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CREATING THEMED BOXES, MEMORY BOXES AND THEMED TRUNKS Creating Themed Boxes, Memory Boxes or Themed Trunks is a very important if not essential component of dementia programming in the long term care setting. The reminisce and sensory stimulation program may be conducted in a group setting or provided to clients individually or as part of your self recreation program. There are many benefits to your clients when the program is implemented correctly. It is important that your staff is trained in reminiscing and sensory stimulation. The staff should also understand the benefits of the program. If you don’t currently have a policy and procedure for remising and sensory stimulation, it is recommended that policy and procedure is developed and implemented. Why is Reminiscing and Sensory Stimulation important? There are so many articles and research solely devoted to this question. Some of the most common benefits cited in the articles are: For the resident there are many benefits:
There are many benefits to care staff as well:
After attending a reminisce program, residents may be more apt to participate in creative programs such as art, painting, drawing, poetry, story telling, singing, music, scrap booking or dancing. How often should sensory programs be held? It is recommended that they be held at least twice a week but obviously the benefits are so numerous that there could be a program offered daily. How long should the program last? The program should last about 45 minutes, however if everyone is responding well continue with the program. What time of day is good for this program? It is recommended that this program is planned after lunch. This is a time when the residents are more relaxed and less stressed. In the morning, just the act of getting dressed can be very stressful. Additionally, many times the day room is also the dining room. When held in the afternoon, you have the option of continuing a program with no time restraints because of other functions. What types of sensory programs should be offered? Sensory enrichment programs have many forms such as:
How to get started in creating themed boxes? It is recommended you meet with your staff. Explain the program and provide the staff with some suggestions or themes. Ask each staff member to create 4 theme boxes for a specific month that are seasonal and related to the month. Give the staff a week to think about ideas and report back their ideas at the next meeting. Each staff member should create 4 themed boxes with 6 to 10 tactile items, as well as at least one other item for the other senses. Provide the staff with plastic rectangle Tupperware boxes and lids that can be purchased at the dollar store. Provide a black magic marker to write the name of the theme on the container. Provide funds for the staff to purchase the items. They would only need a few dollars for each container. This type of program involves all of your staff and utilizes one of the most unique traits found in activity professionals and recreation therapists and that’s “creativity.” Where to purchase the items: The items can be purchased at thrift shops, garage sales, dollar stores and job lot stores. Place a sign in the staff lounge as well and specifically list what items you are seeking for a specific month. You can also solicit donations from families. Place a Want Ad column in your facility newspaper and explain your new program and list the types of items you are seeking. You might be surprised and have families who really want to get involved and might even volunteer to present their own themed boxes. When residents are discharged, families might be interested in signing out a specific theme box to use at home. Especially if they saw positive feedback from their loved one when in the program. This is a fantastic way to demonstrate your level of compassion and commitment to your residents. Make a list of all the theme boxes you have available. To see a sample letter sent to families see http://ezinearticles.com/?SOS-Success-Oriented-Sensory-Stimulation,-Kits-and-Theme&... One facility, also assigned themes to each department that were related to their function. For example, dietary was asked to come up with two ideas. One was on items used for cooking. Another was items used for washing dishes. This was an excellent way to get the whole building involved. It’s important that you give written detailed instructions to the departments so that the department heads clearly understand what the program is and how to design themed boxes. Provide an example, such as a theme box called Baseball which would include a baseball, baseball diamond, uniform, cleats, etc. You could also put up a wish list in the employee lounge of specific items you are seeking. For example, your theme might be “babies”. You could list, baby blanket, baby lotion, baby power, new born diapers and clothes, pacifier, etc. When creating the memory kits keep the following in mind:
To provide an interesting visual to your program, purchase an old trunk. Before beginning your program, transfer the items into the old trunk. This will really peak their curiosity rather than walking in with a plastic Tupper ware container. You can purchase small old trunks at thrift shops, garage sales and antique shops. Be sure to clean the trunk and make sure it’s safe and won’t close on any ones hands. Have your maintenance department check your hinges. Provide interesting theme names on the calendar for your theme boxes, such as a Day at The Beach, Blue Sunday (Blue Colors) or Famous Sweethearts. This article is intended for those residents in later states of dementia; however this program could be adapted and called “Guess what’s In the Trunk”, and used with your highest functioning resident’s. You would give clues until they guessed each item. How Do I Conduct the Program? It’s important to have not only visual items but something to taste or smell related to your theme. For example, if you were going to discuss a Picnic, you would not only have items