Celebrating the festive season with a person who has dementia

Elderly ChristmasAs we get closer to the Christmas holidays the question of how to make it a pleasurable experience for a person with dementia is always a big question. Essentially, this time of year can be rather overwhelming for all of us with increased noise, hustle and bustle and flashing lights. It can also be an opportunity for sensory stimulation and reminiscence. Below are my ten top tips for a calm and enjoyable Christmas.

  1. Start slowly and gradually – don’t introduce all the decorations at once. This can make the environment feel unfamiliar and increase a sense of disorientation.
  2. Encourage the person with dementia to take part in putting up decorations – they may not do it quite like you planned but doing a job and seeing it through can give you a great sense of achievement.
  3. Noel Festive Room SpayUse a multi-sensory approach – Christmas is an opportunity to great an multi-sensory atmosphere. We focus a lot on lights but what about the smell of cloves and cinnamon, carols with a slow tempo, textures of making holly wreaths, baking mince pies.
  4. Create oasis of calm – if people are coming to visit give the person with dementia time to adjust to the noise level and create quiet time after the visitors have left.
  5. Talking Photo AlbumHelp the person with dementia feel included – when visitors arrive provide some props to help they create conversations with the person with dementia such as a photo album of familiar photos or an item from a past interest. Basically focus on the memory they have.
  6. Pace yourself – don’t plan too much as transitioning from one event to another can be overwhelming.
  7. The Christmas diary – create a Christmas diary and put in a place where the person with dementia can see it. Keep it straight forward with the day and what is going to happen. Refer to it to help the person with dementia prepare.
  8. Remembering Christmas past – use Christmas events as an opportunity to reminisce. Christmas photos, old Christmas decorations and family stories all help generate conversations.
  9. Social Games Saver PackBeing part of Christmas – sometimes you don’t have to be doing something all the time. Being on the edge looking in can be just as pleasurable, for example listening to carol singers, watching a children’s nativity play or watching a game of charades being played out.
  10. Make sure you have some quiet time too – put on some favourite music, dim the lights and have a good multi-sensory holiday.

Weighted Blanket and Vests – Tips and Hints

Weighted BlanketOur nervous systems can be challenged in responding to changes in daily rhythms of light and dark, sleep, eating, and physical activity. For people who are sensory sensitive and rely on routine, predictable sensory experiences to function well, the holiday season can be a strain on one’s inner resources and adaptability in managing the day to day.

Wristful FidgetTo help balance the effect of the stressors of the season, it is important to take care of the needs of our nervous system which influences immune health, sleep, and mood. It may be helpful to think about how to maintain some basic rhythms and routines in these areas:

  • Sleep: going to bed at a similar time with adequate time and space before bed to downshift into sleep and waking in time to start the day without rushing.
  • Exercise: making time for physical activity that brings joy, pleasure, and stress release.
  • Nutrition self-care: taking care to drink and eat soothing and nourishing foods, such as herbal teas and soups.

Weighted VestIncorporating weighted items into more daily activities at home, such as using the Sleep Tight weighted blanket while watching a movie before bed, or the Wristful Fidget wrist bands while eating breakfast, can add calming and organizing sensory input to moments of the day.”

Celebrating the festive season with a person with autism.

Tips to manage autism at christmasThe festive season can be an opportunity for fun and good cheer as we change our environment and behaviour. However, for some people with autism the change of environment can also be overwhelming and stressful. Here are my top ten tips for a multi-sensory Christmas.

  1. Start slowly and gradually – don’t introduce all the decorations at once. This can make the environment feel unfamiliar and increase a sense of disorientation.
  2. Be flexible – Don’t plan too much as you may need to adapt as you go along.
  3. Encourage the person with autism to take part in putting up decorations – they may not do it quite like you planned but doing a job and seeing it through can give them a great sense of achievement.
  4. The Christmas calendar – create a Christmas calendar which details when things are going to happen, at what time and when they will finish.
  5. Getting out and about – going to see the Christmas lights can be overwhelming because of the noise and other people around you. Try viewing the lights from a car or bus where you have your own space and can control the noise level.
  6. Party games – if you are going to a party perhaps practice the games that will be played before hand to help the person with autism prepare
  7. Being part of Christmas – if unfamiliar people are visiting explain who these people are and provide a photo. For your visitors, give them ideas of what they can talk about with the person with autism.
  8. Quiet space – create spaces and opportunities for the person with autism to withdraw to if the party is getting too noisy.
  9. A multi-sensory Christmas – Christmas is an opportunity to great an multi-sensory atmosphere. We focus a lot on lights but what about the smell of cloves and cinnamon, carols with a slow tempo, textures of making holly wreaths, baking mince pies.
  10. Make sure you have some quiet time too – put on some favourite music, dim the lights and have a good multi-sensory holiday.

