The QCS Pool Activity Level (PAL) Instrument for Occupational Profiling by the same author From Dementia to Rementia Jackie Pool ISBN 978 1 83997 315 4 eISBN 978 1 83997 316 1 of related interest About University of Bradford Dementia Good Practice Guides Under the editorship of Professor Murna Downs, this series constitutes a set of accessible, jargon-free, evidence-based good practice guides for all those involved in the care of people with dementia and their families. The series draws together a range of evidence, including the experience of people with dementia and their families, practice wisdom, and research and scholarship to promote quality of life and quality of care. End of Life Care for People with Dementia A Person-Centred Approach Laura Middleton-Green, Jane Chatterjee, Sarah Russell and Murna Downs ISBN 978 1 84905 047 0 eISBN 978 0 85700 512 0 Developing Excellent Care for People Living with Dementia in Care Homes Caroline Baker ISBN 978 1 84905 467 6 eISBN 978 1 78450 053 5 Leadership for Person-Centred Dementia Care Buz Loveday ISBN 978 1 84905 229 0 eISBN 978 0 85700 691 2 Playfulness and Dementia A Practice Guide John Killick ISBN 978 1 84905 223 8 eISBN 978 0 85700 462 8 The QCS Pool Activity Level (PAL) Instrument for Occupational Profiling A Practical Resource for Carers of People with Cognitive Impairment Fifth Edition Jackie Pool Previous editions published in 1999, 2002, 2008 and 2012 by Jessica Kingsley Publishers This fifth edition first published in Great Britain in 2023 by Jessica Kingsley Publishers An imprint of Hodder & Stoughton Ltd An Hachette UK Company 1 Copyright © Quality Compliance Systems 2023 Copyright Chapter 5 © Lesley Collier and Jackie Pool 2023 Copyright Chapter 10 © Lesley Collier 2023 Copyright Chapter 4 © Jennifer Wenborn, David Challis and Martin Orrell 2023 Text from Wenborn et al. 2007 in Chapter 4 is reproduced by permission of Taylor & Francis. Table 10.1 from Brown and Dunn 2002 on pp.162–163 is reproduced by permission of Winnie Dunn. Figure 10.1 from Kovach 2000 on p.165 is reproduced by permission of John Wiley & Sons. Front cover image sources: iStockphoto®/Shutterstock®. The cover image is for illustrative purposes only, and any person featuring is a model. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means without the prior written permission of the publisher, nor be otherwise circulated in any form of binding or cover other than that in which it is published and without a similar condition being imposed on the subsequent purchaser. All pages marked may be photocopied for personal use with this programme, but may not be reproduced for any other purposes without the permission of the publisher A CIP catalogue record for this title is available from the British Library and the Library of Congress ISBN 978 1 83997 502 8 eISBN 978 1 83997 503 5 Printed and bound in Great Britain by CPI Group Ltd Jessica Kingsley Publishers’ policy is to use papers that are natural, renewable and recyclable products and made from wood grown in sustainable forests. The logging and manufacturing processes are expected to conform to the environmental regulations of the country of origin. Jessica Kingsley Publishers Carmelite House 50 Victoria Embankment London EC4Y 0DZ www.jkp.com CONTENTS About the Author and Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 PART 1: QCS POOL ACTIVITY LEVEL (PAL) INSTRUMENT 1. QCS Pool Activity Level (PAL) Instrument. . . . . . . . . . . . . . . . . . . . . . . . . . 13 2. Introduction to Part 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 3. The Four Activity Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 4. Reliability and Validity of the PAL Checklist. . . . . . . . . . . . . . . . . . . . . . . . . 61 5. Validity and Use of the QCS PAL Engagement Measure . . . . . . . . . . . . . . . . . 71 6. Life History Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 7. QCS PAL Checklist Case Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 8. Planning Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 9. Implementing Interventions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 10. Planning and Implementing Sensory Interventions . . . . . . . . . . . . . . . . . . . . 157 11. Seeing Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 PART 2: USING THE POOL ACTIVITY LEVEL (PAL) INSTRUMENT IN LEISURE ACTIVITIES 12. Introduction to Part 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175 13. Table-top Games Activity Pack. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177 14. Social Games Activity Pack. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185 15. Creative Activities Pack . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 16. Sensory Activities Pack . