In someone else's hands, an old puzzle might be just that, but in the hands of a dementia patient, it can be a game-changer.
The Fort Frances Branch of the Canadian Mental Health Association (CMHA) recently began working with La Verendrye General Hospital to provide activation materials to the patients at the hospital who live with different types of dementia.
CMHA Psychogeriatric Resource Consultant (PRC) Alastair Greig explained that there have been similar programs in other hospitals, and he and his colleagues saw a need for something similar here.
“My program is actually brand new in this region,” Greig said.
“There are community PRC's elsewhere, like in Thunder Bay, but with the hospital and Rainycrest being closed, the hospital had a need, because they were getting inundated,” he added.
“People were coming in from the community because of acute illness or failure to cope at home and had a dementia process, and then Rainycrest with their doors closed, there was a real need for a PRC to be there to help provide consultations to address responsive behaviours.”
Greig explained that responsive behaviours are very much what they sound like: the actions that dementia patients sometimes take in response to their surroundings as the illness affects their brains. Responsive behaviours include wandering, striking out, verbalizing or calling out repetitively.
As patients with dementia processes were never meant to stay at the hospital long term, Greig and his colleagues began to collect materials that would engage the patients on a mental level in hopes of lessening the severity or frequency of those responsive behaviours.
“One of the sad facts that we see across Canada is that individuals with dementia actually end up spending longer times in hospitals, so the day-to-days can be monotonous,” Greig said.
“One of those issues that comes with that is boredom, so when boredom happens then irritability can occur as well, especially if somebody has a dementia process, so getting those materials, as simple as things like puzzles, working blocks, or things of a tactile nature can really allow them to preserve memory.”
The materials, Greig said, are beneficial to individuals on either end of the spectrum of severity for their dementia.
“It's like rebuilding memories for individuals who are earlier on in the dementia process,” he said.
“Then later on it's more of a way to activate the mind cognitively, get them to focus on something other than just staring at four walls. It's a great little opportunity, and I think we have plans for donating more in the future.”
Greig also noted that the same principle as the activation materials is at work in larger projects like the lifestyle stations that have begun to appear in hospitals and long-term care facilities, including Rainycrest, which has a “Life Skills” nursery station where patients can interact with lifelike dolls in an authentic nursery setting.
“It might be something like a desk with a typewriter and a phone for individuals to sit there and they kind of go through the motions,” Greig said.
“It's really a means of activating them cognitively in that sense.”
Greig's program is just over a year old now, and he consults with many people who are living with dementia, and their families, in order to determine how to best address the responsive behaviours they might be exhibiting.
“In my consultation I do a comprehensive assessment of their physical, their intellectual, their emotional capabilities and their social background to see how to augment our approach or care so these behaviours don't come up, or we can lessen them in severity,” he said.
“It can be individualized. I often ask, if I know they're a farmer, I'll say 'do you ever play cards?' And a lot of them will say, 'that's how we pass a lot of times, playing cards.' So we might do something like a card based donation. Puzzles are a great one just for individuals of any background. It's a great way to keep the mind sharp, to keep occupied. So it can be specific, but also can be very general.”
While Greig said there isn't a lot of academic literature on what activities are best when it comes to these kinds of activation materials, he has seen plenty of evidence that they do make a difference.
“I went over by today in the patient lounge on the second floor and there's people already putting puzzles together,” he said.
“It seems that all the activation material is out, people are showing an interest to them, and it really brings a smile to their face, so longer term we'd want to see if there's a lessening of behaviours, issues about general apathy, not wanting to engage in things, and then seeing if there's any kind of buy in.”
Longer term, Greig said the plan is to continue to donate different kinds of activation materials, but he also hopes that they might be able to arrange something more substantial at the hospital.
“I think it would be great if we could set aside some space to actually do a life station, whether it be a desk or office station, or a nursery is one that's been very effective, it's great,” he said.
“Julie Cousineau has seen that being very effective in the past at the hospital, so I think that would be the next step, maybe setting up a little nursery in the patient lounge, or another one, whether that be an office or otherwise.”
Greig also noted that the materials are a benefit to the hospital staff as well.
“It's really good that we're able to provide this material to the staff,” he said.
“One of my roles is always providing education to staff about how we can best engage individuals, understanding their specific dementia process. Dementia is really an umbrella term for any kind of cognitive degenerative disease, so that's from Alzheimer's to a stroke or TIA that can cause a vascular dementia. Or there's certain subtypes like frontal temporal disorder, so even though it's an umbrella term, they have very different presentations, so we're always there to provide that resource as an education means.”
As the population in Fort Frances continues to change and age, it becomes increasingly likely that town residents will have a friend or family member who is affected by dementia and Greig mentioned there are ways to get involved if that itch to help out needs to be scratched.
“There's always a great opportunity if you volunteer through LaVerendrye Hospital,” he said.
“I know they have their own processes of doing vulnerable sector checks and things like that. Even donating some old puzzles or word finds, they can always donate them to the hospital or come to CMHA and we can help facilitate as well.”