Friday, May 15, 2009

Some thoughts on our last morning

Dear Colleagues:

I woke up this morning realizing that for me, the learning here has been to see how any truly successful approach to transforming activities needs to be encompassing, from individual learning to a societal shift of perception and policy. I made these notes, recognizing that my understanding is surely very partial compared to those of you who have been focusing for decades on these questions. I hope that beginner's mind will be of some value!

All best,


* * * *

Transforming activities is an encompassing process, involving every dimension from individual awareness to a global transformation of understanding and action. Instead of treating public issues like private troubles, what’s needed are interventions at every level, to relieve the burden on families and reframe aging as a universal human process, not a medical problem. This involves learning, providing services, rethinking institutional practices and changing public perception ands policy from the grassroots on up.

Where the rubber meets the road, everyone has the capacity to transform activities for those in need of long-term care or in structured environments, by “enchanting” even mundane tasks and simple play through creativity, remaining present and responsive to the whole person, rather than treating an individual like the embodiment of his or her deficits.

In every setting, at home or in institutions, key elements of actualizing this potential are:
  • Prioritizing more than physical well-being, giving equal weight to quality of life in all dimensions;
  • Eschewing or supplementing assessment tools and standards of judgment that privilege what is easy to measure while omitting the deeper human story;
  • Valuing and making use of creative individuals such as well-trained community artists, who naturally work in these ways;
  • Choosing and supporting people with the necessary outlook and sensitivities to work with those in need of care;
  • Supporting partnership and leadership at all levels.

But things to need to change to fully realize this potential.

For families and individual caregivers, some key needs are:
  • Education and training in what’s possible, delivered in ways they can receive and use;
  • Encouragement and support in building community, learning from other families and sharing the burden;
  • Aggregating voices to shift public policies to provide meaningful economic and social support, such as policies where money follows the individual, whether at home or in an institutional setting, and a paradigm shift to universal healthcare.

In day centers and long-term care facilities, some key needs are:
  • Supporting leaders in bearing and managing the risk of culture change, being willing to risk failing in new ways rather than settling into familiar failures;
  • Using hiring and evaluation processes that prioritize the needed qualities of openness, presence, caring, responsiveness and understanding;
  • Developing and using assessment tools that measure progress toward what we actually want to happen, not just what someone else thinks is important or easy to measure;
  • Active openness to and support for partnerships with artists, not as a frill but as an integral aspect of care.

For everyone, some key needs are:
  • Reframing our understanding of aging, so that people are not written off as their capacities change, but continue to be seen and valued as whole persons;
  • Transforming media portrayals of aging to convey this deeper understanding;
  • Transforming aging policy at every level, reversing the privatization of suffering to bring about a public culture of care and support.

Monday, April 27, 2009


What if we asked people in long term care if they would like to give a gift to someone...what would it be? To whom? How might they actually go about making/giving it?

Just reading more in this dissertation about the use of plants in long term care, and it turns out that residents tended the plants and then some gave them as gifts to people they cared about. That's fascinating...and so normal outside of LTC.

What's "meaningful?"

I'm reading a dissertation by Emi Kiyota, and thought this quotation might be helpful for us as we think in the tank.

"Meaningful occupations are conceptualized in occupational science literature as ones 'which enhance individual well-being, help establish and maintain identity, and help connect ones' past, present, and future into a meaningful life.'" (Ikiugu, 2005). (21)

and "A series of studies show that decreased mortality and psychological disability occur when individuals feel a sense of usefulness, purpose, and meaningfulness." 22.

Providing choices gives people control over their environment. Choices that actually determine the shape/outcome of something are crucial to well-being.

I would also encourage us to think "relationally." Transforming activities is about providing choice/meaning for elders, AND it is about providing choice/meaning for their care partners (family, friends, staff). These choices and meaning might be different. But part of transforming activities is community building.

Thursday, April 23, 2009


What a treat we have for you all as our kick off for the Think Tank...

Our 2008 Artist in Residence David Greenberger will perform Cherry Picking Apple Blossom Time with the Paul Cebar Stage Ensemble at the Pabst Theater Wednesday evening!

Milwaukee Public Television will film it and combine their footage with a documentary being made on Greenberger's residency for broadcast next November.

Monday, April 6, 2009

Improv Resource

I like this one since it involves movement, sound and creating scenarios:
Applied Improv

Sunday, April 5, 2009

More resources

To follow on Anne's resource list of sites offering conceptual, practical and otherwise compelling challenges I wanted to add:

CCA actions
Learning to Love you More