One of the challenges of dementia engagement is focusing on what an individual can still do instead of what they can no longer do.
Creating engagement and programming around the resident’s desire is at the core of person centered care, but to be successful, it needs to take into account the kinds of tasks they can perform. Taking into account two components: who the person is (preferences, interests) and their cognitive ability, is what makes engagement and programming successful.
There are numerous ways of assessing a resident’s skills. A widely accepted tool is the Global Deterioration Scale (GDS). Although its performance has been questioned, especially in the late stages of dementia, it is one of the tools that can still guide quality and person centered engagement.
Here is how a tool, such as the GDS scale can be applied based on how the resident performs in the assessment.
Higher functioning (score of 1-3)
The person who scores in this category can participate in large groups (6 to 20 residents at a time) for longer periods of time. There doesn’t need to be more than one staff member present and there can be some level of distraction.
Middle functioning (score of 4-5)
The person who scores in this category can participate in medium size groups. The pace should be constant and the time frame should be slightly shorter than the higher functioning residents; no more than 45 minutes. Staff needs to be more involved with guidance and cuing. Distractions should be kept to a minimum.
Low functioning (score of 6-7)
The person who scores in this category will most likely have poor performance in large and medium sized groups and should be limited to 2 or 3 residents at the most. The session should last no more than 15 minutes and will require both verbal and physical cues. Sensory based programs are likely to be more successful.
Understanding what category the residents that are being served fall under in the GDS assessment can guide programming and engagement by helping to determine appropriate activities, the size of the groups and also staffing, resulting in more successful residents and staff!
