Activate the Cat Dude: Activity Log.
Stealthy accurate sleek feline forms.
This report is for Resident :
First Name
Last Name
Or :The residents in the group today were:
Date Form Generated:
-
Month
-
Day
Year
Date Picker Icon
Name Of Establishment:
The Person Filling out form:
First Name
Last Name
Their Position in the Organisation Is that of :
Please Select
Activity Organiser
Manager
Care Staff
My Weekly Objective this week is :
*
That they Continue to be interested/Motivated
That they Maintain attention/Concentration
That that they Solve problems satisfactorily
That they Form good relationships/others/staff
That they recieve person Centered Activities
That they are Meaningfull occupation Activities
That they use physical movement to aid mobility
That they show Cognitive memory retention
That they show an improvement in their general health
That agression displays are Minimised
Mondays Activity Was
Please Select
Craft exercise making Tissue Art.
Craft exercise making Paper Flowers.
Craft exercise Knitting.
Craft exercise using Plastercine to make Models.
Craft exercise of Potato shape stamping.
Craft exercise of making Paper Airoplanes.
Craft exercise of Painting.
Craft exercise of Pom Pom Making.
Craft exercise of Sowing.
Memory agility of Word Search.
Memory agility of Speeling test.
Memory agility of Memory Game.
Memory agility of Name that Sound.
Memory agility of A Quiz
Gardening exercise of Arranging Flowers in a vase
Gardening exercise of Weeding in the Garden
Gardening exercise of Planting Seeds Into Pots.
Gardening exercise of Cleaning Tools.
Gardening exercise of Picking Up Leaves.
Relaxing Watching TV.
Relaxing Listening to Music.
Relaxing with Radio 4.
Relaxing Reading a Newspaper.
Relaxing with a good Book.
Relaxing with a crossword.
Relaxing having a Head Massage.
Relaxing having a Hand Massage.
Relaxing with an aromatherapy Session.
Relaxing Listening an watching a Singer or entertainer.
Physical exercise with an instructor.
Physical exercise Hitting a Balloon around.
Physical exercise using a Ball.
Physical exercise using a Hoola Hoop.
Physical exercise using Bean Bags.
Physical exercise in a Chair.
Physical exercise in a Bed
Physical exercise using Tie Chei.
Physical exercise Singing.
Physical exercise Walking in the grounds.
Physical exercise helping with a Job.
Physical exercise of Pass The Parcel.
Physical exercise of Skittles.
Physical exercise of Indoor Croquet.
Had a Family Visit.
Had a Doctors Visit.
Had a Dentist Visit.
Had an Opticions Visit.
Had a Friend Visit.
Attended a Party In the Care Home.
Attended a Special Occation In the Care Home.
Attended another Persons Birthday Party.
Attended an Outside Function.
Taken by Friends or Relatives Outside of the Home.
Taken by the home to a Garden Center.
Taken to a Day Care Center.
Taken to a Hospital
Taken to a Funerall.
Given a task of Cleaning Shoes.
Given a task of Laying a Table
Given a task of Folding Napkins.
Given a task of Folding Laundery.
Given a task of A Rummage Box.
Given an Activity Lap tray.
Given a task of Tidying Up A Draw.
Given a task of Polishing.
Culinary exercise of Making Bread.
Culinary exercise of Filling Up Sugar Bowle.
Culinary exercise of Filling up Salt and Pepper Pots.
Culinary exercise of Making Jelly.
Culinary exercise of Making a Salad.
Culinary exercise of Making Rice Cakes.
One to one conversation session.
In Which They :
*
Did not enjoy
Partially enjoyed
Wholeheartedly enjoyed
Participated Fully
Participated very little
They did a Secondary Activity
Please Select
Craft exercise making Tissue Art.
Craft exercise making Paper Flowers.
Craft exercise Knitting.
Craft exercise using Plastercine to make Models.
Craft exercise of Potato shape stamping.
Craft exercise of making Paper Airoplanes.
Craft exercise of Painting.
Craft exercise of Pom Pom Making.
Craft exercise of Sowing.
Memory agility of Word Search.
Memory agility of Speeling test.
