Florida: Alzheimer’s Disease and Related Dementias for Nursing Homes, Adult Day Care, and Hospice, 3 unitsPage 7 of 15

5. Activities for Residents with Alzheimer’s

We all yearn for meaning in our lives. We like interacting with one another, teaching someone a new skill, and contributing to the success of an activity. In many institutional settings, we have stripped people of meaningful ways to contribute, to help, to learn, and to grow as a person.

Often, a person with dementia residing in a nursing home, another type of long-term care facility, or even in an adult day care facility is not engaged in any activities. This leads to a perception of “warehousing”, the belief that moving to a facility or even participating in adult day care is nothing more than a place to be while waiting to die. Low levels of engagement and lack of stimulation are problematic because they cause boredom and loneliness that can lead to behavior challenges (Cohen-Mansfield, 2018).

The good news is that there have been some notable successes in the design of activity programs for people with dementia. A good activities program matches a person’s abilities with the activity. It encourages people with more mild cognitive changes to help and teach those with more severe dementia.

For example, Montessori-type activities 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. People with mild dementia or no dementia are encouraged to help teach and demonstrate activities for people with impaired cognition (van der Ploeg et al., 2012). This allows people who can still contribute to do something meaningful.

Well-designed activities should include physical activity, which has the added health benefits of improving balance, decreasing falls, increasing strength, and improving mood. And because cognition and physical activity are linked, there is evidence that regular physical activity can favorably affect physical and cognitive function, quality of life, and activities of daily living. Lack of physical activity and a sedentary lifestyle are associated with an increased risk for cardiovascular disease, metabolic disease, and other adverse health conditions known to act as mediators in the early onset and progression of dementia (van Alphen et al., 2016).

Individual Activities

Individual activities that are carefully matched to a person’s abilities and interests are recommended at all stages of dementia. Keeping in mind that adults often have a fear of failure (especially those aware of their cognitive decline), activities must be appropriate to a person’s cognitive level, consistent, creative, and enjoyable.

Individual Activities for People with Dementia

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 or email
  • Use social media
  • Dictate a letter or email
  • Use social media with help
  • Listen to a letter or email being read
  • Listen to stories or books

Art/Music

  • Take photos
  • Create a photo album
  • Draw
  • Play an instrument
  • Lead a group song
  • Take photos
  • Listen to music
  • 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
  • Assist others with gardening tasks
  • Perform specific tasks with supervision
  • Help with simple gardening tasks such as raking, weeding, and soil turnover
  • Eat food grown in garden
  • Sit in garden
  • Participate in projects as able
  • Eat food grown in garden

Crafts

  • Knit or crochet using large needles and bulky yarn
  • Help with design
  • Create a poster
  • Help manage an activities board
  • Choose colors, roll balls of yarn
  • Participate in creation of a poster
  • Help choose the location for posters and artwork
  • Choose colors
  • Use the items that are created
  • Comment on projects
  • Observe the activities board

At home activities

  • Help with laundry
  • Supervise others with laundry tasks
  • Put clothes away
  • Assist with housekeeping
  • Sort and fold laundry
  • Help put away laundry
  • Help with cleaning of common areas
  • Fold laundry—may want to fold the same items repeatedly
  • Carry laundry

Shopping

  • Go with to store
  • Help with purchasing decisions
  • Choose types of food for self and family
  • 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
  • Go into store using wheelchair or electric cart

Group Activities

Group activities and socialization are critically important for people with cognitive decline. Compared to unstructured time, well-designed group activities decrease boredom and loneliness and improve engagement and mood.

However, both the type and quality of the content matters. Because cognitive impairment isolates people from one another, activities that encourage social interaction can provide a sense of belonging and decrease feelings of anxiety and depression. Small group activities are generally preferred because they allow more activity and personal attention, although well-planned large-group activities can also be successful.

In one comprehensive review of the impact of different types of activities, the most successful group activities were games and choral singing; the least successful were storytelling and poetry, with other activities, such as exercise in between. The level of success was related to the specific activity as well as the choice of content. In the case of singing, older, familiar popular songs were more successful than newer, unfamiliar songs. Activities are less successful if they are too difficult or inappropriate for the population (Cohen-Mansfield, 2018).

Group Activities for People with Dementia

Group Activities for People with Dementia

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