Florida: Specialized Alzheimer’s Adult Daycare, Level One (347)Page 7 of 13

6. Activities for Clients with Alzheimer’s


Carefully designed activities can have a positive effect on depression, confusion, and challenging behaviors. Activities should provide a positive experience, be meaningful, and be challenging.

Telenius et al., 2022

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. Caregivers often make the mistake of doing everything for the person they are caring for, stripping them of any meaningful way to contribute, to help, to learn, and to grow as a person. Everyone yearns for meaning in their lives and a good activities program can help accomplish that goal.

Activity programs start with a detailed interview about the person’s interests and skills. The nursing and therapy staff complete a thorough cognitive, language, and motor skills assessment. As a person’s dementia advances, activities are reassessed and simplified.

Activities programs can positively influence a person’s quality of life. Adult daycare facilities typically provide include strength and balance training, flexibility exercises, and cardiovascular activities. Other common activities are recreation and games, arts and crafts, musical activity, and rest.

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 uses personalized interventions to maximize the abilities of each individual (Chan et al., 2021).

Montessori programming highlights task breakdown, guided repetition, progression in task difficulty from simple to complex or concrete to abstract, the careful matching of individual past interests and occupations, and self-correcting. The activities are designed with an individual’s past experiences and interests in mind. This approach is consistent with the person-centered care approach recommended for dementia care (Chan et al., 2021).

This program engages participants in meaningful activities that promote learning through procedural* or implicit** memory with the support of a prepared environment and external cues. The acronym “CREATE” represents the principles of type of activity design.

Program designers create a prepared environment and remove unnecessary distractions. They design an error free process in which all materials are familiar to the participants. Templates are provided according to individual needs and ability, and the environment is home-like. (Chan et al., 2021).

*Procedural memory: a form of long-term memory associated with motor skills, habits, and tasks.
**Implicit memory: unconscious or automatic memory.

6.1 Individual Activities

Successful individual activities for individuals with dementia are based on a person’s likes, dislikes, and interests. This means a caregiver must learn a person’s history and understand their capabilities and preferences. Understanding a person’s lifestyle, whether they can still read, write, or use a computer and determining what a person is physically capable of doing is the basis for the design of individual activities. Individual 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 organizations that serve older adults, such as the Eden Alternative, encourage pets in their facilities. Pets provide companionship, promote relationships, and provide meaningful activity and exercise. Taking care of an animal gives a sense of purpose and companionship and is a key component of person-centered care.

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 on the lookout for signs of frustration and agitation and address these behaviors immediately.

Individual Activities at Different Stages of Dementia





Word games

Word searches, crossword puzzles

Card/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, social media

Dictate a letter or email

Use Facebook with help

Listen to a letter or email being read


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


Use tools

Plan and complete projects with assistance

Use simple tools with supervision

Assist with projects

Use activity board with bolts, screws

Watch projects


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


Garden in raised beds

Help plan the garden and harvest

Perform specific tasks with supervision

Eat food grown in garden

Sit in garden, eat food grown in garden

Participate as able


Knitting or crochet using large needles

Choose colors, roll balls of yarn

Choose colors, use the items that are created

At home activities

Help with laundry, put clothes away, assist with housekeeping

Sort and fold laundry

Fold laundry—may want to fold the same items repeatedly


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

6.2 Group Activities

Cognitive impairment isolates us from other people, and can lead to anxiety, depression, societal withdrawal, and decreased self-confidence. Meaningful social interactions help a person with dementia regain a sense of self-worth.

As dementia progresses, group activities may become more challenging and individual activities may be preferred. Small groups of 5 to 6 people allow more activity and personal attention, although well-planned large-group activities can also be successful.

Group Activities at Different Stages of Dementia






Sing while reading words

Sing familiar songs

Listen and sing along


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


Nature walks, outings to nature areas, fruit picking

Shorter walks

Picnicking outdoors

Escorted walk or wheelchair outside the facility, attend picnic


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


Shopping, eat out

Theater and music events, museum visits, library visits, 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

6.3 Virtual Reality

Recently, a great deal of research has been done on the use of virtual reality programs for older adults with and without dementia. The programs are designed to reduce loneliness, improve physical activity, and engage older adults in activities such as virtual travel.

Mynd Immersive, in collaboration with several large companies, has created the “Great American Elderverse”, which allows older adult to socialize with friend and family, learn about the world, and engage in pursuits and passions. Elderverse programs focus on exercise and rehabilitation, recreation, reminiscence, and distraction. For older adults with dementia, the programs have been shown to reduce challenging behaviors, improve mood, and stimulate cognition.