One-on-One activity for the elderly – What You Can Teach Staff

It is the responsibility for the entire facility, including staff and volunteers, to participate in delivering individualized activities – including one-on-one activities.

Who needs one-on-one activities?

Residents who are room-bound or bed-bound and cannot physically get out to regularly scheduled activities.

Residents who are totally dependent or unresponsive (i.e., comatose or semi-comatose residents, residents on ventilators, stroke victims).

Residents who do not benefit from traditional group activities (i.e., late-stage Alzheimer's residents).

Residents who choose not to participate in scheduled group activities and Residents who want one-to-one attention.

If one-on-one activity is to be meaningful, it must have purpose, be voluntary, and feel good to the participant and offer the person a reasonable chance of success.

A one-on-one activity must be relevant to each person’s individual interests designed to reduce isolation, passivity, agitation, bring the person pleasure/enjoyment, etc.

It is important to identify activities with personal significance to the person before and after residing in the facility.

Ask each person about activities they “enjoyed the most” in recent weeks, those they enjoyed the most shortly before becoming an LTC resident, and those they enjoyed the most five to ten years before entering the nursing home

A one-on-one activity can provide intimate, private time to build relationships.
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The Director of Recreation/Activity Director is responsible for organizing and training staff and volunteers to provide room visits/activities.

A one-on-one activity can take place in the person’s room, another room in the facility, outside the facility or in the community.

Activities should be planned to address the needs, history, strengths and challenges of each individual.

Avoid focusing activities that serve the interest of the facility and lose sight of the participant’s individual needs.

Keep expectations realistic—consider the person’s current capabilities, rather than what they used to do.

All activities and items used during the activity must be age-appropriate and if the person is diagnosed with A.D./dementia, stage appropriate.

How to carry out a one–on–one activity: 7 Useful Tips

During one-on-one visits: minimize background noise and distractions, such as turning off the TV or radio; be sure to have proper lighting; maintain good eye contact; give your full attention; be patient; monitor temperature if outdoors.

1. Document the resident’s response (or lack of it) to activity; how many visits per week; time spent during each visit and the time of day.
2. Stick to short, simple plans—avoid elaborate, multi-step activities.
3. Keep your comments positive and encouraging.
4. Avoid treating the person like a child.
5. Watch for signals, such as increased distraction, restlessness or agitation.
6. Make the most of the skills and interests the person retains.
7. Take your time and be patient. Be in the moment!

How do you justify if a resident needs a one-on-one activity and the number of times per week?

Residents who are bed bound or who are unable to benefit from group activities, should receive 2-3 per week. Those who are able to voice that they prefer independent activities and those who are in therapy only need to have 1-2 per week.

One on one engagement art by the bedside for residents with Alzheimer’s disease/dementia: Useful Tip: 

Have on display, a variety of completed art projects by residents.

At times, a person may choose not to participate in a special group project/activity in your activity room. In turn, bring the activity to the person.

Expression through art can become especially important as a person’s ability to communicate through words deteriorates. Art projects can add to quality of life. They can create a sense of accomplishment and purpose.

They can provide the person with Alzheimer's disease an opportunity for self-expression and creativity.

Participating in an art project can help the person to relax and offer a sense of well-being and accomplishment.

When planning an art activity, keep these tips in mind: (Discuss each of the following during the in-service)

1. Have all your materials ready. What exactly will you need for this project? (Present three examples of an art project. Have the group list all items they would need for the project.) Be sure to include wet wipes for clean-up, esp. for a painting project.
2. ALWAYS keep the project on an adult level. Avoid anything that might be demeaning, condescending child-like. (Discuss the importance of this. Ask for examples of both appropriate and inappropriate art projects. 
3. Assist the person at the beginning the activity. (Example: If the person is painting/ drawing/coloring, you may need to start the brush/pencil/crayon movement to serve as a reminder for how it is done.)
4. Keep instructions to a minimum to avoid confusion and frustration but give as much instruction as needed for each individual. 
5. Build conversation/reminiscing into the project. (Ask the group, “What are some questions/statements you might include?) Remind the group to always be sure to include in the conversation what the person is creating.
6. Provide encouragement. (Present a “situation” and ask the group how they would encourage the person) 
7. Assess the person throughout the activity and provide as much assistance as the person requires. Assess: How much assistance does the person need? Observe facial expressions, comments. Is the person calm? Anxious? Is the person enjoying the experience? 
8. Allow plenty of time. Sometimes a project cannot be completed in one session, although ideally, a person with poor short term memory benefits more if the project can be completed in one session.
9. Don’t be a critic. For example, if you don’t agree with the colors the person has chosen, keep it to yourself! Give positive feedback. (Ask the group why it is important not to criticize and examples of what not to criticize during an art project)
10. Always use safe materials. When using paint, observe for any sensitivities. Avoid sharp tools.

Use for examples some of the completed art projects that you have on display. Explain the process to give a better understanding of a person's engagement in the project.

