Engagement Resource Guide Engagement Resource Guide Azura Living Copyright 2014 Engagement Resource Guide MOSAIC Engagement Resource Guide The contents of the MOSAIC Engagement Resource Guide are based off of the Azura Memory Care Engagement Supply List and should be used as a reference with the required items that each home has in their on-site inventory. By participating in these suggested engagements with residents, we are able to meet their Core Psychological Needs to boost self-esteem, have the power to choose, to be needed and useful, to care for others, to share joy and laughter, and to love and to be loved. In addition, each item on the Engagement Supply List to work on reminiscing therapy, cognitive therapy, active therapy, chore therapy, and creative therapy. Although many of these items may be very simple through our MOSAIC Connections training we are able to use innovative approaches to create many magical MOSAIC Moments of personalized joy! Azura’s 5 Core Values 1. We treat our guests and coworkers with the utmost RESPECT. 2. We help people to RECOVER physically, mentally and spiritually. 3. We encourage INNOVATION and creativity 4. We hire and RETAIN the finest people. 5. Be EXCEPTIONAL! Azura Living Copyright 2014 Engagement Resource Guide Azura Living Copyright 2014 Engagement Resource Guide Table of Contents MOSAIC Approaches & Communication Techniques: 12 Steps Current House Engagement Supply List Music Therapy Cognitive Therapy General Music BINGO Sing-a-Long Checkers Musical Instruments: Chess Music CD’s and Records Tic-Tac-Toe Dominos Active Therapy Dice Pool Noodles & Beach Ball Wooden Building Materials Smaller Balls Yahtzee Rib-It-Ball Trivia Parachute Card Games Bean Bag Toss Game Puzzles Basketball Hoop Word Search & Crosswords Balloons Reminiscence Therapy Creative Therapy General Reminisce Basket General Arts & Crafts Dress-up & Hats Paint & Markers Chore - Floor Sweeper Paper & Coloring Sheets Laundry Basket Sculpting Spa Basket Cooking Basket Fishing Basket & Men Engagements Farming Basket Childhood Toys Baby Doll & Doll Basket Gardening Basket Teacher Basket Wedding Basket Sewing Basket Azura Living Copyright 2014 Engagement Resource Guide Azura Living Copyright 2014 Engagement Resource Guide Table of Contents, Continued Sensory Therapy Dementia Information Gel Pad Alzheimer’s Disease Stuffed Animals Lewy Body Dementia Bubbles Frontotemporal Dementia Sensory Room or Sensory Station Aromatherapy Engagement Calendar Ideas Calendar of Painting Possibilities Reading Therapy Monthly Engagement Ideas Poetry and Rhyme Reading Picture Books Craft Ideas Devotional & Bible Magazine & Newspaper Cooking Recipes Expression Specific Engagements Exploring & Focused Aggression, Determined and Sundowning Seeking and Collecting Voiding and Incontinence Yelling and Asserting for Resolution of Unmet Needs Self-Sufficient Inappropriate Sexual Expression and Disrobing Paranoia, Delusions and Hallucinations Worksheet: Five W’s of Behavioral Expression Investigation Behavioral Expression Tips and Approaches Azura Living Copyright 2014 Engagement Resource Guide Azura Living Copyright 2014 Engagement Resource Guide MOSAIC Approach and Communication Techniques: 12 Steps 1. Get the person’s attention. Use eye contact. Securing eye contact helps to get the individual’s attention and gets them to focus on you and what you are saying. A gentle touch can also accomplish this. Remember that your facial expression helps communicate your intention. Maintain contact and extend yourself to the person to convince them that you want to talk to and be with them. Look directly at the person to get undivided listening attention before you speak and identify yourself at the beginning of each interaction. 2. Speak clearly, in short, direct sentences – use one-step commands. Keep it simple. Complex or abstract subjects will be difficult for a person with Alzheimer’s to follow. Talk about things that are seen, heard, touched or smelled. Be matter of fact, ask, “either/or” or as a last resort “yes” or “no” questions as much as possible. a. Avoid open-ended questions b. Ask questions that include limited choices: Would you like to shower before or after dinner. c. Be direct, say exactly what you mean. People with Alzheimer’s disease find it difficult to understand hints or suggestions. “Do I look like I have nothing to do?” say “I am busy now. I will come back.” d. Be concrete (“Your daughter is going to visit after lunch,” not “We are having company today.” e. Be literal. Nonliteral terms are used frequently in conversations: “That dress is a knock- out;” “This dessert is heavenly.” People with Alzheimer’s disease find it increasingly difficult to understand nonliteral terms. f. Present a limited number of choices, and give positive direction (for example, “Now it is time to take a shower,” not “Would like to take a shower now?” 3. Be willing to repeat and rephrase. a. Repeat yourself and restate