“A blog a day blether” for #DAW2015 Allied Health Professionals Q&A Day 3 “Ask an Occupational Therapist”

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Previously published this week on ‘Let’s Talk About Dementia Blog’

Welcome to day three of our AHP Dementia blog posts.  I’m really pleased to answer some questions as an occupational therapist.  People often think of occupational therapists as the people who provide equipment and while this is an important aspect of the role we can also help in other ways.  It’s about what people need to do and want to do in their daily lives, the habits and routines that we have and the roles and responsibilities.  But without any further ado I will answer the questions….

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“My mum used to be very creative.  Painting, dressmaking, soft furnishings etc.  I have bought pastels and crayons to encourage her to draw/colour in, but she thinks these are childish activities.  What approaches would the OT recommend?” Catriona, carer

Thanks Catriona, that’s a great question.  Supporting people to be involved in activities is so important but it can be challenging at times to get that “just right fit”.  For an activity to be enjoyable for any of us we need to find it interesting and relevant to our lives and it needs to be something that is realistic for us to do but not so easy that we find it boring.  Here are some suggestions for approaches to try and hopefully you will find something that helps.

  • Sometimes people might comment that an activity is childish if it is too easy or if the materials appear child like.  If your mum was not previously interested in colouring in she might consider this an activity for children.  However, colouring in for adults has become quite fashionable and there are a number of colouring books designed for adults that you could try.  There are a range of designs with some very intricate but some more simple and lots of themes from the animal kingdom, art deco, flowers and geometric patterns.
  • I’ve found when using art as an activity that the type of art materials used can make an activity more or less inviting for people.  Some of the materials which have worked well in my experience are colouring pencils which you can then apply water to and they look like watercolour paints, having a sketch book rather than sheets of paper, a simple paint pallet with a good quality brush etc.
  • Sometimes people can find it challenging to get started with an activity and creating the right environment can be helpful.  Setting up a spot at a table with good lighting and the required materials in clear view can be helpful.  Your mum might also find it helpful to have some inspiration to get started with painting.  In the past I’ve used a selection of photographs as a starting point e.g. a beautiful scene, a familiar place etc something to trace can even work.  Sometimes taking a sketch book and pencils/paints out for a drive and seeing if your mum is inspired to do some sketching of a view.
  • Sometimes having a goal or an end product that is going to be used can make an activity more inviting.  Here are a few ideas I’ve used in the past:
  • Using blank greeting cards or postcards which can then be sent or given to mark an occasion.
  • Scanning the finished art work and it can then be used to make a calendar, magnet, integrated into a printed photo book etc.

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  • Sometimes we assume that people will want to continue with an interest or hobby from the past.  This is often the case but people can find it less enjoyable as they might compare what they are able to do now with their previous abilities.  If you have a few examples of projects that your mum has completed in the past you could use these to prompt a discussion and get a sense of how she feels about these activities now.
  • If your mum is still interested in her creative hobbies but doesn’t want to paint or colour in you could try:
  • Joint projects can be a good way to involve the person
  • Having a box of fabrics, threads, yarn etc that your mum can enjoy looking through and sorting.
  • Looking at patterns, photographs, books related to the interests.
  • Going to an exhibition or group related to the interests.  You might find a session for people with dementia e.g. the National Gallery of Scotland runs a Social Gallery event where people with dementia can visit the gallery to see the art, join in a practical art session and have tea and cake (https://www.nationalgalleries.org/education/gallery-social-programme/ )

The last question in this blog has some other ideas about finding activities that you might find useful too.

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If you do not have a CPN, can you still get help in the community if you need aids and adaptations in your house?  Alison, living well with dementia

Thanks for your question Alison, you do not need a CPN to get access to aids and adaptations.  If you think you would benefit from a piece of equipment you should be able to refer yourself via your local social work department or you could ask your GP to make a referral on your behalf.  Many councils have a selection of simple equipment that you can access directly e.g. a grab rail or cutlery that’s easy to grip.  This information will probably be available on the council website.

