Fieldwork Reflection

For the fall of 2016, my fieldwork placement has been at a local group for individuals with Alzheimers and Dementia, as well as their caregivers. At stepping stones, there are roughly 15 participants in the program. Sessions are held once weekly, for 1.5 hours and includes a warm up activity, fine motor activity and gross motor activity. The model that I feel is reflected best from the program is PEOP. The activities are meticulously chosen specifically for the likes, dislikes and most importantly, cognitive and physical functional level of each patient. While this addresses the intrinsic factors, the environment that Stepping Stones is held in promotes the intrinsic factor. The program is held at a local church and the space utilized for
the sessions is an effective size and contains a calming waterfall and greenery space. There are five tables set up with assigned seating to ensure individuals with similar functioning levels are placed together. The combintation of person, environment and occupation allow for optimal participation for the clients. The cognitive disability frame of reference is utilized within Stepping Stones. Prior to admission, each client is assessed with the Allen Cognitive Levels screen. This assessment allows for an accurate estimate of the cognitive ability of each client, which aids in keeping the program client centered. Currently, majority of the clients are around a 4.0 on the scale, which informs the choices on the appropriate activites and abilites based on the clients cognitive disabilites. While there is nobody employed by Stepping Stones, there are plenty of volunteers.
However, the leaders of Stepping Stones are two occupational therapists. One of which is always present at each session and works collaboratively with the graduate assistant assigned to the program, and the students completing fieldwork. Her role includes overseeing the content of each program, budgeting and advising fieldwork students on their strengths and weaknesses. She has provided invaluable feedback and knowledge on individuals with dementia or Alzheimers. For example, prior to this fieldwork experience, I have had no experience with this type of cognitive disability and while producing a powerpoint for one of the sessions, she explained the importance of using sounds to during each slide transition to reorient clients back to the screen. This would not have crossed my mind without her helpful insight. As FW students, we are responsible for coming up with ideas for the powerpoint, fine motor and gross motor activites. Last week, the theme was thanksgiving. Thus, we created a fun powerpoint, everyone made cornicopias with waffle cones filled with trail mix and then we played a pine cone tossing game to fill a bucket that looked like a turkey. The students and our supervisor work closely together to find the just right challenge for all. For example, during the pine cone tossing, we had some clients stand, while others sat down and had the bucket close to them. We have to be constantly
aware of who is having on or off days and be ready to grade an activity on the spot. The clients at stepping stones really seem to enjoy coming to the program. While it isn’t plausible to ask them if they feel more fulfilled or if their social needs were met, we have their caregivers who provide insight. As FW students, we do not sit in on the caregiver support group, but each week they come and tell us the differences they notice with their loved ones prior to the session and after it. Interestingly, most of the clients remember the past themes we have had and even some of the activites that we have. The most popular would be pumpkin bowling. The wife of our lowest functioning client told us that her husband didn’t stop talking about it for three days. This shows me and the others at Stepping Stones that what we are doing is worthy of continuation and praise.