Course content – PFLEGE-16
7. Module 6 · Everyday life & daily structure
7.3. Case, consolidation & transfer
Two cases and what to take away
The favourite song
Mr T. (advanced dementia) hardly speaks any more, seems apathetic and is often restless. Through his life history, the team learns his favourite songs from his youth. When these are played, something astonishing happens: Mr T. begins to smile, sways to the beat, sings along to individual lines – he is present, lively, content. Music becomes a fixed, joyful part of his everyday life and calms him when he is restless. The case shows the power of music (suited to the person’s life history) to reach people with dementia, bring them joy and calm them – a simple, effective means of support.
Mrs Berg and the group programme
Mrs Berg (fictitious), 86, lived alone for many years and always avoided crowds. In the care home, she is taken each afternoon to the large singing group. She sits stiffly, then begins to pull at her blouse and tries to leave. A staff member says she is “not interested in anything” and a colleague suggests asking about medication. The care assistant, Joanna (fictitious), asks the daughter about her mother’s habits. The daughter explains that her mother loved reading aloud, enjoyed one or two friends rather than groups, and was always up at six. The team offers Mrs Berg a seat in a quiet corner at ten o’clock with a book of short poems. A volunteer sits with her twice a week. On the other days, a carer brings her a cup of tea and reads one poem. Mrs Berg listens, sometimes recites a line, and begins to join the singing for a few minutes now and then, when she chooses.
Analysis. (1) The programme was designed for the group, not for the person. A group activity was too much for her (Figure 6.2, “too hard”). (2) Her refusal and her restlessness were messages (Module 4), and not a lack of interest. (3) The life history showed what suited her: quiet, one-to-one, reading. (4) The new offer matched an anchor point of her own day, the morning (Figure 6.1). (5) Joining the group later was her choice. Participation grew from the offer and not from pressure. (6) Medication was not the answer here. The team should still watch for pain, low mood and other causes, and involve the doctor if the distress continues.
What is an anchor point in a daily structure?
Why does an activity need a real purpose?
How do you recognise an activity that is too hard?
Why is music so useful in dementia care?
What do sections 43b and 53b SGB XI deal with?
Key messages
- A calm, repeated rhythm with a few anchor points gives security and reduces anxiety.
- Meaningful activity is a basic need and not a luxury.
- Start from life story and today’s abilities, never from a fixed programme.
- Find the right level: not too easy, not too hard, and always with a way out.
- Offer and invite. Accept a refusal on the day, and look for the reason.
- In German residential care, additional care and activation is a statutory entitlement (section 43b SGB XI).
- Which anchor points does the day of a person you care for already have, and which are missing?
- Think of an activity in your workplace that people avoid. What could be the reason?
- What would your own meaningful day look like if you were ninety and needed support?
- ☐ I know at least one favourite song and one familiar task of the person.
- ☐ I keep mealtimes, greetings and the evening ritual the same.
- ☐ I offer an activity and accept a refusal.
- ☐ I watch for the signs of too easy and too hard.
- ☐ I note what worked and share it in the team.
Exercise: Review the organisation of everyday life in your area of work: is there a reliable daily structure/are there rituals? Which meaningful activities suited to people’s life histories are offered? Choose one person and think of a suitable activity (e.g. their favourite music, a familiar task) – and try it out.