Weighted Products for Sensory Processing Disorders

What is a sensory processing disorder?

Weighted Vest

Weighted Vest

Children with sensory processing disorder have difficulty processing information from their senses (touch, movement, smell, taste, vision and hearing) and responding appropriately. These children typically have one or more senses that either over, or under react to stimulation. Sensory processing disorder can cause problems with a child’s development and behaviour.

How is a sensory processing disorder treated?

Weighted Blanket

Weighted Blanket

Sensory integration therapy, usually conducted by an occupational or physical therapist, is often recommended for children who have sensory processing disorder. It focuses on activities that challenge the child with sensory input. The therapist then helps the child respond appropriately to this sensory stimulus.

Therapy might include applying deep touch pressure to a child’s skin with the goal of allowing him or her to become more used to and process being touched. Also, play such as tug-of-war or with heavy objects, such as a medicine ball, can help increase a child’s awareness of her or his own body in space and how it relates to other people.

Although it has not been widely studied, many therapists have found that sensory integration therapy improves problem behaviors.

Heavy Work and sensory processing issues

Weighted Lap Pad

Weighted Lap Pad

A child may get a number of therapies to help with his or her sensory processing issues. Specialists who work in this area may recommend some therapies that you have not heard of. Using weighted sensory products is sometimes called “heavy work”. Occupational therapists use weighted blankets, weighted vests and other weighted items to help children who desire or reject certain kinds of sensory input.

Proprioception and Heavy Work

We typically think of five senses: sight, smell, hearing, taste and touch. There are two other senses that can affect motor skills. One controls balance and movement and is called the vestibular sense, the other controls body awareness and is called proprioception or the proprioceptive sense.

Weighted Cutlery

Weighted Cutlery

If the receptors in a child’s muscles and joints are not communicating effectively with their brain it may affect their ability to do certain tasks. A child may write too lightly with their pencil or slam a door because they’re not aware of their own strength. When children struggle with this sense, weighted products help them know where their body is and what it should be doing. This type of therapy is also called heavy work.

How Heavy Work Can Help Kids With Sensory Processing Issues

Some children with sensory processing issues may need extra help with the the systems that control balance, movement and body awareness. That’s where heavy work can help.

The Weighted Blanket Guide

The Weighted Blanket Guide

Heavy work is any type of therapy that encourages pushing or pulling against the body. Swimming or vacuuming could be considered as heavy work. Trampolining or hanging from bars could also be considered heavy work as the child is using their own weight.

Children with sensory processing issues often seek out or avoid sensory input. A child who is seeking input is looking for proprioceptive input. That’s because it can help calm her body and make her feel more oriented in space. Without heavy work therapeutic activities, the child may seek input by running into or bouncing off things in unsafe manner.

Heavy work is designed to provide the required sensory stimulous in safer, more controlled way. The most effective heavy work therapies use lots of different muscles and joints at the same time, for a short periods of time. This makes some heavy work activities swimming more effective than others.

Explaining the Pool Activity Level (PAL) Instrument

Jackie PoolI am an Occupational Therapist with a specialism in dementia and in 1999, I developed the Pool Activity Level (PAL) Instrument with the encouragement and mentorship of Professor Tom Kitwood. I was convinced that a more helpful view of dementia is to identify the ability level of each individual. With that viewpoint, we are likely to enable rather than disable the person as we understand the physical and social environment required to sustain those abilities. If we only recognise the difficulties an individual is having, we will always disable them as we will only provide care and support to address their difficulties. So, the PAL Instrument uses a strengths based approach, underpinned by cognitive developmental theory.

