In his book A Life Worth Living: The Eden Alternative in Action, Dr. Bill Thomas (1996) states "Loneliness, helplessness, and boredom are impervious to the silver bullets of modern medicine" (p. 25). In other words, there is no pill for the three conditions that he calls the "nursing home plagues." These plagues, however, are not reserved for nursing homes or facilities only. They appear in many private homes daily.
One important strategy to counter institutionalization in any environment is to offer meaningful activities. Not just bingo. Not just shuffleboard. Not just folding laundry. Think individual interests.
Geriatrician and colleague of Dr. Thomas, Dr. Allen Power (2010) discusses the role of engaging persons living with dementia in his book Dementia Beyond Drugs :
A simple pleasure is just what the name implies: a simple activity one engages in regularly that brings pleasure and satisfaction. Everyone has one or more of these. The key is that each person's simple pleasures are highly individualized and often carry special meaning for the person. In fulfilling a simple pleasure, it is critical to obtain all of the little details that make it a special experience. (Power, 2010 p. 93 kindle)
A 2009 article by Kolanowski and colleagues discusses the use of recreational activities to reduce "behavioural symptoms" that typically frustrate both family and professional care partners (Kaolanowski, 2009 p27) rather than drug interventions. Let's not forget the frustration of the person living with dementia. The symptoms include screaming, kicking, elopement (i.e. wandering). They present evidence of past studies demonstrating that activities can reduce psychotropic medication use. One must truly partner with the person to try this change for the better.
Now, there are whole books written just on choosing the right activity and adapting it for the person's retained abilities. This article will introduce discovering the interest behind activities, with future posts expanding on more details (but start implementing now with your instinct).
In order to find meaningful activities, we should look at a person's entire lifespan or career, hobbies, passions, and interests. This may sound like a daunting task, and it sure could be!
Wouldn't it be great to have a list of topics that help to discover personal interests so you could offer something to counter loneliness, helplessness, and boredom?
Enter the Farrington Leisure Interest Inventory (FLII). Professor Marianne Smith and her colleagues at the Iowa Geriatric Education Center (IGEC) collaborated with Dr. Linda Buettner to adapt a version for use in IGEC's activity-focused dementia training program.
This checklist of over 150 items will allow you to ask your loved one or client about activities that may pique their interest. My hope is that YOU will consider using this free resource to discover things that will delight your loved one or client.
"But I know everything about ...my Dad, Mom, Husband, Wife, etc..." you say?
Consider these points:
1. The human life is so rich, complex, and interesting; there are likely things that we do not know about each other.
2. Perhaps the person living with dementia is on a Trip Back in Time to their childhood with hobbies that you do not know about? How will you discover them?
3. You may be a professional Care Partner just meeting a client with dementia with little or no access to the person's family.
4. Perhaps you will uncover an interest that they never had a chance to explore in their busy life.
Professor Smith tells the story of a woman with whom she was reviewing the FLII. When they got to the topic of motorcycles, the woman told the story of how she traveled cross-country on a motorcycle. Who would have known?! Of course, she is probably not going to be riding a Harley soon, but there are other enriching activities that can be created around motorcycles of that era.
Not only will this survey help uncover topics of meaningful activities, but it could also create a stronger bond between professional Care Partner and client. As the Care Partner goes through the Farrington Leisure Interest Inventory, he or she will start to see the whole person with decades of life and experience.
This FLII asks one question regarding enjoyable music, which is a very rich topic deserving its own assessment. I recommend reading my article on preventing and soothing agitation in dementia that includes a music assessment.
As always, be cautious of overwhelming the person living with dementia (or anyone). Break up the FLII over time if needed. Also, the music preference survey may be offered another time.
Now it is time to put this knowledge to use and create Peace with Dementia. Tell us about your experiences with meaningful activities and when you use the Farrington Leisure Interest Inventory.
If you appreciate this article, don't keep it all to yourself. Please share so that more persons living with dementia can benefit!
Update: In the original version of this article, I stated that Professor Marianne Smith and her team at Iowa Geriatric Education Center created the Farrington Leisure Interest Inventory. This was my mistake when I misread Dr. Smith's email to me. As Professor Smith says in the comments section below, she and her team "collaborated with Dr. Linda Buettner to adapt a version for use in our activity-focused dementia training program." This post has been corrected.
In Peace,
Matt
Matt Estrade, MBA, CAPS is the Founder and Chief Mentor at Care Partner Mentoring, LLC in Covington/New Orleans, LA, USA. A more extensive biography can be found here.
Literature cited:
Kolanowski, A., Fick, D. M., & Buettner, L. (2009). Recreational Activities to Reduce Behavioural Symptoms in Dementia. Geriatrics and Aging, 12(1), 37-42. Retrieved May 1, 2016, from https://healthplexus.net/files/content/2009/January/1201dementia.pdf.
Power, G. Allen. (2010). Dementia Beyond Drugs: Changing the Culture of Care. Baltimore, MD: Health Professions Press.
Smith, M., Buckwalter, K., Buettner, L., & Seydel, L. (2010). Farrington Leisure Interest Survey from Dementia Training to Improve Involvement in Meaningful Activity. The Iowa Geriatric Education Center, The University of Iowa: Iowa City.
Smith, M., (2010). Non-Pharmacological Management of Behavior Problems in Dementia [iTunes U Podcast]. The Iowa Geriatric Education Center & The University of Iowa College of Nursing, The University of Iowa: Iowa City. Retrieved from http://itunes.apple.com.
Thomas, William. (1996). A Life Worth Living: The Eden Alternative in Action. Acton, MA: Vander Wyk & Burnham.
