Therapeutic Activity Program
An activity is any project a person enjoys and that produces a positive feeling. A therapeutic activity program is a total plan of care based on assessment of the client’s needs and a history of previous activities. The activity program for persons with cognitive disorders is specifically designed to meet identified needs and to prevent or lessen problematic behaviors caused by unmet needs (). The goal is to keep the person functioning at comprehensive, and holistic approach that includes all daily activities and behaviors show the greatest success in caring for individuals with dementia (see Research for Evidence-Based Practice box).
Building on strengths – such as retained remote memory, use of habitual skills, preserved large and fine motor skills, and intact emotional responses – is the basis of success. It is exceedingly difficult, if not impossible, for the person with AD to learn new skills. “Use it or lose it!” is a motto, especially when working with clients with dementia. Once a client loses a skill, it is usually gone for ever and the client is not able to relearn it.
A therapeutic program is a primary treatment for persons with dementia, as often the first neurologic losses result in the inability to plan, initiate, carry out activities in ordered steps (sequence) , or remember activities by themselves. Thus it is the role of the caregiver to guide or assist the client throughout the activity, from beginning to end. Use positive reinforcement at each step of the way.
Nurses measure success of a therapeutic activity program on some objective terms by addressing the following questions:
• Has the number of times per day or week that the client is actively involved increased of decreased?
• Have incidents of catastrophic reactions of sundowning decreased?
• Have incident of the client aimlessly pacing or wandering and getting lost decreased?
• Has the level of functioning in ADLs and IADLs remained stable, or is it decreasing at a slower pace than before the program was initiated?
• Are caregivers feeling less stress, which is indicated by fewer incidents of anger or crying, improved sleep patterns, or enhanced feelings of physical and mental well-being?