Memory agility of Memory Game.
Memory agility of Name that Sound.
Memory agility of A Quiz
Gardening exercise of Arranging Flowers in a vase
Gardening exercise of Weeding in the Garden
Gardening exercise of Planting Seeds Into Pots.
Gardening exercise of Cleaning Tools.
Gardening exercise of Picking Up Leaves.
Relaxing Watching TV.
Relaxing Listening to Music.
Relaxing with Radio 4.
Relaxing Reading a Newspaper.
Relaxing with a good Book.
Relaxing with a crossword.
Relaxing having a Head Massage.
Relaxing having a Hand Massage.
Relaxing with an aromatherapy Session.
Relaxing Listening an watching a Singer or entertainer.
Physical exercise with an instructor.
Physical exercise Hitting a Balloon around.
Physical exercise using a Ball.
Physical exercise using a Hoola Hoop.
Physical exercise using Bean Bags.
Physical exercise in a Chair.
Physical exercise in a Bed
Physical exercise using Tie Chei.
Physical exercise Singing.
Physical exercise Walking in the grounds.
Physical exercise helping with a Job.
Physical exercise of Pass The Parcel.
Physical exercise of Skittles.
Physical exercise of Indoor Croquet.
Had a Family Visit.
Had a Doctors Visit.
Had a Dentist Visit.
Had an Opticions Visit.
Had a Friend Visit.
Attended a Party In the Care Home.
Attended a Special Occation In the Care Home.
Attended another Persons Birthday Party.
Attended an Outside Function.
Taken by Friends or Relatives Outside of the Home.
Taken by the home to a Garden Center.
Taken to a Day Care Center.
Taken to a Hospital
Taken to a Funerall.
Given a task of Cleaning Shoes.
Given a task of Laying a Table
Given a task of Folding Napkins.
Given a task of Folding Laundery.
Given a task of A Rummage Box.
Given an Activity Lap tray.
Given a task of Tidying Up A Draw.
Given a task of Polishing.
Culinary exercise of Making Bread.
Culinary exercise of Filling Up Sugar Bowle.
Culinary exercise of Filling up Salt and Pepper Pots.
Culinary exercise of Making Jelly.Culinary exercise of Making a Salad.
Culinary exercise of Making Rice Cakes.
One to one conversation session.
In Which They :
Did not enjoy
Partially enjoyed
Wholeheartedly enjoyed
Participated Fully
Participated very little
They used these sences in the tasks:
Touch.
Hearing
Smell
Sight
Taste
Second Sight
Intuition
At this time of the day they seemed:
Tired
Sleepy
Normal
Exhuberent
as this activity took place after Breakfast
as this activity took place after Lunch
as this activity took place after Dinner
Today their emotional state seemed to be one of:
Participation.
Enthusiasm.
Inclusion.
Purpose
Achievement
Security
Engagement
In a Group They Were:
Responsive to Others
Responsible for Others
Sharing
Civil
Aloof
Solitary
Declined to Participate
Tuesdays Activity was :
Please Select
Craft exercise making Tissue Art.
Craft exercise making Paper Flowers.
Craft exercise Knitting.
Craft exercise using Plastercine to make Models.
Craft exercise of Potato shape stamping.
Craft exercise of making Paper Airoplanes.
Craft exercise of Painting.
Craft exercise of Pom Pom Making.
Craft exercise of Sowing.
Memory agility of Word Search.
Memory agility of Speeling test.
Memory agility of Memory Game.
Memory agility of Name that Sound.
Memory agility of A Quiz
Gardening exercise of Arranging Flowers in a vase
Gardening exercise of Weeding in the Garden
Gardening exercise of Planting Seeds Into Pots.
Gardening exercise of Cleaning Tools.
Gardening exercise of Picking Up Leaves.
Relaxing Watching TV.
Relaxing Listening to Music.
Relaxing with Radio 4.
Relaxing Reading a Newspaper.
Relaxing with a good Book.
Relaxing with a crossword.
Relaxing having a Head Massage.
Relaxing having a Hand Massage.
Relaxing with an aromatherapy Session.
Relaxing Listening an watching a Singer or entertainer.
