Amazing Activities for Low Function Abilities: And Caregiver Guide

By Amira Choukair Tame

Amazing Activities for Low Function Abilities addresses a growing public health issue in America: providing therapeutic activities for people with Alzheimers, other dementia disorders, and persons with low function abilities. A dedicated activities professional with many years of experience, the author champions the advancement of non-drug therapy for this population.

Amira Choukair Tame has shared these techniques with other professionals through her caregiver training sessions and workshops. Her book includes therapeutic activities for caregivers to use for anyone with dementia. The text isnt just a list of activities. The techniques offered in the book are designed to assist caregivers in identifying individual strengths and weaknesses that will help them customize a set of activities suitable for diverse needs, and address the frustrations and difficulties encountered while caring for this population. The exercises are suitable for individuals at any stage of dementia, as well as those with low function abilities. A one-hour training video complements the book with an informative lecture and real-life examples.

• Language: English
• Publisher: iUniverse
• Release date: Mar 9, 2017
• ISBN: 9781532013096

Amira Choukair Tame

Amira Choukair Tame, ACC, CDP, CLL is a nationally Certified Activities Consultant (NCCAP), Certified Dementia Practitioner, and Certified Laughter Leader (World Laughter Tour). Amira has published several activities books and has shared her techniques with other professionals in caregiver training sessions and workshops. Training hospice care volunteers has been especially rewarding. Her techniques have gained the trust and respect of her peers, the medical community, and most importantly, those she has helped to re-establish a sense of respect and dignity to their lives — the person with Alzheimer’s disease.

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Copyright © 2017 Amira Choukair Tame.

All rights reserved. No part of this book may be used or reproduced by any means, graphic, electronic, or mechanical, including photocopying, recording, taping or by any information storage retrieval system without the written permission of the author except in the case of brief quotations embodied in critical articles and reviews.

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Any people depicted in stock imagery provided by Thinkstock are models, and such images are being used for illustrative purposes only.

Certain stock imagery © Thinkstock.

ISBN: 978-1-5320-1307-2 (sc)

ISBN: 978-1-5320-1308-9 (hc)

ISBN: 978-1-5320-1309-6 (e)

Library of Congress Control Number: 2016921508

iUniverse rev. date: 03/08/2017

Contents

Acknowledgments

Testimonials

Introduction

Hope is the Power of Life

Chapter 1 Understanding Alzheimer’s Disease and Its Devastating Effects

Understanding the Changes (Tim Brennan Story)

Facts About Alzheimer’s Disease

Ten Warning Signs of Alzheimer’s Disease

Stages of Alzheimer’s Disease

National Support for Caregivers

Researchers Seek Treatments for Behavioral Symptoms

The Effects of Alzheimer’s Disease

Chapter 2 Caregiver Treatment: Confront Your Anger and Frustration

You Are Not Alone

Understanding Caregiver Stress

Minimize Your Negative Feelings

Reduce Caregiver Stress

Care for the Caregiver

Caregivers’ Rights

Chapter 3 Gathering and Discovering Important Information

Why Should Information Be Gathered?

Why This Information Is So Important

What Information Do You Need?

How and Where Do You Obtain the Information?

Personal Profile Form

Intake Goals — Assessment

Activities Progress Report

Chapter 4 Understanding the Concepts, Tools and Techniques

You Can Make a Difference

Improve Relationships

Reduce Negative Emotions: Fear, Anger, Frustration, Guilt

Cope With and Decrease Mood Swings

Increase Positive Attitudes and Self-Confidence

Improve Long and Short-Term Memory Function

General Techniques

1. Curiosity / Interest Arousal

2. Motivation Stimulation

3. Attention Diversion

4. Familiarization by Creative, Repeated Use

5. Improve Enthusiasm with Positive Encouragement

6. Communicating at the Appropriate Level

7. Enticing Them to Participate in Activities

8. Overcoming Fear of Change

9. Provide Love, Support, and Friendship

10. Use White Lies as a Diversion Tactic

11. Be Flexible with Activity Selection

12. Always Give Undivided Attention

13. Encourage Decision-Making Power

14. Introduce New Activities Slowly

15. Begin with Simple Responses

16. Select Activities That Can Be Modified as Skills Improve

17. Reward Achievements

18. Humor Therapy

Minimizing Resistant Behavior

Summary

Chapter 5 Resolving Physical and Functional Issues

Understanding the Healing Process

Getting Started

Prioritize Goals

How to Identify Root Causes

Resolving Physical and Functional Issues

Hearing

Seeing

Eating

Mobility

Personal Appearance / Hygiene

Resolving Cognitive Issues

Orientation and Familiarization

Wandering

Behavioral / Emotional

Anger

Isolation

Attachment

Resistance to Taking Medication

Mistrust and Misunderstanding

Relocation

Money Issues

Environment

Personal Property

Monitor Progress

Sundowners Syndrome

Chapter 6 Custom Design an Effective Activities Program

No One Said It Would Be Easy

Important Guidelines

Medical Conditions

Minimize Injury Risks

What Is an Activity?

