ABC’s of OT: achieving a functional ROUTINE within the SNF

Personally, when my routine has a good flow and rhythm and consistency, my days tend to go much better and my mind feels a lot less cluttered. The same is true for many of our residents. Most of them long for routine as much as we do.

Often, skilled nursing facilities naturally have a flow and routine to them. But sometimes, it can still be challenging for many of our long-term residents to identify and follow a meaningful routine, especially those residents who exhibit progressed dementia.

So how do we help to establish a functional routine for a long-term residents?

I have found a few tricks that have been useful.

1. Ensure that the resident is awake at a reasonable hour (if able). Obviously, we can’t participate in our routine if we aren’t able to stay awake. This means working to ensure that the patient is in bed at a reasonable time, can sleep through the night as much as possible, and is up and out of bed at a reasonable hour. Throughout the rest of OT Month, we will talk more about sleep hygiene our role in improving rest and sleep.

2. Ensure that completion of toileting tasks is consistent. Many of our residents with progressed dementia also deal with incontinence, as well as an inability to indicate the need to initiate a toileting task. Because of this, establishing a prompt-void program (a program in which a patient is brought to the bathroom every 1-2 hours throughout the day) can be incredibly helpful in managing incontinence and thereby maximizing environmental participation.

3. Engage the resident in activities and tasks that are meaningful and engaging. For residents who exhibit progressed dementia, this task might be a simple block stacking task, toy washing activity, or the presentation of a doll or stuffed animal. It doesn’t have to be complex, it just needs to spark joy.

4. Try to establish group activities as much as possible. Humans were made for community, and this doesn’t change in those individuals with dementia. We have the skill set to help identify common ground among residents, empowering and enable them to interact with other residents. Groups can include reminiscence groups, craft groups, knitting circles, music groups, or sensory groups.

5. Keep things as consistent as possible. Older adults with dementia thrive on consistency. So whatever routine you help to establish for your patients, make sure it’s consistent. The use of visual aids and one-on-one staff education can help to maximize carryover of these routines among all nursing shifts.

How do you work to establish functional routine with your patients?

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