During the in-service, ask the participants to;

1. Think of a person who enjoys art and have them 
2. Identify the art project that the person is working on or has completed. And,
3. Share with the group some of the benefits that person received from participating in an Art by the Bedside project.

One-on-One activity for the elderly – What You Can Teach Staff

Activity directors - one on one activities and visits

I had to sort out some opinions on Facebook and here is what I got:

Here is what Jean Ellen Capachione-Govoni says about one-on-one activities

I find one-on-one with residents can be difficult because it requires a change of focus on my part, going from group to singular.  Once in the mind set though, simply engaging a person in any type of conversation while having them actively engage with their hands works for me asking them too many questions.

Sensory usually involves hand washing and lotion applied, essential oil diffusing, a food or drink according to their diet and liquid consistency.  We have scratch off paper crafts that are perfect and fun as well and "stained glass" crafts which are plastic panels for hanging in windows or boxes for trinkets we paint.


Daily one to one activities can be challenging. For very little money (I purchased everything here from Dollar Tree) I have created a very simple set that can be used a hundred ways. Pack everything in a fun canvas bag and it can travel to wherever the resident is!

Each set can contain the following; a variety of colorful plastic bowls, clips of various sizes and strengths, rainbow plastic cups in several sizes, poker-chips, pop cycle sticks, small muffin tin with color disks glued into cups etc. You can create so many fun games and "purpose focused tasks" to do with your resident:

• Sort the various objects by color and place into bowls. 
• Stack the cups by color or varying color pattern. 
• Lay out the pop cycle sticks by color or in a pre-determined pattern. 
• Clip the clips onto the side of the bowl using a variety of grips (pincer with thumb and forefinger, or pinch with closed fingers and palm). 
• Use each hand, clips on and then off into the bowl to put away.
• Use the large clips as a pick-up device to stack cups or pick up objects for dexterity.

Credit: Jean Ellen Capachione-Govoni

Credit: Jean Ellen Capachione-Govoni

Credit: Jean Ellen Capachione-Govoni

Credit: Jean Ellen Capachione-Govoni

Credit: Jean Ellen Capachione-Govoni

Credit: Jean Ellen Capachione-Govoni

Credit: Jean Ellen Capachione-Govoni

Credit: Jean Ellen Capachione-Govoni

Credit: Jean Ellen Capachione-Govoni

It's fun to add to the kits; Shawe building blocks found on Amazon, playing cards, skip-bo, Jenga (Dollar Tree had Pitco which is like a rainbow colored Jenga), colorful pompoms, multi-color rubber bands, etc! Each Care Team member has a set so that anytime, they can sit down to engage with a resident day or night! Hope this helps you all, our residents seem to really enjoy!


Here is what Becky Harris does with her mom

"My mom likes to do anything “domestic“The dollar store will become your best friend. She likes to take plastic knife fork and spoon and roll into a napkin to make a picnic pack. 

Sort and stack pot holders, make artificial flower arrangements, fold washcloths, sort and fold socks. Each activity takes about 20-30 minutes. We play music while she’s doing them. 

It allows me to go take a shower or take care of other things around the house. She can also spoon cookie dough onto a cookie sheet. I make the cookie dough and monitor the baking; it’s something we enjoy doing together. 

She also makes goodie bags with little fun items from the dollar store, paper bags and clothes pins… See pictures! At the end of the day I undo everything so it’s ready for her to do all over:)"

Other one-on-one activities you can do with the elderly with dementia/Alzheimer's 

• Go on some walks with your love one and listen to nature sounds and smell flowers etc, improves mood to get out especially if your love one has depression.
• Get books for your love one of things the person used to enjoy -- lots of pictures and not many words.  If you don't have any, you can get them at the library if you don't want to purchase.
• Listen to CD's and Sing along to songs your love one might know.
• For females, Brush her hair, sing to her, rub lotion on her hands
• Record your love one telling stories of their childhood.

Here are two suggestions from Janet Pond 

Two suggestions:  Fiddle boards or rugs and Music therapy.  Fiddle items have all sorts of sensory and reminiscing items on them and can distract the person from other things.  Just Google and you will find loads of images.  You can buy them or make one yourself specifically for your loved one.  I made a book for my mum from an old towel - I'm attaching a video of it.  Unfortunately after hours and hours of sewing and work making it mum thought it was sooo important that she hung it on the wall like her precious photos and so she used it occasionally but not to the extent I had anticipated.  Music therapy can have amazing outcomes too - Google, there's heaps of info.

Cassie McKinney Lincoln say

Laurie Thompson Hansen says

And here is another from Jen Wood

References:

ACTIVITIES AND EDUCATIONAL INFO POSTED DAILY

https://www.facebook.com/groups/500169056821185/

IN-SERVICING CNA'S AND VOLUNTEERS

ONE TO ONE ENGAGEMENT

TOPIC: ART BY THE BEDSIDE FOR RESIDENTS WITH ALZHEIMER'S DISEASE/DEMENTIA

Length of in-service is approximately 30 minutes

https://www.facebook.com/groups/JoAnneHarrisonBecker