Physical exercise with an instructor.
Physical exercise Hitting a Balloon around.
Physical exercise using a Ball.
Physical exercise using a Hoola Hoop.
Physical exercise using Bean Bags.
Physical exercise in a Chair.
Physical exercise in a Bed
Physical exercise using Tie Chei.
Physical exercise Singing.
Physical exercise Walking in the grounds.
Physical exercise helping with a Job.
Physical exercise of Pass The Parcel.
Physical exercise of Skittles.
Physical exercise of Indoor Croquet.
Had a Family Visit.
Had a Doctors Visit.
Had a Dentist Visit.
Had an Opticions Visit.
Had a Friend Visit.
Attended a Party In the Care Home.
Attended a Special Occation In the Care Home.
Attended another Persons Birthday Party.
Attended an Outside Function.
Taken by Friends or Relatives Outside of the Home.
Taken by the home to a Garden Center.
Taken to a Day Care Center.
Taken to a Hospital
Taken to a Funerall.
Given a task of Cleaning Shoes.
Given a task of Laying a Table
Given a task of Folding Napkins.
Given a task of Folding Laundery.
Given a task of A Rummage Box.
Given an Activity Lap tray.
Given a task of Tidying Up A Draw.
Given a task of Polishing.
Culinary exercise of Making Bread.
Culinary exercise of Filling Up Sugar Bowle.
Culinary exercise of Filling up Salt and Pepper Pots.
Culinary exercise of Making Jelly.
Culinary exercise of Making a Salad.
Culinary exercise of Making Rice Cakes.
One to one conversation session.
In Which They :
*
Did not enjoy
Partially enjoyed
Wholeheartedly enjoyed
Participated Fully
Participated very little
They did a Secondary Activity:
Please Select
Craft exercise making Tissue Art.
Craft exercise making Paper Flowers.
Craft exercise Knitting.
Craft exercise using Plastercine to make Models.
Craft exercise of Potato shape stamping.
Craft exercise of making Paper Airoplanes.
Craft exercise of Painting.
Craft exercise of Pom Pom Making.
Craft exercise of Sowing.
Memory agility of Word Search.
Memory agility of Speeling test.
Memory agility of Memory Game.
Memory agility of Name that Sound.
Memory agility of A Quiz
Gardening exercise of Arranging Flowers in a vase
Gardening exercise of Weeding in the Garden
Gardening exercise of Planting Seeds Into Pots.
Gardening exercise of Cleaning Tools.
Gardening exercise of Picking Up Leaves.
Relaxing Watching TV.
Relaxing Listening to Music.
Relaxing with Radio 4.
Relaxing Reading a Newspaper.
Relaxing with a good Book.
Relaxing with a crossword.
Relaxing having a Head Massage.
Relaxing having a Hand Massage.
Relaxing with an aromatherapy Session.
Relaxing Listening an watching a Singer or entertainer.
Physical exercise with an instructor.
Physical exercise Hitting a Balloon around.
Physical exercise using a Ball.
Physical exercise using a Hoola Hoop.
Physical exercise using Bean Bags.
Physical exercise in a Chair.
Physical exercise in a Bed
Physical exercise using Tie Chei.
Physical exercise Singing.
Physical exercise Walking in the grounds.
Physical exercise helping with a Job.
Physical exercise of Pass The Parcel.
Physical exercise of Skittles.
Physical exercise of Indoor Croquet.
Had a Family Visit.
Had a Doctors Visit.
Had a Dentist Visit.
Had an Opticions Visit.
Had a Friend Visit.
Attended a Party In the Care Home.
Attended a Special Occation In the Care Home.
Attended another Persons Birthday Party.
Attended an Outside Function.
Taken by Friends or Relatives Outside of the Home.
Taken by the home to a Garden Center.
Taken to a Day Care Center.
Taken to a Hospital
Taken to a Funerall.
Given a task of Cleaning Shoes.
Given a task of Laying a Table
Given a task of Folding Napkins.
Given a task of Folding Laundery.
Given a task of A Rummage Box.
Given an Activity Lap tray.
Given a task of Tidying Up A Draw.
