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:

IMPORTANT NOTE: Since this DVD was recorded in a hotel meeting room, and not a studio, the audio and video have been digitally optimized as much as possible.  However, the features of the speaker’s face will appear blurry at times.  This will not hamper your learning experience. The quality of the content speaks for itself.

Admission and Be Persistent with Change
(Additional Instructor's information for this track found on page 19)

No Magic!
The speaker stated she did not have magic.  What is it that she stated she would provide?
Ideas that worked for her, or Activity Directors with whom she consulted.

Admission
What is the most important day in the facility in a resident’s life?
The first day, because the resident may learn he or she does not have to go out of his or her room.

What are two tools you might use with a new resident to assess his or her responsiveness and capabilities?
1. An Assessment Book.
2. A Days Diary

Residents with whom to use the Assessment Book or Assessment Folder

Be Persistent with Change
If a resident continually declines invitations to group activities, what are two important steps to consider?
1. Continue to be persistent with invitations.
2. Consider if the resident is not motivated by the nature of the activities.  Perhaps the resident has worked all of his or her life, and is not motivated by fun.

Residents to Motivate by using a "Different Approach" than ones used in the past

QUESTION #1: Regarding motivation, what is the most important day for a resident and why?
The most important day is the first day regarding motivation because the resident learns what is expected of him or her.  The resident learns whether or not they are expected to leave their room for meals, etc. AB

DVD TRACK 2
Positive Approach, Think He’s Helping, Necessity, and Service Project
(Additional Instructor's information for this track found on page 24)

Positive Approach
What were the two approaches given for Suzy, an unmotivated resident?  Which approach is positive, and why?
1. Would you like to come down to the Bingo game?
2. Would you like to come down to the Bingo, or did you want me to bring you down to the lounge so you can watch TV?
The second approach is more of a positive motivator, because it offers a choice between two activities.  However, in the first approach, the resident is offered a choice between activity and inactivity.

Residents to Motivate by offering a "Choice between Two Activities"

Think He’s Helping, Necessity, Service Project
What were 5 service projects suggested by the speaker?
1. Holding decorations as the Activity Director puts them up, 2. Folding towels or Chux pads, 3. Filling salt and pepper shakers, 4. Dusting banisters, 5. Cutting cardboard

Residents to Motivate by telling him or her they are "Helping"

What problem did the speaker run into after using Necessity to motivate Sue to help her cut out stars to decorate the facility?
The speaker did not put up the stars for four or five days, which contradicted her asking Sue for help because she needed the stars right away.

Residents to Motivate by giving them a "Job" to do

QUESTION #2: What is important to keep in mind when asking a resident for help?
Follow through and show the resident that you really did need their help.

DVD TRACK 3
Grow Slowly
(Additional Instructor's information for this track found on page 28)

Grow Slowly
What are three reasons why the speaker suggested posting pictures from non-traditional magazines, such as Sports Illustrated, in the hallway outside the dining room?
1. By posting the pictures, it shows that Activities has a well-rounded program to meet resident’s needs, including male residents.
2. It gives the Activity Director a means by which to introduce the Men’s Discussion Group to a new resident’s family touring the facility.
3. It provides a vehicle for motivating a male resident to attend the Sports Discussion Group.

Residents to motivate by the use of a "Picture Gallery"

QUESTION #3: What is the most important factor to the family of a potential resident?
The most important factor to a resident’s family is what the facility has to offer their family member.

DVD TRACK 4
Visual Aid
(Additional Instructor's information for this track found on page 29)

Visual aid
How did the Activity Director in Martinsville adapt Inner Tube Stretching to meet the social needs of Joe, a contractured resident?
The inner tube was attached to Joe’s wheelchair, so that he could ask visitors and staff nearby to count how many times he could stretch the inner tube strip.

QUESTION #4: What are two ways to adapt inner-tube tire (Thera-band) stretching?
Loop over resident’s foot or loop over resident’s hand.

DVD TRACK 5
Visual Aid Demonstration
(Additional Instructor's information for this track found on page 31)

Demonstrate with a Visual Aid
To avoid a conflict with nursing, on what does the speaker recommend basing care plan goals and approaches?
Observations, such as ‘cold hands’, rather than medical terminology, such as ‘hand in a contracture’.

Residents to motivate by the use of a "Visual Aid"

QUESTION #5: What would be an example of a Care Plan Approach for inner-tube tire (Thera-band) stretching?
To gently cradle the resident’s hand.

DVD TRACK 6
Unfinished Job
(Additional Instructor's information for this track found on page 32)

The Unfinished Job
How was Harold, the former policeman, motivated to do Coupon Clipping by using an unfinished job?
The Activity Director motivated Harold by stating, “I need to go to the Care Plan Conference, Harold, could you finish cutting out this one line of coupons for me?”

What were two important concepts in motivating Harold with an Unfinished Job?
1. Giving Harold a task so small he could not possibly refuse. 2. Leaving right after making the request.

Residents to be motivated by Completing an "Unfinished Job"

QUESTION #6: What are the two ways explained to motivate an unmotivated resident like Harold?
Ask the resident to do a very small task in a large amount of time, leave the room before the resident has time to make excuses.

