Ideally, discharge recommendations and program planning should be based on evidence based predictions about patterns of activity performance in another setting. The data gathered should be based on standards of practice, with measurements that you trust to generalise from one location to another and from one action or activity to another. To meet those ideals, you need to know what you are supposed to do during the treatment process.
To set up and sustain actions or activities that the person enjoys doing for months and years, the following process is recommended:
- Select actions or activities that match the person's cognitive abilities.
The information that captures attention and causes effects generalises to different locations and different actions and activities.
- Exclude materials, tools, or steps with safety hazards.
With the cognitively disabled, safety must be a major consideration because there are so many hazards that do not arouse their attention, creating dangers to self and others.
- The cost of materials must be able to be justified. This cost must be less than the cost of providing other care like having to provide an active night staff shift as the person is either awake, wandering or yelling all night. Taxpayers and government agencies resist spending money on supplies to entertain people.
- Test the created action or activity and make further modifications when necessary and possible.
- Develop a schedule of daily activities.
When testing succeeds, start developing a schedule of daily activities. Something to do after every meal is the beginning recommendation, i.e. three times a day, every day for the rest of their lives.
- Educate carers.
- Include family, friends and staff members in carer education by demonstrating what the person can do and enjoys doing too.
- Maintain activities.
Actions and activities are necessary to maintain the mental health of the person by engaging the cognitive abilities that they have left. An occupational therapist may create a wonderfully successful activity plan, but no activity lasts forever. Human beings get bored doing the same activities all of the time, and people with a cognitive disability are not exempt. However, they do take longer to get bored, but when they do they stop. Solving the problem often requires going back to the beginning of finding a new action or activity.