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 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
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
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