Four dimensions of planning activities for residents with dementia

News & Blog

Stay up to date on what’s going on in the world of enhancing life in senior care.

Four dimensions of planning activities for residents with dementia

Posted on March 28, 2011

Activities represent a key aspect of quality of life. Throughout our life, we pick things that relax us, bring us pleasure, stimulate our curiosity or expand our knowledge. We all select activities based on our interests and abilities.
People suffering from dementia have the right to recreational activities. This is as much a moral obligation as it is an issue of care and wellness management. Their activities, too, need to be adapted to what they can do and their personal preferences.

Here are the four dimensions of planning the best activity program for someone with Alzheimer’s disease or other types of dementia:

1. Person

Keep the person’s skills and abilities in mind
He or she may be able to play simple songs learned on the piano years ago. Bring these types of skills into daily activities.

Pay special attention to what the person enjoys
Take note when the person seems happy, anxious, distracted or irritable. Some enjoy watching sports, while others may be frightened by the fast pace or noise.

Be aware of physical problems
Does he or she get tired quickly or have difficulty seeing, hearing or performing simple movements? If so, you may want to avoid certain activities.

2. Activity
Focus on enjoyment, not achievement
Find activities that build on remaining skills and talents. A professional artist might become frustrated over the declining quality of work, but an amateur might enjoy a new opportunity for self-expression.

Look for favorites
The person who always enjoyed drinking coffee and reading the newspaper may still find these activities enjoyable, even if he or she is no longer able to completely understand what the newspaper says.

Change activities as needed
Try to be flexible and acknowledge the person’s changing interests and abilities.

Consider time of day
Caregivers may find they have more success with certain activities at specific times of day, such as bathing and dressing in the morning.

Adjust activities to stages of the disease
As the disease progresses, you may want to introduce more repetitive tasks. Be prepared for the person to eventually take a less active role in activities.

3. Approach

Be flexible
Offer support and supervision and concentrate on the process, not the result. When the person insists that he or she doesn’t want to do something, don’t force it. If the person insists on doing it a different way, let it happen, and fix it later.

Help get the activity started
Most people with dementia still have the energy and desire to do things but may lack the ability to organize, plan, initiate and successfully complete the task.

Stress a sense of purpose
If you ask the person to make a card, he or she may not respond. But, if you say that you’re sending a special get-well card to a friend, the person may enjoy working on this task with you.

Encourage self-expression
Include activities that allow the person a chance for expression. These types of activities could include painting, drawing, music or conversation. Involve the person through the use of conversation.

Substitute an activity for a behavior
If a person with dementia rubs his or her hand on a table, put a cloth in his or her hand, and encourage the person to wipe the table. Or, if the person is moving his or her feet on the floor, play some music so the person can tap them to the beat.

Try again later
If something isn’t working, it may just be the wrong time of day or the activity may be too complicated. Try again later, or adapt the activity.

4. Place
Make activities safe
Modify a workshop by removing toxic materials and dangerous tools so an activity such as sanding a piece of wood can be safe and pleasurable.

Minimize distractions that can frighten or confuse
A person with dementia may not be able to recall familiar sounds and places or may feel uncomfortable in certain settings.

Caregivers are sometimes concerned about a potential demeaning aspect of activities. Alison Mahoney addresses this topic in a study published in the American Journal of Alzheimer’s Disease and Other Dementias. She maintains that, “stage-appropriate activities do not demean dementia patients when caregivers present play as a legitimate recreation and create a sense of fun and interest”.

Finally, one should remember that although it is a very rewarding position, caring for people with dementia can be overwhelming, frustrating and emotional. This is why it is important to plan ahead and pace oneself. As the caregiver, the one who knows the individual’s interests and abilities, you will make these important choices and have a direct impact on the quality of life of people.

Further reading is offered here by the Alzheimer’s Association