The Pool Activity Level (PAL) Instrument for Occupational Profiling: A Practical Resource for Carers of People with Cognitive Impairment Fourth ... of Bradford Dementia Good Practice Guides)

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Simple assessment tools can help staff to understand the types of activities that might benefit a person with dementia. Two of the best-known examples are the Pool Activity Level (PAL) Instrument (Pool, 2007) and the Cardiff Lifestyle Improvement Profile for People in Extended Residential Care (CLIPPER) (Powell, 2007).

Pool Level Activity (PAL) Instrument | QCS Digital Pool Level Activity (PAL) Instrument | QCS

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. 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. While individuals may have different views on the use of dolls and children’s toys with people with dementia, it is now widely recognised that dolls can offer a very powerful therapeutic benefit if used at the right time and in the right way.

Assessment tools

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.

Pool Activity Level (PAL) Instrument for Occupational - UK The QCS Pool Activity Level (PAL) Instrument for Occupational

A number of different approaches within dementia care offer helpful ways to develop meaningful activity and improve quality of life for 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 Body language may be inappropriate and may not always be coherent, but can use simple language skills.

A programme approach

Powell, J. (2007) Care to communicate: Helping the older person with dementia, (2nd edition), London: Hawker. This book includes the CLIPPER assessment tool with forms to photocopy. Spector, A., Thorgrimsen, L., Woods, B. and Orrell, M. (2006) Making a difference: An evidence-based group programme to offer cognitive stimulation therapy to people with dementia, London: Hawker. 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.

Activity resources and approaches for dementia - SCIE Activity resources and approaches for dementia - SCIE

Aware of others in the group and will work alongside others although tends to focus on own activity. Plans to use and looks for objects that are not visible; may struggle if objects are not in usual/familiar places (eg. toiletries in a bathroom cupboard). Roe, P. (1998) Let’s talk, Milton Keynes: Speechmark. This includes discussion and prompt cards for use by groups in a range of settings.Some depend on using a particular practical resource, some emphasise skilful assessment before planning activities. Others promote a programme, philosophy or therapeutic intervention. 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. The Best Friends approach was developed in the mid-1990s by Virginia Bell and David Troxel in the United States. Simply put, the model suggests that what a person with dementia needs most of all is a friend, a ‘Best Friend’. National Association for Providers of Activities for Older People. ‘Activity allsorts’ (includes 101 things to do). London: NAPA. The National Association for Providers of Activities for Older People (NAPA) is a membership charity that promotes the importance of activity for all older people. It offers members regular bulletins full of practical activity ideas including quizzes, discussion topics and art activities.