Given a task of Polishing.
Culinary exercise of Making Bread.
Culinary exercise of Filling Up Sugar Bowle.
Culinary exercise of Filling up Salt and Pepper Pots.
Culinary exercise of Making Jelly.Culinary exercise of Making a Salad.
Culinary exercise of Making Rice Cakes.
One to one conversation session.
In Which They :
Did not enjoy
Partially enjoyed
Wholeheartedly enjoyed
Participated Fully
Participated very little
They used these sences in the tasks:
Touch.
Hearing
Smell
Sight
Taste
Second Sight
Intuition
At this time of the day they seemed:
Tired
Sleepy
Normal
Exhuberent
as this activity took place after Breakfast
as this activity took place after Lunch
as this activity took place after Dinner
Today their emotional state seemed to be one of:
Participation.
Enthusiasm.
Inclusion.
Purpose
Achievement
Security
Engagement
In a Group They Were
Responsive to Others
Responsible for Others
Sharing
Civil
Aloof
Solitary
Declined to Participate
Wednesday Activity was :
*
Please Select
Craft exercise making Tissue Art.
Craft exercise making Paper Flowers.
Craft exercise Knitting.
Craft exercise using Plastercine to make Models.
Craft exercise of Potato shape stamping.
Craft exercise of making Paper Airoplanes.
Craft exercise of Painting.
Craft exercise of Pom Pom Making.
Craft exercise of Sowing.
Memory agility of Word Search.
Memory agility of Speeling test.
Memory agility of Memory Game.
Memory agility of Name that Sound.
Memory agility of A Quiz
Gardening exercise of Arranging Flowers in a vase
Gardening exercise of Weeding in the Garden
Gardening exercise of Planting Seeds Into Pots.
Gardening exercise of Cleaning Tools.
Gardening exercise of Picking Up Leaves.
Relaxing Watching TV.
Relaxing Listening to Music.
Relaxing with Radio 4.
Relaxing Reading a Newspaper.
Relaxing with a good Book.
Relaxing with a crossword.
Relaxing having a Head Massage.
Relaxing having a Hand Massage.
Relaxing with an aromatherapy Session.
Relaxing Listening an watching a Singer or entertainer.
Physical exercise with an instructor.
Physical exercise Hitting a Balloon around.
Physical exercise using a Ball.
Physical exercise using a Hoola Hoop.
Physical exercise using Bean Bags.
Physical exercise in a Chair.
Physical exercise in a Bed
Physical exercise using Tie Chei.
Physical exercise Singing.
Physical exercise Walking in the grounds.
Physical exercise helping with a Job.
Physical exercise of Pass The Parcel.
Physical exercise of Skittles.
Physical exercise of Indoor Croquet.
Had a Family Visit.
Had a Doctors Visit.
Had a Dentist Visit.
Had an Opticions Visit.
Had a Friend Visit.
Attended a Party In the Care Home.
Attended a Special Occation In the Care Home.
Attended another Persons Birthday Party.
Attended an Outside Function.
Taken by Friends or Relatives Outside of the Home.
Taken by the home to a Garden Center.
Taken to a Day Care Center.
Taken to a Hospital
Taken to a Funerall.
Given a task of Cleaning Shoes.
Given a task of Laying a Table
Given a task of Folding Napkins.
Given a task of Folding Laundery.
Given a task of A Rummage Box.
Given an Activity Lap tray.
Given a task of Tidying Up A Draw.
Given a task of Polishing.
Culinary exercise of Making Bread.
Culinary exercise of Filling Up Sugar Bowle.
Culinary exercise of Filling up Salt and Pepper Pots.
Culinary exercise of Making Jelly.
Culinary exercise of Making a Salad.
Culinary exercise of Making Rice Cakes.
One to one conversation session.
In Which They :
Did not enjoy
Partially enjoyed
Wholeheartedly enjoyed
Participated Fully
Participated very little
They did a Secondary Activity
Please Select
Craft exercise making Tissue Art.
Craft exercise making Paper Flowers.
Craft exercise Knitting.
Craft exercise using Plastercine to make Models.
Craft exercise of Potato shape stamping.
