Brain Stim Implementation Guide

1. Before starting any activity, read all the Program Information. There are a lot of details that will help you understand the importance of each activity.
2. Begin Brain Stim as soon as possible.
3. While you are awaiting the arrival of your Engagement Supply Kit, begin the New Subscriber’s Activities. These do not require any supplies for implementation.
4. When your Engagement Kit arrives, read and follow the instructions that come with the kit. This is a key element of the program’s success. You will need the supplies as they are called for in the instructions. Be prepared with the correct items before you attempt to engage them because they may lose interest while you run around trying to get organized.
5. Use the tote that is included to keep the Engagement Kit supplies separate from items you use in everyday life. Keep them out of reach from the participant and do not leave them alone with Kit items.
6. Follow all the steps of the provided instructions. Each step is given for a reason and plays a role in the cognitive impact the activity has on the participant.
7. Only give the participant ONE step at a time.
8. Unless the directions say Activity Partner: (AP:) the instructions are for the participant to do. The Activity Partner (AP) should only assist with a step the participant is unable to do themselves and the completion of that step is crucial to completion of the next step.
9. Brain Stim follows a proprietary Process-Focused Strategy that is designed to reduce refusals to participate. This will occur when the participant is set up for success. Never tell them what the expected outcome of an activity is so they do not anticipate failure.
10. Concentrate on trying to help them participate in the process of each small step instead of focusing on the participant getting expected results.
11. Encourage but do not force participation. Use a Mindfulness Moment exercise prior to beginning. If that does not help, come back to the activity later when they are less resistant. Your patience now will build trust which will lead to less resistance in the future.
12. When you are able, use environmental adjustments to create a positive environment: aroma therapy, appropriate lighting for the activity, music to set the right mood, a pleasing temperature for them, etc.
13. Always come to the table with a smile and a happy mood. Your enthusiasm and positive attitude will be infectious.
14. Be aware that conditions out of your control like weather, a full moon, and a wakeful night can interfere with program participation. If you encounter resistance, it is best to wait until the cause is resolved.
15. Never correct a participant with comments like, “You did it wrong” or “You were supposed to do it this way”. Instead, say things like “Would you rather chose this…and point to the correct choice”. If they continue to make an incorrect choice, move on to the next step.
16. Allow adequate time for activity completion. If they feel rushed, they may become agitated. Know how much time you need to implement the activity and adjust accordingly.
17. If there is not enough time to complete even a short version of a Cognitive Engagement, do it later when there is more time. Each step of the engagement is important.
18. In group settings, use clusters of no more than 5 when an activity involves taking turns or sharing supplies. Participants may lose interest if they must wait.
19. Encourage participants to help others (or you if you are one-on-one) so they feel purposeful and helpful.
20. Compliment them often and celebrate and reward small accomplishments. Do this throughout the activity process, not just at the end.
21. Always watch your tone. They are adults, not children. They have a brain disease that is not their fault. They have accomplished many things in their lifetime and continue to have value. Love and respect are still important.
22. Brain Stim is designed to have the flexibility to fit into your schedule the way you need it to. The Order of Activities gives you a guideline that has shown to produce positive results, but all routines should be tweaked in some way periodically.
23. Be patient with the program. You will not notice quick results. In fact, you may not notice a cognitive IMPROVEMENT at all. The goal of Brain Stim is to level off decline over time.
24. Don’t judge the activities based on your personal cognitive ability or the intellectual level of the participant. The activities are dementia-friendly, not academically challenging. Brain Stim uses simple techniques to set the participant up for success.

Reminders

Helping people with dementia is serious business. Brain Stim is a Cognitive Engagement Program – not an entertainment or recreation program. However, the program can and should be fun. Enjoyment will be derived through the positive interactions that occur between the participant and the Activity Partner as they go through the steps of the program together. Because Brain Stim ahs done the work for you behind the scenes, you can keep the atmosphere lighthearted and make the time spent using Brain Stim enjoyable.

The instructions for Brain Stim activities are written concisely to keep them simple and to keep the pages as uncluttered and as easy to read as possible. Some participants will be able to correctly follow most of the directions as they are written while others will not be able to due to the degree of dementia they have. Since the object of using Brain Stim is to expose the participant to as much cognitive stimulation and emotional support as possible, Activity Partners need to be careful not to "give orders" or to tell the participant what they have to do in cases where following an instruction may be impossible. Instructions are written as a guide for the Activity Partner to explain to the participant what the steps of the activity are. As you pre-read the instructions, gauge which steps your participant should be able to do and which ones they may have difficulty with. For steps they should be able to complete you can read the instruction as it is written.
For the steps you anticipate them having difficulty with, use the following guide and change the instruction by adding one of the following phrases to the instructions as it becomes necessary to prevent their frustration.

Phrases to Use During Activities

Use these to indicate you are in this together:

"Let's..."
"Now we are going to..."
Use these to lessen expectations and reduce frustration:
"See if you can..."
"Let's attempt to..."
"Let's see if we can..."
"Try to..."
"Imagine if you were to..."

Phrases to use when a step is completed for the participant by the Activity Partner:

"Imagine if you...would it look like this?"
"If I did...would it look right to you?"
"Do you think we should...?"
"Does this look okay to you?"
"How do you feel about doing it this way?"
"How about this?"
"In your opinion..."

Suggested Order of Activities

Keep in mind the entire Brain Stim Cognitive Engagement Program was designed with a flexibility that allows you to pull out parts of the program and insert them into the time frame that works for you on any given day. The following are simply guidelines to give you a place to start.

Brain Stim Basic

• Begin with Seated Stretch or Just Breathe! to help improve blood flow to the brain and to help the participant feel awake yet relaxed – this also effective to help wake someone after nap
• Follow that with the Cognitive Engagement of the Day
• End with the Mindfulness Moments exercise of your choice
• Repeat the Seated Stretch or a Mindfulness Moment of your choice any time of day that there is evidence of anxiety, restlessness, fear, or anger and prior to bed for better sleep.

Brain Stim Advanced

• Begin with Seated Stretch to help improve blood flow to the brain and to help the participant feel awake yet relaxed
• Enjoy the GIG of the Day (Greetings, Inspiration & Gratitude)
• Use Just Breathe! to prepare the lungs and get the most benefit from singing prior to Nostalgia, Notes & Neurons
• Enjoy Nostalgia, Notes & Neurons
• If there is a break between Nostalgia, Notes & Neurons and the Cognitive Engagement of the Day, you may want to repeat a short version of Seated Stretch prior to the cognitive activity
• Next, do the Cognitive Engagement of the Day
• End with the Mindfulness Moments exercise of your choice
• Repeat the Seated Stretch or a Mindfulness Moment of your choice any time of day that there is evidence of anxiety, restlessness, fear, or anger and prior to bed for better sleep.