There are so many times in our lives when our circle of friends makes a positive change in our lives. Our toddlers learn how to share when they play with each other, school children learn how to negotiate with friends in their class “today we will play your choice of game and tomorrow I get to choose” and young parents look to each other for wisdom and knowledge in raising their children. Why is it that we think that our elderly loved ones will not benefit or need their peers?
People with Alzheimer’s disease and Related Dementias (ADRD) need to be with other people with similar abilities. It is important that they have opportunities to lead and to follow. Active community involvement begins to diminish as our elderly parents experience illnesses, aging disabilities (like poor eyesight), and anxiety about going out to unfamiliar and familiar places. Once their social network of friends shrinks, the result is that family members take a more central role in the responsibility in caregiving. It is a noble thing to do want to keep Mom or Dad comfortable at home as long as possible, but please keep in mind that without the positive stress of providing structure (by encouraging friendships with compatible folks and providing opportunities for activities that promote self-worth) our elderly parents can become very isolated.
One size of programming does not fit all needs of the cognitively impaired. Below are suggestions of what you should look for when you need to provide more structure for someone that you love.
• Listen to the language that is used when the daily life of a building is described. Do they use words like adult, dignified and purposeful?
• Are there choices available for type and location of programming?
• Is there a consistency of daily programming that would appeal to a variety of interests and/or abilities?
• Does the daily program provide familiar structure, location and timing without becoming stale? Look for spiritual/patriotic opportunities along with physical, creative and social.
• What individual pursuit opportunities are available? Not everyone is able or desires to participate in a group. Do the physical features of the building allow for areas where one can wander safely, support a purposeful task such as reading, sweeping, folding or sorting? Look for safe items that can be picked up and rearranged. Some individuals need to have an appropriate object to carry with them.
• How often are programs offered that provide intellectual opportunities to share their opinions, experiences and further explore interests? Do these opportunities provide the tools to read and write when appropriate? If people are not encouraged to continue to read and write (having a reason to sign your name promotes dignity) these skills can be lost. Are the participants grouped together by interest and ability?
• What programming opportunities are offered for those that are over-stimulated by large groups? Or more medically frail? Look for programming that provides soothing music, slow movement for visual stimulation, extra hydration, therapeutic touch, range of motion. This should be provided in an area separate from the group programs.
"Collectively, do the daily opportunities provide meaningful, engaging moments for people, no matter what stage or type of dementia they are experiencing? If so, be at peace with your decision that you have chosen the most therapeutic environment available. I know that the information above will not make your decision any easier. However, you will rest easy knowing that you have chosen a program that honors the whole person - past, present and future." - Noreen Gray, Director of Lifestyle Programming Assisted Living Division, HCR ManorCare.