Everyone finds enjoyment engaging in a variety of activities that they have enjoyed all their lives. An artist or musician may want to continue to paint or play an instrument. A carpenter or contractor might enjoy an activity board with nuts, bolts, screws. The type of activity depends on the level of dementia, personal interests, and the person’s physical abilities.
A number of studies have suggested that carefully designed activities can have a positive effect on depression, confusion, and challenging behaviors. Structuring a program to include activities in each of the following three categories may positively influence cognition, general functioning, and overall quality of life:
- Physical activity—aerobic exercises (walking, swimming, and cycling) and non-aerobic exercises (strength and resistance training, flexibility and balance exercises).
- Intellectual stimulation—cognitive hobbies (reading, word puzzles, and card games) and cognitive training (computer training games, memory and attention games)
- Social interaction—participation in group-related activities, such as mealtime conversations, support groups, or other forms of social engagement. (Ruthirakuhan et al., 2012)
The Montessori-based Activities for Person with Dementia has had some notable successes in the design of activity programs for people with dementia. This approach emphasizes matching a person’s abilities with the activity. It borrows from the concept of having older children teach younger children by setting up programs in which people with mild dementia serve as group activity leaders for those with advanced dementia.
Montessori-based activities promote engagement in learning by sequencing tasks from simple to complex, providing cues to successful completion, encouraging repetition, and carefully matching demands to individuals’ interests and levels of competence (van der Ploeg et al., 2012).
For people with dementia, Montessori-type programs include detailed interviews with family caregivers about the resident’s former interests and skills coupled with assessments of cognitive, language, and motor skills. A range of activities are then presented, tested, and refined. When dementia is advanced, the activities are simple (eg, completing a jigsaw made from a family photograph). Facilitators present tasks deliberately, demonstrating them first, and using language as appropriate. The main objective is to engage participants’ interest and involvement (van der Ploeg et al., 2012).
Individual Activities
Individual activities involve a caregiver or family member and the person with dementia. Activities that stimulate the senses, such as cooking, singing, exercise, going for a drive, gardening, and aromatherapy, are encouraged at all stages of dementia. Some nursing homes allow birds, cats, and dogs in the facility. Taking care of an animal gives a sense of purpose and companionship and is a key component of person-centered care.
Successful activity programs for individuals with dementia are based on a person’s likes and interests. This means a caregiver must learn a person’s history and understand their capabilities and preferences. Determine whether a person can still read, write, or use a computer. Understand what a person is physically capable of doing. Learn about the person’s lifestyle prior to moving to a care facility.
Adults often have a fear of failure (especially those aware of their cognitive decline) and may refuse to participate in activities because of this fear. Be consistent, have fun, and by all means introduce new activities. Look for signs of frustration and agitation and address these behaviors immediately.
Reality orientation is a component of cognitive stimulation and focuses on orienting the individual with AD to person, place, and time. Overall cognitive functioning was improved in AD patients receiving reality orientation and cognitive stimulation, with some studies indicating additional positive changes to social and communicative functioning and quality of life (Ruthirakuhan et al., 2012).
Individual Activities for People Who Have ADRD |
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Type of activity |
Mild |
Moderate |
Severe |
Word games |
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Letter writing |
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Art/Music |
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Woodworking |
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Sewing |
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Gardening |
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Crafts |
Knitting or crochet using large needles and bulky yarn |
Choose colors, roll balls of yarn |
Choose colors, use the items that are created |
At home activities |
Help with laundry with supervision, put clothes away, assist with housekeeping |
Sort and fold laundry |
Fold laundry—may want to fold the same items repeatedly |
Shopping |
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Group Activities
Many people with AD sense that their cognitive impairment isolates them from other people. This leads to anxiety, depression, societal withdrawal, and decreased self-confidence. Encouraging social interaction may help those with dementia regain a sense of self-worth and have a better attitude toward life. This may improve eating and exercise habits and social interactions, which may result in improved AD prognosis (Ruthirakuhan et al., 2012).
People in the early stages of ADRD may especially enjoy working with others. As dementia progresses, the person may be more likely to enjoy solitary activities. Small groups of 5 to 6 people are generally preferred because they allow more activity and personal attention, although well-planned large-group activities can also be successful.
Group Activities for People Who Have ADRD |
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Activity |
Mild |
Moderate |
Severe |
Karaoke |
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Cooking |
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Nature |
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Crafts |
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Outings |
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Whatever the stage of the dementia, everyone appreciates meaningful activities. We like helping one another, teaching someone a new skill, and contributing to the success of an activity. In our institutional settings we have very nearly stripped people of any meaningful way to contribute, to help, to learn, and to grow as a person. Remember that everyone—even those with dementia—yearn for meaning in their lives. A good activity program can help accomplish that goal.
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