To a be a whole person, you must fulfill the dimensions of health. Neglecting one or more of the dimensions of health can have negative effects on overall health. The same is true for someone living with dementia.
Research suggests that people who neglect the dimensions of health may be at higher risk of developing dementia. Meeting these needs may enable individuals already living with dementia to maintain their abilities longer as the disease progresses.
At the James L. West Center for Dementia Care and the Senior Day Program, activities are planned targeting the dimensions of health. The goal is to ensure participants and residents alike have opportunities to fulfill their needs in six dimensions of health – occupational, social, emotional, physical, spiritual and intellectual health.
Meeting these basic needs helps residents and participants maintain and retain abilities. The activities offer opportunities to meet needs in the six dimensions of health and follow a natural rhythm similar to what a person may have done before the onset of dementia.
In the Senior Day Program specifically, the mornings start with a continental breakfast of pastries and coffee, followed by the Daily Chronicle, which covers current and past events and this day in history. The morning also includes exercise, devotions and getting ready for lunch, where participants are encouraged to socialize with each other and the staff.
“It gives familiarity,” said Heather Macchietto, day program director. “My goal is that they come anytime between 7:30 when we open and noon and every day looks the same, so it isn’t some new, scary thing.”
The afternoon schedule changes frequently, and activities move about the day program building and outdoor spaces to keep participants engaged. After lunch, the schedule typically includes things that are more physically interactive or intellectually stimulating. Then the day ends in a similar fashion with small group activities for winding down.
Feeling accomplished contributes to health
Intentional activities that serve the occupational health dimension foster feelings of accomplishment.
Macchietto said it’s important to let people living with dementia do as much as possible for themselves because it contributes to a sense of purpose and accomplishment.
“Caregivers want to make things easy for their loved one,” Macchietto said. “So they take away everything they can do for themselves. You take away all their choices.”
The team at James L. West intentionally breaks down activities into tasks and engages participants in those tasks according to their skill levels. All planned activities can be adapted to participants’ different levels of ability to foster a sense of accomplishment and purpose.
The cooking club is one of Macchietto’s favorite activities because there are many ways the participants can join in. Some can read the recipe. Others can measure the ingredients. Still others can mix or dish out the dough. Some may only be able to taste the finished product. But everyone has a role, and they all feel like they contributed.
Macchietto said that’s especially important for the men who attend the day program because their identities are wrapped up in what they did for a living.
Meeting social needs
Macchietto sees socialization at the day program as one of their biggest selling points. From playing games together to sharing meals, socialization is encouraged.
“Socialization is so important because it helps stave off Alzheimer’s disease and the symptoms of dementia,” Macchietto said. “It keeps their minds sharp and active.”
As the symptoms of dementia worsen, seniors often isolate themselves.
“People with dementia who are trying to hide that they have dementia start withdrawing from their friends, and they don’t go out and do things like they used to,” she said.
At the day program, everyone has dementia. They all have struggles, and no one is alone.
“I think that’s important. They don’t have to feel embarrassed that they forget a name or something because everyone here does,” she said.
Lunchtime has become an event because the participants talk and visit with each other during the meal, which can last an hour or more.
Meeting emotional needs
Self-expression is tied to emotional health. Allowing and encouraging participants to express themselves through art, music, or sharing stories and memories is an integral part of the programming at the senior day program.
“It really doesn’t matter if the stories they are telling are true,” Macchietto said. “What’s important is letting the person express themself and share.”
Macchietto said we often try to keep people living with dementia from experiencing negative emotions, but emotions are part of life.
“Emotional programming can be reminiscing about something, and sometimes it does bring back a sad memory, but that’s okay,” she said. “That’s human. We want to let our people be people.”
While the team tries to minimize the negative, they want participants to experience joy and happiness.
Exercising for better function
Exercise is especially important, not only for maintaining physical abilities but for your brain as well. Whatever is good for your heart is also good for your brain.
“When you stay home and sit in the recliner or on the couch and don’t get up at all, it’s easy to lose the ability to do things for yourself and put yourself at greater risk for falls,” Macchietto said.
Participants in the day program start the day with some exercise, and various physical activities are scheduled throughout the day.
“When you exercise, you’re keeping your blood pumping and your limbs strong,” Macchietto said. “Nobody sleeps here all day. We’re always getting up and moving from one activity to another.”
The physical activities are adaptive, so participants can participate regardless of their capabilities. They may have to sit instead of standing, but they can still move their feet, arms, and legs and get their heart rate elevated.
Participants often spend time outside walking the path through the secure courtyard or using the putting green. Music therapy invites participants to dance, clap, play instruments and move along with the beat.
Macchietto is an advocate of letting participants do what they can do for themselves and not doing those things for them.
Satisfying spiritual needs
Meaning and purpose are often found in meeting spiritual needs, which is the seventh aspect of health addressed at the day program.
“We do have a lot of people who are religious and want to participate in the Bible studies,” Macchietto said. “Some of them even help us and lead us in prayer. We pray before lunch and somebody different leads it every day.”
People are different and have different experiences and beliefs, which sometimes makes meeting spiritual needs challenging.
“We try to provide outlets for them to relax and feel connected to other people. That can help meet their spiritual needs as well,” she said.
For some music or spending time outdoors contribute to their spiritual health.
Stretching the mind
Using the brain to solve puzzles, answer trivia questions, and play table games helps maintain mental capabilities.
“We definitely do a lot of challenging things, and we love to watch them master something challenging,” she said. “People with dementia can still learn.”
Sometime during the day, participants have the opportunity to stretch their minds by learning new information, learning to play a new game, answering trivia questions, matching phrase cards or other intellectually stimulating activities.
Meeting all the dimensions of health every day is a big job, but it’s one the James L. West Senior Day Program team is ready to tackle.
“You just have to be creative,” Macchietto said.
To learn more about the James L. West Senior Day Program, call 817-877-1199 or visit our webpage.
