feedthesenses1

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Presented by: Joanne Seid, MS, R.D. Charles A. Sourby, MS Ed., C.T.R.S. INTEGRATING TR NUTRITIONAL SETVICES AND CREATIVE ARTS IN DEMENTIA CARE

INNOVATIVE PROGRAMOF THE YEAR 2002: 

INNOVATIVE PROGRAM OF THE YEAR 2002 New York State Therapeutic Recreation Association NYSTRA

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To sustain the nutritional status of dementia residents. To plan appropriate nutrient dense meals and snacks. To foster social, emotional, physical & cognitive functioning.

Presenting Problems: 

Presenting Problems Decreased attention. Increased wandering & agitation (results in risk for weight loss & dehydration; risk of falls; risk of fatigue). Lack of cognitively appropriate activities in congregate setting. Lack of desire to eat & consume nutritious snacks.

Presenting Problems: 

Presenting Problems Traditional nutritional interventions ie: pharmaceutical supplements may interfere with meal intake. Utilizing nutriceuticals foods to enhance variety of texture/flavor for meals & snacks.

Improving Quality of Life: 

Improving Quality of Life Art, Music, Dance, Reality Orientation, Pastoral Care, Pet Therapy & Therapeutic Recreation Programs are designed to improve social interaction and cognitive functioning and to encourage the consumption of snacks.

Integrating Socialization Activities with Snacks: 

Integrating Socialization Activities with Snacks This is an interdisciplinary program initiated and designed to maintain optimal nutrition/hydration status of dementia residents. Incorporating nutrient dense snacks and scheduled Therapeutic Activities has resulted in improved health status. FOR MORE INFO...

Description: 

Description Project has been conducted for one year. Music therapy, dance therapy, art therapy horticultural therapy, recreation therapy, pastoral care and nutrition combine to yield efficacy based outcomes. Residents engage in daily activities to enhance their quality of life.

Planning the Menu: 

Planning the Menu Nutriceuticals - enables use of calorie dense/protein enhanced foods/fluids. Select food items that can easily be incorporated into your facility’s menu. Taste testing for ALL products.

Planning the Menu: 

Planning the Menu Protein/calorie enhanced, ready to serve - potatoes, cereals, juices, ice creams, cookies. Consider modifying recipes utilizing modular supplements.

Comparative Analysis : 

Comparative Analysis Strengths - positive status for many residents re: intake/weight trends Total Population - 73 14 GT fed/55 orally fed/6 hospital

Comparative Analysis: 

Comparative Analysis Intake ~75% w/stable wt. 18 Intake ~75% w/wt. gain 6 Intake ~75% w/wt. gain 8 (undesirable) Intake Inc. ~50% w/stable wt. 5 Intake Inc. 50-75% w/wt. gain 2 Intake ~75% w/pos. wt. loss 5 (6 hosp. & 5 w/progressive decline)

Comparative Analysis: 

Comparative Analysis Total Supplement provided 31 Supplement reduced 13 Supplement discontinued 8 Supplement added due to 2 unplanned rapid weight loss 68% reduction of pharmaceutical supplements

Comparative Analysis .: 

Comparative Analysis . Therapeutic Recreation Activities Art, Music, Dance, Movement, Pastoral Care, Reality Orientation & Pet Therapy Enhance attention during snacks Focus on completing tasks during activities Provide encouragement & praise Assist as per individual needs FOR MORE INFO...

Art Therapy : 

Art Therapy Is that imaginative, creative expression, that is in itself, a source of growth and sustenance and can be a language of communication in the every day life of residents diagnosed with Senile Dementia of the Alzheimer’s Type . Helps those residents who are less able to express their thoughts and feelings in words and are closer to the more primitive expressions of themselves through art. Is a process which fosters attention, spontaneity and originality of expression.

Art Therapy Activities: 

Art Therapy Activities Foam sculpture Jackson Pollock Travel Collage Paper Mache’ Bracelets Decorating Bracelets Mandala Painting Bird Coloring Stamp Painting Painting Shells Art Samples: note the color note the control note the stereotypic themes

Music therapy: 

Music therapy Music Therapy in Dementia Care is a means of improving memory, health and identity in those suffering from dementia - particularly the Alzheimer's type. Explores the issues which may arise in working with this group, such as coping with wartime memories, facilitates and enables communication through sound and movement.