DVD TRACK 7
Rewards and Labeling
(Additional Instructor's information for this track found on page 33)

Reward
What was a non-traditional reward used to motivate Henry, the resident who sat in the hallway saying “I can’t!”
Henry was motivated by using a 10-second backrub as a reward.
Residents to motivate by Use of a "Non-Traditional Reward"

Labeling
How can labeling be used to provide reinforcement and motivation for a resident who works on handicrafts independently?
The Activities Department could have an ‘appreciation day’ for the resident, during which time the resident’s work is put on display.

Residents to motivate by the use of "Labeling"

QUESTION #7: What is one reason male residents are often the most difficult to plan activities for?
Male residents have often worked all their lives and usually have never done anything regarding crafts

DVD TRACK 8
Recognition and Non-recognition
(Additional Instructor's information for this track found on page 36)

Recognition
How is recognition a double-edged sword?
For every group that is recognized, there is another group who feels left out.

How did the speaker adapt ‘Resident Volunteer Recognition Awards’ to be motivational for Kathy, the sidewalk superintendent?
The activity director told Kathy ahead of time that the awards ceremony would take place, and what she would need to do in order to receive an award.

Residents to motivate by the use of "Recognition"

Non-recognition
How did the speaker adapt the men’s discussion group to meet the non-recognition needs of a resident who had had a leg amputated?
The speaker changed the format of the men’s discussion group so that the men sat around a table, rather than in an open circle.

Residents to motivate by using "Non-Recognition"

QUESTION #8: How can non-recognition motivate self-conscious residents?
Residents who feel self-conscious about appearance or behavior need to know that attention will not be drawn to their differences.

DVD TRACK 9
Leader and Competition
(Additional Instructor's information for this track found on page 38)
Leader
How was Harold, the former policeman, motivated using a leader approach?
Harold was motivated by being asked to call a few Bingo numbers to give the activity director a chance to rest her voice.

Residents to be motivated by "Leading" an Activity

Competition
What is one difficulty in regards to using competition as a motivator?
There is such a disparity among resident’s abilities, you might end up with the same small group of high-functioning residents ‘winning’ all of the time.

How did the speaker use competition to motivate Margaret, and stop Margaret’s harassment of the other residents during the bowling game?
The speaker kept a record of Margaret’s scores at bowling, and put her in competition with her own past performance.

Residents to be motivated by "Decreasing Comparisons" in a Competition

Residents to be motivated by playing "Help Your Neighbor" or "Las Vegas"

QUESTION #9: What is a way to make playing cards easier to read for the “Help Your Neighbor” game?
Use white out or tape to cover the smaller pictures (diamonds, spades, etc.) next to the numbers so the resident will be able to count the regular-sized pictures.

DVD TRACK 10
Helps Others, Please Someone, Opposite Sex, Curiosity
(Additional Instructor's information for this track found on page 42)

Helps Others
How did the speaker use helping others to motivate a male resident?
The male resident brought a tape of a hand exercise record around to four other bedridden residents.

Residents who might be motivated by "Helping Other Residents"

Please Someone
What is one way that the speaker suggested to use pleasing someone as a motivator for a resident?
Invite the resident to help construct a Christmas card for another resident, perhaps selecting the picture or pattern to go on the card.

Residents to be motivated by "Pleasing Someone"

Opposite Sex
What are three factors to consider when deciding if it is appropriate to use the opposite sex as a motivator for a resident?
1. The alertness level of the resident, 2. The wishes of the resident’s family, 3. The opinions of the facility staff.

Residents to be motivated by the "Opposite Sex"

Curiosity
What need was met for the Traffic Cop through using the Guess Box?
The Traffic Cop’s need for control was met by making the Guess Box ‘his’ game.

Residents who might be motivated by "Being in Control"

QUESTION #10: The “Guess Box” was good for what three reasons?
The Guess Box gave him something to be in control of; it gave him the opportunity to interact with people; it encouraged him to remember his actions and put his energy into positive use.

DVD TRACK 11:
Monetary Value, Common Interest
(Additional Instructor's information for this track found on page 45)

Monetary Value
What is one important idea to notice when a resident is complaining?
When a resident is complaining, he or she is basically waving a red flag and saying “This is a motivator to me.”

Residents who may become motivated by their "Complaints"

Common Interest
How might you use a common interest to motivate those who want to know more about their medical condition?
Start a common interest club, like a “stroke club,” or a generalized “health club.”

Residents who may become motivated by a Discussion Group of a "Common Interest"

QUESTION #11: How can Activities support a dietary or nursing Care Plan Goal with a diabetic resident?
By providing the resident with a discussion group during which informational pamphlets on diabetes are discussed.

DVD TRACK 12:
Referrals, Clothing
(Additional Instructor's information for this track found on page 46)

Referrals
What are two ways to use referrals to motivate residents?
1. Reference someone who the resident knows who will (or won’t) be at the activity, 2. Reference a past interest of the resident.