The PAL Instrument has a Checklist of statements that identifies how the person can perform in nine every day activities. There are four statements for each of the activities and each statement describes a slightly different level of ability. By completing the PAL Checklist, it is possible to identify the overall level of cognitive and functional ability. From that knowledge, we can select the appropriate PAL Profile which describes how to support the person at that level of ability.

Pool Activity Level InstrumentI began developing the PAL Instrument by building on the work of Claudia K Allen. She had developed an Occupational Therapy model for understanding cognitive disability, based on developmental theory. Allen’s model has a robust assessment for OTs and then relies on their professional knowledge to interpret the outcomes of the assessment. I wanted a tool that would self-interpret and provide a guide to those without the clinical skills so that they could enable individuals with cognitive difficulties to be less disabled in every-day activities.

The first draft of the PAL Instrument was tested out in a local Hospital ward for people living with severe dementia and also in care homes where people were living with early to moderate dementia. Following feedback, I refined the PAL Checklist and Profiles and, with the support of Professor Tom Kitwood, published the first edition of the PAL book. This was published by Jessica Kingsley publishers as part of the Bradford Dementia Group Good Practice Guide series.

In 2008, the PAL Instrument Checklist was validated by Jennifer Wenborn and team at the Department of Mental Health Sciences, University College London.

The book is now in its 4th edition, with additions to the case studies and guidance on the use of the PAL Instrument. The PAL is now translated into several languages and is used within research programmes and also in health and social care settings to support care and activity planning. I regularly receive wonderful messages from care professionals telling me of the difference that using the PAL Instrument has made to their service. Their feedback describes the positive impact it has had on enabling people with dementia and other forms of cognitive impairment, including acquired brain injury, stroke and, learning disability to live meaningful and fulfilling lives.

Click Here to buy the Pool Activity Level (PAL) Instrument

Dr Anna van der Gaag talks to us about the CASP assessment tool

Dr Anna van der Gaag CBE talks to us about her background and the Communications Assessment Profile also known as the CASP profiling tool.

What’s your background?

Anna van der Gaag

When I finished school, I had little idea of what I wanted to do, and ended up volunteering in a school for children with learning disabilities. I met Pat Stephenson, a speech and language therapist, who encouraged me to apply, despite my lack of any science A levels. Much to everyone’s surprise, I was accepted at the National Hospital College of Speech Sciences (now UCL) in London, and qualified in 1981.

Immediately after I qualified, I went to India to work as a volunteer for 8 months, and when I returned I found myself in Glasgow, where I first encountered an “Adult Training Centre” for adults with learning disabilities. It very quickly became clear that all the communication assessments that used to assess adults had been developed for children. I returned to London a few years later, determined to use my Masters degree at the University of London as a route to developing an assessment designed for use with adults. It took many more years than my masters to complete this work, and I was fortunate to have the support of various research grants that allowed me to complete the work.

The Communication Assessment Profile was first published in 1988. It remains the only communication assessment standardized with adults – over the course of three clinical trials, its reliability and validity were tested with over 350 individuals, 66 SLTs, and 384 care workers working in 21 hospitals and 31 Adult Training Centres across the UK. We were incredibly fortunate to achieve this level of testing before we published the final version of the CASP. Since then, CASP has been updated, modernised and revised, with input from UK users and therapists, and is now in its third, colour, edition. All the data from the reliability and validity studies are included in the CASP manual. I am grateful to all those who took part and to the many people who helped me along the way.

Who can use CASP?

CASP is designed for individuals with learning disabilities, used by speech and language therapists, psychologists and OTs, working with care workers, peers and families. It has also been used with young people on the autistic spectrum and with adults with dementia (particularly the section on communication environment and vocabulary use).

What was the purpose behind CASP?

CASP Assessment ToolThe drive behind the research was simple – to develop a way of assessing communication skills of adults with learning disabilities that was respectful, relevant and robust. This meant using age appropriate photographs and materials, like money, toothpaste and shoes, rather than toys and farm animals.

