Dementia Special: Delirium, Alzheimer's, Dementia Care, and Supporting CaregiversPage 36 of 51

10. Arrange for Appropriate Activities

guideline 9

Arrange for Appropriate Activities.

The quality of a life is determined by its activities.

Greek Philosopher

Helping residents to maintain their independence and preserve their life care skills depends in great part on providing them with enough exercise, appropriate activities and interesting and stimulating things to do.

Think about the way you spend the day. How many tasks and activities do you accomplish? How often are you multi-tasking so you can fit it all in? Now imagine you have dementia and are living on a memory care unit with 2 or 3 hours of activities available each day. What will you do with the rest of your time?

What are the interests of the person with dementia? Since we are all so different and have different backgrounds and cultures, the things that would interest us are varied. No one activity will suit everyone. Using person-centered care and some common sense, the staff will be able to modify the interests a person had before dementia and create activities that are enjoyable.

Ideally, activities should:

  • Provide mental stimulation.
  • Reflect the past interests of the person with dementia.
  • Seek to maintain or slow the loss of skills without requiring the person to learn new ones.
  • Provide socialization, stimulation, and physical activity within the functional limits of the person with dementia.
  • Be sensitive to the cultural differences of those attending the activity.
  • Be failure free.

Staff should be aware that activities may be too loud or too stimulating for some people with dementia.

The benefits of activities and regular exercise have included better physical health, higher self-esteem, maintenance of socialization skills, improved sleep habits, and decreases in depression and anxiety.

A recent study showed that mental and physical activities delay cognitive decline in older persons with dementia (Sheung-Tak Cheng et al., 2014). In addition to scheduled activities, dementia care staff should be taught to consider any contact with the person who has dementia as an opportunity for positive activity. Reminiscing, singing old songs, talking about interests they share, getting the resident to help with minor chores like watering plants, and breaking tasks down to allow the person to complete them, can all be enjoyable and stimulating activities and should be a regular part of the day. The more enjoyable it is, the more beneficial it will be.

I was Director of Nursing in a nursing home with a 40-bed dementia unit. Although we had a small activity budget, we used it wisely. We almost always had music available, but also had quiet areas for residents who wanted to do other activities. Everything from colorful magazines to puzzles and games appropriate for our residents’ levels of functioning were on the unit. We used free talking books from the library, had a small indoor garden donated by the garden club, and set up an aquarium. There was also an old upright piano in the recreation room for residents who could still play or wanted to tinker.

The unit was not fancy and needed updating, but the staff had decorated it with meaningful items that would often be the source of wonderful old stories from the residents. Hand crocheted lap robes, Norman Rockwell prints, and collections of things the residents could rummage through were found throughout the unit. We found that our residents seemed happier in this environment and so did the staff. The unit was more relaxed and the staff felt free to do such things as bring in flowers from their gardens and bring their children to visit. I’ve always remembered that unit as being the one that offered the highest quality of care to its residents.