The Basics

The Basics
The Activities Assessment has a variety of information that is unique to the activities department. It should reflect the leisure patterns and skills of the resident. These basics cover should give a snapshot of the resident for the Medical Record. The assessment basics would include the following:

A. Name of Resident
B. Date of Assessment
C. Residents Room Number
D. Diagnosis that affects residents participation in Activities
E. Work History
F. Marriage status
G. Primary Language
H. Signature of Individual Completing Assessment

Some of the above information is obvious. The first three are part of the Medical Record. In some circumstances this information not only appears on the front of the form, but also on the back of the form. Some facilities also require that the resident's number appear as well.

diagnosis
The diagnosis of a resident should be those that directly affect the residents ability to participate in activities. For example a resident who has a diagnosis of depression may still enjoy their leisure pursuits but their diagnosis of Multiple sclerosis may impede their ability to continue their interest in crafts. On the other hand the reverse might be applicable and their depression causes them to stay in their room and not participate in a craft program. The professional would need to visit with the resident several times to assess which diagnosis either physical or psychosocial would affect their continued interest in leisure pursuits. A full list of diagnosis is available in other parts of the Medical Record for future reference and should be used as a guideline for the activities assessment, not necessarily transcribed over again.

Work History
The residents work history defines who the resident was. Many activities assessments merely reflect the company or general work of a resident. A person who worked for the local car plant could have done a number of various jobs. They could have been a foreman, the plant nurse, a secretary or an assembly line worker. Through an interview with the resident one needs to find out what exactly the resident did. Also there are a number of people who had various jobs. Remember Miss Jones in the previous chapter who did her job because she had to and didn't particularly enjoy it. An interview with the resident may yield a hobby or a volunteer job that better reflects the residents definition of themselves in society. Stating the work, but reflecting their avocation on the assessment will assist with designing an activities program that best reflects the psychosocial needs of the resident.

Marital Status
The resident's marital status is also self explanatory, but in today's day and age it may not be the "traditional" information that you are looking for. A single never married resident may have children, a married resident may have been divorced longer than married and not have any children of their own. The actual status of a resident may give you clues to who to talk to for further information. Imagine for a minute that Elizabeth Taylor is your resident, where would you begin?

Primary Language
A resident may not be English speaking, but can comprehend English. Knowing this information would provide the activities department with a way to go about adapting activities for this resident. There would also be an opportunity to provide cultural programming to meet this particular residents needs.

Additional Information
You might want to include additional information in the beginning of your assessment that can be easily accessible for you and your staff to address immediately.

A. Registered Voter
B. Clubs/Associations Belonged to
C. Home Town
D. Places traveled to

Registered Voter
Residents in facilities can vote and should be afforded the opportunity. Upon completion of the assessment or during the assessment process you can register a resident according to your area's procedure. There have been many discussions in facilities about the capacity of a resident to vote. Activities departments are usually the ones that assist resident's with filling out their application and arranging voting in their facilities. Many facilities act as polling places and can benefit from having them onsite. Also there are deadlines for registration that can be found at your Board of Elections. Take a moment to familiarize your department with the information available in your area. If in doubt you can contact your League of Women Voters for assistance and questions.

Club/Associations
Many resident belong to church, civic or social organizations. This information may come from a resident or their family members. It is a vital key to finding support for the resident and your activities department. A resident who was a member of the American Legion may want to go there for an event or to socialize with others. The American Legion might have resources that can be used in your facility for a number of residents.

A resident who plays Bridge is always a challenge. They might have belonged to a Bridge studio in your community or played with others at the local Senior Center. By asking where and with whom they played Bridge you might be able to set up a game at your facility for them. You might also be able to find additional resources at your library, find a computer game of Bridge or online.

These are examples of some of the clubs/associations that residents might belong to there are hundreds of others available within your community. A list of some of the community clubs/associations can be found at your library or at your Chamber of Commerce.

Home Town
A resident that comes to live with you may be there because their family lives near your facility, but was not brought up in your area or even lived in your area. Many Baby Boomers retire to other parts of the world. Knowing their home town and getting their local paper or getting articles off the internet for them to keep in touch with friends and family may give you an extra hint as to their leisure interests and pursuits.

Travel
Now that the Baby Boomers are starting to come into facilities, travel is part of their social makeup. Foreign travel, domestic travel or going to visit friends and families has become a way of life. Places traveled would indicate the vast interests and the resident's lifestyle.
A resident who spent their leisure time camping in National Parks or a resident who went to Disney World can indicate what they are most interested in. A resident who experienced foreign travel be it through the military or as a leisure pursuit would have a variety of interests in an activities program. Using this information on an assessment will assist you in developing programs that meet their needs and interests.

Leisure Interests
There are as many leisure interests as there are residents. Developing a form that would reflect the multitude of interests can vary from facility to facility. Annually updating your assessment form to reflect your current population allows you to assess and find activities that would most interest those who will be participating in your activities. The check list that follows can be adapted to meet your resident needs and your departments programming needs. It can also reflect those activities that your facility offers. As each facility is different there may be activities that you offer that residents may be interested in. You can list them as well when interviewing the resident and their families to ascertain the types of activities that would be appealing to an individual.