Types of Activities

Therapeutic Activities

Communication

Reminiscing

Daily Functional

Meal & Food Preparation

Exercise

Verbal Activities

Fun Activities

Therapeutic Humor Activities

Chapter 7 Documented Case Histories of Clients’ Improvements

Appendix Additional Recommended Resources

Order form

About the Author

Acknowledgments

Working with people who have low function abilities has given me a deep respect for the caregivers and professionals who work every day to help overcome the obstacles and difficulties encountered to develop a successful activities program. This book would not have been possible without the support and encouragement of many individuals and institutions. I extend my deep appreciation and heartfelt thanks to the following people and organizations:

The Alzheimer’s Association for allowing me to reprint information from their website that helps us better understand Alzheimer’s disease, and also for providing those in need with compassion, support and guidance. For more information about Alzheimer’s disease visit their website at http://www.alz.org/ Tel. [phone]

My peers and other professionals who listened to my stories, tried my techniques, and inspired me to write this book.

Mike and Hanan Akra of DocuMall for their painstaking effort to arrange my material in a way that is informative and easy to read.

Mary Shoucair for her literary and grammatical guidance.

Linda Shannon Rugel for her honest and thoughtful critique of the arrangement and flow of information in this book.

Caregivers and family members of those who suffer from dementia, for their knowledge and compassion.

Last, but not least, to my loving husband, Omar Tame, for years of patience and encouragement that helped make this dream come true.

No one cares how much you know,

Until they know how much you care

Hopefully, this book provides you with a systematic approach to reduce the emotional, functional and environmental effects of low function abilities, including cognitive and physical decline. Even Alzheimer’s disease symptoms can be reduced and sometimes alleviated through the use of these therapeutic activities and creative techniques.

The strongest emotional healers for people with low-functioning abilities or Alzheimer’s disease are love, care and respect.

Dementia is not brought on by anything you or your loved ones did or didn’t do. So, be easy on the person you are caring for and especially easy on yourself as you embark on this difficult journey. The emotional lift you will feel as you see your loved one benefit from this program will also help heal the wounds you may be feeling.

And in the end,

it’s not the years

in your life that count.

It’s the life in your

years.

- Abraham Lincoln

Amira, your work really touches people and moves them. You inspire others to action.

Steve Wilson,

Founder, President and Cheerman of The Bored (tm) World Laughter Tour, Inc. www.WorldLaughterTour.com

Testimonials

From Caregivers

Dear Amira,

You may be pleased to know how much I’ve appreciated your work with my sister Adela. Her eyes would sparkle with joy as you treated her. Throughout the last six years of her life she responded enthusiastically to your suggestions, interacting with you to the best of her ever-diminishing ability in various projects and games. Your skill and patience brought the best in her. Also, thank you for the video you made last session with her and me before she slipped out of consciousness on her 10-day slide to death.

Sincerely

Mary Shoucair

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"To whom it may concern

I have known Amira Tame for one and a half years. We employed her when my mother first moved into a senior apartment and she was very agitated and unhappy. Amira has proven to be a big help in my mother’s case. My mother at first was not too comfortable with strangers, but over time she came to trust Amira and enjoyed her company. She now feels secure in her presence. My mother’s short term memory is very poor, but when she sees Amy, I feel she considers her a friend.

Amira has tried to vary her activities and has taken my mother out of the facility for a ride and has included a lot of the other residents at times. The American house has now employed her due to her rapport with these people. We have been very satisfied with Amira’s assistance and friendship with my mother"

– Corinne

From Clients

I was sitting and talking to a client (Sophie) that I had been seeing for about 2 years. Her short-term memory was already severely diminished. I was surprised that during this particular session she recalled a stop we made to look at antique jewelry. I told her I was proud of her that she recalled that outing which occurred about 6 months prior. She responded that her brain seemed to be improving. I asked why she thought it was getting better She replied, Because I’m not as nervous as I was…. maybe because I have you now, and I can depend on you.

Amira

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From professionals

Amira, your knowledge, talent, love and caring nature is revealed throughout this AWESOME! book.

