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Creative Currents A life-affirming approach to storytelling that helps people with dementia; a workshop that trains Meals-on-Wheels volunteers to help homebound elders with signs of cognitive impairment to make healthy-aging choices; "a total workout program for the mind" in seven steps; and a grassroots education program that involves elders and youth becoming engaged in the political process: These are the winners of the 2005 Mind-Alert Awards presented in March by the American Society on Aging (ASA) and the MetLife Foundation at the Joint Conference of ASA and the National Council on the Aging in Philadelphia.
The MindAlert program recognizes replicable research-based programs, products or tools that promote cognitive fitness in later life in three categories: educational programs that enhance mental fitness for older adults in the general population, programs designed for cognitively impaired elders and lifelong learning programs with an implicit element of mental fitness. Following are the 2005 winners. TIMESLIPS "TimeSlips is a creative storytelling method that helps people with dementia reaffirm their humanity and connect with staff, family and friends," said Anne Basting, who began the program under a two-year National Brookdale Fellowship research project from 1998 - 2000. Now the director of the Center on Age and Community at the University of Wisconsin, Milwaukee, Basting explained, "Rather than pressure people with dementia to remember, TimeSlips encourages them to cultivate their imaginations. Staff, family or friends facilitate the process, but the participants with dementia direct the activities themselves. TimeSlips is also designed as a way for personal or professional caregivers to awaken or reawaken a sense of their own creativity." Basting conducted the initial study at the Schulman and Schachne Institute for Rehabilitation at the Brookdale Hospital in Brooklyn, N.Y. She found that among 17 storytellers with Alzheimer's or related dementia who participated in 24 sessions over six months, 10 improved their verbal skills. Of these, four improved so much that professional staff at the institute set new goals for them during the study period. In 2001, Basting and colleagues developed TimeSlips as a replicable training method and by 2004, six regional training bases were headquartered in New York, New Jersey, North Carolina, Texas, Wisconsin and Ohio, with more being developed in Florida and California. TimeSlips follows a clear, ritualized structure, she said. At least once a week, a group of people with symptoms consistent with middle-stage Alzheimer's disease gather in a circle of chairs. Staff or volunteer facilitators first welcome each storyteller to the activity and read a story from the previous week to reassure the storytellers that they are capable of creative expression. Next, facilitators hand out an image to each storyteller and ask open-ended questions, those not requiring a "yes" or "no" reply. A facilitator writes down all the responses on a sketchpad large enough for the storytellers to see. All responses, including any nonsensical answers, are validated and woven into the fabric of the story. Basting stressed, "Even today, when concepts of person-centered care are taking hold among dementia-care workers, activities for people with dementia rarely offer meaningful opportunities for meaning-making and self-definition. Reality orientation is still common, and reminiscence exercises can seem cruel for people who have great difficulty remembering and articulating their lives." She continued, "Words are where the disease reveals itself, and people with dementia often edit themselves into silence out of fear of saying the wrong thing. Such silence makes it difficult for caregivers to come to know people with dementia, isolating them even more." The free-form storytelling process of TimeSlips "requires that facilitators leave behind preconceived notions of what constitutes a 'story'," Basting said. A single character might end up having several names, and multiple plot turns often cause the story line to meander and read "more like a chronicle of the storytelling process than a traditional, linear story with a clear beginning, middle and end, and a focus on conflict and resolution." The stories that emerge, Basting added, "are rich in humor and poetic images, and provide a window into the experience of living with dementia." A single story often lasts up to one hour, but most run 30 minutes, she said. In the final step of the ritual, facilitators thank the storytellers for their input as a way to acknowledge the risk and energy demanded by a full hour of creative storytelling. Basting emphasized, "Because there are no right or wrong answers in the creative process, creative activities allow people with dementia to enter from where they are -- with memory gaps, word fragments and so on -- without judgment." For more information about Time Slips, contact Basting at (414) 229-2732 or basting@uwm.edu. MEMORY LOSS Understanding Age-Related Memory Loss and Dementia shares the 2005 MindAlert Award with TimeSlips in the category of programs for older adults with cognitive impairments. The two-hour workshop was developed by Oregon State University's (OSU) South Oregon Research and Extension Center, Central Point, Ore., to instruct Meals-on-Wheels volunteers, who deliver food to homebound older adults. The workshop is part of a healthy aging workshop series for community volunteers titled "Maximizing Brief Encounters: Realizing Measurable Gains." According to OSU assistant professor Sharon Johnson, who developed the workshop and handsome replication package, "The information provided in the workshop vividly demonstrates how good nutrition, adequate rest, medication use, smoking, alcohol consumption and exercise have the potential to affect memory ability. It draws from current research on lifestyle or behaviors and their relationship to age-related memory difficulties." The