Long-Term Care Survey Alert

Follow this facility's lead in offering a mix of activities.

If there's an inside secret to developing an effective activities program for people at the end of life, it's that there isn't one. Or at least not one that's any different from how your facility normally develops activities that hit the spot for any resident.

Start with an assessment of the person's unique interests, abilities and psychosocial needs. People at end of life tend to grapple with similar issues but in their own ways.

"Residents on palliative care at Schervier Nursing Center complete a survey that asks about their hobbies, favorite music -- and whether they want pets to visit, etc.," says Paulette Sansone, PhD, the licensed medical social worker for the facility in Riverdale, NY.

The interdisciplinary team  also uses the MDS assessment to identify signs of isolation and the resident's individual interests, adds Charles Sourby, MTRS, special projects coordinator for therapeutic recreation for the facility.

The activities program for palliative care residents offers a mix of individual and group activities. One example is a "Sound and Senses in the Garden" activity where residents work with Biblical plants in a sensory garden.

The sensory aspect of gardening -- the feel of the soil, the smell of the plants and sound of the water -- really engages people in the later stages of dementia.

Charles Sourby, MTRS

"The residents and group leader discuss the plants' meanings as they nurture the plants and listen to ecumenical readings, poems and reflections," he adds. "We talk about the symbolism of life in the garden and have developed the concept of a 'gifting' where residents each make a dish garden or flower arrangement for a family member, friend or caregiver -- and one for themselves," reports Sourby.

The program also offers activities geared to people in the later stages of dementia or Alzheimer's disease. "We give them a task such as putting soil mix and seeds in a planter," Sourby notes. "The sensory aspect of gardening -- the feel of the soil, the smell of the plants and the sound of the water -- really engages people in the later stages of dementia," he adds.

Use a Palliative Care Cart

The activities department has also developed a palliative care cart that staff takes to the resident for an individualized activity. The cart contains refreshments, hand creams and sensory materials.

Sample activities include guided imagery, life review, hand massage and flower arranging. "The activity offers the resident an opportunity to ventilate feelings and receive support," says Sourby.