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Healthcare Training Institute - Quality Education since 1979

Section 16
A "Push Ball" Success Story

Table of Contents | NCCAP/NCTRC CE Booklet

Warm Damp Cloth
Use of a Warm Damp Cloth with an Advanced-Stage Alzheimer’s resident is explained on the DVD.  Use the space below to record your implementation of this activity.

Cradle Head
Cradling a resident’s head as explained on the DVD is a totally passive activity to create a successful experience for the Advanced Alzheimer’s resident.  Use the space below to record your implementation of this activity.

Room Lighting and/or Family Photo
Use of Room Lighting to increase alertness and Family Photos with is explained on the DVD.  Use the space below to record your implementation of this activity.

A "Push Ball" Success Story
This Section expands upon the Note-Taking exercise for DVD Track 3, found on page 10 of this Manual.

As mentioned at the beginning of this Manual, the purpose of this course is to teach you step-by-step techniques for implementing each of the low-functioning activities described.  If you have not read the “Introductory Commentary” at the beginning of this Manual, you might consider doing so now to have the concepts of 1. Observation, 2. Assessment, 3. Creativity, and 4. Sensitivity set clearly in your mind. These concepts will be described in detail for you repeatedly as implementation of each activity in this Manual is described.  The “Observe and Assess” sections summarize these concepts.

Push Ball is exactly what it sounds like.  You ask the resident to push the ball.   I used the "Push Ball" activity with Betty, who was diagnosed as being mildly mentally retarded.  Her hands were extremely contractured. I requested that she push the ball off the over-the-bed-table. An important point in implementing this activity was I placed the ball immediately in front of her wrist and hand.  Thus Betty did not have to reposition her hand to push the ball off of her over-the-bed-table.  Once she got the idea, I moved the ball further from her wrist.  By moving it further from her wrist, pushing the ball required more hand-eye coordination.  However, remember the idea is to provide the resident with a successful experience.  Pay close attention to your resident range of motion and mental ability to assure success.     

(Note:  An "elbow prompt" means merely nudging the resident's elbow to start the process of the movement of his or her arm towards the ball.)

The Push Ball activity provides a situation, a circumstance, and a task that allows you an opportunity to say to your resident, “Good, great. You did a good job!  You pushed the ball off the table.” 

However, once the ball rolls off, it then needs to be retrieved. Thus the Push Ball activity in this form is a good activity for a volunteer to do with the resident, because it has no potential to be independent.

A way to adapt the Push Ball activity to facilitate the resident's independence is, rather than using a rubber ball, try using a large 6" to 9" Styrofoam ball.  Use a pencil to poke a hole in the ball.  Place yarn in the hole and fill the rest of the hole with Elmer's glue.  The Styrofoam ball can then be tied to one of the supports of the table.  Experiment with this one and an over-the-bed-table with the yarn going totally through the ball and the yarn tied at the end to the table.   Then, try to encourage the resident to bat or hit at the ball.  Providing it is not contraindicated in your Betty’s Care Plan, this can be a great range of motion activity, as well as a socially acceptable way for combative residents to vent some of their hostility.  An activity similar to Push Ball is Balloon Batting.  Balloon Batting is described in further detail in Volume Two of this series and might be considered for use with a combative resident.

Observe and Assess Positioning!
In the above Push Ball Goals, the progression of Goal revisions was based on moving the ball in front of your resident's arm by an increasing number of inches.  Clearly, you can apply this manipulation of materials to other activities.  Brainstorm with your staff!  Think of your current program… plastic bowling, throw the ball in the hoop, etc.  Is it possible to enhance the success level of your resident who is performing an activity with a certain level of proficiency by saying, "Martha, let's move the hoop closer by a couple inches and see if you can get the ball in?  Good! Great! You did a good job."  I challenge you regarding activities you conduct today and the rest of this week, evaluate whether materials could be positioned closer?  Further away?  More to the right?  More to the left?  Higher?  Lower? ... in order to create a more successful experience for your resident.

Residents with whom to try Push Ball

Culture Change Implementation: Place Ball in labeled Activity Project Bag left in resident’s room for CNA, volunteer, etc. use.