elders are often left alone and are prone to get depressed, lose interests and start living an idle life, affecting physical, ,mental and spiritual well being. some techniques are listed which can be applied in a day care setup to cheer them up...

1. SERVICES PROVIDED BY
OCCUPATIONAL THERAPISTS IN A
DAY CARE CENTRE FOR THE ELDERLY
SARA SHEIKH
OT STUDENT
DOW UNIVERSITY OF HEALTH
SCIENCES

2. WHAT IS A DAY CARE FOR ELDERLY?
A facility for the supervised care of older
adults, providing activities such as meals and
socialization one or more days a week during
specified daytime hours. The participants, primarily
persons with physical and/or mental limitations who
need socialization, physical assistance, and/or
psychological assistance, return to their homes each
evening. The program is often used as respite by
family members caring for an older person who
cannot be left alone safely in the home.

3. WHAT AN OT CAN DO IN THIS SETUP?
The main goal of setting a day care for elderly is to motivate them to
move out of their possible isolated, depressed state, therefore an
Occupational therapist can:
• Set the daily routine and strategies
• Engage the elders in activities of their interests in a friendly and co-
operative environment
• Evaluate them and make engagement plans for each individual
• Socialize them by making them do work in groups
• Talk, talk, and listen, listen, listen to them
• Counsel them in order to reduce their depression
• Make adaptations in equipments used by the elders according to
their needs.
• Help and teach them to get through their routine at the day care and
usage of possibly new equipments (adapted).

4. Can also assign Home Program
An Occupational therapist can guide an elder through:
• Transfer techniques in case of wheel chair bounds
• One bowl method, Work-Rest-Work rule
• Energy conservation techniques (correct posture, doing jobs
sitting, using both hands, slow movements etc.)
• Instructions to maintain weight, avoiding strenous work or
exercises, or to use a mask when on road or near someone
smoking, esp. to cardiac, hypersensitive and patients with
respiratory prob.
• Teach an elder with memory or orientation problems to keep a
diary, or cues (tying a knot on a finger) to remember important
tasks. A card having his name and address should be placed in one
of his pockets. Family can also be instructed on that.
• If the elders agree, adaptive equipments or slight modifications in
the home should be made.
• Those with incontinence problems should be taught to take care of
catheters/diapers. Those having constipation should be instructed to
drink more water

5. OVERVIEW OF ROUTINE ACTIVITIES
TASK TIME/SETTING
BREAKFAST Preferably in group; Greetings offered
TALK/DISCUSSION From newspaper or last night news
on TV; Quizzes
LIGHT EXERCISES Refreshing ( ½ hour max.)
CONSTRUCTIVE WORK According to individual interests ( 2-2
½ hours); Rest periods will be allowed
LUNCH Preferably in group; Light talking
REST PERIOD ½ hour- 45 mins.
SPARE TIME Watching TV; Group Sessions;
Individual Counseling etc.
TEA Plans for next day, etc.
Monitoring Medicine schedule, Vital signs and Sugar level are also routine tasks.

6. BREAKFAST SERVICES
A large table with chairs around it should be placed
in a spacious room so that elders may become social
by meeting other elders.
But, in case any elder wants to have breakfast alone,
either out of first visit shyness or any other reason, a
separate breakfast table, or a separate cubicle should
also be provided in the setup. But this habit should
be broken up as soon as possible.
Greetings should be offered to each other and
sharing (passing the marmalade, talking about
the taste of minced meat etc) should be
encouraged.

7. TALK/DISCUSSION
Discussion on news from the morning newspaper or last
night TV program can be carried out.
It should be short, for instance
20-25 mins. Orientation and memory
can also be checked in it by asking
the current date, day, or asking
how the people liked the
breakfast (asking names of things
they ate) etc. If hints are required,
a calendar, a wall clock should be
present. A digital clock can also be given to the person to set
the correct date so they remember it.

