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The National Association for Providers of Activities for Older People (NAPA) is a membership charity that promotes the importance of activity for all older people. It offers members regular bulletins full of practical activity ideas including quizzes, discussion topics and art activities. The PAL instrument positively shaped my practice as an occupational therapist and continues to do so today. If you support people living with dementia and their caregivers this is the book for you - it combines expertise, with evidence and practical guidance for anyone with an interest in dementia care. The Spark of Life Club is an approach developed in Australia which is designed to improve the social, emotional and spiritual wellbeing of people with dementia.
Pool Activity Level (PAL) Instrument for Occupational - UK The QCS Pool Activity Level (PAL) Instrument for Occupational
The focus of the approach is on providing meaningful activities that don’t have to be structured but do need to stimulate the senses, encourage participation, boost self-esteem and fulfil one or all of the five universal emotional needs. Assessment tools Aware of others in the group and will work alongside others although tends to focus on own activity. Plans to use and looks for objects that are not visible; may struggle if objects are not in usual/familiar places (eg. toiletries in a bathroom cupboard).Body language may be inappropriate and may not always be coherent, but can use simple language skills. May grip the paper if it is placed in the hand but may not be able to release the grip; or may not take hold of the paper. Simple assessment tools can help staff to understand the types of activities that might benefit a person with dementia. Two of the best-known examples are the Pool Activity Level (PAL) Instrument (Pool, 2007) and the Cardiff Lifestyle Improvement Profile for People in Extended Residential Care (CLIPPER) (Powell, 2007). This provides a unique profile of an individual’s likes and dislikes. A care plan can then be carefully tailored to create the best possible quality of life for that individual. CLIPPER is published within Jennie Powell’s 2007 book, Care to communicate (see ‘Further reading and resources’ below). A programme approach
Explaining the Pool Activity Level (PAL) Instrument - Rompa Blog Explaining the Pool Activity Level (PAL) Instrument - Rompa Blog
If in doubt about which statement to select, choose the level of ability that represents their average performance over the last 2 weeks. I began developing the PAL Instrument by building on the work of Claudia K Allen. She had developed an Occupational Therapy model for understanding cognitive disability, based on developmental theory. Allen’s model has a robust assessment for OTs and then relies on their professional knowledge to interpret the outcomes of the assessment. I wanted a tool that would self-interpret and provide a guide to those without the clinical skills so that they could enable individuals with cognitive difficulties to be less disabled in every-day activities. The PAL Instrument uses a strengths-based approach, opposed to where we only focus on the difficulties people with dementia might have and disable them. It contains a valid and reliable assessment tool for assessing the overall level of individual cognitive and functional ability. A PAL Guide that describes how to support the person at that level of ability is produced from the completed assessment. The PAL Instrument is a widely used framework in care settings across the UK and around the world.
The Best Friends approach was developed in the mid-1990s by Virginia Bell and David Troxel in the United States. Simply put, the model suggests that what a person with dementia needs most of all is a friend, a ‘Best Friend’. Bell, V., Troxel, D., Cox, T. and Hamon, R. (2004 and 2007) The Best Friends book of Alzheimer’s activities, vol 1 and 2. Baltimore, MD: Health Professions Press. National Association for Providers of Activities for Older People. ‘Activity allsorts’ (includes 101 things to do). London: NAPA. Pool, J. (2007) The Pool Activity Level (PAL) Instrument for occupational profiling: a practical resource for carers of people with dementia (3rd edition), London: Jessica Kingsley Publishers. Can plan to carry out an activity, hold the goal in mind and work through a familiar sequence; may need help solving problems.
pool activity level (PAL) instrument for occupational profiling: a The pool activity level (PAL) instrument for occupational
Spector, A., Thorgrimsen, L., Woods, B. and Orrell, M. (2006) Making a difference: An evidence-based group programme to offer cognitive stimulation therapy to people with dementia, London: Hawker. Technology has so much to offer people living with dementia and their carers; access to information, advice and entertainment as well as reassurance for a carer who does not live near a loved one. Used sensitively and thoughtfully, technology enhances rather than replaces human relationships and interactions. To be successful, an activity has to match the personal interests of an individual and be pitched at the ‘just right’ level of challenge: too easy and it may be boring, too difficult and it will be frustrating. A number of different approaches within dementia care offer helpful ways to develop meaningful activity and improve quality of life for people with dementia. Roe, P. (1998) Let’s talk, Milton Keynes: Speechmark. This includes discussion and prompt cards for use by groups in a range of settings.More interested in the making or doing than the end result, needs prompting to remember purpose, can get distracted. However, it is not uncommon to find relatives, other older people, managers and staff members resistant to the idea of using dolls, because they think it seems patronising or demeaning in some way for the person, or they are worried about outside visitors’ reactions. Activities need to be broken down and presented one step at a time, multisensory stimulation can help hold the attention.
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