Using Contract Bridge in Clinical Therapy: How and Why Card Games Can Help

Using Contract Bridge in Clinical Therapy: How and Why Card Games Can Help

There are plenty of studies supporting the fact that the card game of bridge helps to promote better mental health – and more, that it can aid the brain when it comes to conditions like dementia. (NCBI; MedicalNewsToday; AARP; Alzheimer’s SA)

Considering this, can the game of bridge be used as a therapeutic tool by therapists, psychologists and educators?

Here’s why it can be useful to learn bridge – and apply it during sessions.

Why Bridge?

Many artistic activities can be used in a therapeutic setting, from a session with the aid of music through to using drawing to better understand the patient when it comes to mental and cognitive abilities, and allowing them to talk more openly and freely about the issues at hand.

A game of bridge can be an excellent therapeutic conduit.

  • Many patients are reluctant to talk about certain issues or traumatic events during a face-to-face consultation
  • Bridge engages the mind and can be a worthy distraction for the patient – e.g. they are actively engaged with an activity, while still able to talk about important issues more openly
  • Any changes in play, or changes and degeneration in mental or cognitive ability is immediately easier to spot in the patient
  • Especially for conditions like dementia, activities like bridge inspires mental activity
  • Patients can continue bridge as a social activity outside of sessions

 Learning to Play

The basic rules of bridge can be found at the American Contract Bridge League, Bicycle Cards and Funbridge.

If you’ve never played before, the essentials are this.

  • Bridge is traditionally played by four people who play in partnerships, sitting opposite the bridge table.
  • Each player is dealt 13 cards.
  • One player is called the “dummy” – their partner is named the “declarer.”
  • The “dummy” hand is played face up, and by the declarer.
  • Bridge is a trick-taking game, and tricks are placed in the middle of the table.
  • The bidding stage chooses the “contract” for the game – which suit, and how many tricks (choosing a number from 1-7, and then adding 6 for the number for the total amount of tricks)
  • The playing stage sees partner teams making “tricks” – the highest ranking card wins each trick.
  • Teams have to win tricks, but also use inventive plays to stop their opponent having the cards to win tricks (and thus points) for the opposing side.
  • After the game, points are scored. More about the different ways of bridge scoring can be found here (YouTube: Peter Hollands; ACBL).

If you’re still learning, it can help a lot to join a club, or play online against computerized opponents through platforms like Bridge Base Online and Funbridge.

Could incorporating bridge into therapy sessions become a useful therapeutic aid?

By Alex J. Coyne

Playing Bridge for Alzheimer’s Research

Playing Bridge for Alzheimer’s Research

Contract bridge is one of the most popular card games of all time, and there are thousands of players in South Africa as well as hundreds of clubs that new and veteran players can join if they want to partner up with someone and play a game – but contract bridge is also a lot more than just a card game, and research shows that it can be hugely beneficial to developing the mind in diagnosed cases of Alzheimer’s.

Here’s how the game of bridge can prove to be useful to Alzheimer’s research, and more about the American Contract Bridge League and the Longest Day campaign.

ACBL Fact Sheet: Bridge Boosts Your Brain Power

A fact-sheet compiled by the ACBL shows just some of the benefits that bridge can have for the brain.

– A study conducted at the University of California-Berkeley (2000) shows that playing contract bridge can help to give the immune system a much-needed boost.
– An educational study conducted by Dr Christopher Shaw (2005) shows us that students who played contract bridge showed higher fifth grade test scores when compared to the students who didn’t play the game.
– An intensive and more recent study by Mayo Clinic (2017) shows that playing contract bridge reduces the likelihood of mental decline before the onset of dementia.

Further studies (including notably the 90+ Study) shows that mentally stimulating activity such as playing cards or completing crosswords can reduce the risk of developing dementia by as much as 75%.


Why Play Bridge?

Taking up the game of bridge is a great way for people to build vital life and business skills. It’s also known for being one of the best ways out there to help the brain itself, and it can help to slow down the mental repercussions of conditions like Alzheimer’s – especially for those who play early.

Here are some of the other reasons why playing bridge is greatly beneficial for conditions like Alzheimer’s – and for raising funds.

• Bridge is Accessible
Contract bridge is one of the most accessible programs that any facility can implement, whether it’s a hospital, a care facility or a school. All you’ll need to play are a deck of cards, and a few print-out score sheets and trump markers. Most facilities have a spare table and chairs somewhere, and that’s really all you’ll need.