Music therapy: 

Music therapy Through the music therapy sessions, residents are able to hum melodies after being given the name of a song. Their general attitude "brightens” and they appear able to better express themselves through music after the sessions.

Music therapy: 

Music therapy Singing is led by a music therapist, and the residents are encouraged to join in singing. Participation is highest when a drum is placed in resident laps. There tends to be less participation in singing exercises without such props. Finally, participation seems to decrease as dementia progresses.

Music therapy: 

Music therapy The residents were observed in activities before and after therapy sessions in order to determine if there was an increase in socialization after a music therapy session. All residents increased social interaction and decreased in non-social interaction. After a few sessions, all patients participated enthusiastically in sessions.

Dance & Movement Therapy: 

Dance & Movement Therapy The psychotherapeutic use of movement as a process which features the emotional, cognitive and physical integration of the individual. Uses sensory and relationally oriented Dance/Movement therapy. Program was created in relation to the resident’s needs and the unit’s structure & culture. Program has a two prong approach...

Dance & Movement Therapy: 

Dance & Movement Therapy The first prong provides a group experience. Sessions are approximately 45 minutes long. The second prong provides individual sessions at bedside 5-15 minutes long. Individual dance/movement therapy allows flexibility to respond to the changing nature of the units.

Dance & Movement Therapy: 

Dance & Movement Therapy Critical processes include: ritual to create consistency and bridge between the known & unknown; reminiscence to re-inform residents of their own story, including the physical, emotional, & cognitive accomplishments & losses; shared movement & touch to increase awareness of self, others and the environment; and to help organize both thinking and action...

Dance & Movement Therapy: 

Dance & Movement Therapy Rhythmic music and movement creates an outlet for vitality and expression of emotion; and consistent leadership is a means of integrating a constant and safe familiar object. Residents show the ability to join others in rhythm, shared movement and dancing.

Dance & Movement Therapy: 

Dance & Movement Therapy No formal evaluation has yet been conducted to establish the long-term effects of dance/movement therapy. Regardless, its application in this setting appears to aid the residents in adjusting to their current reality and in finding moments of peace, dignity, connection & joy.

Recreation Therapy : 

Recreation Therapy Redirects residents toward past leisure experiences. Helps residents maintain a sense of self through career and or family identifiers. Provides structure to daily routine. Fosters cohesive groups. Lends itself to individual needs. Provides setting for family supports.

Recreation Therapy: 

Recreation Therapy Coordinates program schedule with nutritional services & nursing. Schedules weekly program plans. Documents resident progress in chart, maintains statistics. Encourages facility wide participation in general programs off the unit.

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By combining creative arts therapies, therapeutic recreation and nutrition we stimulate the senses in such a manner that eating becomes secondary to active participation. Facilitates creative expression in people who either are nonverbal or have deficits in communication skills. Provides the opportunity for experiences that open the way for and motivate learning in all domains of functioning. Creates the opportunity for positive, successful and pleasurable social experiences not otherwise available to them.

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To improve self-image and body awareness To increase communication skills To increase the ability to use energy purposefully To reduce mal-adaptive (stereotypic, compulsive, self-abusive, disruptive, perserverating, & impulsive) behaviors To increase interaction with peers and others To increase independence and self-direction To stimulate creativity and imagination To enhance emotional expression and adjustment

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To increase attending behavior To improve fine and gross motor skills To improve auditory, tactile, oral, olfactory and visual perception

Weekly Program Statistics : 

Weekly Program Statistics

Team/Resources: 

Team/Resources Resources allocated to this project Dietitian - assesses nutritional needs Recreation Therapist, Dance Therapist, Music Therapist & Art Therapist Certified Nurses Aides Pastoral Care Chaplain

Project Review: 

Project Review Mainstreaming of residents Program expansion to include early onset dementia residents walking program initiated horticultural therapy to begin biographical histories of each resident http://www.alzheimers.org/ http://www.recreationtherapy.com/rt.htm FOR MORE INFO...

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Funding Provided by: THE UNITED HOSPITAL FUND

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Written by: Heidi Fledderjohn M.A. A.D.T.R. Dance Therapist Page F. Oliver MA ATR--BC Charles A. Sourby MS. Ed. CTRS—HTR Joanne Seid MS R.D. Clinical Dietitian