ATrain Education

 

Continuing Education for Health Professionals

FL: ADRD for Specialized Alzheimer's Adult Day Care, Level 1

Module 4

Activities for Clients with Alzheimer’s

Everyone finds enjoyment engaging in activities 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. Enjoyment 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 (Ruthirakuhan et al., 2012). Structuring a program to include activities in each of the following three categories can 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).

Montessori-type programs include detailed interviews with family caregivers about the person’s former interests and skills coupled with assessments of cognitive, language, and motor skills. A range of activities are then presented, tested, and refined. As dementia advances, the activities are simplified. 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. 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. Learn about the person’s lifestyle and determine what a person is physically capable of doing.

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 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
  • 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 Alzheimer’s disease 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 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 in turn may result in improved AD prognosis (Ruthirakuhan et al., 2012).

People in the early stages of dementia 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 Dementia

Activity

Mild

Moderate

Severe

Karaoke

  • 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

Nature

  • 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

 

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. Remember that everyone yearns for meaning in their lives. A good activity program can help accomplish that goal.

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