Craft exercise of making Paper Airoplanes.
Craft exercise of Painting.
Craft exercise of Pom Pom Making.
Craft exercise of Sowing.
Memory agility of Word Search.
Memory agility of Speeling test.
Memory agility of Memory Game.
Memory agility of Name that Sound.
Memory agility of A Quiz
Gardening exercise of Arranging Flowers in a vase
Gardening exercise of Weeding in the Garden
Gardening exercise of Planting Seeds Into Pots.
Gardening exercise of Cleaning Tools.
Gardening exercise of Picking Up Leaves.
Relaxing Watching TV.
Relaxing Listening to Music.
Relaxing with Radio 4.
Relaxing Reading a Newspaper.
Relaxing with a good Book.
Relaxing with a crossword.
Relaxing having a Head Massage.
Relaxing having a Hand Massage.
Relaxing with an aromatherapy Session.
Relaxing Listening an watching a Singer or entertainer.
Physical exercise with an instructor.
Physical exercise Hitting a Balloon around.
Physical exercise using a Ball.
Physical exercise using a Hoola Hoop.
Physical exercise using Bean Bags.
Physical exercise in a Chair.
Physical exercise in a Bed
Physical exercise using Tie Chei.
Physical exercise Singing.
Physical exercise Walking in the grounds.
Physical exercise helping with a Job.
Physical exercise of Pass The Parcel.
Physical exercise of Skittles.
Physical exercise of Indoor Croquet.
Had a Family Visit.
Had a Doctors Visit.
Had a Dentist Visit.
Had an Opticions Visit.
Had a Friend Visit.
Attended a Party In the Care Home.
Attended a Special Occation In the Care Home.
Attended another Persons Birthday Party.
Attended an Outside Function.
Taken by Friends or Relatives Outside of the Home.
Taken by the home to a Garden Center.
Taken to a Day Care Center.
Taken to a Hospital
Taken to a Funerall.
Given a task of Cleaning Shoes.
Given a task of Laying a Table
Given a task of Folding Napkins.
Given a task of Folding Laundery.
Given a task of A Rummage Box.
Given an Activity Lap tray.
Given a task of Tidying Up A Draw.
Given a task of Polishing.
Culinary exercise of Making Bread.
Culinary exercise of Filling Up Sugar Bowle.
Culinary exercise of Filling up Salt and Pepper Pots.
Culinary exercise of Making Jelly.Culinary exercise of Making a Salad.
Culinary exercise of Making Rice Cakes.
One to one conversation session.
In Which They :
Did not enjoy
Partially enjoyed
Wholeheartedly enjoyed
Participated Fully
Participated very little
They used these sences in the tasks:
Touch.
Hearing
Smell
Sight
Taste
Second Sight
Intuition
At this time of the day they seemed:
Tired
Sleepy
Normal
Exhuberent
as this activity took place after Breakfast
as this activity took place after Lunch
as this activity took place after Dinner
Today their emotional state seemed to be one of:
Participation.
Enthusiasm.
Inclusion.
Purpose
Achievement
Security
Engagement
In a Group They Were
Responsive to Others
Responsible for Others
Sharing
Civil
Aloof
Solitary
Declined to Participate
Thursday Activity was :
Please Select
Craft exercise making Tissue Art.
Craft exercise making Paper Flowers.
Craft exercise Knitting.
Craft exercise using Plastercine to make Models.
Craft exercise of Potato shape stamping.
Craft exercise of making Paper Airoplanes.
Craft exercise of Painting.
Craft exercise of Pom Pom Making.
Craft exercise of Sowing.
Memory agility of Word Search.
Memory agility of Speeling test.
Memory agility of Memory Game.
Memory agility of Name that Sound.
Memory agility of A Quiz
Gardening exercise of Arranging Flowers in a vase
Gardening exercise of Weeding in the Garden
Gardening exercise of Planting Seeds Into Pots.
Gardening exercise of Cleaning Tools.
Gardening exercise of Picking Up Leaves.
Relaxing Watching TV.
Relaxing Listening to Music.
Relaxing with Radio 4.
Relaxing Reading a Newspaper.
