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Stand Tall Don’t Fall
A program developed for residents who have severe dementia and are unable to participate in traditional exercise programs
Individualised functional exercise
Facilitated by Occupational Therapist
Evidence based and assessed
Functional Exercises
They focus on building a body capable of doing real-life activities in real-life positions, not just lifting a certain amount of weight in an idealized posture created by a gym machine.
“The key to functional exercise is integration. It's about teaching all the muscles to work together rather than isolating them to work independently." Greg Roskopf, MS, a biomechanics consultant
Why?
Traditional exercise class did not work
Increasing number of falls as disease progresses
Engagement difficulties
A new way had to be found
Process
Think tank – clinical staff, leisure and lifestyle staff, occupational therapist
Literary search – most if not all concentrated on time limited traditional exercise regime
Program designed with functional exercise both group and individual
Funding application successful through Medicare Local
The Program
Took place in Palm Court: 14 bed secure unit
Led by OT but strong involvement from LLM
5 days per week
2 groups (1 of 4: 1of 5)
4 individuals
A4 pictorial program developed for all residents
Total dedicated staff time of 10 -12hrs per week over 8 weeks
Before Commencement
Cohorts and friendship groups were carefully chosen
All participants had to have a high falls risk assessment
And a moderate to severe rating score on PAS
And of course had to be mobile
Letter and consent was sent to each family or EPOA – none withheld
So what does that mean in Palm Court?
Bed Making
Folding Linen
Cooking
Shopping
Setting and Clearing Tables
Gardening
Dusting
Tidying up
Chopping
Walking
Sweeping
Flower Arranging
Sewing
VALUE
The one thing all of these ‘exercises’ have in common is
that are valued jobs and a normal part of everyday life
Measurement
Falls
Aggressive incidents
Sleep patterns
Family feedback
Resident mood
Resident engagement
Data
Results Table Results Table
Alzheimer’s Queensland, 1800 639 331
Agg Falls
Before 9 11
During 4 5
5 6
Decrease 66% 65%
0
5
10
15
Before
During
Family Members
Thrilled
Comments ranged from ‘amazing’ to ‘life changing’
No negative feedback or comments
Residents family were asked to participate wherever possible e.g. shopping, cooking
Anecdotal reports of improved sleep patterns
Residents
Joyous
Ambience in Palm Court uplifted
Engaged
Responding
More eye contact
More socially aware
More restful when quiet
Alzheimer’s Queensland, 1800 639 331
Barriers
Nursing staff were and are the biggest barrier
No clear data for mood or engagement – ( dementia mapping )
Time and resources to keep program going
Initial cohorts and grouping were artificial and broke down quickly and were really only used for financial purposes
Staff need to think on their feet to adapt o changing capabilities of participants
Positives
Obvious positive resident outcomes
Staff were re energised
Promoted flexible thinking and engagement by all team members especially in daily tasks
Family engagement
Moved away from ‘routine’
Non traditional approach less warehouse more funhouse
47 Tryon St, Upper Mount Gravatt, QLD 4122,Ph: 07 3422 3000, Fax: 07 3343 2557
email: [email protected]: http://www.alzheimersonline.org
Helpline Freecall 24hours: 1800 639 331
Alzheimer’s Queensland