critical facts several times. Restate and paraphrase what is not understood: use simpler words to express your ideas and beliefs. Remember that at some point, logical explanations will be meaningless and persistence in explaining leads only to frustration. b. Use simple subject-verb sentence structure. c. Left-branching sentences (“Because Ben let the house without his coat, his mother was upset.”) are more difficult to process and require more memory than right-branching sentences (“His mother was upset because Ben left the house without his coat.”) 4. Don’t use slang. Consistently use the same word for the same thing, and use the word more familiar to the person. (“It is time to go to the bathroom or toilet or lavatory.” However, vary the introduction of a topic, such as bathing, if it triggers resistance. 5. Keep your tone warm and empathetic. Provide affectionate encouragement; use diversion and humor to overcome resistance. Azura Living Copyright 2014 Engagement Resource Guide MOSAIC Approach and Communication Techniques, Continued 6. Ask simple questions. Closely related words are often used instead of forgotten words. When you can’t make out what a person needs, point while asking simple questions: “Do you want your sweater? Your necklace?” 7. Show respect and be sensitive to cultural and regional differences. Hispanic and African- American people generally find addressing an older person by first name to be disrespectful. The formal “you” should be used when speaking to an older person in Spanish. Religious practices should always be respected. For instance, for some Haitians who practice voodoo, hearing and speaking to spirits is a natural part of life. 8. Avoid pronouns – use specific words and names for clarity. Use names often so it is clear who you are talking about. Don’t say he, she, or that group. Also, be sure to call a person who has Alzheimer’s by the name he or she is most comfortable with. 9. Write big, clear messages and post them. If exercise class meets Monday, Wednesday and Friday at 10 am, post a big sign that says “Exercise Class 10 am today.” It may also be helpful to have signs on facilities such as restrooms, dining halls and recreational rooms. These help remind people where the rooms are. 10. Use your non-verbal skills. a. Provide illustrations. Drawings and photography give additional cues and jog the memory. b. Enhance what you say with frequent gestures. Additional physical cues and emphasis increase the chance of successful communication. c. Avoid environmental distractions. Noisy and busy surroundings are distracting. It is easier to get and keep someone’s attention in a quiet environment. d. If verbalizations do not make sense to you, search for important clues. Smile to make a connection with the person. 11. Praise and encourage the person; show affection. Be patient. If you or the person becomes frustrated, take a break and try again later. Remember that person with Alzheimer’s will sense when you are tired, stressed or in a hurry, and may become upset or confused as a result. Although they are not able to comprehend the reason, people with Alzheimer’s disease still seem to sense emotions such as frustration, anger and happiness. A quiet, soothing voice, gentle touch or a calm presence may reassure and calm someone who is confused or upset. 12. Be patient! a. Give the person time to respond. If a verbal or non-verbal response does not occur in one to two minutes, repeat the exact set of words and gestures. b. Do not attempt to force a person to do anything. If he or she will not cooperate, leave for five or ten minutes and then try again. c. Do not assume that one set of behaviors, whether positive or negative, will stay the same. Simple changes in the environment, such as a different caregiver or a room change may cause behavior changes in a person with Alzheimer’s disease. Azura Living Copyright 2014 Engagement Resource Guide Music Therapy 1. General Music: old fashioned record, CD and radio player for main part of house 2. Sing-a-Long: sing-a-long CD’s and books 3. Musical Instruments: maracas, drums, rain stick, sleigh bells, tambourines, etc. 4. Music CD’s and Records: 50’s, 60’s, Country, Holiday, Religious, etc. Azura Living Copyright 2014 Engagement Resource Guide Azura Living Copyright 2014 Engagement Resource Guide Music Engagement- General Purpose: To engage the person in an opportunity to boost self-esteem, have the power to choose, to be needed and useful, and share joy and laughter. Prep: music player, cd(s), record(s), sing-a-long sheet music, microphone (real or created), instruments (hands will do) and vocal leader – choose which items you use. Presentation: Approach the resident using the proper MOSAIC techniques. Begin singing to and with them as a way to invite them to participate in the engagement. If done one-on-one sit at a 90 degree angle or side-by-side with the resident to offer physical reassurance and support.