Relaxing with a good Book.
Relaxing with a crossword.
Relaxing having a Head Massage.
Relaxing having a Hand Massage.
Relaxing with an aromatherapy Session.
Relaxing Listening an watching a Singer or entertainer.
Physical exercise with an instructor.
Physical exercise Hitting a Balloon around.
Physical exercise using a Ball.
Physical exercise using a Hoola Hoop.
Physical exercise using Bean Bags.
Physical exercise in a Chair.
Physical exercise in a Bed
Physical exercise using Tie Chei.
Physical exercise Singing.
Physical exercise Walking in the grounds.
Physical exercise helping with a Job.
Physical exercise of Pass The Parcel.
Physical exercise of Skittles.
Physical exercise of Indoor Croquet.
Had a Family Visit.
Had a Doctors Visit.
Had a Dentist Visit.
Had an Opticions Visit.
Had a Friend Visit.
Attended a Party In the Care Home.
Attended a Special Occation In the Care Home.
Attended another Persons Birthday Party.
Attended an Outside Function.
Taken by Friends or Relatives Outside of the Home.
Taken by the home to a Garden Center.
Taken to a Day Care Center.
Taken to a Hospital
Taken to a Funerall.
Given a task of Cleaning Shoes.
Given a task of Laying a Table
Given a task of Folding Napkins.
Given a task of Folding Laundery.
Given a task of A Rummage Box.
Given an Activity Lap tray.
Given a task of Tidying Up A Draw.
Given a task of Polishing.
Culinary exercise of Making Bread.
Culinary exercise of Filling Up Sugar Bowle.
Culinary exercise of Filling up Salt and Pepper Pots.
Culinary exercise of Making Jelly.
Culinary exercise of Making a Salad.
Culinary exercise of Making Rice Cakes.
One to one conversation session.
In Which They :
*
Did not enjoy
Partially enjoyed
Wholeheartedly enjoyed
Participated Fully
Participated very little
They did a Secondary Activity
Please Select
Craft exercise making Tissue Art.
Craft exercise making Paper Flowers.
Craft exercise Knitting.
Craft exercise using Plastercine to make Models.
Craft exercise of Potato shape stamping.
Craft exercise of making Paper Airoplanes.
Craft exercise of Painting.
Craft exercise of Pom Pom Making.
Craft exercise of Sowing.
Memory agility of Word Search.
Memory agility of Speeling test.
Memory agility of Memory Game.
Memory agility of Name that Sound.
Memory agility of A Quiz
Gardening exercise of Arranging Flowers in a vase
Gardening exercise of Weeding in the Garden
Gardening exercise of Planting Seeds Into Pots.
Gardening exercise of Cleaning Tools.
Gardening exercise of Picking Up Leaves.
Relaxing Watching TV.
Relaxing Listening to Music.
Relaxing with Radio 4.
Relaxing Reading a Newspaper.
Relaxing with a good Book.
Relaxing with a crossword.
Relaxing having a Head Massage.
Relaxing having a Hand Massage.
Relaxing with an aromatherapy Session.
Relaxing Listening an watching a Singer or entertainer.
Physical exercise with an instructor.
Physical exercise Hitting a Balloon around.
Physical exercise using a Ball.
Physical exercise using a Hoola Hoop.
Physical exercise using Bean Bags.
Physical exercise in a Chair.
Physical exercise in a Bed
Physical exercise using Tie Chei.
Physical exercise Singing.
Physical exercise Walking in the grounds.
Physical exercise helping with a Job.
Physical exercise of Pass The Parcel.
Physical exercise of Skittles.
Physical exercise of Indoor Croquet.
Had a Family Visit.
Had a Doctors Visit.
Had a Dentist Visit.
Had an Opticions Visit.
Had a Friend Visit.
Attended a Party In the Care Home.
Attended a Special Occation In the Care Home.
Attended another Persons Birthday Party.
Attended an Outside Function.
Taken by Friends or Relatives Outside of the Home.
Taken by the home to a Garden Center.
Taken to a Day Care Center.
Taken to a Hospital
Taken to a Funerall.
Given a task of Cleaning Shoes.
