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Healthcare Training Institute - Quality Education since 1979

Instructor’s Guide
for DVD Inservice Training

Table of Contents | NCCAP/NCTRC CE Booklet | Administrator Post Test

DVD TRACK 1. Effie
Can Rolling & Geometric Puzzle

What two questions were asked using Effie’s words as a basis of communication? 
1. Cathy:  Was that a long time ago?
Effie:  Oh about a year ago. 
2. Cathy:  About a year ago?

What question was asked to assess Effie’s recall?
"What did you do right before you came into the nursing home?"

What is said to focus on Effie's capabilities rather than her limitations? 
"You’ve got really good movement in your right hand."

How was Can Rolling introduced to Effie as a Hand Exercise? 
"I've got something I wanted you to try to see about exercising your right hand."

What was the motivating reason that was given to Effie for doing Can Rolling? 
"What it does is it encourages your hand to lay flat."

What question was asked to relate the Geometric Puzzle to Effie’s life experiences? 
"Did you and your sister ever play games or puzzles when you were a kid?"

What would be the Care Plan Goal starter phrase and approach for Effie?
Goal starter phrase: To do can rolling with physical assistance…
Approach: Provide terry cloth-covered work surface…

DVD TRACK 2. Marie S.
Caps in a Bowl, Bank Exercise, & Color Pattern Cards

How was the challenge of getting at Marie's eye level solved?
A kneeling pad is set on the ground next to her wheelchair, and Cathy kneels on it.

What are four questions that were asked to assess Marie's ability to recall?  
1. "What are some of your favorite songs?" 
2. "Have you lived in Evansville a long time?" 
3. "Do you have children, sons or daughters?" 
4. "What are their names?"

How was Marie's hand assessment initiated?   
"Can I see your hands for a minute, to see what your hand movements are like?" 
"Can you close and open your hand for me?" 

What was said to compliment Marie for her success with Caps-in-a-Bowl? 
"Great. Good job! I see you are using those fingers there. Ah, you even got the last one!"

When Marie had problems opening the butter dish, what was said to blame her difficulty on the item and not on her stiff fingers?
"Yeah, it's hard to hold onto.  It's not a good size, is it?"

DVD TRACK 3. Frieda
Three Piece Puzzle & Reality Orientation Book

What are two examples of responses that are totally based on the resident's conversation? 
Freida:  Who did you mrrry…?
1. Cathy:  Who did I marry? 
Freida:  What were you before you mrrrr? 
2. Cathy:  My name was Hill.
What was said to provide a "personal, appropriate" sharing with the resident?
"I have an aunt and her name was Freida.  She lived in Chicago."

How was Freida’s ability to follow simple directions assessed?
"Can you close and open your hand like that for me?"

DVD TRACK 4.  Fannie
Bean Bag Rolling

What were two questions that were asked to make a question out of Fannie's words and noises?
Fannie:  I just live right up here. 
1. Cathy:   You just live over there? 
Fannie:  Uhh...about three houses. 
2. Cathy:   About three houses over?

Don't pretend to understand if you don't.  How did the instructor ask for clarification?
"In the what? In the sole?  Do you know what she said?  In the sole part?”

How was permission to conduct a Hand Assessment requested? 
"Can I see your hand a minute here?"

What was said to explain "Bean Bag Rolling" to Fannie?
"This is a little Bean Bag…do you want to hold this in your hand?  This is an exercise.  Can I hold your hand over here?  See if you’ll let me do this.  Can you squeeze that?"

What were three "Approaches" suggested for Fannie? 
1. Repeating understandable words  2.  Maintaining eye contact  3. Making simple requests

What simple direction was Fannie able to follow? 
Closing and opening her hands

DVD TRACK 5. Marie J.
Lacing Cards, Bead Stringing, & Styrofoam Ball

What were three questions that were asked to assess Marie’s recall?
1. “How long have you been a resident here, Marie?”  2. “Do you have any children that come to visit you?”  3. “Out on the coast?  You mean near California?”

What was stated as the motivator for the Hand Exercise?
“You have really nice hand movement… Let’s see if we can give you something to help remind you to move your hands in order to keep them nice and limber.”

What question was asked to relate something in Marie’s life to Lacing Cards?
“Did you ever sew very much?”

What were the two reasons why Marie could not do Lacing Cards?
1. Her fingers were too stiff  2. Her eyesight was not good.

DVD TRACK 6. Mabel
Assessing Long Term Memory

What was said to assess Mabel’s ability to communicate?
“I like your white sweater, that’s very pretty…  I like the pattern on the front of it.  It kind of looks like a snowflake pattern.  I guess I’m thinking of snow since we’ve had some lately.”

What was asked to assess Mabel’s ability to recall?
“What kind of winters do you remember as a child?”
What were two supportive responses given to Mabel?
1. “That would be hard.”  2. “That’s good that you were able to say how you felt about it.”

What three statements formed a sincere closure with Mabel?
1. “You know Mabel, it was nice talking with you.”  2. “You’re a nice lady.”  3. “Thank you.”

