The Memory Unit OT

When working with individuals with dementia or other neurocognitive disorders, providing autonomy for them within their daily routine is a crucial part of promoting their quality of life. But how do we effectively execute this while also keeping them healthy and safe? We know that we can’t give them complete autonomy and freedom to make all their own decisions. After all, they are in our care because their brains have changed with the disease process, and they need our assistance when making those critical safety decisions.

My Top Tip: Identify the tasks you can give autonomy in, and prioritize those within the daily routine.

These tasks will be different for each individual, and should in some ways reflect the aspects of their functional routines that are most meaningful to them. You might have one resident who has always really loved to wear beautiful clothing. You may have another resident who would always make the dinner plans for his family and he really enjoys choosing his own food. Use your Occupational Profile skills to help you in this process. Then, provide ‘this or that’ options within your resident’s routine.

Let’s look at a practical example: You’re seeing a resident for ADL routine development. She frequently refuses bathing in the morning, but is agreeable to getting dressed. Instead of using language like “Are you ready to get washed?” or “When do you want to take a shower?”, give her autonomy by allowing her to select an outfit from 2 or 3 options and then say something like, “Now that you’ve picked an outfit, let’s go into the bathroom to wash and put this beautiful outfit on”.

By using language like this, you’re allowing your resident to have autonomy within her own routine, but you’re also providing the assistance she needs to maintain safe and appropriate hygiene to prevent infection and skin breakdown.

Simple language swaps with some structured autonomy thrown in is usually a highly effective strategy to improve compliance with care and maximize quality of life.