There were three other important innovations – CASP was designed as a joint assessment – in which the care worker who worked most closely with the individual – was given a formal role in assessing communication. Hard to believe, but this was highly contentious at the time, as many professionals said they did not think that an ‘unqualified’ person should have a formal role in assessment. I argued that care workers (this included family members too) were frequently the people who really knew what was happening on a day-to-day basis and knew the most about the person’s experience of communication. Click here to find out more.

The second was that the CASP assessed not only the individual’s speech and language skills, their understanding and expressive skills, but also their communication environment, and the demands made upon them to use their skills. We conducted a piece of research which showed that adults with learning disabilities under-utilise their communication skills if they live in poor communication environments (click here to read this) and published this work in a paper called ‘the view from Walter’s window’ in 1989.

The third innovation was that CASP was designed to assess and build upon the person’s strengths – now called an ‘asset based’ approach – rather than their ‘deficits’ or what the person cannot do. The final part of the assessment is when the therapists, the individual and their care worker come together to talk about ‘priorities for change’ – which might mean change in their communication or it might mean change in their environment and the way that people around them communicate.

I’m delighted that all three of these innovations – seen as radical in the 1980s, have now become mainstream, part of how we approach our work, with many new advances and further innovations along the same lines occurring across the globe. CASP is now used in other parts of Europe, Canada, the US and Australia and New Zealand as well as continuing to be used in the UK. It has stood the test of time, I think, because it reflects contemporary approaches to working with people, rather than (as was the case) doing things to them.

What’s been your inspiration?
My inspiration was a man called William, who came to me for help during my years working as an SLT in Glasgow. He helped me make a short film about the CASP, and was as excited as I was that at last there was something that respected him as an adult. He had very limited expressive skills but his understanding of language far exceeded his ability to make himself understood – and he, like others, had suffered from discrimination, having been dismissed or ignored because he could not communicate like everyone else around him.

The other inspiration was a book by Joanna Ryan, called the ‘Politics of Mental Handicap’ (the title shows how long ago that was!) in which she exposed the systemic discrimination against people with learning disabilities that existed at the time. My sense from my days working in Glasgow was that people with learning disabilities and communication difficulties experienced even more discrimination – and part of my goal was to design an assessment that they were comfortable with, that showed them the respect they deserved, and was based on rigorous research.

Over the last few decades, I have been involved in teaching, research and regulation and have worn many hats. When I look at CASP, I feel that this is work I am most proud to have started, and most pleased that it continues to have practical relevance to the lived experience of people with learning disabilities.

References

The view from Walters window (1989)
van der Gaag, A (2009) eliminating professional myopia

10 Reasons to choose Rompa’s Aromatherapy Kit

Rompa Aromatherapy KitRompa’s aromatherapy kit is an easy to use compact kit with its own attractive, wooden case that allows the user to store the 12 oils upright. Suitable for a wide range of uses – with the Aroma Stone, Interactive Aroma Panel, Aroma Diffuser Professional, in the bath or for massage.

1. Choice
This comprehensive kit includes 12 different aromas, from Grapefruit and Bergamot, to Tea Tree and Lavender

2. Longevity
As you only need to use a couple of drops each time, this kit typically lasts for 2 to 3 years, if not longer. Oils are bottled just before they are despatched to us

3. Natural
The oils are essential oils – high quality, natural oils – not synthetic, water-based alternatives

4. Ethical
The oils are ethically sourced from all over the world – our supplier has established strong relationships with producers for many years, often through travelling to sites to maintain these links

5. Tested
The oils are tested for quality and a MSDS is available on our website

6. Multi-purpose
Useful for stimulating memories, encouraging appetite, massage, bathing, freshening rooms and masking less pleasant odours … these oils can be used in many different ways. Using an oil in a fan-operated diffuser is both simple and safe.

7. Sensory
Despite having the quickest and most direct route to the brain of all the senses, our sense of smell is often over-looked as many of us use our sense of sight as our primary sense. In order for Multi-Sensory Environments to be truly multi-sensory, aroma should be considered with the other senses, including the vestibular and proprioceptive senses

8. Comforting
Our sense of smell is not only very sensitive and powerful, it is connected to mood, emotions and feelings. Aromas can transport us to our childhood and stimulate memories of loved ones and happy times. Aromas can also be used to distract during treatment and to help maintain connections with individuals when incorporated into massage.