If you aren’t sure what you need or if you think you need a bigger piece of equipment or adaptation to your home then you can ask for an occupational therapy assessment through your local social work department.  You can usually do this via a telephone call or some council web pages have a form you can complete on line.

The web site “ask sara” is another place where you can find out more information about equipment.  You can select an aspect of your health, home or daily life that you are finding challenging e.g. your memory, the stairs or communicating and the website will ask you some simple questions which will guide its recommendations.  It may suggest some strategies, sources of help and advice as well as equipment that you might be able to borrow or purchase.

If economics & person centred care are behind the drive towards greater care in the community, who is looking at the provision of equipment in the home to enable carers to care at home for longer? (e.g. wet rooms, hoists, bed raisers, rise & recline chairs, hospital beds.  It seems to be getting harder not easier to obtain support as local funds are being tightened.  How can we rethink ways in which expensive equipment might be safely repurposed and recycled?  Kathryn, carer.

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Thanks for your question Kathryn.  This is a challenge indeed and it is being looked at by the Scottish Government (information available here). The west of Scotland has a service which decontaminates and recycles equipment and this has been shown to save a considerable amount of money.  We can all play a small part in helping to recycle equipment too.  If you or someone you know has been provided with a piece of equipment which is no longer required then you can contact your council and ask for it to be collected, I’ve often come across equipment when I’ve been out to visit someone as an OT that people hadn’t thought they could return.

My father can no longer follow TV programmes or read books and my family are concerned about him.  He’s never been very outgoing and refuses to go to day care or any clubs.  They want to know what they can do to keep him occupied during the day.  ??

Thanks for your question, sometimes people can find activities that use lots of language harder to concentrate on so reading and watching television can become tiring and less enjoyable.  Everyone is different but here are a few ideas to find things for your dad to be involved with:

  • What other hobbies and interests has your dad had?  Did he enjoy gardening, watching or playing sport, listening to music, walking, painting, going to the theatre or cinema, photography etc.  This can be a really great place to start.
  • Starting with a few ideas of things that have interested your dad in the past you can have a trip down memory lane and chat about these things and your dad’s memories.  That might give you a sense of how he feels about trying these things again.  Sometimes it helps to have a few props to hand to help the conversation e.g. a few photographs.
  • If your dad identifies something he enjoyed and would like to do then its finding a way to help him to do the activity (you might find some ideas in the answers to the first question on this blog too).
  • Your dad might need a bit of help to get started with an activity – it might be as simple as getting the things he needs out and putting them all in the one place, making sure there is good lighting and inviting him to be involved.
  • Your dad might find it easier to do an activity jointly e.g. doing some gardening with another family member.
  • There are an increasing number of dementia friendly initiatives in the community as a recognition that not everyone with dementia wants to go to day care they might want to keep going to the theatre or football just as they did before.  There are an increasing number of events which are being advertised as being dementia friendly e.g. relaxed theatre performances with less people in the audience, shorter performances that are more visual and less reliant on language.  Have a look online to see what’s available in your local area.
  • Some people find listening to music a really good activity that can be relaxing, spark memories and even inspire people to get on their feet to have a dance.  The charity Playlist for Life has lots of useful information about using music that’s personal to the individual.
  • Another activity which I’ve found works for lots of people is making a life story.  It can be a good family activity gathering some photographs and stories together in a photo album, scrap book or box and then this can be used as a conversation starter or just an enjoyable book/box to look through.  There is some really helpful guidance on life story work in the Communication and Mealtimes Toolkit if you would like some ideas to get started.
  • Other ideas might just be in finding ways to keep your dad involved in the daily routines at home e.g. getting out for a walk to buy milk, helping out with washing the dishes, meal preparation, washing the car etc.

Thanks to everyone who submitted a question and have a look tomorrow for answers from our Physiotherapist colleague, Lynne.

We welcome ideas and comments from our readers about this blog.

Tomorrow’s blog will be by Lynn – “Ask a Physiotherapist” Q & A.

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