Adapting Activities for Success
by Debbie Hommel, ACC/MC/EDU, CTRS
One of our goals as activity professionals is to offer our residents or clients an opportunity to continue life long interests and leisure pursuits.
  Unfortunately, most of our residents and clients arrive in our centers and facilities with a variety of limitations – both physical and cognitive.   The activity/recreation profession has always taken a positive approach to this concern.  While the medical profession focuses on the losses and disabilities – we tend to focus on what strengths are remaining and what they can still do.   This is accomplished, in some cases,  through adaptation or modification of the activity.  

In order to appropriately change activities to address the individual needs of each resident or client, we need to address two important areas prior to adapting the activity or program.    The first area is knowing the resident or client’s strengths, abilities and skills are imperative when offering any therapeutic approach.  Adaptation is one example of a therapeutic approach.   A thorough assessment will assist the activity professional in understanding the client’s abilities as well as where they will need modification of the approach or activity to succeed.    The second area is to know the activity well.  There are many facets of each activity we conduct and being able to analyze the activity will allow breaking it down into specific parts for adaptation.

There are four standard methods for adapting activities:
  -Materials : This is altering or changing the materials or supplies utilized in the activity.  Using large print bingo cards,  built up handles on brushes or pencils; and larger designs in crafts are examples of material adaptation.
 –Procedure or rules :  Changing the rules or how you do the game in order  to make it simpler or less complicated is considered Procedural adaptation.  An example of procedural adaptation would be to take the direction cards out of a deck of Uno.  This would make the game simpler and easier to follow for the cognitively impaired.  Another example would be during Bowling games.  Allowing the resident to stand closer to the pins and take as many throws as they need would be altering the game so the resident can succeed.
  -Skill sequencing  :  This process requires the activity professional to break the activity into smaller tasks or sections for completion.  Residents would be grouped according to their ability or how much they could accomplish.  This is commonly called “assembly line” adaptation – as the tasks are organized into an assembly line of sorts.  Crafts, cooking and other task sequencing activities lend themselves well to this adaptation.
Lead up activity : This process is incorporated into the therapeutic process and allows the activity professional and the resident to work together to rebuild lost skills.  The activity professional needs to determine one activity or action which would prepares the resident for a bigger or more complex activity or action.  For example, certain exercise steps in exercise group prepare the for many ADL or ambulation programs. 

 Finally, when modifying the activity, REMEMBER ……
– Keep the activity as close to the original form as possible
-Modify only parts of the activity needing changing to adjust to a particular limitation in the resident/client
-Individualize as much as possible.
-Keep the project or approach as adult like as possible.

 Keep in mind – our overall goals are to allow for success, prevent sense of failure and  maintain resident/client participation in tasks and activities of interest.

Check out the NCCAP Pre-approved 3 Hour Distance Learning Program
Task Breakdown for Elders with Mild Cognitive Loss