9. Alternative
Akin to the values of Snoezelen®, aromatherapy can be used effectively as an alternative to medication. For example, essential oils such as Lavender and Vetiver can be used to help encourage sleep – safe avenues to explore before resorting to sedatives

10. On trend
Aromatherapy is coming back into vogue, notably in the USA, but also in the UK. Some perfume houses are consciously choosing to use more essential oils in their perfumes to avoid the use of preservatives.

Note: it is recommended that this kit be used by someone who has attended an aromatherapy course (such as ISPA or IFA) and has sufficient knowledge for its safe application.

Multi-Purpose Furniture

Multi-purpose furniture can greatly enhance life for Older Adults suffering from Dementia and other conditions, they not only delight but encourage engagement and interaction which can be extremely fulfilling. We provide a wide range of multi-purpose furniture which we recently had the opportunity to present to clients at Edmund Street – a local activity centre for the elderly and those with additional needs.  The response from the clients to the furniture was extremely heart-warming to watch and we were able to capture some great photography.

Deluxe 8 Colour Wirefree Controller

The 8 way switch provides endless interactive possibilities. It can be wirelessly connected to other furniture in a room, resulting in immersive colour changes at the touch of a button. This acted as a great talking point for colour preferences and helped to reinforce cause and effect. The switch not only acts as visual stimulation but provides audio too, much to the delight of the clients, the switch ‘speaks’ the number on the button when pressed. When linked to the correct software, the switch also plays musical notes when buttons are pressed. This was particularly popular with the clients as they were able to produce high and low notes themselves and to play their own songs.

    

Please click here for more information on our Deluxe 8 Colour Wirefree Controller https://www.rompa.com/8-colour-wirefree-controller-1.html

Grandfather Glow Clock

The first comment we had regarding our Grandfather Glow Clock was how great it looked in a room. It provides a beautiful, classical timepiece with added sensory benefits. The outside of the clock glows in a variety of different colours. When used with the 8 way switch, this provided obvious enjoyment for the clients at Edmund Street.

   

For more information on our Grandfather Glow Clock click here: https://www.olderadults.co.uk/grandfather-glow-clock.html

Infinity Table

The infinity table fitted perfectly around the sofas at Edmund Street and immediately provided a striking and functional centrepiece for a couple of clients to focus on. The LED lights give the illusion of continuation within the table. This proved a hit when paired up with the 8 way colour switch. The colour changes provided a great talking point.

  

For more information on our Infinity Table click here https://www.olderadults.co.uk/infinity-table.html

To find out more about our entire Multi-Purpose furniture range, visit our Older Adults website: https://www.olderadults.co.uk/reminiscence/house-home.html

Author Spotlight – Gali Salpeter

Introducing The World of Trains by Gali Salpeter – This unique train-themed set contains 50 illustrated cards and 50 story cards, accompanied by a professional guidebook detailing suggestions for individual and group sessions.

Gali shares with us her reasoning behind developing this exciting NEW set of therapeutic cards for healthcare professionals.

How and why these are developed?

Gali Salpeter

Gali Salpeter

I am an expressive therapist (M.A.) with specialization in drama and narrative therapy. My background is in psychology, sociology and anthropology and I am always fascinated with the ways in which these fields interact. I have been fortunate enough to live in different countries and work with inspiring children, in settings of individual therapy and group therapy.

I like to travel… Each station along the path of my life has had valuable lessons to teach me. I enjoy discovering new environments, studying them and finding my own way of being and becoming along their fixed rails and wild landscapes.

I also respect the power of narratives, both those built word by word within and – the ones told by others. Narratives are carried by the wind around us and I try to open myself to listen to them.

These are the grounds from which “The world of trains” set has grown and developed. “The world of trains” set is a psychological tool designed for facilitating, enriching and supporting therapeutic work with children. The set includes a deck of projective cards and a deck of story cards, as well as a professional encompassing guidebook.

The visual and metaphorical channels of expression, combined with the verbal and imaginary channel provided by the two decks – enrich the modes of communication offered to the client and to the therapist.

The client-child can thus choose whether to express her/himself verbally, to work through a visual mode or (as often happening naturally-) to combine the two.