Given a task of Laying a Table
Given a task of Folding Napkins.
Given a task of Folding Laundery.
Given a task of A Rummage Box.
Given an Activity Lap tray.
Given a task of Tidying Up A Draw.
Given a task of Polishing.
Culinary exercise of Making Bread.
Culinary exercise of Filling Up Sugar Bowle.
Culinary exercise of Filling up Salt and Pepper Pots.
Culinary exercise of Making Jelly.Culinary exercise of Making a Salad.
Culinary exercise of Making Rice Cakes.
One to one conversation session.
In Which They :
Did not enjoy
Partially enjoyed
Wholeheartedly enjoyed
Participated Fully
Participated very little
They used these sences in the tasks:
Touch.
Hearing
Smell
Sight
Taste
Second Sight
Intuition
At this time of the day they seemed:
Tired
Sleepy
Normal
Exhuberent
as this activity took place after Breakfast
as this activity took place after Lunch
as this activity took place after Dinner
Today their emotional state seemed to be one of:
Participation.
Enthusiasm.
Inclusion.
Purpose
Achievement
Security
Engagement
In a Group They Were
Responsive to Others
Responsible for Others
Sharing
Civil
Aloof
Solitary
Declined to Participate
Friday Activity was :
Please Select
Craft exercise making Tissue Art.
Craft exercise making Paper Flowers.
Craft exercise Knitting.
Craft exercise using Plastercine to make Models.
Craft exercise of Potato shape stamping.
Craft exercise of making Paper Airoplanes.
Craft exercise of Painting.
Craft exercise of Pom Pom Making.
Craft exercise of Sowing.
Memory agility of Word Search.
Memory agility of Speeling test.
Memory agility of Memory Game.
Memory agility of Name that Sound.
Memory agility of A Quiz
Gardening exercise of Arranging Flowers in a vase
Gardening exercise of Weeding in the Garden
Gardening exercise of Planting Seeds Into Pots.
Gardening exercise of Cleaning Tools.
Gardening exercise of Picking Up Leaves.
Relaxing Watching TV.
Relaxing Listening to Music.
Relaxing with Radio 4.
Relaxing Reading a Newspaper.
Relaxing with a good Book.
Relaxing with a crossword.
Relaxing having a Head Massage.
Relaxing having a Hand Massage.
Relaxing with an aromatherapy Session.
Relaxing Listening an watching a Singer or entertainer.
Physical exercise with an instructor.
Physical exercise Hitting a Balloon around.
Physical exercise using a Ball.
Physical exercise using a Hoola Hoop.
Physical exercise using Bean Bags.
Physical exercise in a Chair.
Physical exercise in a Bed
Physical exercise using Tie Chei.
Physical exercise Singing.
Physical exercise Walking in the grounds.
Physical exercise helping with a Job.
Physical exercise of Pass The Parcel.
Physical exercise of Skittles.
Physical exercise of Indoor Croquet.
Had a Family Visit.
Had a Doctors Visit.
Had a Dentist Visit.
Had an Opticions Visit.
Had a Friend Visit.
Attended a Party In the Care Home.
Attended a Special Occation In the Care Home.
Attended another Persons Birthday Party.
Attended an Outside Function.
Taken by Friends or Relatives Outside of the Home.
Taken by the home to a Garden Center.
Taken to a Day Care Center.
Taken to a Hospital
Taken to a Funerall.
Given a task of Cleaning Shoes.
Given a task of Laying a Table
Given a task of Folding Napkins.
Given a task of Folding Laundery.
Given a task of A Rummage Box.
Given an Activity Lap tray.
Given a task of Tidying Up A Draw.
Given a task of Polishing.
Culinary exercise of Making Bread.
Culinary exercise of Filling Up Sugar Bowle.
Culinary exercise of Filling up Salt and Pepper Pots.
Culinary exercise of Making Jelly.
Culinary exercise of Making a Salad.
Culinary exercise of Making Rice Cakes.
One to one conversation session.
In Which They :
*
Did not enjoy
Partially enjoyed
Wholeheartedly enjoyed
Participated Fully
Participated very little
They did a Secondary Activity
Please Select
Craft exercise making Tissue Art.