in the picnic basket but also Ice Tea for taste. To make this program even more unique, try incorporating music or a song related to your theme. For example, if you were doing a day at the beach as your sensory theme you could use a Beach Boys Song. Prepare about 20 questions ahead of time related to the theme kit. Once you are finished with the questions, place those questions back in the kit for the next therapist or activity professional to use. Try to use what, where, when and why questions. If you get a response, ask, “Tell me more.” To begin this program, place the residents around a large table. Introduce the residents to each other and to you the facilitator. Explain the theme you will be discussing. Begin bringing the items out one by one and discussing what each item is. Have each resident touch the items. Ask for input from each resident. Place each of these items on the table. Each response will be different for each resident and their responses are neither right nor wrong. The goal is to prompt a response, emotion or memory. Knowing the residents strengths and past history may also be away of opening the discussion. There are times when the group members may be shy. You could begin, for example when using a “Teacher’s Kit”, sensory program, “Mr. Smith I heard you were a great history teacher, what do you think of this text book.” Give everyone an opportunity to respond. Remember, a dementia resident needs time to process what you have just asked. Ask one question at a time and wait for a response, even if the silence seems uncomfortable. If you do not get a response, thank the resident for trying. Some residents input may be a simple one word answer while others may give you several sentences. However detailed or fleeting, all of their thoughts and input are to be valued. (Coaten, 2001, pg 20) Don’t rush the resident. Give the residents ample time to express themselves as they are searching for their words. Be aware of their gestures, facial expressions and body movements as these are non verbal cues to what they are trying to express. If you have a white board, write down their responses and at the end of the session incorporate their responses into a story. You could then publish your story in the facility newsletter. Sometimes the reminiscing or tool kit may elicit an emotional response, such as sad or tearfulness. This is not a bad thing as long as the resident is not a danger to himself or others. It’s ok to ask the person why they are sad. All feelings that are experienced during a reminisce session are valid and important. Next provide something to eat, drink or smell that is related to the theme. Be careful if using liquid aroma therapy as the concentrated liquid should not be placed directly on the skin. In closing a reminisce group, try to use a song related to the theme as music can uplift the spirit. Always thank the participants for coming to the program. Explain what they will be doing next. This program may also be used “one on one” or incorporated into your room visits program. There are endless possibilities for themed boxes, memory boxes and memory trunks. Kits could be developed based on holidays, colors, themes, resident’s interests, cultures, hobbies, items from the past, work experience, pets, children, religions, countries, horticulture, etc. See the link provided in this article for West Virginia Activity Association and Nova Scotia Recreation Professionals Newsletters for specific supplies. The kits that are developed should use all of their senses which includes; Kinesthetic (Movement), Visual (Sight), Auditory (Sound), Tactile (Touch), Olfactory (Smell) and Gustatory (Taste). As you develop your kits, try to keep this in mind when collecting items. Some kit ideas to consider are: Life Roles Kits: Mother, Father, Daughter, Grandparent, Best Friend The Activity Director should provide an in-service to the CNA’s and explain how they are used as well as conducting a program. This will help the CNA to be more comfortable with reminiscing and memory kits. Once you have developed the sensory kits, they can be used as a last minute program by the nursing assistants should your activity staff not be available due to illness. Another sensory program is creating a very large mural that the residents would work on daily until the mural is completed. Start by going to your local newspaper and ask for a donation of print paper. They generally will donate this but may ask for a small fee. Place the paper on the entire wall. Most cities have a teacher store. Purchase a pretty border and place the border around the paper. Be sure to use adult themes. At the teacher stores you can purchase adult coloring books. The internet has endless possibilities for pictures to download. Create a mural based on the season. For example, a February mural might depict a winter forest scene which would have ever greens, pine trees, snow, cardinals, deer, pine cones, winter berry bushes. Begin by finding pictures of ever green trees and copying onto transparency and blowing up the picture on your over head projector. ACE Moore Store sells projectors in their art department. Now trace the picture onto the large mural paper. Each day, provide a picture for the residents to paint and cut the picture out and glue onto the mural. Try to use actual sizes of the item you are painting. Again the ideas are endless, from a day at the beach, to picnics, state fairs, oceans, marinas, flower garden, farming, etc. The residents will take a lot of pride in creating this gorgeous mural. Again, be careful that the mural is not child like. The mural will provide hours of discussion, reminiscing and enjoyment. “Someone with dementia they may only give you a small piece of themselves-all there is, and is enough at that moment. That small piece is precious and may become a strand or thread woven into your life as well. The fragments may, like the creation of a mosaic, gradually be pieced together and something new is created (Coaten, 2001 pg 21)”.
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