The projective therapeutic space provided by the theme of an imaginary world of trains, which is shared by carriages and engines of different types, enables the client to get to know issues from his own world better and to share and process them with the therapist in a safe, metaphorical arena.

It is the flow between working therapeutically in the layer of the imaginary and working in the layer of reality that adds value to the therapeutic process.

The theme of the set – a world of personified trains – was chosen as it holds images and metaphors that can easily apply to issues children cope with daily.

Why these are different from everyone else’s card resources? What is their unique selling point?

The set is a rich and useful resource which contains a deck of 50 illustrated cards, a deck of 50 story cards and a professional guidebook for therapists. Three professional tools for therapists in one kit ! As such it is unique.

The deck of projective cards contains 50 images of carriages and engines, where each card can be worked with as a single stimuli. In addition, when the child puts one card next to the other, it creates an image of a train. The train and the cards composing it can represent a situation, a place, a feeling, an event or a group of people from the client´s life.
The deck of story cards contains the beginnings of stories told by different carriages. The client can work with the story cards, either in combination with the illustrated cards or separately.

The professional guidebook describes methods for working with the cards in settings of individual therapy and group therapy. These suggestions are organized according to relevant themes, such as: relationships and groups in different areas of the child´s life, strengths, difficulties, separation, transitions, issues within a family, coping with illness or death, aggressive behavior and violence, control, fears and more.

The set is a wonderful resource that can be used by mental health professionals from different fields according to their areas of expertise.

World of TrainsTell me why you are so proud of them and how long they took to develop.

For the world of trains to develop and come to life – as with many meaningful journeys in our life – it needed time and space, involved building relationships and demanded many hours of working alone.

A couple of years of hard work went by before I managed to create the imaginary world I envisioned, a world where therapists and clients join and are enabled to embark together safely on meaningful journeys of their own…

Each illustration was carefully designed to address relevant issues that can be processed in therapy. The colors of the cards, the material, size and shape of each illustrated carriage, the relation between each carriage and its environment, as well as other objects and features in the cards, were all carefully and professionally controlled in order to address a wide area of themes and emotions. The result of these efforts will hopefully assist the clients working with the cards to deal with the issues they are dealing with.

The story cards were created one word at a time, with the goal of offering beginnings of stories that would both enable and encourage children to relate to, articulate and work with narratives from their own lives.

The numerous options of using the cards in therapy when working with children having different needs emerged in a flow of ideas stemming from my professional knowledge and experience. These suggestions for application were edited (and re-edited☺ ) to result in the broad and useful guidebook, which can stand as a valuable therapeutic resource on its own.

As in other adventures we embark on, there were obstacles along the way, stations that kept the train from moving forward or times when an engine or two had to halt or search for the right rails to follow.

Hence, when I hold the set now, with both hands… I feel and acknowledge its visual and thematic richness and the professional therapeutic value it contains. These were born and embedded in the stations and over the tracks, in the carriages and through the changing vistas of this world of trains.

I am proud of this set. I would like to believe that the future inhabitants of this world of trains, be it passengers or drivers, by-passers, clients or therapists – will benefit from exploring its landscape and find their own trails and stations along it.

Please use it with respect, responsibility and sensitivity, for with these it was created.
From the bottom of my heart and mind, I wish you a safe and fruitful journey.

Digital Donkeys

On a chilly afternoon in January with Rompa’s Marketing Manager Kayleigh, our IT Director Graham and I found ourselves at a donkey sanctuary just outside Knottingly, near Pontefract.

Our mission: To discuss online marketing strategies and how Wonkey Donkey can improve their website and online presence. We talked about the opportunities available through Facebook, Pintrest and Instagram pointing out that the donkeys are a content generating resource in themselves.

After our meeting we had the opportunity to meet the donkeys and Jenny took us through all their backstories. All of theses stories began with heartbreaking tales of mistreatment by previous owners. There was always a happy conclusion to these tales of woe, the turning point being the donkey’s rescue by the Wonkey Donkey Sanctuary.

Find out more about Wonkey Doneky’s work

Website: http://www.wonkey-donkey.co.uk/

Facebook: https://www.facebook.com/Wonkey-Donkey