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Healthcare Training Institute - Quality Education since 1979
Section 16
Clay and Success Therapy® Bags
Table of Contents | NCCAP/NCTRC CE Booklet
Part III
Instructor’s Implementation Guide
Activities that Require a Work Surface
Part III contains activities that require a work surface. Work surfaces ideally need to be evaluated regarding their distance from the resident and height. Refer to Volume One of this series for a detailed explanation of factors to consider when providing a work surface for your resident.
Clay: Three Levels of Difficulty
(The last track of the DVD contains slides illustrating implementation of this activity with two residents.)
In using clay with a resident, you have to assess whether or not he or she is going to eat the clay. Obviously, if you present the resident with a lump of clay and the resident immediately picks it up and puts it in his or her mouth, the use of clay is not appropriate for this level of resident. However, using clay is great therapy for residents' hands. Of course, with all of the activities presented in this series, it is necessary to coordinate with the Interdisciplinary Team to make sure that the activities you are using are not counter-indicated on that resident's Care Plan. You might shop around for various brands and prices of clay. I find that sometimes more expensive clay is easier for the residents to mold rather than a less expensive brand. You might try shopping on the Internet, or at school supply or toy stores. More expensive brand name clays are worth the extra pennies because of their added pliability, and with residents’ stiff fingers, you realize how crucial this can become to the level of success your residents experiences.
The first step in having a resident work with clay is to provide the resident with a ball of clay, perhaps a 3-5” ball. You probably are thinking, "How obvious! So, now what?" However, I find there are three levels of difficulty when a resident is asked to use clay.
The "art" of having a resident manipulate clay can be an "art" in and of itself,
regarding the assessment of the level of difficulty your resident is experiencing.
Level 1: Clay Flattening
The easiest activity for a disoriented resident to perform is to flatten or pound or pat the clay.
First, of course, get at your resident's eye level and establish eye contact.
Second, see if you can get your Frieda to look at the clay. Say, "Frieda, I have something for you to look at. Can you look at this for me?" Hold the clay ball in her line of vision.
Third, move the clay out of her line of vision and observe her eye movement. Then, place the ball of clay on the work surface.
A key step here is to watch your Frieda's eyes and evaluate
if she moves her eyes to the work surface.
If she is unable to follow the clay with her eyes, the chances are pretty high that this object manipulation type of activity is too difficult for her. You will probably need to go to an activity earlier in this Manual, like Bean Bag Rolling, for your Frieda.
Fourth, if you seem to have her attention, and she has the mental ability to track the clay with her eyes, demonstrate to the resident what you want her to do by patting or pushing the ball of clay flat. Then ask, "Would you like to try? I bet you can do this. It's kind of like patting out dough."
Fifth, if appropriate for this resident's level of functioning, gently glide the resident's hand over the clay ball. Place your hand on top of hers, and help her to pat, push, or pound the clay flat, whichever seems to be her preference. I find that each resident has his or her own style of flattening the clay. Some like to pat it flat. Some like to push it flat. Others like to actually pound it flat. Obviously, you do not want to correct residents to do it the way that you would prefer. The key is, of course, to get your Frieda involved in a structured activity that provides you with an opportunity to say, "Good, Great! You did a good job!" or some such similar positive reinforcement phrase indicating success. Thus, the concept of Success is reinforced with this resident.
It goes without saying that you provide the least amount of assistance needed and continually are assessing or evaluating from moment to moment how you can increase or decrease the amount of assistance you provide in order to create a successful experience for Frieda.
Goal: To pat a clay ball flat with total physical assistance…. |
Goal: To pat a clay ball flat with partial physical assistance… |
Goal: To pat a clay ball flat independently once started...
Approach: Request resident to flatten the clay, reward with praise, continually assess resident's interest in and ability to do Clay Flattening… |
Residents with whom to try Clay Flattening
Resident |
Who will gather materials and/or construct project? |
Staff /Volunteer to work with resident? When? |
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Culture Change Implementation: Place Clay Flattening in labeled Activity Project Bag left in resident’s room for CNA, volunteer, etc. use.
Level 2: Clay Tearing
The next level in difficulty in working with clay is to tear the clay apart. If your Mabel can pat clay flat, perhaps she can tear clay apart. However, some residents have the ability to tear the clay but they do not like to get their hands, what they perceive as "messy," so they will not tear clay. I find that some residents will pat or roll clay, but not tear it. Steps 1-5, outlined above for Clay Flattening, are similar for Clay Tearing, where you assess eye contact, demonstrate to the resident, and then, with total physical assistance, if necessary, have the resident tear the clay.
Goal: To tear the clay ball into two pieces with total physical assistance… |
Goal: To tear the clay ball into four pieces independently once started with an elbow prompt… |
Goal: To tear the clay ball into four pieces independently once started… |
Goal: To tear the clay apart into seven pieces independently… |
Residents with whom to try Clay Tearing
Resident |
Who will gather materials and/or construct project? |
Staff /Volunteer to work with resident? When? |
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Culture Change Implementation: Place Clay Tearing in labeled Activity Project Bag left in resident’s room for CNA, volunteer, etc. use.
Level 3: Clay Rolling
The third and highest level of difficulty with clay is to roll the clay out into a rope. The reason this is the most difficult level is that your resident needs to apply an even pressure to the clay, as well as have the mental and physical capability to get the rolling motion to make a clay rope. Clearly, he or she also needs the ability to lay his or her hand somewhat flat. The steps of implementation are similar to those outlined above for Clay Flattening. However, I find this high level of clay activity is not implemented at a total physical assistance level, because it is extremely difficult to totally physically assist a resident to glide his or her hand over the clay with the varying amounts of pressure required as the shape moves from a ball into a narrower and narrower rope.
Goal: To roll clay into a rope with partial physical assistance… |
Goal: To roll clay into a rope independently once started…
Approach: To demonstrate to resident how to make a clay rope. Then provide physical and verbal prompting as
needed…
Approach: Place clay in bag taped to resident night stand with note inviting others to try clay activity with her… |
Residents with whom to try Clay Rolling
Resident |
Who will gather materials and/or construct project? |
Staff /Volunteer to work with resident? When? |
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Culture Change Implementation: Place Clay Rolling in labeled Activity Project Bag left in resident’s room for CNA, volunteer, etc. use.
Activity Bags Encourage Staff Involvement
(The last track of the DVD contains slides illustrating implementation of Activity Bag in residents’ rooms.
See beginning of this Manual for details regarding the Activity Bag.)
As the approach above indicates, clay can be put in a brown paper or plastic bag. If using a brown paper bag, cuff or fold this bag twice at the top for stability. Tape the paper or plastic bag to the resident's night stand. Label the bag with a note inviting others to use the clay with the resident. The note could say something like, “Frieda is rolling, tearing, or patting (depending which is appropriate) this clay ball to exercise her hands. Please, feel free to remove it from the bag and help Frieda with this hand exercise.” Clearly, since the projects in this Series are at no or low cost, they become ideal to be placed in labeled Activity Bags to be left in residents’ rooms, encouraging staff, volunteer, and family involvement in Activities with the resident.
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