Activity Goals and Interventions Bank for Nursing Homes, Fillable PDF With Cited Sources

A fillable 8-page Activity Goals and Interventions Bank for activity directors, life enrichment coordinators and activity professionals in nursing homes, memory care, assisted living and skilled nursing. Stop starting from a blank page: tick goals that fit the resident, add the details, pick the supports, and keep a short response journal. Every goal and every support shows the source it was adapted from.

SOURCES (listed with dates on page 1)
- 42 CFR 483.24(c) Activities and 42 CFR 483.21(b) Comprehensive care plans (measurable objectives and timeframes)
- National Institute on Aging: Adapting Activities for People With Alzheimer's Disease (content reviewed July 2024)
- National Institute on Aging: Coping With Agitation, Aggression, and Sundowning (content reviewed July 2024)
- Alzheimer's Association: Activities at Home tip sheet TS-0053 (updated September 2022), plus its Middle-Stage and Late-Stage Caregiving pages

The NIA and Alzheimer's Association pages are written mainly for dementia caregiving. The ideas are adapted for facility activity staff. We are not affiliated with or endorsed by these organizations. This is a planning tool and not an official CMS form, not a clinical standard, and not a guarantee of survey compliance. Base every goal on the resident's own assessment and follow your facility policy and care-plan process.

It works alongside our Activity Assessment Form and our 1:1 In-Room Activity Plan. Use the assessment to learn what the resident enjoys, then use this bank to turn it into goals.

WHAT IS INSIDE (8 pages, US Letter and A4)
Page 1: What a good activity goal rests on (with source tags), a one-sentence template, the list of sources, and a practice box
Page 2: 8 goals for everyday roles and routines (household tasks, meal-time tasks, cooking, plants, pets, favorite habits)
Page 3: 8 goals for thinking and self-expression (photo albums, music, drawing, reading, games, cards, instruments, TV)
Page 4: 8 goals for movement and outdoors (walks, exercise, balloon or ball play, sunlight each day, gardening, dancing, short outings)
Page 5: 8 goals for connection, faith and meaning (visits, children, social time, worship and prayer, holidays)
Page 6: 12 goals for comfort, the senses and rest, including residents who stay in their rooms (favorite music, photos, scented lotion, hair brushing, a consistent daily schedule, rest breaks)
Page 7: 32 supports to match to the resident: cue and prompt, adapt the activity, adapt the setting, and approach
Page 8: Activity response journal built on the Alzheimer's Association's daily-plan questions: how they seemed, how it went, what worked, what did not, what next

COLOR AND BLACK-AND-WHITE
- Color version for screen use and color printing
- Black-and-white ink-saver version with light grey bars and no dark fills, made for copiers and low-ink printing
- Both versions have the same 8 pages and the same fillable fields

FILLABLE AND PRINTABLE
- 206 fillable fields: check boxes, detail boxes, text boxes and drop-down lists
- Type on a computer or tablet in a PDF reader, or print and write by hand
- Save a blank copy and make one copy per resident

GOOD TO KNOW
- Digital download: one zip file with four PDFs (US Letter and A4, each in color and black-and-white) and a Read Me First page. Unzip before you open the PDFs
- No physical item is shipped
- Fillable fields work best in Adobe Acrobat Reader or a similar PDF app. Check that your app saves typed entries before you use it for real records
- Not medical or legal advice. Do not enter resident information into a file you store on an unsecured device. Follow your facility's privacy rules
- Designed by BeingBrightStudio