Elderly residents admitted to rest homes should not be expected to give up previously active lives. In fact, the key to maintaining their quality of life is to keep them as active as possible, says Canadian senior care worker Donna Calvo.

Ms. Calvo was on the Island last week for a three-day Activities Health Care Workshop hosted by the Activities Association of Bermuda.

An activity manager for an intermediate level care facility called Luther Court Society in Victoria, Canada, she spoke to Healthcare workers, activity workers, administrators, physiotherapists and nurses about the importance of structured activity for seniors.

It was something that those working with Bermuda's seniors have long recognised, hence the establishment of the Activities Association of Bermuda in March 1993. The AAB became inactive in 1995 and was only revived at the end of 1999.

Selina Tankard, the president since then, will step down this month to hand over the presidency of the association to Patience Godfrey.

Those who formed the AAB believe in the benefits of activity to enhance the quality of life for their clients. A similar association exists in North America called the National Association of Activity Professionals (NAAP), of which Ms. Calvo has been a member since 1986.

"My association with the National Association of Activity Professionals has been a rewarding one," she said.

"I credit the association with bringing to my attention all the resources that are available to activity professionals. They have offered workshops that nurture my professional development and challenge me to be a better activity manager.

"It is a professional association dedicated to serving the residents by educating staff members in the best practices of how to deal with aging and working with the elderly."

In the senior home where Ms. Calvo works, there are some 66 men and women residents, 65 per cent of whom suffer from Alzheimers, a brain disorder that causes senility amongst the elderly.

"In the workshop I'll share the physiology of the deterioration of the brain due to Alzheimers type dementia," said Ms. Calvo, on the first day of the workshop last Thursday.

"We will talk about how it progresses and what kinds of behaviours are influenced by the degenerative progression of the disease.

Specific behaviours indicate that the dementia has developed to a certain portion of the brain, then we realise an individual can't see or can't hear or can't move around.

"Once we realise the whole brain is in trauma then we can understand why people behave as they do. That's important for the staff members, people working around and with persons with dementia, to understand how to approach them and that they can't help it."

She added: "Dementia is a deterioration of the brain due to cell loss and there are a number of dementias, but the one I'm presenting are Alzheimers-type dementia. We work with the process of elimination in diagnosing, you just rule out one thing or another and you work with the resident to use the best of the abilities they still have.

"We acknowledge and credit them for their lifetime experiences, they are living and caring human beings. Through the disease process they have lost lots of time but if you can figure out where their brain is still functioning and fit into their time frame and reality. It's a marvellous thing to be able to communicate with them."

Alzheimer's is associated with elderly persons, but Ms. Calvo points out that persons younger than that can be afflicted as well.

"There is really no minimum, right now I know of three ladies in Canada who are late 40s - early 50s, professional ladies with multiple degrees and high management skills who have lost their positions because of the disease process," she revealed.

"They are working with the Alzheimer's Society in Canada with an Alzheimer's Sufferers Support Group. These ladies tour and give incredible workshops and when you study the disease process you can see how hard they work at what they are doing to make a presentation and how they are teaching their families to cope with it. They are in the very early stages of it (Alzheimer's)."

Keeping an elderly parent active is very important, Ms. Calvo says.

"Things that you can do even when a person is still living at home with home support is family life review, getting the family member to recall as much as they can," she revealed.

"Go through the family albums and start writing down things because come two weeks they might not remember again. Then check for authenticity, asking aunts and uncles 'was mom right'.

"I work with a lot of people who are immigrants to my country, so they come from a number of backgrounds and so we try to validate where they are right now. For instance, one gentleman would sit in the room with us when other things are going on and all of a sudden he would say 'oh, they bombed the hell out of Pearl Harbour', so you know what place and time he's thinking in.

"(For an Alzheimer's sufferer) the past is far more significant than the future, so let's honour that past and the dignity of that individual. Sometimes the best we can do is help them maintain their self respect and dignity. We're always working on that self esteem issue."

Rest homes locally regularly arrange activities for their residents so that they are not sitting around all day with little stimulation.

"Physical activity is very important...walking, exercise and it has to be within a framework like an escorted walk, for instance," said Ms. Calvo who is an activity consultant certified by the National Certification Council for Activity Professionals.

"Keep them as busy as you can, but within what they can deal with. I also find music is a valuable tool, no matter what culture we come from there is music in us."

She also stressed the importance of knowing each resident's past and what they previously liked to do.

"So many people become isolated and dejected and that's what we try to prevent," she disclosed.

"We try to keep the community involved by bringing volunteers in. If an individual is part of a Kiwanis or Lions group, can we have the meetings at our facility once or get them out to their club meetings? It's so important to the self esteem and self worth of the individual to participate."

Ms. Calvo works with seniors ranging in age from 64 to 107, with a variety of challenges and needs.

"There are a lot of European immigrants there, eight to nine different languages amongst the 66 persons," she revealed.

Pets, too, have been proven to be an excellent source of therapy for the elderly, especially for those who previously had a pet or like animals. Reading is also vitally important.

"We do a lot of history reading, crosswork type puzzles," Ms. Calvo stated.

"We have a group called the Pacific Animal Therapy Society, a collective volunteer group who bring pets into the facility. I even had a Llama in my main lounge!

"We had a wonderful facility cat that was seven or eight when he came to us. He's retired now because of dietary problems - everybody fed him - but he used to make his visits around and had his friends and non-friends.

"Then we had a beautiful mountain dog that weighed about 185lbs. and his name was Drummer and his mission in life was just to visit one particular lady who was dying. She was a dog trainer and wasn't conscious very often but every time Drummer came in Drummer's handler would bring the leash and put it in her hand.

"When Drummer sat down his head was on the edge of the bed and she could pet the dog and in her mind she could go walkies with the dog. Drummer would sit there for hours and hours and the lady, in her mind, was so comfortable, quiet and spiritually satisfied...very much at peace. It made the last days pleasing and comfortable for her."

Ms. Calvo has been an Activity worker for 24 years, graduating from Brandon University in Manitoba, Canada in 1977 with a Bachelor of Teaching degree.

She began work as an Activity Director in 1977 and since 1987 has been involved in the development of curriculum for Activity workers. She has also taught activity courses in Manitoba for the Assiniboine Community College.

"We're not just dealing with the residents we live within the facilities, but their families too," she pointed out. "It's a tremendous career.

"We need to educate the public that mom and dad are absolutely doing the best they can. From outside the family unit we can see it, and if we can support the family to see it eventually, that's part of our mission.

"People age the same in your country as they age in my country. Life expectancy is getting longer and longer."