Elderly Cognitive Health Education Lesson Plan for Middle Class

The core of this lesson plan is for the "middle class" group in the classification of elderly care services - that is, the elderly who are basically self-care, have mild cognitive impairment (MCI) but have not yet reached moderate dementia, and do not need 24-hour dedicated care. Based on the principle of "low resistance, high participation, and implementability", it takes into account the three core goals of cognitive delay, social maintenance, and risk avoidance. It rejects standardized "question-based" training and integrates intervention content into daily life scenarios, ultimately achieving the goal of slowing down cognitive decline and improving the quality of life of the elderly.

Speaking of which, I have been working as a cognitive intervention volunteer at a community nursing home for almost 4 years. This is the group I have the most contact with, and I have gone through more pitfalls than I have accumulated experience. At first, I copied the standardized lesson plans from the university laboratory, and asked the elderly to do number elimination and building block matching. Every time, the attendance rate could not even reach 50%. Uncle Li, a retired teacher, hid when he saw me. Later, I heard from the nurse that he felt that these were "questions for fools."

There are actually quite a lot of differences in thinking about cognitive intervention in the industry: academics prefer standardized tools, saying that training data can be quantified, making it easy to track effects, and there is a clear basis for applying for government service subsidies.； Most front-line elderly care practitioners prefer life-oriented training and feel that the elderly are highly accepting and will not have the stigma of "I am a patient." I have been trying it myself for more than half a year, and I feel that it is actually possible to combine them without having to take sides.

For example, in the first class, I never said, "Today we will do cognitive training." I started by handing out washed tomatoes or tangerines to everyone, and chatting while eating: "What did everyone eat last night?" Who remembers what I mentioned last week that I would bring an old family photo with me today? 」No one will think that this is training. In fact, this is a test of instant memory. By the way, you can also find out the cognitive baseline of each elderly person - those who can accurately name three dishes, those who can only name one, and those who can't even remember what they ate yesterday will naturally have to separate the difficulty when arranging tasks later.

Oh, by the way, here is a controversy that has been quarreling in the industry for a long time: Should the results of cognitive screening be reported directly to the elderly? One group says that it must be informed, and the elderly will take the initiative to adjust their living habits if they know their situation clearly. ； The other group is firmly opposed, saying that the elderly are prone to anxiety, and hearing that there is something wrong with their brains will actually cause psychological problems and accelerate cognitive decline. My own experience is really impressive: for someone like Uncle Li who has been a teacher and loves to read health science, if you explain the screening report clearly to him and tell him that it is just a mild recession now, and that good intervention can last for more than ten years without affecting his life, he will take the initiative to quit smoking and limit alcohol, and arrive ten minutes early for every class. ； But like Aunt Wang upstairs, she cried for three days when she heard that her neighbor had Alzheimer's disease. In this case, I only tell the family members the results. I usually just say to her, "Let's play some games together to use our brains so that we don't forget things, so that I can make delicious food for my grandson in the future."

The theme that I often post recently is "Nostalgic Food". Every time I talk about the dishes I ate during the Chinese New Year when I was a kid, the place gets hot instantly: Some people say that when I was a kid, I could only eat braised pork with pickles and vegetables during the Chinese New Year. It was so fat and oily that I couldn't bear to leave any.； Some people say that they are most looking forward to the sugar cake made by grandma. It has just been fried and hot and they have to change hands to take a bite. When the conversation got interesting, we asked everyone to make a list of ingredients for their favorite dishes. Those who could name more than three ingredients would be given a small prize - a few yuan of pure cotton handkerchiefs and sulfur soap, which are treasured by the elderly. You see, this is actually hiding the training of semantic memory and executive functions in the chat. It is much more effective than sitting there doing exercises all afternoon. The attendance rate of the last class on this topic went straight to 90%. Uncle Li also took the initiative to stand up and share that when he was young and working in other places, what he wanted to eat the most was the hand-made noodles made by his wife, which made his wife secretly wipe his tears underneath.

The biggest pitfall I ever encountered was that in an arithmetic competition before, there was a 78-year-old Grandma Zhang who had never gone to school, could not read, and could not do arithmetic. She sat there with her face turning red from holding herself back. She excused herself to drink water and left in the middle of the competition. She did not come to the inn for the next half month. From then on, I always designed the content with three levels of difficulty: the elderly who could not read were asked to recognize pictures of common vegetables, those who could read were asked to write the names of the dishes, and those who were highly educated were even asked to calculate how much it would cost to cook the dish. There was absolutely no unified standard. The self-esteem of the elderly was more important than any training effect.

As for effect evaluation, I will not ask the elderly to do the scale every month. Last time, there was an aunt who couldn't even remember her son's phone number when she first came here. She had been taking classes for three months. Last week, she came over to tell me that she called her grandson yesterday and asked him if he wanted to come to her house to eat the braised pork she cooked. Her eyes lit up when she said it. Do you think this change can be compared to a few points increase on the scale?

Oh, by the way, this lesson plan has never been fixed. Some time ago during the Dragon Boat Festival, I changed all the content to the theme of making rice dumplings. We counted the rice dumpling leaves together, recorded how many dates and meters to put in, and practiced calculations and hands-on skills. The results were much better than the preset content before. There are no absolute standards for teaching lessons to the elderly. If they are willing to come, they can greet people with a smile when they come, and they can remember to share with their families what they played today, this is better than anything else.