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PreSchool in Alzheimer's Care Center
By Diane Guthrie
(Page 2 of 3)  

Preschool staff presents options to a student to redirect them to another choice when they exhibit undesirable behavior rather than just saying, “No.”  They see caregivers doing this with the Alzheimer’s residents too.

During a two-hour spa activity Dotty Davis-Walsh, Life Enrichment Director, has residents soak their hands in a see-through plastic container of warm, soapy water.  Rocks and shells lie on the bottom to encourage exploration and longer soaking.  Parents of a preschooler use a similar method of placing bath toys in a bathtub to encourage children to extend their soaking time.

The spa activity is disturbed when Bill W., a resident, enters the room. “Get these people out of here,” he says.  He thinks that the table that they are sitting around is his. Davis-Walsh asks a caregiver to direct him out and tell him that she needs five minutes to clear the table.

Davis-Walsh uses redirection to interrupt unwanted behavior.  Sometimes she emulates what a parent might do–offer food to entice a change of behavior.  She keeps three dozen donut holes – chocolate and glazed – on hand.  “If you promise coffee and donuts you better deliver,” she says.

For the noon meal, the preschoolers eat first at the child-sized table. They are served the same food that the residents are.  While they are eating, residents get seated and a nurse dispenses medication to them prior to their meal.

Caregivers offer to help residents that are unable to cut their food.  Several residents wear towel-sized bibs. “This is called a shirt-saver and I’ve got it on,” says Arlene, pointing at her bib.

When residents get up to leave their table, those that use walkers search for theirs.  Arlene attempts to take another person’s walker.  Diana Warren, a caregiver, intervenes. “This is Juanita’s.  Yours is green; hers is blue.”  Warren playfully refers to the walkers as automobiles. Arlene’s is new and fancy and she calls it a “Cadillac.”  To a resident nearby she refers to his as a “Ford truck.”

In the early afternoon, the preschoolers sleep on mats on the floor of their room.  The room has windows on three sides so during naptime, shades are pulled down to darken it.  The rest of the time, the shades are up and people can observe the children through the windows.  Residents notice when the children are gone.  During the week the Preschool had off for the Christmas holiday, residents kept asking caregivers where the children were.

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