packaged workshop materials include a CD containing the PowerPoint Presentation, together with extensive teaching notes; a voice-over option is available on the CD (with the author teaching the class). The package of teaching materials also offers an instructor's manual, a participant workbook with a variety of memory-enhancing activities, a memory road map and a matrix outlining the seven most common memory complaints with specific, research-based ideas about how to address each identified problem. For community educators who are not familiar with PowerPoint, colored overheads are also available. Topics include responding to age-associated memory loss, recognizing depression in older adults and facilitating improved food-safety practices. Health-related information offered in the classes has significantly benefited the volunteers and, in turn, the meal recipients. In its first two years, Johnson said, more than 500 people took the workshop, which is a regular offering in Providence Hospital's Community Education series and has been adapted for community cable television as a live, interactive one-hour program that encourages viewer call-in. For more information, contact Johnson at (541) 776-7371, ext. 210, or s.johnson@oregonstate.edu; or visit her website at http://extension.oregonstate.edu/sorec/family. MENTAL FITNESS The Mental Fitness Program for Life is an eight-week series of three-hour workshops for adults ages 50-plus that has been translated into a personal mental fitness program via a new book, Mental Fitness for Life: 7 Steps to Healthy Aging, by the program's creators -- Sandra Cusack, a research fellow at Simon Frazier University, Vancouver, B.C., and Wendy Thompson, a gerontologist consultant based in Richmond, B.C. The program and book draw on the authors' decade of research and development to design what they call a total workout program for the mind. Each session or step in the new book integrates the latest, most effective research, strategies, homework assignments, warm-up exercises, quizzes and puzzles designed to exercise one of the seven key components of mental fitness. The final step is the goal: to put the participant or reader on a sustainable personal mental fitness program. Greta Hurst, age 68, wrote Cusack and Thompson that the program not only helped her decide to lose weight -- 70 pounds, "which I have maintained for a year and a half" -- but also "got me thinking in a more focused way and more broadly in areas where I had no previous interest." Pauline Mowat, another participant, wrote, "The opportunity to participate in a vibrantly organized, safe, unstressful, pressure-free, fun-inducing classroom was a dream come true. After each session, we left with the assurance of a limitless potential destined to materialize. Indeed, I am about to launch my first published book at the age of 85-1/2."
In the 1990s, Cusack and Thompson asked, "What exactly is 'mental fitness' and how do we develop or maintain it?" They assembled a research team of 37 adults ages 50 and older (average age 73) from the Century House, New Westminster, B.C., a city-operated recreation center for elders on Canada's west coast serving more than 1,900 older members. Working with a facilitator and a researcher, they explored key questions about mental fitness "and concluded that mental fitness is vital to healthy aging and includes essential components and skills that can be developed." They added, "Like physical fitness, mental fitness is a condition of optimal functioning that is achieved through regular exercise and a healthy lifestyle." Since 1997, more than 400 older adults ages 50 - 92 have taken the program, which consists of a series of eight intensive three-hour workshops that exercise each one of the essential components. To learn more about Mental Fitness, contact Cusack at (604) 291-5177 or scusack@sfu.ca; or Thompson at (604) 275-0091. VOCAL Voices of Community Action and Leadership (VOCAL), Mount Vernon, N.Y., is an intergenerational, grassroots, nonpartisan advocacy education program designed to involve elders, mature adults and youth in the political process. "Implicit in the program is work that maintains the essential mental fitness of older adults and continued participation of older adults as informed, active members in the civic life of their communities," noted VOCAL director Reva Greenberg. VOCAL, rooted in cooperative partnerships with local organizations, clubs, businesses and agencies, offers free information and skills-training workshops that address the interests and needs of diverse populations. The program is sponsored by the Westchester County Department of Senior Programs. Through a selection of topical workshops, VOCAL aims to rouse interest by focusing on current issues concerning older people and those involved in their lives. Skills training sessions focus on key areas of speaking, writing, leadership and coalition-building. The twice-annual VOCAL Action Planner details current community presentations and the "VOCAL@Your Local" initiative customizes workshops for individual groups. VOCAL EasyAction includes a preprinted postcard, directory of elected officials, and lists of issues and websites for people concerned about the later years. The Youth VOCAL-ists are an integral part of the network and add an important dimension for hearing a variety of perspectives. "By uniting in a chorus of voices," Greenberg said, "local youth and older adults engage in meaningful collaboration to define issues of mutual concern." Greenberg added that participants report that the workshops give them more self-confidence to participate in the democratic process. "VOCAL advocacy keeps both the mind and body active, brings emotional satisfaction from learning and doing plus seeing that what you do can create change. The flexible, cost-effective design makes it ripe for replication," she said. For additional information, contact Greenberg at (914) 472-4551 or revag@optonline.net.
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