Craft exercise making Paper Flowers.
Craft exercise Knitting.
Craft exercise using Plastercine to make Models.
Craft exercise of Potato shape stamping.
Craft exercise of making Paper Airoplanes.
Craft exercise of Painting.
Craft exercise of Pom Pom Making.
Craft exercise of Sowing.
Memory agility of Word Search.
Memory agility of Speeling test.
Memory agility of Memory Game.
Memory agility of Name that Sound.
Memory agility of A Quiz
Gardening exercise of Arranging Flowers in a vase
Gardening exercise of Weeding in the Garden
Gardening exercise of Planting Seeds Into Pots.
Gardening exercise of Cleaning Tools.
Gardening exercise of Picking Up Leaves.
Relaxing Watching TV.
Relaxing Listening to Music.
Relaxing with Radio 4.
Relaxing Reading a Newspaper.
Relaxing with a good Book.
Relaxing with a crossword.
Relaxing having a Head Massage.
Relaxing having a Hand Massage.
Relaxing with an aromatherapy Session.
Relaxing Listening an watching a Singer or entertainer.
Physical exercise with an instructor.
Physical exercise Hitting a Balloon around.
Physical exercise using a Ball.
Physical exercise using a Hoola Hoop.
Physical exercise using Bean Bags.
Physical exercise in a Chair.
Physical exercise in a Bed
Physical exercise using Tie Chei.
Physical exercise Singing.
Physical exercise Walking in the grounds.
Physical exercise helping with a Job.
Physical exercise of Pass The Parcel.
Physical exercise of Skittles.
Physical exercise of Indoor Croquet.
Had a Family Visit.
Had a Doctors Visit.
Had a Dentist Visit.
Had an Opticions Visit.
Had a Friend Visit.
Attended a Party In the Care Home.
Attended a Special Occation In the Care Home.
Attended another Persons Birthday Party.
Attended an Outside Function.
Taken by Friends or Relatives Outside of the Home.
Taken by the home to a Garden Center.
Taken to a Day Care Center.
Taken to a Hospital
Taken to a Funerall.
Given a task of Cleaning Shoes.
Given a task of Laying a Table
Given a task of Folding Napkins.
Given a task of Folding Laundery.
Given a task of A Rummage Box.
Given an Activity Lap tray.
Given a task of Tidying Up A Draw.
Given a task of Polishing.
Culinary exercise of Making Bread.
Culinary exercise of Filling Up Sugar Bowle.
Culinary exercise of Filling up Salt and Pepper Pots.
Culinary exercise of Making Jelly.Culinary exercise of Making a Salad.
Culinary exercise of Making Rice Cakes.
One to one conversation session.
In Which They :
Did not enjoy
Partially enjoyed
Wholeheartedly enjoyed
Participated Fully
Participated very little
They used these sences in the tasks:
Touch.
Hearing
Smell
Sight
Taste
Second Sight
Intuition
At this time of the day they seemed:
Tired
Sleepy
Normal
Exhuberent
as this activity took place after Breakfast
as this activity took place after Lunch
as this activity took place after Dinner
Today their emotional state seemed to be one of:
Participation.
Enthusiasm.
Inclusion.
Purpose
Achievement
Security
Engagement
In a Group They Were
Responsive to Others
Responsible for Others
Sharing
Civil
Aloof
Solitary
Declined to Participate
It is noted that Cognitively there may be deterioration in the following:
Please Select
Memory
Orientation
Calculation
Attention
It is noted that in Communication there may be deterioration in the following
Please Select
Speech
Gesturing/Non verbal
Writing
It is noted that in Physicallity there may be deterioration in the following
Please Select
Eyesight
Walking
Sitting
Reaching
Do You/ Did You/ use this week, any of the following. Do You Know What they are?
Please Select
Cognitive Stimulation Therapy (CST)
Validation Theory (VT)
Dementia Care Mapping. (DCM)
Mark as to How acurate you believe this information to be.
1
2
3
4
5
Less Acurate
Most Acurate
1 is Less Acurate, 5 is Most Acurate
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