Lisa Ost-Beikmann

ADC, CDP, AC-BC, CADDCT, CAEd

Education Outreach Trustee

National Association of Activity Professionals

While I was participating in the Alzheimer’s Activities Workshop on March 24, 2005, I observed how each person was reacting to the techniques that Amira was showing them. I encouraged one of our residents, Mary, to participate. Mary has a hearing and speech impairment and dementia. Mary sits for hours a day smiling and never participates in our activities. During this particular activity, we were singing You Are My Sunshine." Mary was watching as everyone was singing. I noticed that she was watching Amira and she began to sing the song with us. This was a tremendous accomplishment. Amira definitely has the skill to reach inside a senior citizen and bring out their inner feelings and talents. I was impressed with the workshop and found Amira’s advice to be very beneficial.

Marie Tester

Activities Director

Maple Heights Retirement Community

Most directly, one of our CLLs is an expert on activities for Alzheimer’s patients. She is Amira Choukair Tame, and is the author of Healing the Wounds of Alzheimer’s. She has a new book and excellent instructional CD, The ABC’s of Activities for Alzheimer’s. Amira was one of the outstanding presenters at this year’s Advanced CLL Workshop. Amira’s books and CD are ’must-have’ resources for everyone who cares about a person with Alzheimer’s. Her methods can be understood and used effectively by almost anybody at any level, professionals, volunteers, friends, and family members, too.

Steve Wilson, Founder,

President and Cheerman of The Bored(tm) World Laughter Tour, Inc. www.WorldLaughterTour.com

Amira, your work really touches people and moves them. You inspire others to action.

Steve Wilson

What a great job you did with your book! I found it to be very informative, real, and diverse in the information given throughout.

Cindy L. Bradshaw MS, ACC

National Certification Council for

Activity Professionals

Introduction

Physical and/or cognitive decline will be faced by most in our waning years. My goal with this book is to provide an activities program that will allow all people with declining abilities to participate in all activities at some level. The most challenging has been the effects of Alzheimer’s.

Although Alzheimer’s is a progressive and irreversible disease, I’ve found that through proper application of therapeutic activities, the progression of behavioral effects caused by memory decline can be delayed and, in some cases, reversed.

Implementing an activities program for residents with Alzheimer’s is usually a challenging and difficult task. Often there are barriers of mistrust, fear, anxiety, low self-esteem and self-confidence, resentment and confusion that must be overcome. Even the most caring attempts to be helpful or to communicate are sometimes met with outbursts of anger, resistance, or complete withdrawal. With my approach, I believe that activity therapy can reduce the negative behavioral effects caused by Alzheimer’s disease, and have a positive effect on memory function.

My common-sense approach in utilizing the practical and logical therapeutic activities described in this book can be easily adopted and enhanced to improve the quality of life for those affected by low functioning abilities, including Alzheimer’s disease. Each approach is tailored to individual needs by utilizing whatever mental and physical skills the person still possesses and, furthermore, continuously enhancing these skills.

It’s not enough to love and care for someone and want them to get better. It takes strong determination to learn as much as possible about Alzheimer’s disease, believe in your ability to make a significant improvement, and have enough patience and dedication to achieve positive results.

Sometimes the only way to deal with stress is to find humor in one’s situation. When it comes to dealing with dementia, a smile often works better than words. Humor and light-heartedness are often the best medicine for the stress the disease brings to you and the person you’re caring for. The phrase, Humor is The Best Medicine has a lot to be said for it.

Who Can Benefit?

Whether you utilize the services of a professional caregiver or shoulder the burden yourself, this book is essential in providing the most appropriate caregiving plan, including helping you select the most effective caregiver for your loved one. This book provides easy to understand and apply activities utilizing readily available materials. Seventy percent of the 5.3 million Americans with Alzheimer’s disease are cared for at home.

Caregivers providing care for their loved one at home

This book is written to be used by the caregiver who does not have a professional caregiving background. The documentation forms are designed to assist you in collecting useful data about the individual you are caring for, without burdening you with complex guidelines for professional caregivers.

Furthermore, when considering residential care, you will know how to assess the treatment program and gain understanding of the basics of a successful activities program.

Friends and Family Members

I would advise anyone who plans to visit a person with dementia regularly to read this book so they can help contribute to the success of his/her activities program. It will even help occasional visitors spend quality time when visiting. The activity program provides guidelines to successful communication skills and techniques that help repair your relationship with the person you’re caring for. Understanding the concepts, tools and techniques will make you feel more comfortable visiting a friend or relative with dementia.

Professional caregivers

As a professional caregiver, you will gain insight by reading actual case studies on how I work with my clients. You will learn new methodologies and concepts that have worked with hundreds of persons in all stages of the disease. Understanding the principles behind the design of these activities will complement and add to your own techniques, tools and activities.