DVD TRACK 7. Elizabeth
Scent Therapy

What six techniques were used to get Elizabeth’s attention?
1. Getting in close and using her name  2. Making simple requests  3. Asking permission before each action  
4. Rubbing her hair  5. Commenting on responsiveness  6. Using Scent Therapy

DVD TRACK 8. Lillian
Mobile & Bean Bag Rolling

What was said to introduce Bean Bag Rolling to Lillian?
“You know, I think it’s important that you keep moving this hand like this. I’ve got a little hand exercise I’d like for you to try.”

What was said to introduce the Mobile to Lillian?
“I’ve got some pictures for you to look at.  Do you want to look at a picture for me?”

What did the instructor indicate was important in communicating with Lillian?
“It’s important, when talking with Lillian, that you use her name and that you also pick up on any words that she says which are understandable.”

DVD TRACK 9. Mary
Listening for Breathing Patterns & Using an Amplifier

What three thing were done to communicate with Mary?
1. Positioning in Mary’s line of vision  2. Commenting on her open eyes and “noises”  3. Asking permission before doing anything

What were two behaviors that Mary exhibited which could be interpreted as attempts to communicate?
1. Making noises  2. Opening and closing her eyes

What was asked to assess Mary’s reactions to her head being touched?
“Is that ok with you, Mary?  Mary, I’m wondering if you can hear me?  Mary?  Can you open your eyes a little for me?”

What was stated to be the most important approach with a resident like Mary?
Being sensitive to the resident’s reaction

DVD TRACK 10. Photos with Commentary/ Success Therapy Slides

Flat Ceiling Mobile or Picture Gallery:
How was Cecil involved in the selection of pictures for his Flat Ceiling Mobile?
Although Cecil could not speak, the Activity Director showed Cecil the pictures and asked him to show a preference by opening and closing his eyes.

Eye Openness:
Why is it important to observe the resident before approaching him or her?
If you do not observe the resident’s Eye Openness, Eye Movement, Breathing and Gestures before approaching, you may not be able to notice a change while working with the resident.

Smell Can:
How can you make clean-up easier when constructing a Smell Can?
Using clear contact paper can make cleaning the Smell Can easier.

A “Sound” Success Story
How was the resident’s favorite song incorporated into his Success Therapy® Program?
Volunteers recorded the resident’s favorite song several times on a tape, so that the resident could listen to it often.

Activity Apron
How did careful observation of Dorothy lead to a successful Activity Apron experience?
Dorothy would fold and refold the blanket placed over her lap.  Observing this, the staff provided her with an Activity Apron to which three dishtowels were attached.

Doll
How did the staff address the problem of the resident who, although interested in the doll, would continually drop the doll?
The staff attached the doll’s left ankle to the left-hand string of an Activity Apron.

Velcro Baseball Mitt
How might you adapt the Velcro Baseball Mitt if your resident does not have the grasping ability in his or her thumb and index finger to hold a small ball?
You might hot glue hooked Velcro around a larger wiffle ball or plastic baseball.

Pillow or Bag Maze
What is one goal you might use with the Pillow or Bag Maze?
Once started, a goal might be to independently pull three bags from the Pillow Maze.

Clay
What is the progression of difficulty for three levels of adapting working with Clay to fit a resident’s needs?
1. Clay flattening is the easiest for a resident with stiff hands to do.  2. The next difficulty level is clay tearing. 
3. The most difficult clay activity is making clay ropes.

Success Therapy® Bags
How might you use Success Therapy® Bags to encourage other Staff or visitors to use an activity with a resident?
By taping the bag to the resident’s nightstand and including a note explaining the activity, the goal, and good approaches to use with the resident.  State in the note that visitors are welcome to use the activity with the resident.

Block Stacking
How was Block Stacking adapted for the second resident shown, who had more mental capability?
The goal for the second resident was to stack and un-stack four items independently once started.

Bean Scooping
What are two important issues to consider before introducing Bean Scooping to a resident?
1. Will the resident eat the beans?  2. Does the facility have any wandering residents in this area who might eat the beans?

Bead Stringing
How can a resident’s inability to follow a pattern card in Bead Stringing be reframed into a positive approach?
Instead of thinking “He or she cannot do that,” think “He or she cannot do this; why not?” and “How can I adapt Bead Stringing to bring it to the resident’s level?”

Fish Game
What are two different methods of constructing the Fish Game?
1. Using a Styrofoam ball with hooped Velcro on the fishing line and looped Velcro on the fish  2. Using paper clips and magnets

Marshmallow Guessing
Why are large marshmallows more successful in the Marshmallow Guess game?
Residents may be intimidated by the small sizes of items in the bottle as well as the number of small marshmallows or jelly beans in a Guess Game, and they might be less willing to attempt to guess.

Bingo
How might you adapt Bingo for a resident who has the mental capacity to play Bingo, but poor grasping ability?
Use corrugated cardboard to make thicker Bingo chips, and a large Bingo card.

Envelope Stuffing
Why was the Work Surface out a little too far for the resident in the photo?
The lowered bed table was hitting the arms of her chair.