Table Of ContentThe 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.
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not be reproduced for any other purposes without the permission of the publisher
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ISBN 978 1 83997 502 8
eISBN 978 1 83997 503 5
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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
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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.
