Florida: ADRD for Specialized Alzheimer’s Adult Daycare Level IPage 7 of 15

5. 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 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. This provides an older adult with the opportunity to give as well as receive care.

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.

Some eldercare organizations, such as the Eden Alternative, encourage pets in their facilities. Pets provide companionship, promotes relationships, and provides meaningful activity and exercise.

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.