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Healthcare Training Institute - Quality Education since 1979

Section 1
Track #1: Success Therapy®

Table of Contents | NCCAP/NCTRC CE Booklet

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Transcript of Track #1

Welcome to the home study course sponsored by the Healthcare Training Institute. This course is entitled Alzheimer’s and low functioning activities. Our primary intent for this home study course is to provide quality education to foster your professional growth. The institute has provided quality education since 1979. Hi my name is Catherine Zugel Appleton and I’ll be the narrator of this Track.

The purpose of this course is to assist you in increasing your knowledge regarding activities for low functioning residents. As individual projects and concepts are given, if the concepts seem to be applicable to your situation, I encourage you to turn your CD player off and make a few notes regarding the application of the idea to your residence. However these notes are for your purposes only and are not to be sent to the institute.

Also, each track is very content dense so feel free to replay the track to review the content. At the end of each track, a question will be asked. These questions correspond with the questions in your answer booklet. The questions in your answer booklet are sequential and deal with the section of content that preceded it.

For this reason, to facilitate the answering of each question, you might read the question from the answer booklet prior to listening to that track. By knowing what the question is ahead of time, you will then know the content to listen for that contains the answer. So, just a hint, after you write down the answer to a question in your answer booklet, read on to the next question in order to give you a heads up to listen for the content that contains the answer to the next question.

Merely write the correct letter on the corresponding blank line your answer booklet. Each answer is only used once. Keep in mind, there is nothing tricky or hard about these questions. They are merely intended to verify the plane of this Track. For the purposes of brevity most generally, I will use the term resident. However if you deal with patients, consumers, clients, etc transpose resident for the term that is the most meaningful to you in your work setting.

So let’s get started. Lets talk about the format of the materials for this home study course. One Track, a manual that contain seven reproducible in service training instructional masters, and a sample success therapy project bag label are included in this course. The purpose of providing in service training materials included in your manual is to encourage you to reproduce these and leave them in the residence room in a bag taped to the residence nightstand along with the success therapy project. Thus staff, family members, and volunteers have access to the activity to support your program with the residence.

Four Steps for In Service Training
Place these bags in residents’ rooms once you have completed the following four steps.
1.You have assessed the residents’ capabilities and limitations.
2. Gathered and constructed the necessary material for this success therapy project.
3. Implemented the particular activity described on this Track with the resident.
4. You would not place a bag in a resident’s room until you have either formally or informally made the staff aware of the goal for this success therapy activity with the resident and the philosophy of success therapy.

However, before you put a bag, a project, or an in service training instructional sheet in a resident’s room, begin by starting at the top with your administrators and your corporate consultants approval and support. As you already know, if you have that, then getting the support of your Director of Nursing, In Service Coordinator, Charge Nurse, etc, will be easier.

Note, the In Service Training sheets located in the manual and the manual content, reinforce the information covered in this Track. The reason for this Track format and manual format with similar content is that some people are visual learners and others are auditory learners. So the manual serves as an easy reference tool.

Success Therapy Activities
Now just what are success therapy activities for low functioning and Alzheimer’s or dementia residents or clients? The definition of a therapy is a method to deal with a disease. Success therapy poses a method to provide the resident with a situation, a circumstance, or a task to give that resident a successful experience and the accompany feeling of accomplishment and joy, or success.

However keep in mind the goal of the projects described on this Track and in the manual is not to produce a finished craft product or to give the resident a great enjoyable time. As you know, many of your low functioning residents, have lost the ability to experience a great time. They are a programming challenge for you because they cannot perform familiar life skills tasks like sock sorting, towel folding, or for some, they cannot even enjoy listening to music, as you are aware.

So what do you do for your sensory one to one cognitively impaired small group in room activities? You take a different perspective. With each success therapy activity the purpose is to provide a structured task far beyond the old days of a “Hi and a Hug” and “Hand Lotion” generic TLC visit. But ST, or success therapy, allows you an opportunity to say sincerely and genuinely to the resident, “good” “great” “you did a good job, now lets see if you can do that again”.

