Building on a Firm Foundation – The Activity Assessment

A few years ago, while attending a conference, I had a conversation with several attendees about the Activity Assessment. One Activity Director remarked, “I don’t waste my time writing a thorough assessment. No one pays attention to it, so what’s the point?”

When I first started in the activity profession, I experienced a moment that shaped my entire approach. A resident passed away, and when I read her obituary, I learned things about her that I had never known. That moment was a turning point for me. I made a personal commitment to gather as much information as possible about the residents in my care. I never wanted to learn about them through an obituary again.

In response to that Activity Director, I said, “I don’t write assessments for other departments. I complete them in detail so I can provide meaningful, person-centered activities for my residents.” If we don’t have detailed information about the people we serve, how can we create truly personalized activities?

For example, if a resident prefers solitude, I need to know what types of activities they might enjoy in their room. Some individuals may seem introverted but still engage in select social groups. I once worked with a medically retired police officer who kept to himself within the facility but remained actively involved with the Fraternal Order of Police (FOP), attending their monthly meetings and special events. Understanding his background allowed us to support his continued participation in a way that was meaningful to him.

Another instance involved a resident who would stay up all night, frequently clearing off the nurses’ station. It turned out that she had been a bartender her entire life—working late hours and keeping an immaculate bar. After learning this from her assessment, we were able to adjust her schedule and provide her with meaningful activities that aligned with her natural routine.

Cultural and language considerations are equally important. One resident’s family insisted that she had spoken English all her life, yet during our assessment, she stared blankly when I asked her questions. After some discussion, her family admitted she had learned English at 19 when she immigrated to the United States. Recognizing that she was reverting to her native language due to Alzheimer’s, we placed bilingual cue cards in her room, helping staff communicate with her effectively.

Religious beliefs also play a crucial role in a resident’s well-being. One woman, married for 76 years, had never owned a television and only listened to Gospel music. When staff took her to a movie screening, she became visibly agitated and started yelling. Once we returned her to her room and played her familiar Christian music, she calmed down immediately. This was a powerful reminder that completing an assessment is not enough—it must be shared with staff to ensure appropriate care and engagement.

Another resident’s assessment revealed a deeply personal trauma. Her family had told us she loved music and socializing, so we assumed she would enjoy group activities. However, each time she attended, she became severely agitated—especially when near male residents or caregivers. Observing this pattern, I asked her son if she had ever been abused. Initially offended, he eventually disclosed that both her father and first husband had been abusive. This knowledge transformed our approach to her care. We ensured that only female staff assisted her and positioned her outside the activity room so she could enjoy the sounds without distress. Her agitation disappeared, and she was able to participate in a way that felt safe and comfortable.

One of the most poignant experiences I had involved a former beautician. She took immense pride in her hair, and as her health declined, her greatest fear was that she wouldn’t be able to maintain it. As she neared the end of her life, she expressed her wish to have her hair washed and styled one final time before her family came to say goodbye. Thanks to the knowledge gained from her assessment, I was able to source a portable sink and water sprayer, ensuring her hair was styled just as she liked. We fulfilled her request on a Friday—she passed away peacefully on Sunday morning.

Yes, assessments take time. Sometimes they require multiple visits or conversations with family members to fill in the gaps. However, the effort we put into gathering this information directly impacts the quality of life for our residents. To build a truly great activity program, we must start with a strong foundation. That foundation is our Activity Assessment.

Tammy Point NAAP Leadership Team