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213 ABOUT THE AUTHOR AND CONTRIBUTORS THE AUTHOR Jackie Pool DipCOT Jackie is an occupational therapist specializing in dementia care. She qualified in 1988 and, following her work as a clinical practitioner in the NHS and local authority, formed her own organization, Jackie Pool Associates Ltd, which specialized in resources for leadership and workforce development in dementia care. In 2021, QCS Quality Compliance Systems acquired the PAL Instrument and Jackie joined them as Dementia Care Champion. Jackie was a member of the Department of Health External Reference Group for the National Dementia Strategy. She was commissioned by Skills for Care to develop the national qualifications and credit framework dementia qualification structure and has published several works on the care of older people with dementia, including books, journal articles, training manuals and chapters in textbooks. Jackie is also a regular speaker at national and international conferences on the subject of dementia care. THE CONTRIBUTORS Sarah Mould DipCOT Sarah is Specialist Practitioner for Dementia/Delirium at University Hospitals Southampton NHS Foundation Trust. Prior to that, Sarah was Co-Director of the Dementia Training Com- pany, which specializes in the delivery of dementia training and consultation services both in the UK and internationally. Sarah worked with Jackie Pool as Director of Training with Jackie Pool Associates Ltd for many years and, as an occupational therapist by profession, she has been delighted to be a contributing author for the PAL Instrument. Sarah is a committed and passionate advocate for person-centred and rights-based approaches in the care and support of people with dementia and their caregivers. Jennifer Wenborn MSc DipCOT Jennifer has worked as an occupational therapist for over 30 years, predominantly with older people. She has wide experience in hospital and community settings, providing physical and mental health services, as a clinician and manager, and has also worked as an independent practitioner. She is currently a clinical research fellow in occupational therapy at University College London. The PAL study was the first phase in her PhD research, a randomized con- trolled trial entitled ‘Does occupational therapy intervention for people with dementia in a care home setting improve quality of life?’ Jennifer has written extensively about activity 7 8 THE QCS POOL ACTIVITY LEVEL (PAL) INSTRUMENT FOR OCCUPATIONAL PROFILING provision within care homes, including co-authoring The Successful Activity Co-ordinator in 2005, published by Age Concern. Professor David Challis PhD Professor of Community Care Research and Director of the Personal Social Services Research Unit at the University of Manchester, David has been responsible for a series of evaluations of the effectiveness and efficiency of intensive care management for older people, which were influential in the development of community care services in the UK. He has also acted as an advisor on care management to a number of governments and service providers in the USA, Canada, Australia and Japan. His current areas of activity include a range of studies on assessment of older people and patterns of service provision. He has authored 19 books and written over 150 articles and chapters in books. Professor Martin Orrell PhD FRCPsych Martin is Professor of Ageing and Mental Health at University College London (UCL) and North East London Mental Health Trust (NELMHT). He trained at the Maudsley Hospital and the Institute of Psychiatry before being appointed at UCL in 1991. At NELMHT, he works as an honorary consultant old age psychiatrist and is Associate Medical Director for Mental Health Services for Older People, and Director of Research and Development. In recent years, he has also worked as a specialist advisor to the Health Advisory Service and clinical advisor to the Audit Commission for the Forget Me Not national study on mental health services for older people. His research interests include needs assessment, health services evaluation and psychosocial interventions for dementia and he has published over 100 academic papers. He is Editor of the journal Aging and Mental Health, course director for the MSc in Ageing and Mental Health at UCL and Director of the London Centre for Dementia Care. Professor Lesley Collier PhD MSc DipCOT Lesley is Head of Allied Health at the faculty of Health and Well-being at the University of Winchester. She has worked as an occupational therapist with a focus on neurology and care of older people for 30 years. More recently, she has worked at the University of Southampton as Programme Lead for Occupational Therapy, and Brunel University London as Divisional Lead for Occupational Therapy and Nursing. Lesley’s research focuses on the use of sensory approaches to improve functional performance in older people with dementia. She has pub- lished extensively in this field and has led a number of international workshops supporting others in implementing this approach.