If you have a resident who is active in the garden during the summer, but withdrawn during the winter, how might you use a referral to their gardening interest to keep them motivated?
You might start an indoor plant club during the winter.

Residents who may become motivated by "Referrals" regarding others Attending or Past Interests

Clothing
How can clothing be a powerful de-motivator?
If a resident had always been very proud of his or her appearance, but now is a sloppy eater, or has lost a lot of weight, he or she may be embarrassed about their appearance.

Residents who may become motivated by "New Clothing or Appearance"

QUESTION #12: When a resident has an appearance issue, what can be said to allow the resident to express his or her feelings?
A staff member can share something negative about his or her own appearance that they’re comfortable sharing at a professional level, giving the resident the opportunity to express his or her own insecurities.

DVD TRACK 13:
Reassurance, Expression, Coffee, Change Staff
(Additional Instructor's information for this track found on page 48)

Reassurance
What are four reassurance phrases you might use when encouraging a resident to attend an activity?
1. “I’ll take you back,” 2. “It’s just down the hall," 3. “It’s only 30 minutes long,” 4. “If you have any visitors, they’ll be notified.”

Residents who may become motivated by words of "Reassurance"

Expression
How might you encourage residents to participate in a "theme party"?
Invite the residents to choose the theme of the party, and pick out supplies from a party catalog.

Residents who may become motivated by "Offering a Choice"

Coffee
What is important to remember about a resident who only comes out when there’s food?
It is important to remember that at least the resident is being motivated to come out of his or her room.

Residents who are motivated by "Food"

Residents who may be motivated to attend a "Culinary Council" meeting

Residents who do not attend Group Activities, but are alert enough to be aware of a Visit

Change Staff
What is one important realization to have regarding motivating residents?
Sometimes, you cannot reach a certain resident based on gender, race, or other personal factors.

How was Jon, the young black male resident who had had both feet amputated, motivated to say ‘hello’?
The Activities staff encouraged other black male residents to stop by Jon’s room to say hello.

Residents who might be motivated by "Changing the Staff" to encourage involvement

QUESTION #13: What makes it difficult for Activities Staff to admit that they may not be the people to get through to a particular resident?
They feel they have to be everything to everybody all the time and admitting that they can’t be is difficult.

DVD TRACK 14:
Workshop Participant Ideas
(Additional Instructor's information for this track found on page 52)

How did Pam suggest using resident’s past clubs or organizations as a motivator?
Pam suggested asking Volunteers or active members of the organizations to take residents to meetings once a month.

How did Kathy adapt using touch as a positive motivator?
Kathy’s staff gave points to residents for giving hugs to staff. The resident with the most points at the end of the day received a “Most Huggable” award and prize.

Residents who may be motivated by one of the "Suggested Activities"

QUESTION #14: In the group participation section, what was the most often mentioned activity for residents that the participants suggested and why?
Activities including food were the most popular activities suggested because almost everyone is motivated by food.

DVD TRACK 15
Key Slides and Commentary
(Additional Instructor's information for this track found on page 53)

The remainder of this DVD shifts focus away from motivational approaches and provides you with some specific activities that might motivate involvement.

Assessment Book
If a resident cannot recognize a picture with simple content, how might you adapt the Assessment Book to provide the resident with a successful experience?
If a resident cannot recognize the picture, they might be able to recognize a line drawing of the same content placed next to the picture.

Tracing
What are three adaptations you might try if a resident is having difficulty with Tracing?
1. A Styrofoam Ball adaptor, 2. use a pencil rather than a ball-point pen, 3. have the resident trace a simpler shape.

Exercise Wands
How can you use an Exercise Wand to create a great range-of-motion activity?
While music is played, residents can make figure 8’s, circles, ovals, draw their initials in the air and so on, depending upon the level of the residents in the group.

Seated Musical Chairs
What might you say to encourage a resident’s comparison with him or herself, rather than with other residents?
You might say “Marie, you really grabbed right at the knot, good job!” rather than “Let’s beat Joe, he won yesterday.”

Roll Across
What are three adaptations of the Roll Across game?
1. The resident tries to roll the ball to the person across from them, 2. residents raise and lower their portion of the sheet to get the ball to roll around in a circle, and 3. residents divide into teams at opposite ends of the sheet, and try to roll the ball across to the other team.

Shuffle Board
What alternative might you use for poker chips, to better meet the needs of residents with stiff fingers?
You might use gallon milk bottle caps or Gatorade bottle lids.

Horse Race Game
What is one advantage of the Horse Racing game in regards to meeting diverse resident needs?
Even some very disoriented residents can grasp the idea of rolling a die and moving their horse.
Grocery Bag Weaving
What can be one interdisciplinary benefit of an activity like Grocery Bag Weaving?
An activity like Grocery Bag Weaving can help a resident maintain his or her grasping ability, allowing the resident to grasp his or her spoon over a longer period of time, delaying the need to be fed by nursing.

QUESTION #15: What is one challenge for a resident doing Tracing independently?
If a resident is doing Tracing independently, he or she will need to figure out how to move the hand that is stabilizing the pattern to trace all of the way around the pattern.