In some cases as you know this is practically a monologue since your resident may only be able to pick up on your feeling tone and not be able to understand your specific words. But a basic success therapy premise is you never know what gets through and you never write any resident off as “totally unreachable” or “hopeless”. Also the increase emphasis in the survey or state operation manuals interpretation guidelines underscores the fact that severely impaired residences are to be involved.

Assessment basics.
Before we get into the seven success therapy projects in this Track, let’ go over 4 basics: eye contact, thumb and index finger movement, attention span, and understanding.

First regarding eye contact, always make sure you are at the resident’s eye level to get eye contact from the resident. Since most residents are in wheel chairs, I find that when I talk to a resident, a kneepad is helpful. The kinds you would use in gardening I find work the best. Or you might get a few scraps of foam carpet pad from a carpet dealer to kneel on. I folded into a 4-layer thickness and staple with 4 or 5 staples. The finish size of my kneeling pad is about 15 inches by 7 inches.

Secondly regarding hand assessment, most of the 50 activities in this success therapy series are activities that I call object manipulations. That is you have the resident manipulate something for you with their hands to accomplish the activity, and thus to create the feeling of success that you are after. For this reason, one of the most importation evaluations to do is an assessment of the resident’s hand movement. By doing this before you start an activity, you can establish a base line or a starting point, which then could be noted as a progress note in your documentation.

To assess hands, after introducing yourself, ask the resident “would you place your hand flat in mine?” what you are assessing is whether the resident is able to understand your simple request. If the resident does not offer their hand to you ask, “is it okay if I touch your hand?” then gently take the resident’s hand. The second area you are assessing is if they are able to lay their hand flat in yours.

Later on in this Track I will talk about an activity called Can-Rolling. This is a good activity for residents who have slightly contracture hands. To assess both understanding hand movement and eye contact, request the resident to close and open their hand. You might say something like “can you close and open your hand like this?” then demonstrate closing and opening your hand.

Now you need to make sure that you demonstrate in the resident’s line of vision. The resident’s line of vision as you know is often times at a 45-degree angle to the floor. So make sure you close and open your hand as you demonstrate what you want them to do that your hand is held low enough or within their line of vision. Also if you or the staff member who attends the facility’s Care Plan Conference, this assessment information will be valuable for accurate MDS initiation and updating by the team.

Thumb and index finger movement.
The next movement to notice is the thumb and index finger movement as you assess the resident’s hands. You might demonstrate the movement you want while asking, “can you move your thumb and index finger like this?” move you thumb and index finger together then apart. Once again you are assessing both the resident’s understanding to follow a simple direction in addition their ability to move their fingers.

Notice if they are able to move their fingers either upon request or with assistance. If they appear to have the slightest ability in their thumb and index finger to closely approximate to each other, they may be a good candidate for a Success Therapy Object Manipulation Activity described on this Track.

Question 1: When you ask a resident to move their thumb and index finger, what two areas are you assessing?

NCCAP/NCTRC CE Booklet
Forward to Track 2
Table of Contents

Note-Taking Exercise

Implementing Culture Change: Reproduce this Note-Taking Booklet for the Inservice Training of Staff and Volunteers.  Assign one or two tracks to be listened to, and pause the CD player frequently to facilitate note-taking and discussion.  However, the most important piece of information you write and discuss with other Staff or Volunteers is the list of residents in your facility with whom you feel the activity or concept may be appropriate.  Clearly, the quality of your resident’s lives, in this area, will not improve unless you actually do these or other activities with your residents.  Don’t just talk the talk.  Walk the walk!  Make a vow with yourself to do something different, based upon the information you receive now, with a resident after each training session! 

Success Therapy®

What is Success Therapy®?

What two goals are not part of Success Therapy®?
1.

2.

What is a basic premise of Success Therapy®?