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May grip the paper if it is placed in the hand but may not be able to release the grip; or may not take hold of the paper. If in doubt about which statement to select, choose the level of ability that represents their average performance over the last 2 weeks. Dementia is a growing challenge. It is estimated that by 2025, the number of people with dementia in the UK will be more than 1 million. As one of the most important health and social care issues facing the world, continuous post-diagnostic care and support are vital. I began developing the PAL Instrument by building on the work of Claudia K Allen. She had developed an Occupational Therapy model for understanding cognitive disability, based on developmental theory. Allen’s model has a robust assessment for OTs and then relies on their professional knowledge to interpret the outcomes of the assessment. I wanted a tool that would self-interpret and provide a guide to those without the clinical skills so that they could enable individuals with cognitive difficulties to be less disabled in every-day activities. Hilary Woodhead, Executive Director of NAPA (The National Activity Providers Association) The QCS Pool Activity Level (PAL) Instrument is the foundation of activity and engagement. This essential resource is a 'must have' for Activity Providers. The Instrument gives us a framework and practical toolkit for person centred practice, and something we have needed for a very long time; the PAL Engagement Measure. I am excited to see the difference it will make to the practice of Activity Providers, and ultimately, the wellbeing of people living with dementia.
pool activity level (PAL) instrument for occupational profiling: a The pool activity level (PAL) instrument for occupational
The PAL Instrument uses a strengths-based approach, opposed to where we only focus on the difficulties people with dementia might have and disable them. It contains a valid and reliable assessment tool for assessing the overall level of individual cognitive and functional ability. A PAL Guide that describes how to support the person at that level of ability is produced from the completed assessment. The PAL Instrument is a widely used framework in care settings across the UK and around the world. Care UK’s activity teams share what they have found to be helpful when supporting people with dementia in everyday activities, arts and crafts, maintaining independence, special occasions, health and wellbeing, and reminiscence.To be successful, an activity has to match the personal interests of an individual and be pitched at the ‘just right’ level of challenge: too easy and it may be boring, too difficult and it will be frustrating. Bell, V., Troxel, D., Cox, T. and Hamon, R. (2004 and 2007) The Best Friends book of Alzheimer’s activities, vol 1 and 2. Baltimore, MD: Health Professions Press. NAPA runs an NCFE distance learning course – Intermediate Certificate in Provision of Activities in a Care Setting – and also offers open and in-house courses on a range of topics, including massage and seated exercise. Other further education colleges also offer the NCFE course. The QCS Pool Activity Level (PAL) Instrument is widely used as the framework for providing activity-based care for people with cognitive impairments, including dementia. The Instrument was recommended for daily living skills training and activity planning in the National Institute for Clinical Excellence Clinical Guidelines for Dementia (NICE 2006). It is an essential resource for any practitioner or carer wanting to provide fulfilling occupation for clients with cognitive impairments. The CLIPPER assessment tool was developed by Jennie Powell (2007). It considers 41 activities that could occur during a typical day. Caregivers note which activities occur, how often, and how the person seems to feel about each activity.
Pool Activity Level (PAL) Instrument for Occupational - UK The QCS Pool Activity Level (PAL) Instrument for Occupational
Body language may be inappropriate and may not always be coherent, but can use simple language skills. Activities need to be broken down and presented one step at a time, multisensory stimulation can help hold the attention. Practitioners can learn to provide CST for people with dementia by following the CST manual by Spector et al (2006) or attending CST training (see www.cstdementia.com). An emphasis on philosophy The PAL instrument positively shaped my practice as an occupational therapist and continues to do so today. If you support people living with dementia and their caregivers this is the book for you - it combines expertise, with evidence and practical guidance for anyone with an interest in dementia care. National Association for Providers of Activities for Older People. ‘Activity allsorts’ (includes 101 things to do). London: NAPA.Aware of others in the group and will work alongside others although tends to focus on own activity.
Pool Activity Level instrument to support meaningful (PDF) Using the Pool Activity Level instrument to support
The Spark of Life Club is an approach developed in Australia which is designed to improve the social, emotional and spiritual wellbeing of people with dementia. The focus of the approach is on providing meaningful activities that don’t have to be structured but do need to stimulate the senses, encourage participation, boost self-esteem and fulfil one or all of the five universal emotional needs. Assessment tools Roe, P. (1998) Let’s talk, Milton Keynes: Speechmark. This includes discussion and prompt cards for use by groups in a range of settings.
Practical activity ideas and resources
Hurtley, R. and Wenborn, J. (2005) The successful activity co-ordinator: A learning resource for activity and care staff engaged in developing an active care home, London: Age Concern Books.
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