A checklist can serve many purposes including reminding the assessor what interests to inquire about. It can also be included as part of the total assessment process. Upon evaluation of the assessment the assessor can then check the areas where a resident has the particular leisure skills or has expressed an interest in learning new skills. This checklist should be a tool that is used to expedite the assessment process.

A narrative section of the assessment will allow the assessor to evaluate the information gathered. Looking at the strengths and the abilities of the resident to participate in a variety of programs the assessor would then complete the initial assessment process.

Activities Documentation

Welcome to Activities Documentation

Throughout this "blog" you are welcome to contribute to the conversations concerning "Activities Documentation" for those in Long Term Care. We will start with the Initial Assessment process and continue on with all of the paperwork required for the Activities Professionals.


Quality of Life

Let's take a moment to explore what a person does in their lives. We are defined by what we do for a living, how we spend our family time and our passions. These define who we are and what we will become. When a resident enters a long term care facility they are defined in medical terms and terms that are measurable. Their Quality of Life has been replaced by their physical or cognitive needs. This role change can prove to be quite daunting to anyone. Those who have been in the hospital for any length of time can attest to this role of “patient.". The medical model looks at what we are unable to do and assists in getting us “better". There is a beginning, treatment and a cure. Quality of Life is a continuum of life, it has no beginning, no treatment and certainly not a cure. It cannot be a specific, measurable goal. It defines our being and how we see ourselves.

The activities department is charged with a task of looking at areas that are hard to measure. We are asked to assess a person's leisure skills and how they relate to others under very unique circumstances. If a resident comes to our facility without a structured leisure past, it is difficult to place them in programs that meet their needs. If a resident, on the other hand, was a social butterfly and has a vast support system of leisure pursuits that can be equally challenging. So where are we placed in order to meet their interests?

A resident was admitted to a facility with a perceived interest in music. According to the Social Worker admitting her, she played the organ and piano for a living. Miss Jones not only taught music, she played at the movies theater during the age of silent movies. She was well known in the community for her musical reputation. The Social worker extolled all of Miss Jones' musical background insisting that the activities department bring her to every musical event. It just so happened that the evening that Miss Jones was admitted to the facility there was a volunteer coming in to play the piano for a sing-a-long. The staff brought Miss Jones down to the program. She was a slight woman, wore fluffy slippers and had thick glasses and was transported to the program in her wheelchair. The activity director placed her in the front row so that she could watch the volunteer play the piano. The AD also asked her if she would like to play the piano after the program. Miss Jones looked up from her wheelchair and stated “I will take care of the piano,". The program ended and the AD wheeled Miss Jones to the upright piano in the middle of the room. The AD then proceeded to transport residents back to their floors. While taking several residents in the elevator there was a building shaking crash. It sounded like a truck had side swiped the building. Windows rattled and staff proceeded to see what has happened. The AD returned to the area where the musical program had taken place to gather more residents to transport back to their floors. There in the middle of the room sat Miss Jones with the piano dead on the floor. She was swinging her feet and had a huge smile on her face. The Activities Director asked Miss Jones what had happened. Miss Jones replied, “I told you I would take care of the piano. I had to play the piano for a living and hated every moment of it. I have always wanted to do that!”

This speaks volumes about properly assessing a residents leisure interests. The assessment is a tool that looks beyond what we are and where we have been. It should look at where we are going and what interests us as a person. We all have interests that change as we age. These lifetime interests may adapt themselves to our current abilities. Some residents may have enjoyed traveling, but as they got older the ability to travel has decreased due to physical limitations. But their interest in traveling has not diminished, just reading a travel book or reading a map may bring that interest to life.

There are a variety of assessments that are designed to look at the residents needs and interests. These are the key to unlocking the Quality of Life for the residents. The Professional Activities Assessment should address the residents lifestyle, leisure skills and be a window into which the Activities department plans programs that reflect their particular population. An example would be that residents who have lived in a rural setting may have life skills that include gardening and canning vegetables while those who have lived in a urban setting delight in going to a Farmers Market to buy fresh vegetables.

The Professional Activities Assessment process should also take into consideration family “traditions”, ethnic preferences, and a “historical” reference for planning activities. Discussions with residents, families and friends complete the total picture of the residents lifestyle. A family member may have some indications of what the resident is interested in, however, it may not be the complete picture.

Many residents have relatives who are acting as the “historian” for the resident upon admission. These relatives may remember that their Aunt enjoyed baking cookies for them when they visited. In reality the Aunt actually baked only when they came to visit and had a hidden stash of store bought cookies that she was crazy about. Does this mean that the Aunt enjoyed baking? Maybe, but may have enjoyed the process of getting ready for the visit and wanted to make the house smell welcoming. A mother who worked and raised her children may have enjoyed the solace of reading a book while her children were at the beach. The children may remember that Mom liked the beach. In reality Mom enjoyed reading romance novels. So the Professional Activities Assessment is a tool that continues to evolve long after being completed.