How to Offer Engagement Opportunities that Engage Us Both
by Teepa Snow, MS, OTR/L, FAOTA
A reality for many people is that as dementia advances, all available resources are focused on care provision, self-care tasks and supplies, and the basics of survival. Fiscal and time funds are devoted to simply getting through another day. It is not uncommon for care providers to feel that they have little or no time to spend doing something that is fun or interesting, when simply getting done what needs to be done seems to fill each waking hour.
When this happens, the moments of joy in being together or in finding purpose or value can all but disappear, leaving everyone involved feeling depleted and empty. But it does not need to be this way, and in fact, should not be allowed to be this way. If there is no joy in living then why keep doing it? If you can’t find purpose in being present and engaging, then why show up? The interesting thing is that it does not have to be expensive or time consuming to change this dynamic and stimulate brains and abilities with just a kick start or two.
It all starts with a decision to focus on the person first and your relationship with them. Greeting prior to treating is a phrase I use to describe the time I spend getting connected to someone prior to starting with an agenda or task. To me, it represents some of the most important moments I will spend with someone. Much as we take vital signs to determine physical well-being, assessing the human being that you will be providing intimate care for should involve an introduction, an opportunity to respond, a chance for that person to let me know what is liked or not liked, and what is preferred or interesting.
Taking a few seconds or minutes to notice where a gaze shifts, what draws the eyes, what turns a head or causes lip or tongue movement, what prompts a nose twitch, a body movement, a vocalization, or change in breathing. This can provide me with much needed data and input about what should happen next and what still matters to the person.
Sometimes it is a stilling or hesitation that signals a spark and an opportunity. Other times it is a change in intensity, frequency, or volume, or a response that helps me decide which direction to take. Once I have established some communication link, then the dance can begin. Sometimes it is a literal dance, other times, it is simply a give and take of showing, telling, and touching. For some people it may involve objects or props, for others it may involve sounds, rhythms, or music, and yet others may be more about what aromas or tastes are offered and taken.
Try one of these attention getters, and see what happens:
- Simply sit down at a tabletop for a minute and open up a section of newspaper. Start tearing it in strips from top to bottom, and then ask someone else to help you with this project. The grain of the newspaper goes top to bottom and the strips offer a satisfying sound. It also fosters bilateral arm action and finger skill use. Thank the person for their help and then begin to gather up the strips and twist a batch together or fold them into small packets. Ask for help once again, and see if the person will work with you for a few minutes. Offer thanks for the effort, if nothing else.
- Sit down with a list of ten of something (flowers, birds, sports teams, tools, or colors) and a pile of letter tiles from a Scrabble™ or Bananagram™ game and begin turning letters upright and lining them up. Then ask the person to help you. To help you turn them over, to find a single letter or a set of letters to create the words on your list, to create a crossword puzzle alignment, to help come up with clues. Maybe nothing will happen, but maybe someone will begin looking at letters, touching or moving letters, or even creating a word on their own. You will never know what is possible, if you don’t provide the opportunity.
- Sit down at a tabletop with a couple sets of chopsticks and your smart phone or a CD player, or a list of songs. Use your chopsticks to offer a rhythm and a beat. Begin to hum a song, then add the rhythm with the chopsticks. Play along with a song or just offer a beat. Then offer the other person a chop stick or two and see where it takes you. Switch to conducting, if the sound is too much for either of you.
- Find a coupon circular and use a marker to draw in the cut lines. Sit down with blunt tipped and short length scissors and talk about clipping coupons and what is on sale as you do it, show the other person some of the coupons to be clipped. Consider having them clip along with you, or offer them the scissors to take over the task, or have them lay their hand over your wrist to follow along. If cutting out coupons is not of interest, how about sorting or stacking them.
- Greet your dance partner and move yourselves to a different place or space, outside or to another room. Admire something you find there. What is seen, heard, felt, or smelled. Sit in stillness and appreciation for the stillness for just a minute or two. Thank the person for being with you and spending their time with you. Finish it off with an offer of a hug, a heartfelt handshake, or shoulder rub.
None of these activities would need to take more than 3-5 minutes, although it might be surprising to notice that once engaged in some of these opportunities, more time passes than you realized. Simply giving ourselves permission to try something outside of our routine or care flow can open windows or doors between us. It might surprise us both, to realize how much we needed these moments to figure out how much we miss when we don’t make the effort to find our moments of playfulness and joy in being with one another. It doesn’t actually have to cost much to find great value in what happens between us.