As you read through the chapters of this book, you will be reminded of how important it is to show respect and love to the person suffering from this disease.

I will dedicate Chapter 1 to understanding Alzheimer’s disease because one’s loss of memory can infiltrate every other emotional and low function ability.

Hope is the Power of Life

&

Fuel for our Dreams

• When we bring sunshine into lives of others, we are warmed by it ourselves.

• Walk through the light and darkness of their experience.

• We must take care of our children for they have a long way to go.

• We must take care of the elders for they have come a long way.

• We must take care of the in-between for they are doing much work.

• Listen completely to their stories; they need to be told.

• When an elder dies it is as if a library has burned.

• A person is only dead when no one calls their name.

• When we stand tall, we are standing on the shoulders of our ancestors.

Chapter 1

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Understanding Alzheimer’s Disease and Its Devastating Effects

Life’s Journey

Do not set your goals by what other people deem important.

Only you know what is best for you.

Do not take for granted the things closest to your heart.

Cling to them as you would your life, for without them, life is meaningless.

Do not let your life slip through your fingers by living in the past nor for the future.

By living your life one day at a time, you live all of the days of your life.

Do not give up when you still have something to give.

To be without hope is to be without purpose.

Nothing is really over until the moment you stop trying.

It is a fragile thread that binds us to each other.

Do not shut love out of your life.

The quickest way to receive love is to give love.

Understanding the Changes

When I began to compile information for this book several years ago, I came across this article authored by Tim Brennan. His account of how Alzheimer’s disease had impacted his life was so eloquent. I truly felt I could not have said it any better. Many people with Alzheimer’s and their caregivers have had similar experiences.

Excerpts from an article written by Tim Brennan in the Detroit News, March 26th, 1995

Sixteen months ago, I was diagnosed as having Alzheimer’s disease. Prior to the diagnosis, my wife and I went from one doctor to another, searching for answers to the mind-related problems I was experiencing. During this search, frequently I would ask myself: Are you crazy or what?

During the early onset of Alzheimer’s, it is extremely difficult for a doctor to properly diagnose the disease. It is also hard for the person to describe all the symptoms he or she may be experiencing, because we don’t know what to look for to tell the doctor.

If you have the flu, often you will tell the doctor about the accompanying cold, chills and fever. The dementia problems I initially experienced included forgetfulness, errors with simple math, misspelling and mispronunciation of words once commonly used and loss of balance, among other difficulties. I don’t know if I told the doctor of all the symptoms I was having at the time. I just thought I was probably crazy.

It was not easy to accept the doctor saying: You have Alzheimer’s disease. My wife and I cried and held each other for a long time following this revelation.

You see, there is no cure for this disease. No miracle drugs are available to stop or slow down its progress. No operation can be scheduled to cut out the parts, helping to heal the good ones that are left.

We both knew, without a word being spoken, that the doctor had just given me a death sentence, with no possibility of a last-minute reprieve.

For a while after the diagnosis, I had to tell myself I had Alzheimer’s quite often in order to accept the fact my life had to change. Like the opening line from an AA meeting: Hello, my name is Joe and I am an alcoholic, the first step toward making necessary life-style changes were, for me, to accept what I had as a problem or a condition. With Alzheimer’s, I slowly learned and grew to accept change as being a necessary response to a gradually deteriorating brain.

At first, I learned I could no longer hold a full-time job. I love to work, and this change was difficult to accept. I then tried to put in a couple of hours a week of volunteer work and found out, each time, that it would take me a day and a half or more to recover mentally from the effort.

My mind was and is continuing to slowly leave me and each time something was lost, such as handwriting ability, shoelace tying or the memories of people and/or events; it set the stage for additional changes to be made with my life. Life is interactive.

Alzheimer’s disease also required my wife to adjust her life to the changes in my life. As time went by, I could no longer grocery shop, so she assumed this duty. Eventually, she had to take over as the household finance manager and appointment maker. We no longer go to dances or to concerts together.

Whenever we are out together, she drives. The chores I am left to do around the house are simple and can be deferred, if necessary.

Our life is one of, more or less, constant change. My life has to be downsized each time further deterioration becomes evident and my wife adjusts to these changes with those required on her part. Things are much harder on my wife, who is my caregiver and mate for life. She sees the changes that Alzheimer’s disease has brought about. She responds with love and understanding. Yet I know she has cried when no one else was nearby. She prays and I pray and this seems to help.

Our relationship is evolving. I am becoming more dependent. I don’t want this to happen, but there is no choice. Slowly, I am becoming more of a child. My wife, in turn, makes more and more decisions about our life. We still interact, but my share of our adult relationship is gradually going away.

Still, there is much hope. As losses