• Bridge Promotes Interaction
The feeling of loneliness is a common one in many facilities, and the game of bridge can help to promote interaction for patients that goes far beyond what facilities offer now – and it’s a great way to host regular events that patients can look forward to.

• Bridge Promotes Alzheimer’s Awareness
There are many charity card events out there that fund non-profit facilities, but more than this, there are many events organized by bridge foundations such as the ACBL that directly raises funds for Alzheimer’s research.

• Bridge Allows Unique Condition Monitoring
It’s true that a game of contract bridge can allow for closer therapeutic monitoring of someone’s condition. What seems like a casual conversation during a regular game of contract bridge can be a means for therapists to assess patients in an environment that doesn’t seem threatening – or even clinical.

• Inclusion of Disability
The game of bridge is greatly inclusive, and this means that everyone within a facility setting is able to participate in it, too: Even braille card decks are available for the blind.

The Longest Day Campaign

The Longest Day Campaign is a fund-raising initiative from the US Alzheimer’s Association, and the American Contract Bridge has partnered up with them for seven years in a row in order to raise funds for crucial research into the condition.
“Every year, bridge clubs across the United States hold fundraising games the week of the summer solstice to raise funds for the campaign,” says Lori Pope, the PR Coordinator of the ACBL. “

“Since the campaign launched, ACBL clubs have raised nearly $4.7 million to help fund the research and efforts of
the Alzheimer’s Association.”

More information can be found at the ACBL’s official website and their section for The Longest Day Campaign.

More information about bridge and life skills can be found at Bridge2Success. (

By Alex J. Coyne

How fear and lack of understanding of Alzheimer’s is stigmatising those who have it

How fear and lack of understanding of Alzheimer’s is stigmatising those who have it

Few of us will escape the impact of Alzheimer’s Disease. The grim pay-back from being healthy, wealthy or lucky enough to live into our late 80s and beyond is dementia. One in three – maybe even one in two of us – will then get dementia and forget almost everything we ever knew. And the lucky others? They will probably end up caring for someone with Alzheimer’s, the most common form of dementia. But it is far more than just a personal family tragedy. It is a major economic challenge to governments and health-care providers around the world, and will force some fundamental rethinking on how we care for sufferers. The costs are already immense. Dementia is now a trillion-dollar disease, and with the numbers of patients doubling every 20 years, the burden will fall unevenly on developing countries where the growth rate is fastest. In this first episode of the series, we explore how fear in some parts of the world is stigmatising those who have it, and denying help to those who need it. But also how to overcome the fear.

Watch the video here

Presenter: Andrew Bomford. Series Producer: Estelle Doyle

Source: BBC

Choosing a suitable home

Choosing a suitable home

This worksheet acts as a simple guideline for people considering admission to a retirement home or to a frail care centre for either themselves or someone they love and care for. Emphasis is on the practical considerations. You are, however, encouraged to look at the emotional implications of your decision and discuss these with someone you trust and can confide in.

It is important to ensure that the home is registered with the Department of Social Development, as registration is required in accordance with the Older Persons Act. The certificate of registration should be visible, displayed in a prominent place.

Of course, no home will meet all these requirements and deciding to enter or admit someone else to such a facility is one of the most difficult decisions one can be called on to make. At our regional offices and on our helpline we have staff and volunteers who can support you as you make this decision and any other important decisions that Alzheimer’s challenges us to make.


  • Is it close to family and friends?
  • Is it close enough to essential community activities e.g. church, shopping centre, hospital?
  • Is it in a familiar environment or a new area?
  • Will the resident be able to meet his/her spiritual needs at the home?
  • Is it a mixed-sex residence?


  • Is the property secure and are there visible security staff?
  • Can a resident wander around freely and can the resident leave the grounds undetected?
  • Is there a security system at the front door?
  • Is the home linked to an armed response company?
  • Friendliness of staff on your arrival
  • Is the interior clean and attractive, with functional and comfortable furniture and decorations?
  • Are there bad odours (especially urine)?
  • Do the residents appear clean and appropriately dressed for the weather?
  • Do the residents seem to be happy and occupied or are they sitting staring into space?
  • Did you see staff and residents sitting talking to each other?
  • Does the staff appear to be respectful and caring?
  • Are there any birds or animals? Are pets allowed to visit?
  • Noise – Are the sounds at a normal level and is there soft music playing?
  • Is there a lounge with television and one without?
  • Are there demarcated smoking and non-smoking areas?


