bless you!” (from my African American friends and Islanders) Ms. Ruth claps her hands and says “I just feel like I could fly!” Well I just hugged her and thanked her and told her that she had made my day worthwhile!
Friday, July 10, 2009
On Music
The magic of classical music and dance are ageless. The young child may be a fairy queen. The teen may imagine herself as Juliet. The elderly are transported back to a time of beauty, grace and romance. It becomes the perfect medium for exercise and self expression. Even neuro-muscular problems can helped when the person focuses on the music instead of the mechanics of movement. It has been found that the part of the brain that processes music isn't usually affected by Alzheimer's or other dementias. Many nursing homes play music all day long. However, unless the residents' attention is drawn to it by the leaders' verbal cues, eye contact and body language, the music will be like white noise in the background and do no good. I have found that classical and semi classical music that have clear rhythms (waltzes, marches, polkas and even adagios) and mood works best for exercise. It doesn't matter if the residents have never listened to classical music. I have used it with residents coming from diverse backgrounds. Through the process of empathic engagement the residents will almost always 'get it'.
Wednesday, July 8, 2009
I hope to update this blog more often now that I have subscribed to twitterfeed. I am not sure how it works. So we shall see. If you are interested in motivating the elderly to participate in group activities especially exercise please follow. The approach I use has been helpful when transferred to activities of daily living. I'd love to know your theories on motivation.
Friday, June 5, 2009
Ballet at My Age…..Oh My!
The magic of classical music and dance is ageless and become the perfect medium for an exercise program for the elderly.
The bright cheery day room of the nursing home was full of residents who had been brought there to spend their afternoon. Some were sleeping. Many were just staring blankly. A few were pacing. Music was playing but no one was listening.
The group’s leader comes into the room and turns off the music. She greets the group warmly first as a whole and then individually smiling and making eye contact with each member of the ‘class’. The ‘teacher’ then announces that some great music is in store for them. The music begins. “Listen! Can everyone hear it?” she asks. “Isn’t it beautiful? It makes you want to dance!” she says or indicates by her movements and body language. “Ready? Reach those arms up high and then down. Stretch them up, up ,up! Oh that feels so good! Doesn’t it?” And so the Benevolent Ballet-Fall Prevention for the Elderly class has begun. Most of the group is participating. Those who were just watching join in with a bit of hand to hand, eye to eye and heart to heart encouragement. After a few more slow stretching exercises the music changes to an up beat tempo. Again the ‘students’’ attention is directed towards the music. “Listen!….Here’s some good toe tapping music” And we have rhythmic toe and heel drops, marching, knee slaps and claps right up to the end of the tract. They rest happy and worn out. Sometimes there is a round of applause. “Is everyone breathing?” One resident comments “I certainly hope so!” After some deep breathing the class continues at a slower pace for thirty minutes more. At this point brightly colored scarves are passed out. With the music as their guide the class is asked to paint the sky with their colors filling the room with color. They can make any design the music inspires them to. At this point magic happens. Faces are transformed as the residents (men and women alike) perform exquisite, perfectly timed movements. Then it is time to say good bye but not without ballet dancer’s ritual reverence (bow). At the end of every class the group mimes “From my heart to yours.Thank you!”
It is the connecting, sharing and caring that makes a program work. The leader’s enthusiasm, passion and joy become contagious. As long as the potential participants feel safe from failure or harm they will join in and enjoy. The energy goes back and forth inspiring both the leader and the class. This empathic engagement can contribute to the success of most programming as well as residents Activities of Daily Living.
Sheila Lehner is the founder of the Benevolent Ballet-Fall Prevention for the Elderly program. Healthcare professions in 11 states have been trained to implement this unique exercise protocol in their facilities. When used regularly up to an 80% reduction in falls has been reported.
The bright cheery day room of the nursing home was full of residents who had been brought there to spend their afternoon. Some were sleeping. Many were just staring blankly. A few were pacing. Music was playing but no one was listening.
The group’s leader comes into the room and turns off the music. She greets the group warmly first as a whole and then individually smiling and making eye contact with each member of the ‘class’. The ‘teacher’ then announces that some great music is in store for them. The music begins. “Listen! Can everyone hear it?” she asks. “Isn’t it beautiful? It makes you want to dance!” she says or indicates by her movements and body language. “Ready? Reach those arms up high and then down. Stretch them up, up ,up! Oh that feels so good! Doesn’t it?” And so the Benevolent Ballet-Fall Prevention for the Elderly class has begun. Most of the group is participating. Those who were just watching join in with a bit of hand to hand, eye to eye and heart to heart encouragement. After a few more slow stretching exercises the music changes to an up beat tempo. Again the ‘students’’ attention is directed towards the music. “Listen!….Here’s some good toe tapping music” And we have rhythmic toe and heel drops, marching, knee slaps and claps right up to the end of the tract. They rest happy and worn out. Sometimes there is a round of applause. “Is everyone breathing?” One resident comments “I certainly hope so!” After some deep breathing the class continues at a slower pace for thirty minutes more. At this point brightly colored scarves are passed out. With the music as their guide the class is asked to paint the sky with their colors filling the room with color. They can make any design the music inspires them to. At this point magic happens. Faces are transformed as the residents (men and women alike) perform exquisite, perfectly timed movements. Then it is time to say good bye but not without ballet dancer’s ritual reverence (bow). At the end of every class the group mimes “From my heart to yours.Thank you!”
It is the connecting, sharing and caring that makes a program work. The leader’s enthusiasm, passion and joy become contagious. As long as the potential participants feel safe from failure or harm they will join in and enjoy. The energy goes back and forth inspiring both the leader and the class. This empathic engagement can contribute to the success of most programming as well as residents Activities of Daily Living.
Sheila Lehner is the founder of the Benevolent Ballet-Fall Prevention for the Elderly program. Healthcare professions in 11 states have been trained to implement this unique exercise protocol in their facilities. When used regularly up to an 80% reduction in falls has been reported.
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