Category: For Recreation Staff

Dr. El’s Theory of Angry Activities

Posted by Dr. El - July 19, 2018 - Depression/Mental illness/Substance Abuse, For Fun, For Recreation Staff, McKnight's Long-Term Care News, Resident care, Stress/Crisis management, Tips for gifts, visits

Here’s my latest article on McKnight’s Long-Term Care News:

Dr. El’s Theory of Angry Activities

“Scream as loud as you can,” I encouraged my companions before we plunged down the waterslide in our rubber raft at the water park on Independence Day. “There aren’t enough opportunities for yelling in everyday life. Let’s make the most of it while it’s socially acceptable.” The shouts of our foursome pierced the air as we flew down the steep slopes and then dissolved into laughter as we splashed to a halt at the bottom of the ride. “That was great!” we all agreed.

Our residents tend to be stressed out. At a minimum, they’ve suffered debilitating and often sudden physical losses, they’re living 24/7 in a communal environment and they have to rely for assistance on helpers they’re sharing with other people. Add to this unfamiliar food, financial stressors, physical separation from their homes and family and worries about the future.

Is there any one of us who wouldn’t be angry about something in that situation? Yet we as organizations strive to have units filled with residents without “behaviors.”

I’m not suggesting nightly “primal scream” sessions, but we could add into the rotation some activities where residents get to be “bad,” or at least aren’t expected to be so darn good all the time.

For example, I used to counsel a 100-year old woman, Claire, whose active life had slowed to a crawl due to age, arthritis and other maladies. She often let out her frustrations by making sarcastic comments to her aides and other residents, which led to conflicts.

To help her blow off steam, as we talked, we slowly set up dominoes in a circuitous row on a table. When the domino chain was completed, I’d give her the signal and she’d gently push the first domino over with one arthritic finger and watch with glee as the whole chain loudly self-destructed. On some days, Claire was particularly “bad” and didn’t wait for the signal. This activity allowed her to be “good” bad and her sarcasm diminished.

For the entire article, visit:

Dr. El’s Theory of Angry Activities

Creative activities for residents with dementia (McKnight’s LTC News)

Posted by Dr. El - October 3, 2014 - Dementia, For Recreation Staff, McKnight's Long-Term Care News, Something Good About Nursing Homes

Here’s my latest article on McKnight’s Long-Term Care News:

Creative activities for residents with dementia

Greetings from Montana! I was in Billings last week conducting a training session for the Montana Department of Health. An enthusiastic group of over 100 LTC staff members from various departments joined the discussion and I came away with some excellent suggestions on how to engage residents with dementia.

The subject of how to best provide care for people with dementia without using antipsychotic medications was a particularly hot one at the conference. As well it should have been.

The topic is particularly timely given that CMS has increased its antipsychotic reduction goal from 15% (below 2011 levels) this year to 25% next year and 30% below for 2016. As G. Allen Power, MD, pointed out in his recent McKnight’s article, antipsychotic medication reduction should be preceded by educating staff members about alternatives to medication.

One important alternative is offering activities that enrich the lives of people with dementia so that they’re engaged in positive pursuits that build on remaining strengths.

Many participants in the Montana training were from the recreation/activities/life enrichment departments and they shared some great ideas they’ve successfully used to engage residents with dementia. These include:

Off-campus trips to a variety of locations, including many of the scenic outdoor attractions in Montana. “A lot of work, but worth it!”
A “whack-a-mole” game where residents use water pistols to shoot down plastic cups decorated as moles. A game such as this allows residents to release anger in a healthy, socially acceptable manner. (It was suggested that since I’m from New York City, we use a “whack-a-rat” version, but I think New Yorkers might enjoy “whack-a-pigeon.” Pigeons, or “flying rats,” as some people refer to them, are much more ubiquitous and annoying but get less media attention.)