The second of Kitwood’s five fundamental needs is occupation.
Being occupied is important for well-being. We can take this for granted if we are employed and have structure, purpose and routine in our day. Being occupied can provide the satisfaction of making, digging, painting, folding, sorting, washing up, cooking and so much more. You get the idea. If we achieve it is good for our self-esteem, our confidence to try other things or even just to keep doing the things we do every day which reinforces memory. This is why dressing, washing, eating, grooming are important activities to maintain for a person with dementia. As the condition progresses the person may require gradually increased assistance to achieve success but it is crucial that we do not take over. Our role is to provide the scaffolding for them to successfully perform the task themselves.
Occupation is good for memory because it causes us to retrieve past skills from memory and use them again and again and again. This reactivates the old skills and knowledge and increases the chances of these abilities lasting longer in the face of dementia. Use it or lose it.
If we don’t have the structure of someone around us prompting what is going to happen next we can sit around waiting, stuck and bored particularly if the disease affects the motivational area of our brain. A person in this state is at risk of depression, in addition to the physical problems that can develop due to inactivity.
Boredom is a problem for some people with dementia. This usually occurs if they have difficulty starting themselves. If their “starter motor” is not working as it used to do, they may need you to prompt and prod or make suggestions. You need to work out what manner, tone and approach is going to get the best result. Adjust your approach until you get the right combination of words, tone and manner that triggers the person with dementia into action.
Occupation provides an opportunity to reaffirm our sense of ourselves. Who am I? I am a carpenter, a mother, a gardener, a farmer. How do I know this? Because I do the things that carpenters, mothers, gardeners and farmers do.