MA: Alzheimer’s Disease and Related Dementias, 3 unitsPage 7 of 12

5. Activities for Residents with Alzheimer’s

Carefully designed activities have a positive effect on depression, confusion, and challenging behaviors. An activities program should include physical activity, intellectual stimulation, and social interaction (Ruthirakuhan et al., 2012).

Research continues to support the efficacy of a variety of activities and therapies for alleviating neuropsychiatric symptoms in dementia patients, and some are also being evaluated for reduction of caregiver burden and use with outpatients (de Oliveira, 2018, 2015). However, much remains to be investigated and the more interventions can be integrated to account for the complexity of dementia the more long-term success seems possible (Caspar et al, 2017).

A recent project evaluated a TAP-O (tailored activity program-outpatient version) intervention designed for outpatients with dementia and their caregivers. During eight sessions, an occupational therapist assessed the patient’s abilities and interests; prescribed tailored activities; and educated caregivers about dementia, NPS, and how to implement meaningful activities in the daily routine. As a result, patients experienced significant decreases in hallucinations, agitation, anxiety, aggression, sleep disorder, aberrant motor behavior, and there was a reduction in caregiver burden, suggesting TAP-O may be an effective non-pharmacologic intervention (de Oliveira, 2018).

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 presented, tested, and refined. When dementia is advanced, the activities are simplified. Facilitators present tasks deliberately, demonstrating them first, and using language as appropriate (van der Ploeg et al., 2012).

Everyone—even people with dementia—yearn for meaning in their lives. We like helping one another, teaching someone a new skill, and contributing to the success of an activity. In institutional settings we have stripped people of meaningful ways to contribute, to help, to learn, and to grow as a person. A good activity program can help accomplish that goal.

Individual Activities

Individual activities that stimulate the senses are encouraged at all stages of dementia. Successful programs for individuals with dementia are based on a person’s likes and interests. 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.

Individual Activities for People Who Have ADRD

Type of activity

Mild

Moderate

Severe

Word games

  • Word searches
  • Crossword puzzles
  • Card games
  • Computer games
  • Simple word searches
  • Simple crossword puzzles
  • Simple computer games
  • Discuss a simple topic
  • Listen to others

Letter writing

  • Write a letter
  • Send email
  • Use Facebook
  • Dictate a letter or email
  • Use Facebook with help
  • Listen to a letter or email being read

Art/Music

  • Take photos
  • Create a photo album
  • Draw
  • Play an instrument
  • Take photos
  • Maintain a photo album
  • Draw
  • Sing along with others
  • View photos
  • Listen to music
  • Sing along to familiar songs

Woodworking

  • Use tools
  • Plan and complete projects with assistance
  • Use simple tools with supervision
  • Assist with projects
  • Use activity board with bolts, screws, and hardware
  • Watch projects

Sewing

  • Use sewing machine with help
  • Plan and complete projects with help
  • Use simple tools with supervision
  • Assist with projects
  • Use sewing cards, activity blankets or aprons with buttons, snaps, ties, Velcro, and zippers
  • Watch projects

Gardening

  • Garden in raised beds
  • Help plan the garden and harvest
  • Perform specific tasks with supervision
  • Eat food grown in garden
  • Sit in garden
  • Participate in projects as able
  • Eat food grown in garden

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

  • Go along to store
  • Help with purchasing decisions
  • Help put groceries away
  • Go along to store
  • Help as able with shopping decisions
  • Help put food away
  • Go along to store
  • Sit in car with supervision or shop with wheelchair or electric cart

Group Activities

Many people with dementia sense that their cognitive impairment isolates them from other people. This leads to anxiety, depression, societal withdrawal, and decreased self-confidence. Encouraging social interaction helps a person regain a sense of self-worth. This may improve eating, exercise habits, and social interactions (Ruthirakuhan et al., 2012).

People in the early stages of dementia may especially enjoy working with others. Small groups are generally preferred because they allow more activity and personal attention, although well-planned large-group activities can also be successful. As dementia progresses, the person may prefer solitary activities.

Group Activities for People Who Have ADRD

Activity

Mild

Moderate

Severe

Singing

  • Sing while reading words
  • Sing songs that are familiar
  • Listen and sing along as able

Cooking

  • Bake cookies
  • Prepare a snack plate for others
  • Clean up after cooking
  • Participate in making cookies
  • Assist with cleaning up
  • Help decorate cookies that are already baked
  • Eat the cookies

Outdoor Activities

  • Nature walks
  • Outings to nature areas
  • Fruit picking
  • Shorter walks
  • Picnicking outdoors
  • Escorted walk or wheelchair outside the facility
  • Attend picnic

Crafts

  • Make ornaments
  • Decorate room or facility for holidays
  • Participate in making ornaments
  • Assist with decorating for the holidays
  • Participate in crafts
  • Participate in decorating parties

Outings

  • Shopping
  • Theater and music events
  • Museum visits
  • Library visits
  • Eat out
  • Attend sporting events
  • Same as mild with some adaptation and more supervision.
  • Set up a store where the resident can purchase items
  • Watch movies
  • Outings with direct supervision