Activity on the wards older adults edit 2011 (1)

The therapeutic use of activity

Is complex, with the same activity being used for diverse purposes in differing contexts. It may:

- develop a skill;- clarify a relationship;- create an end product.

To be of value, the activity must be selected to suit the individual’s needs, skills and readiness in relation to their stage of life and social and cultural values.

Why do people “do”?

Goal oriented – means to an end Purposeful – has an end in itself Meaningful – has cultural, social,

symbolic, emotional relevance Engages interest, concentration and

capacity

Some service user views of their experiences:

“ Some of the things we do and benefit from, such as music or singing, have no tangible benefit but leave us feeling invigorated and happy.”

“Doing things increases our sense of self worth. If we have nothing to do then we can become very isolated and this works against us”.

“it may help us to laugh and enjoy ourselves”

Activity?

Some service user views of their experiences: - on occupation and activity

“it may help us to laugh and enjoy ourselves but equally it may help us create an ordinary routine, which may seem simple but is a big step for some of us. For others it can give us the skills and motivation to look for paid employment. It can also help us with our feelings”;

“It can open up new opportunities by exposing us to new situations and help us find a voice and means of self-expression that we lost when we became ill.”

Some service user views of their experiences:

“What do we mean by occupation?

Occupation had many meanings for us. Being occupied can keep us well especially when we feel that what we have done is productive. Achieving something can prevent illness. If we do things with no end result then we can feel that what we are doing is done in vain and may question why we did it in the first place.”

from Recovering Ordinary Lives (2006) C.O.T. - service user consultation

“It is also important that it strikes a balance between helping us regain the ability to resume the skills of everyday living without us feeling that we are being patronised or asked to do tasks that are over-simplistic. This needs to be matched with helping us to do things that we can succeed at and yet at the same time not creating a pressure to succeed that we can’t live up to.”

In short – activity can be:

Mitigating/protective - impact of hospitalisation and associated experience

Preventative – from further damage to identity, esteem, hope

Maintaining – skills and valued roles

Restorative – recovering occupational performance and health

Activity? Or occupation?

Activity…

any mental or physical action that is performed voluntarily and directed towards a goal or end result;

The value that an individual ascribes to an activity influences her/his commitment to spend time on it

Activity meets basic needs, enables self-expression, may give pleasure or ensure comfort, enables relationships with others, encourages adaptive behaviour, meets specific objectives fosters active involvement by the individual in

addressing her/his specific problems and needs.

the essential elements of ‘occupation’:

It is culturally, temporally and ecologically contextualised,

it has a purpose or goal which may differ from received cultural ideas of its purpose.

It is understood to be subjectively experienced and the product of human capabilities.

Building towards occupation

Skills

Tasks

Activities

Occupations

If you observe a really happy man, you will find him building a boat, writing a symphony, educating his son, growing double dahlias in his garden, or looking for dinosaur eggs in the Gobi desert. He will not be searching for happiness as if it were a collar button that has rolled under a radiator.

W Beran Wolfe

Boredom….the enemy of therapeutic

experience?

What’s OK about boredom?

What’s problematic boredom?

Can we banish boredom from our units?

People experience boredom for different reasons…

External causes: Inadequately stimulating situations Inadequately stimulating environments

Internal causes: Some are skilled enough not to be bored whatever the

circumstances Others do not have the skills so may be bored whatever the

situation or environment.

We can do our best to diminish boredom by…

Assessing if someone has regular and on-going problems with boredom and involve an occupational therapist to help them develop skills to address this

Learn more about people who are seldom bored and share this information (understanding ‘flow’ experiences).

A continuum of “just right challenge”

challenge

skill

There are shortcuts to happiness, and dancing is one of them.

Vicki Baum

Three grand essentials to happiness in this life are something to do, something to love, and something to hope for. Joseph Addison