Laura Gitlin, dean of the College of Nursing and Health Professions at Drexel University, said that adding meaningful activities to the day is particularly crucial for people with dementia, who often face blank calendars as their cognitive problems grow.
“Boredom and having nothing to do contributes to having an array of behavioral symptoms, agitation, aggressiveness, apathy, rejection of care,” she said. Dr. Gitlin and colleagues have developed the Tailored Activity Program that identifies activities that are meaningful to people with dementia — it could be woodworking or making a salad — adapts them to their abilities and regularly schedules them into the patients’ days.
“Activity is part of what makes us human,” Dr. Gitlin said.
Patients being treated with PATH include those who are having their first episode of depression, and those, like Ms. Firmender, who have long struggled with mental health issues. She has seen a therapist for 20 years and has been on various psychiatric medications.
Over the years, the depressive thoughts have waxed and waned. About three years ago, Ms. Firmender was hospitalized for suicidal thoughts and underwent a course of electroconvulsive therapy. After another brief hospitalization, she did PATH in early 2018 as a participant in a Weill Cornell study looking at the treatment for suicidal ideation. After her depression symptoms surged again recently, Dr. Kiosses started her on another course of PATH, this one focused on depression.
When Ms. Firmender slides into depression, she turns to writing poetry. During one therapy session, she took out a yellow notebook and read a verse she wrote:
I can’t find my happy place
It was never easy to find but now it seems forever gone
It’s in my mind in some deep dark places.
Ms. Firmender said the program was helping her get a handle on such feelings. What she really likes is that it focuses on solving problems.
“It isn’t, ‘oh, poor Anne,’ because then you do nothing about it and you feel worse, you feel really sorry for yourself,” she said. “It’s like, ‘O.K., Anne, what are you going to do about it?’”