MEANINGful Engagement more than Busywork, Entertainment or Activity Attendance

A friend of mine spent time with her sister’s mother-in-law Maria who has dementia for an evening of respite for her sister and brother-in-law. My friend was told if she ran out of things to do to have Maria just sort buttons. Well, they got to the sorting buttons point and it began by sorting the buttons by size and then my friend suggested maybe sorting by color. And then, et this, Maria, who has dementia, said, “Who told us to sort these buttons?” “Your son.” To which Maria responded, “Well, he can sort his own damn buttons.” Her quote, not mine. When people use swear words, it holds emotion and shows us they mean what they say.

One-time well-meaning professionals gave towels to a woman with dementia to fold. After folding them they thanked her, hid somewhere to mess up the towels and then brought them back asking if she would like to fold these towels. Her response? “I just folded those damn towels.” Her quote, not mine and there it is again. Swear words reveal high emotion. Notice, she knew. Naomi Feil, developer of The Validation Method®, studied the works of known psychologists who discovered that we all have various levels of consciousness and in other words people with dementia know. They know their mom died, they know they just folded those towels, and they know sorting buttons for no reason when they see it. Where did the notion come “Oh, they have dementia, they’re confused, they don’t know”…?

Dr. Joanna Fix, a beautiful woman with a PhD in Psychology and former college professor because she lives with young onset Alzheimer’s disease also confirmed this during the 2023 Validation World Congress. She says, “I don’t want to be lied to. I mean, who wants to be lied to? WE WILL KNOW. WE ALWAYS KNOW. Please be transparent with us.”

Some people enjoy entertainment at times, we all do. But do we want it to be the main focus?

Ask people, What brings you meaning? Meaning is in the regulations, not entertainment. Meaning is one of the seven domains of the Eden Alternative? and part of Tag 679 Activities in the INTENT.

Ask people what brings them meaning/what meaningful engagement to them is. We could have fun naming it MEANINGful Engagement. The point is meaning and engagement. Let us no longer be guilty of jut taking a person to some group and yet the person is never engaged with. That is only a checkmark on our lists, don’t let that happen to you, don’t let that happen to that beautiful person.

One group of people living at a nursing home had Crafts on the calendar once a week. They ended up saying to each other and the activity professionals, “Why are we making crafts for ourselves?” They turned this event into Project Club and chose to do for others instead of for themselves and no longer just crafts. They help any team in the nursing home with anything such as stuffing folders for education, filling goodie bags for kids who come to the nursing home, care packages for volunteers. They fold bulletins for a nearby church. They want to serve others more than make crafts for themselves.

Ask people and offer more meaningful engagement than simply attendance at a group. It cannot be about that anymore. At CMS Tag 679 Activities, attendance at groups is not the focus. And, we cannot let a person’s identity become whether or not they attend group activities. Do not let this be the focus of care plans: Resident refuses activities. That is not the point. The point of this regulation is INTERESTS. I recommend care planning that first. Then let the INTENT guide you next with the seven domains of wellbeing…

INTERESTS: What are your interests?

MEANING/MEANINGFUL ENGAGEMENT: What brings you meaning?

IDENTITY: What have we missed about you that is unique to you/your identity?

GROWTH: How would you like to continue to grow?

AUTONOMY: What choices are important to you to be able to make to support your autonomy?

CONNECTEDNESS: With whom and what do you want to be connected and how can we help make that happen?

SECURITY: What do you need to feel secure here?

JOY: What brings you joy?

I can’t just talk about one of the seven domains without talking about all of them. Many earlier articles address each of the domains in more detail. Bring these to your team, lead a team-wide effort, and you are backed by regulation. How would you feel if you were asked these MEANINGful questions if you were moving into a nursing home or assisted living? If you represent assisted living, lean on these good federal regulations as standards of practice, you’ll be glad you did.

P.S. What brings you joy?

Carmen Bowman, MHS, Regulator turned Educator of Edu-Catering: Catering Education for Compliance and Changing Institutional Culture is an activities/engagement/community life, regulatory compliance and culture change consultant.  She offers new or not-yet-qualified activity director consultation and personalized continuing education for professionals/teams/associations. At www.edu-catering.com join The Be Encouraged Blog, Become a Leader of Normal Life with the eResource GUARDIANS OF NORMAL LIFE: How Activity/ Recreation/ Engagement/Community Life Professionals can Save the World of LTC and share with your team the eBook Individualizing Medication Administration using Regulations. At the Edu-Catering YouTube channel, see the documentary that highlights the seven domains of wellbeing: Mission at Castle Rock Wyoming Culture Change Video 2023.