  • Who are the major funders of the home?
  • Is it a profit or non-profit organisation?
  • Is there any form of financial assistance if frail care is needed or additional care that the residents may not be able to afford?


  • Will you be able to afford the fees, possibly for an indefinite period?
  • What is the annual increase in fees?
  • If you have medical aid/disability cover/insurance, will it cover any of the costs?
  • Are there additional costs that are not part of the monthly rate?
  • How is ‘pocket money’ handled?


  • Are the rules and regulations made for the benefit of the residents or are they regimented e.g. fixed bedtimes and strictly enforced visiting hours?
  • How much is the family involved in the individual managed care programme of the resident?


  • Is there a residents’ committee?
  • Are there channels for residents’ complaints?
  • What means of communication are available to the residents e.g. telephones, facsimiles, e-mail?
  • Is there privacy available for telephone calls?
  • Is there transport to a hospital, clinic, shops etc?
  • Are residents encouraged to remain physically and mentally active and to see to their own needs where possible and suitable?
  • Are residents allowed to assist in the chores/activities of the home?
  • Are residents called by name by the staff?
  • Do residents have a choice of food and quantity? Are second helpings allowed?
  • Are residents allowed to be sexually active?


  • Own or shared?
  • Bath and/or shower that has been adapted to the needs of the older person?
  • Is there easy access to the bathroom, for a wheelchair?


  • Is the food of good quality and varied?
  • Is provision made for special diets e.g. diabetic, low fat, halaal, kosher etc?
  • Are the services of a dietician available?
  • Are desserts and fruit part of the regular menu?
  • Are there separate areas for food preparation, dishwashing and garbage disposal?
  • Are visitors allowed to have meals in the dining room and at what cost?
  • Are there ever any special meals e.g. Christmas, birthdays etc?
  • Are there regular teatimes, with tea supplied by the home? Is anything served with the tea?
  • At what times are the meals served?


  • Is the garden easily accessible and available to residents?
  • Are more active residents encouraged to assist in the garden?
  • Are there benches outside?
  • Is there a suitable safe path to walk on, in the garden?
  • Are frail residents helped to gain access to the garden?


  • Are residents allowed to go out for days/weekends and/or holidays?
  • Can visitors come and visit at any time or strictly only at visiting time?
  • Is there a private room for visitors?
  • Do visitors have to sign in on arrival?
  • Are relatives/friends encouraged to participate in the care of the resident?


  • There needs to be good staff-resident interaction
  • Are there enough caregivers on duty for every shift?
  • Is there a Registered Nurse on each shift?
  • Does the staff receive on-going training?
  • Is there a resident doctor? Are you required to use him or may you use your own?
  • What specialist medical services are available e.g. doctor, podiatrist, occupational therapist, physiotherapist?
  • Have senior staff and management been trained in institutional management and care of the elderly and frail?


  • Is there adequate lighting in the home?
  • Are there safety rails in the corridors?
  • Are the floor surfaces non-slip?
  • Are there easily accessible panic buttons, especially in the bathrooms?
  • Is there a disaster plan for evacuating the home?
  • Are there visible and accessible fire hydrants?
  • Are there smoke alarms?
  • Do they have regular fire drills in the home?
  • What emergency medical equipment is available on the premises?
  • Are there procedures to deal with elder abuse?
  • What part does the family play in these procedures?


  • Is there a view from the room?
  • Is there adequate lighting?
  • Is there a problem with damp in the room?
  • What personal furniture and belongings are allowed?
  • Is it a single or double room?
  • Are the rooms shared? What happens if someone does not like the person with whom s/he is sharing?
  • Is there an emergency bell in the room?
  • Are there enough cupboards and drawers in the room?
  • Is the resident allowed to have a kettle, toaster etc in the room?
  • Are there enough plug points for bedside light, kettle, hairdryer, radio, TV etc? If not, are adaptors allowed?


  • Podiatrists (foot care)?
  • Hairdressing facilities?
  • Tuck shop or canteen?
  • Day clinic/examination room?
  • Are there activity rooms?
  • Is there a regular activity programme?
  • Taking into consideration their capabilities, do frail residents receive physical and social stimulation?
  • Are residents encouraged to learn new skills?
  • Are outside trips, outings or shows arranged?
  • Is there any community involvement?
  • Does the home use volunteers?
  • Is the laundry done on the premises or contracted out?
  • Compiled by Lindy Smit, Loraine Schirlinger and staff of the national office