Anna is a 79-year-old lady living with 2nd stage dementia. She seems to understand what staff say but is slow to respond. She is restless most of the day, sitting for only minutes at time...
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Case Study

Anna is a 79-year-old lady living with 2nd stage dementia.

She seems to understand what staff say but is slow to respond. She is restless most of the day, sitting for only minutes at time. As she wanders, she enters other resident’s rooms and takes possession of whatever calls her attention.

At meal times she will reach and take food from other people’s plates and offer it around. Anna walks with an unsteady gait and falls occasionally.

She enjoys good rapport with staff but she can become very resistive to requests. Staff have to employ diversionary strategies to retrieve other people’s possessions from Anna and one strategy that works well is inviting Anna to ‘help out’ with something.

Social/Emotional Care Pan

Resident: Anna May
DOB: 02/07/1925
Recorded by: Solange Kindermann
Date of Record: 23/04/2021
Activities Support: Requires supervision at all times.

Community Outings

Anna requires one-to-one assistance. Staff will request her family accompany Anna on bus trips or ensure that there are enough volunteers.

Extra Support

Anna will be escorted to see the hairdresser, podiatrist and all other medical appointments.

Issues & Strengths

  • Uncooperative behaviour, holding onto other people's belongings
  • Tendency to antagonise her peers at the dining table and in the recreation area
  • Slow to respond verbally
  • Unsteady gait
  • Anna is alert most of the day
  • Good rapport with staff occasionally

Goals:

Anna will be given suitable distractions to curb her intrusive behaviours.

Anna will feel safe and secure at all times.

Interventions:

Staff will provide Anna with daily sensory stimulation and activities suitable to her capabilities such as garden watering, walks, magazines, puzzles and serviette folding. Staff will give Anna ample time to understand instructions and answer questions.

When Anna is restless and upsetting others, staff will approach her in a non-directive and sensitive way and offer Anna a choice of alternative activities e.g. a hand massage with essential oils, hair grooming, manicure and/or make-up or a walk in the garden. Anna responds well to kindness and this will help staff remove her from challenging situations.

Anna will attend all cooking sessions and staff will assist her to participate actively e.g. stirring, sorting, top and tailing vegetables, measuring.

Anna enjoys ball and balloon games, picture bingo and sing-along and will continue to attend these activities.

Staff will orient and guide Anna several times a day making sure she is safe and secure when wandering around. She will attend music therapy, concerts, visits from children, pet therapy and special screenings of animal/nature movies.

Anna belongs to the Catholic faith and will be escorted to the monthly service in the facility.

Staff will liaise with Anna’s family regarding her well-being and offer support when needed.

Evaluation:

Quarterly

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Comments   Post a Comment

Catalina 1st Jul 2018 Activity Director
Thank You so much! I have found this article so much helpfulness for my reports and very so many ideas its help me a great dial with my new position as a Director of Activities.
My residents just have so much fun with the jokes and they have become more creative with your arts and crafts. and their names thank you.
Catalina
Talita 7th Jul 2018
I'm so glad y ou found this article helpful Catalina. Thanks so much for your feedback and all the very best to you! x
Hyacinth blake 21st May 2018
This scenario has really helped me in writing my care plan on challenging behaviour.
Thank you so very much. You have been a big help to me.
Keep up the good work
Talita 21st May 2018
Thanks so much for your feedback Hyacinth. All the best!
Jenny 25th Oct 2017
Activity aprons are useful in keeping individual's hands occupied and offer fine motor work.
Maria 10th Aug 2016 Lifestyle Assistant
Yes I also have issues with our dementia residents especially for sundowners. I would appreciate if you have any more suggestions.
Tolufale Junior 16th Jun 2016
As a male student trying do some research came across with this scenario relly helps with my studies Thank you
Tammy Lindsey 27th Jan 2016
Need information on activities for last stages of dementia residents how to designed a fun day for them
Clare 25th Jun 2015 Respite Option Facilitator
Its all about Empowering people findig a niche in every person you focus on.
Chandanii 31st May 2015
I red most information from your programme and increase the knowledge of activity plan how it is work for my facility thank for sharing this all ideas
Solange 27th May 2015 Diversional Therapist
Hi Carol, I couldn't agree more. Much is said about 'person-care' but very often the support is not there, hence the stress.
Carol Craddock 26th May 2015
Wondering why such a big burden is put on the Activities Assistant at all the facilities to cope with such a diverse range of needs, when there is supposed to generally be a reasonable ratio of staff to residents? No wonder there is so much stress and anxiety in such workplaces. Two activities staff and volunteers are a compulsory necessity at all times for a successful outcome, don't you think?
Viv 10th Apr 2015
Thanks for such pertinent and easily accessible information it will provide evidenced based research for my Bachelors in Health Practice.
dorothy 28th Jan 2015 diversional therapist
thanks for the ideas i would like to add that it sounds like Anna would benefit from the Montessori principals she seems to have a need to help and care , i would put into place a program where she is helping at meal time then invited to sit down and have her own meal i find that the Montessori principals help to reduce many behaviours as you are fulfilling the need to be useful and needed . it is usually the case meet the need and reduce the behaviour .
Tina 22nd Jan 2015
This has been very helpful as i am doing my Aged Care Course...
Viktoria 27th May 2014 Lifestyle assistant and PCA
Hi, Anne. Tell me ,please, where are I can find The Sonas Session-training in Melbourne? Thanks, Regards, Viktoria
row 26th Feb 2014
Hello I have found your activities very encouraging and would like to put some in to practice in the home where I work, I find music is the greatest way to promote better moods better people and a sense of peace and well being for the residents. Another thing is not to rush them, nothing worse than a staff member on there own mission, in now we are going to do this this and this it does my head in imagine what it does to them
Dorothy 13th Feb 2014 Lifestyle Coordinator
Hi Sandra,
Can you help me with the following, I look after 25 residents and work 3 days a week for 6hrs struggling to put things in place without preparing things at home, with no help from nursing staff,l am told I do not need to do any documentation only exceptional reporting for accreditation? . I have 9 dementia clients in this and struggle with activities for sundowners do you have any ideas ?
Great information
Indeera 3rd Dec 2013
Great ideas thank you so much.
Michelle 8th Sep 2013 Occupational Therapist
Hi there,
Great ideas here thank you very much. Similar to your situation Sandra, i too am new to a residential care setting and am in the process of setting up a programme for over 60 patients. I'll check out the sonas programme now havn't heard of it before but any other suggestions or tips are welcome!
Anne 22nd Jan 2013
Sandra, do you know anything about the sonas programme? This has proved popular/succesful in our facility, it would be great if you had a volunteer to assist you. Rgds, Anne
sandra 18th Jan 2013 Diversional Therapist
Desperate for new ideas for my sundowners. I am one therapist for 45 residents and I have no assistance from other staff. i am finding the expectations unbelievable and three weeks feel like three years any ideas? the Programme I am taking over from was non existant and I am having to start from scratch and am working a full day and having to do all planning documentation etc at home. needless to say I am getting exhausted.
Regards Sandra
Filidea 18th Jan 2013
Hi Sandra.
I feel for you!!! I have been where you are now.
I look after 85 residents, and we have an excellent "sundowning" evening program which runs well and effective and our resdients are participating in meaningful activities.
I will be glad to offer you some help and ideas if you want to email me your details.
My email address is (sent privately).
Regards
Fil :)
Solange 17th Oct 2012 Diversional Therapist
Great ideas Nicole, thank you for the feedback.
Nicole 17th Oct 2012 Lifestyle Coordinator
You might like to try a raised 'weed' garden (with flowering weeds) outside for the resident gardener who likes to pull out plants or perhaps objects at waist or shoulder height for distraction, ie: rainbow flags, wind chimes, washing line etc. We have potted fake flowers/plants in plaster of paris so they can't be pulled out. Good luck.
Marilyn 9th Oct 2012 Carer
Love it. I will come back again and again.
Dianne Rudd 7th Sep 2012 Recreational Activities Officer
Hi. Yes thats a hard one. i have gone outside and put fake flowers in the ground for the residents to pick. just need to keep putting them back when you find them lying around.
Could laminate some nice signs that say
please enjoy the flowers but please dont pick me, Thats if your client can read.
We do flower arranging. we have a large selection of cheap artificial flowers 1St I place a fitted bed sheet on the table then put all the flowers on the table. some men weiil also join in due to the sensory stimulation. Good luck.
diannerudd 7th Sep 2012 Recreational Activities Officer
You really need to know the persons Life history to work with most behaviours.
Example: We have many R.N's in our Dementia unit who are patients. They are invited to our staff meetings and training sessions if appropriate. Another resident who was also an R.N likes to sort out our linen trolley. The afternoon staff ask her to help give out the linen with them.
Another lady grew up in an orphanage in India. She likes to bring water to the back door so we can have water for the cooking/ cleaning etc. we allow this but will remove this when she is occupied with other things.
I think the main thing is being switched on to where they are currently in their minds with there dementia and how old they think they are.
Doll Therapy works well but there are lots of protocols and guidelines to follow and EVERYONE must treat the dolls as real babies .
Food activities are great for the sundowners, i find this settles most residents
Lyndsey 11th Apr 2012 Lifestyle leisure Therapist
We have a John like this. Loves to torment. Pulls out all the flowers/vege in the garden, much to the sorrow of our plant lovers!!! Any ideas???
sally mcdonald 24th Oct 2011 yoga teacher, and recreation therapist
great read stragities are very help full, keep up the good work
clayton 10th Jan 2011 lifestyle manager
i have a resident who is in the 2nd stage of demensia, he has worked hard all his life and gets confused when staff wont do as he says. He likes to work with his hands and we have tried all kinds of activities with him( building activities,puzzles,workshopping, ect but he soon losses interest, any help with new activities would be appreciated. ( Ideas ) Kind regards Kelly
Lorraine Lambert 10th Jan 2011 Registered Diversional Therapist
Yes, I have found this most helpful. Thank you and look forward to more info regarding our challenging
clients.
Jackie 16th Dec 2010 Activities / Volunteer Coordinator
Yes, our Ann is very similar in behaviour, have also tried to engage her in helpful activities. Face washer & serviette folding, unwinding knitted garments, watering, washing up etc.... She looks and expresses anxiety often, walks to exhaustion, can't rest.
Susan 3rd Sep 2010
I have found the golden carers web pages to be very informative and useful - full of great ideas - keep up the good work!
Dawn Merante 30th May 2010 Diversional Therapist
very good.
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