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Healthcare Training Institute - Quality Education since 1979

Section 20
Magazine Folding

Table of Contents | NCCAP/NCTRC CE Booklet

My Rant about Crafts :)
Magazine Folding is exactly what it sounds like.  You offer your resident an opportunity to experience success by folding the pages of a magazine.  Besides the pom-pom ball chicken, rabbit, snowman, etc made from Yarn Winding, explained previously, this is the only other project I have found from which a "product" or end-result craft is produced appropriate for an advanced stage Alzheimer’s resident.  That is… these are the only two that I have thought of, so use you imagination if you have a resident who needs that "craft" project motivator.

However, I would not over-tax myself trying to find simple crafts for your advanced stage Alzheimer’s residents.  Most of our residents never made crafts in the first place, and if they did, by the time they meet the stringent Medicare standards to be admitted to your facility, most aren't alert enough to be aware of a craft.  So be honest, if you find yourself scratching your head trying to think of craft ideas for your advanced stage Alzheimer’s residents, ask yourself, "Whose needs are really being met… mine or the residents'?"  Hmmm, Ouch!  Did I hit a nerve?  Does the preceding describe you?  Do you find yourself constantly questing the unobtainable craft for your advanced stage Alzheimer’s residents?

I the Activity Director has to drop his or her pie-in-the-sky Adult Daycare ideal and face the reality of working with the severely impaired in the ICF/SNF facility.  In short, if you find yourself spending a lot of time scouring the web and magazines for activities that produce a product, or activities that are a craft, you might consider assessing if your corporation owns a Daycare.  I don't mean to be rude, but I have consulted with many Activity Directors who felt bamboozled into their job, lured with the idea of what fun they would have with their residents.  However, by now, you are acutely aware that a lot of your time is spent doing documentation, and the craft program you may have dreamed of after you were hired, but before your first day at work, is disappointingly non-existent.  This is why projects in this five Course Alzheimer’s Series only contains a couple of product-producing craft ideas, because they flat-out don't work with the level of most residents admitted into today's long-term care facility.  Oh well, so much for my rant about craft focused activity programs.  Let's get back to Magazine Folding, one of the two craft ideas in this five Course series.

The best kind of magazine to use for Magazine Folding is a thicker magazine that has at least a 1/16" to a 1/8" spine.  Bridal magazines are usually fairly thick.  If you do not plan to make a craft item out of the folded magazines, the thickness really does not make a difference, because you discard the magazine after the resident has attempted to fold several pages anyway. 

Assessment 
After you have acquired some magazines, assess your resident for Magazine Folding by, you guessed it, getting eye contact, getting at eye level and then asking something like “Harvey, how are you today?” and so on.  Assess his ability to answer your questions. Since Magazine Folding is an activity for a higher functioning resident, the resident has to…
1. have an attention span of at least 60 seconds
2. be able to maintain eye contact during this time
3. show understanding of what your are saying.
To assess this, you do what?  In unison… "Ask your Harvey to place his hand flat in yours to assess his ability to follow a direction, as well as to assess the mobility in his hand."   Very good! :)

As with the Three Piece Puzzle, I find with disoriented residents it is advantageous to use as few words as possible, so I might say to Harvey, “Watch how this works.”
1. With the magazine in front of Harvey, I would take one corner of the page and fold that top edge of the page down to the center binding of the magazine. 
2. Then I would flip that page over.
3. I would go to the second page and take the second corner of that page that’s in the upper right hand corner, and fold that to the center binding and turn that page over. Remember, if the resident is right handed, you must stand to the right of the resident to make sure that your forearm is not blocking his line of sight to the corner you are folding.
4. Observe:  I would then state, “Harvey, let’s see if you can try this."  Then I take the residents hand, if needed, and guide it up to the corner of the page.  To make this easier for the resident, I take this next page and slightly crease the corner of the page up to facilitate the resident's grasping the corner to fold it to the center binding of the magazine.
5. You then might assist him, after he has moved the corner of the page to the center of the magazine, in folding it along the edge as illustrated above.

If you happened to have an HIV or stroke patient that perhaps is capable enough to fold entire magazines, you can make decorative items by gluing a couple folded magazines together, spray painting them, putting Styrofoam heads on to make decorations for the facility.  (Gee, did I just say make decorations for the facility?  Hmm… wash my mouth out with soap.)  So this is an activity that cannot only be implemented for the Low Functioning, but also with higher functioning residents who have a need for the gratification of decorating the facility or producing a product.

Observe and Assess!
A way to adapt the Magazine Folding is to stabilize the magazine by taping its cover to the over-the-bed-table or table that your Harvey or Hazel is working on.

"Independently once started," as used above, means that once you get your Harvey started doing the Magazine Folding, he would be able to fold at least one or two more pages on his own. As he gets several pages folded down to the center, the pages that are already folded have a tendency to flip up.  Therefore, you might use a bean bag or similar type item to weigh down the pages that have already been folded. The Seminar DVD illustrates the use of a spray paint can lid with clay in it for weight.  Use clay, of course, if you don't have a wandering resident who eats things.  The lid is a good size and easy for the resident to grasp.  A way to organize this with the rest of your one-to-one activity programs is to start your Harvey or Hazel on Magazine Folding in a Small Group setting, in the lounge perhaps, and as he or she starts to fold independently, turn to work with another resident on their project.  Then go back to Harvey/Hazel and offer assistance as needed.

One way to motivate your resident to do Magazine Folding is to say, “Harvey, this is a really good movement for your hands or good therapy for your hands.  This will keep your hands from getting stiff.” If it’s someone who is a little bit more alert, you might indicate that you are going to use these to make clowns, Halloween cats, snowmen, or whatever else you can think of to decorate the facility, if that is the case.

Magazine Folding Success Story
When I used Magazine Folding as an Activity Director, I would tell some residents that their magazines were being used to decorate the facility, but in fact they would have a hard time folding only one page at a time to the center, usually grasping and folding several at a time, or have a hard time making a uniform fold.  As you will find, most residents will grasp several pages at time to fold when left to do this independently.  Of course the purpose is to create a successful experience.  So you say, of course, "Good job!"  Or another variation I have found is they will fold the magazine every way, but the way you have demonstrated.  This, of course, is fine because they received the mental stimulation of doing "something" as opposed to sitting doing "nothing."  You also have created a "reason" for your Harvey/Hazel to move his or her hands.  Hmm PT, OT, and/or nursing may like this.  Do you think?

So when the “messed up” folds would invariably happen, I would take the magazines that a more alert residents had folded and after it had been decorated, I would show the finished decoration to the resident with less capability and tell Harvey/Hazel how he/she had helped to decorate the facility.  And in a way, they had! The fact that their particular magazine had not been selected to be used for a finished product was irrelevant. They still had been involved in the effort to fold magazines and they had a sense of pride and accomplishment with that.  They experienced a feeling of… you guessed it… success!  Of course leave this in an Activity Project bag labeled in the residents room with directions how to implement the activity with the resident available for CNAs, etc.

Illustrated  to the right is a more elaborate fold.  You might consider using this if, as I mentioned earlier, you should happen to have non-Alzheimer's, high-functioning residents admitted perhaps recovering from surgery.
1. Fold the short top edge of the page to the center binding and crease.
2. Fold the newly creased edge over to the center binding.
3. Flip up the bottom triangle and crease to square off the bottom edge.  The illustration shows items made with this three-step fold.

Residents with whom to try Magazine Folding

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