8. LIGHT EXERCISES
Exercises as “up, down”, trunk
rotation and gross arm and
leg movements may serve as
warm up exercises and
prepare the elders to deal
with the whole day in the
day care.
Care should be taken to keep
the exercises light, as
vigorous exercises will
result in fatigue and
idleness.

9. CONSTRUCTIVE WORK
All elders will be given activities
acc. to their interest and abilities
which will help them feel useful
and involved. Males can be given
some light mechanical work and
females can be given straw to
make baskets. Gardening, canvas
painting, playing music are some
options. They can even help in
preparation of lunch by cutting
vegetables and meat, or choosing
or setting crockery. Equipments
(brushes, knives, flutes, saws etc)
should be adapted acc. to patients’
needs and problems.

10. Short rest periods are necessary
during work time, so the elders may
not get fatigued very early and will
start work anew, willingly.

11. LUNCH
An appetizing lunch should be
served to them on the same
breakfast table, the therapist
talking and asking them
about the day and other light
subjects. The elders who
helped in preparing lunch
should be praised
accordingly.

12. REST PERIOD
Beds and couches should be
available as elders need
more rest than young adults.
Warm quilts should also be
provided as old people feel
cold.
Moreover, dressing tables with
combs, puffs etc should be
provided. Care should be
taken to adapt these
equipments with long
handles or adjusted angles.

13. SPARE TIME
WATCHING TV/VIDEOS:
A television and a multimedia
with computer should be
present in a large space
where everybody will
cluster about and watch
programs, presentations or
videos together and discuss
them later. Elders should be
encouraged to bring movies
of their memorable
moments to share with
others

14. SPARE TIME
COUNSELLING SESSIONS:
Short counseling sessions may
be carried out with/without
psychologist to improve the
self-esteem and sense of
involvement and reduce
depression, aggression and
negative behaviors and
thoughts.
Breakfast table shyness, lack of
interest in discussions or
work can be addressed.

15. SPARE TIME
MEDITATION/IMAGERY:
These are necessary to refresh
the elder minds and will
help us achieve our ultimate
goal. These sessions maybe
fitted in with the time table
thrice a week.
Light music, pleasant sounds
(birds chirping, stream
running etc), or the
therapist’s low, calm voice
can be used as imagination
stimulating aids.

16. SPARE TIME
GROUP SESSIONS:
An occupational therapist can
assemble elders suffering
from a same ailment or
elders belonging to similar
age group (60s, for instance)
and give them
counseling, or activities
requiring co-operation of the
whole group.

17. TEA
Tea time should be a fun time
for the elders, as they will
soon be leaving for their
homes. Feedbacks maybe
taken and plans for the next
visit maybe discussed.

18. MEDICINES/VITAL SIGNS
Every elder/family should be
asked, on admission, for a list
of necessary medicines, their
quantities and the schedule of
using them. The therapists (in
case no nurse is present) will
be then responsible to ensure
that every elder is getting
medicines on time.
Regular BP, pulse rate, sugar level
should be noted for each
elder, especially for those with
hypertension, cardiac or
respiratory problems and
diabetes. BP
apparatus, Glucometer, Therm
ometer should be available.

19. EXTRA SERVICES AN OT CAN PROVIDE
BATHROOM/BED ADAPTATIONS:
• Can make use of non-slip
mats, hand railings, raised
toilet/bath seats etc in
washrooms.
• Can adapt the height of bed,
attach railings on either side,
or even place a side table.

20. EXTRA SERVICES AN OT CAN PROVIDE
OUTINGS/FIELD TRIPS:
• Taking a group or an
individual for a walk in the
park
• Arranging a trip to a famous
place, historical relic or
even a cozy restaurant or tea
house

21. EXTRA SERVICES AN OT CAN PROVIDE
EXHIBITIONS:
An occupational therapist can
organize exhibitions of the
objects made by the elders.
The elders maybe motivated
to deal with the visitors so
that they may be socialized
and feel contented.