The Memory Unit OT

Can we just talk about how the basics can be okay? We don’t always need fancy-pants interventions in order to make a big impact or achieve the outcome measures we want. Sometimes, the simplest of activities can be turned into highly therapeutic strategies. For me, word searches and cross word puzzles are one of those simple activities.

1. Visual Scanning and Visual Perception. Let’s start with the basics of this activity. Strategy: just do the word puzzle. I like to invite patients to work on these with me in a well-lit, minimally distracted environment that they are comfortable in. Then, we just work on the puzzle together. There are tons of free printable word puzzles online, and more often than not skilled nursing settings will keep word puzzle books within the facility for residents to use at their leisure. When I’m using a word search to address visual scanning and perception, I’m highly focused on helping the patient be successful with the task. So I’m giving cues to help with initiation and execution of the activity. There’s no added strengthening or balance component. We’re just sitting together, looking or words in the puzzle.

How to Objectively Document:

• amount of words found within the session; amount of time taken to find a single word; amount of cues provided; observed head movements; observed eye movements; emotional response to the activity

2. Standing Posture and Upper Extremity ROM. You can work on these areas of function using all sorts of activities, but let’s talk specifically about word puzzles. Strategy: complete the puzzle on a vertical surface. Tape it to the wall and have the patient complete it in standing. Address posture and functional reach by taping it at or just above eye level to promote neutral spinal position and shoulder flexion. When I’ve used this strategy, I tape it to the door of an over-the-counter cabinet so that the patient can steady themselves on the counter as needed.

How to Objectively Document:

• duration of standing tolerance in minutes; amount of assist required to maintain standing posture; amount of cues needed to achieve neutral spine; degrees of shoulder flexion achieved; reports of pain

3. Community/Group Integration. Crossword puzzles can really fun when completed in a group. Strategy: do the puzzle together as a group. Even if you don’t have the ability to print out a poster-sized puzzle for everyone to see, if you’ve got access to a whiteboard you can make this work. Create a visual cue to show how many letters we need to find (filling in any spaces that have already been filled in by other clues). Think Hangman for this, just without the hanging man. Then read the clue aloud and work collaboratively to solve.

How to Objectively Document:

• amount of times the individual participated; amount of cues required; duration of time the individual could tolerate the group setting; skilled benefit of performing this activity in a group setting vs 1:1

Happy Treating and as always follow along for more OT activity analysis!!