- Everyone likes having something to do or to look at. Being occupied is healthy and improves the quality of life. One of the aims when caring for people with dementia is to encourage them to do as much as they can for themselves.
Why planned everyday activities are important
An activity with others encourages socialising.
- Activities can help the person keep up his or her skills.
- Activities can help people feel that they have achieved something
- The activities can be interesting and fun. They can help people to feel better about themselves and be more alert and interested in the things that are going on around them.
- Activities can also help them to express their feelings.
- The activities can help people make up for what they have lost. Talking about the past, while looking at old photographs or listening to music, may trigger strong emotions. Remember always to be sensitive to the person’s feelings, as feelings are not damaged with dementia.
- The activities will also help keep the person’s mind active.
- Taking part in activities with the person is a natural way of assessing abilities. Sudden deterioration is a matter of concern and could otherwise be missed.
- It is a means of managing behaviour. If someone is kept busy in a way that he enjoys, he will not get bored or frustrated. Boredom and frustration can cause strange behaviour that is a problem for the carer. If kept busy, this behaviour lessens or may even disappear altogether.
- Having fun or sharing an activity with the person may bring you closer together.
- It is a means of communication. The person may have difficulty in communicating verbally and could find it easier to communicate through drawing, painting, dancing, going for walks and pointing out things of interest.
- Activities do not have to be planned and to the rule; they can be part of daily life. The activities should involve daily living skills (called Activities of Daily Living or ADL) and encourage maximum functioning. Some of these activities could be:
- Catching a taxi or bus
- Choosing clothing
- Cooking, hobbies and other interests
- Going out for a drive
- Going for an outing with your family
- Going to parties, weddings and funerals
- Shopping
- Visiting friends and relatives
- Washing / personal hygiene
- Going to the toilet
What to consider when planning activities
- Do not try to force the person into an activity; leave it and try again later, or even the next day
- The activity must be according to the person’s needs and interests
- Give the person activities that are going to help maintain her/his skills and interests.
- Match the activities to the person’s skills
- Choose an activity that the person will succeed in so that there is no sense of failure. Activities of daily living are a good way to start.
- If you are going to use equipment, make sure that it is all there and is ready.
- Let him work at his own pace even though it may be slow. Help him only if you feel that he will not think you are treating him like a child.
- People with dementia are not able to concentrate for long periods of time. Sometimes they can only concentrate for 5 to10 minutes. If this is so, give him a task that has steps so that he can stop when he loses concentration and start again later.
- Choose adult-level activities that are simple to do. Do the activities one step at a time and make sure he knows what you want him to do and what the final aim is.
- If possible, choose a suitable environment that the person likes to be in.
- Encourage play and imagination.
- Should you have a group of people together, make sure that the group is not too big for you to manage on your own and ensure that the people in the group will get on together.
- When we look at the objective of an activity programme, it is to maintain and develop skills. Skills need to be used to be retained. The saying “If you don’t use it, you’ll lose it” is very true.
Much-needed exercise:
Walking, if the person is physically able. Even a walk in a wheelchair will prove to be most beneficial. Slow walks in the house are more beneficial than a quick push in a wheel chair. Walking uses up adrenaline, which is produced by stress and frustration. Thus, both the carer and the person with dementia will probably benefit. It also provides the opportunity to talk about anything that you see on the walk. If possible, a walk to the nearest coffee shop is also an idea and a pleasant outing (and a reason for the person to get out of bed and have a bath).
Dancing is good for getting rid of agitation and frustration. Exercises to music can also be fun. Should the person be disabled, he could sit in a chair and do those exercises that he can.
Painting is also good at each stage. The person does not have to paint a picture as such but can do “modern art” such as just painting colours on the paper. Let her/him choose the colours. Put the paintings up on the wall in the passage with the artist’s name on them. Ensure that the paints used are toxin-free (not poisonous), which most children’s poster paints are.
Reminders of the past. People with dementia usually find it easier to remember events that happened in the past. Remembering with them will help them take an interest and be more alert. A photo album made up by the family, which you can page through with him, will help jog his memory. So will playing music from his youth. A box containing “treasures” (old objects) that he has kept may trigger memories, even more so than pictures. It also gives the family members and friends something to do when they come to visit him.
People with dementia usually respond well to animals that they can touch and stroke. If there are no pets in the house, try to borrow one for a short while. Do ensure, if it is a dog, that it does not jump up as this might frighten or even knock him/her over.
Early stages:
In the early stages of dementia people want to do all the things that they did and are doing. It is very important to try to maintain their abilities. Many of the activities can be carried out on their own while you encourage and reassure them that they can ask you for help when they want it. Now and again they might need to be reminded how to do a task. Put things the person needs for such activities, where they will be seen.
- People who knit or crochet may still enjoy something simple like knitting squares or a straightforward child’s jersey. They may need your help with where they are in the pattern. Should a stitch be dropped or a mistake made and they do not notice it, you can fix it yourself or ask someone else to do it.
- Those who enjoy crossword puzzles may still be able to attempt them but may need to use a dictionary as the disease progresses. They may also have enjoyed doing cryptic crosswords but will find them more difficult and may have to resort to the more basic crosswords.
- Playing cards or scrabble can also be enjoyed. They can enjoy the card game “patience” on their own. As the disease progresses the games can become simpler, such as “pick up”. From a full pack of cards you can take out as many pairs as the person can manage, ending with only the Aces, Kings, Queens and Jacks. This game is good for both the memory and practical skills. The pack of cards is shuffled and placed face down on the table. Turns are taken to turn the cards over two at a time. The aim is to find two matching cards. Once the cards are turned over and there is no matching pair, they are turned face down in the same place, after all the players have seen them. It is then the next player’s turn. Should the cards match, they are removed from the table and the person with the most pairs at the end is the winner. If players feel threatened by a ‘win/lose’ game, do not count the cards.
- Other simple activities can be enjoyed i.e. dusting, laying the table, washing and drying dishes, cleaning up in the kitchen, baking and all the other routine tasks that we have mentioned. It does not matter if the task is not done perfectly. Do not make a big issue of praising them as this is patronising. One praises children, not adults. A ‘thank you for helping’ will be enough.
- Although people may have lost their memory for some activities, they might still remember how to do other things because that part of the brain has not been affected. An example is that they might not be able to dress themselves properly but can still play the piano or type or read a book.
- Music is important to the person with dementia. If possible, get someone to tape or bring music that the person likes. Singing, dancing or just listening to music is often enjoyed when other memories and abilities are lost.
- The radio can also be enjoyable but, for some people with dementia, the television is confusing, as they might not be able to differentiate between what is real and what is not. Some of the actions may even be frightening for them and changing the channels tends to make the confusion worse.
- The maintenance of social skills is important, as people with dementia tend to withdraw once they realise that they have a tendency to forget names or appropriate behaviour. Therefore, encouragement and subtle assistance with remembering names and behaviour would be appreciated. Sharing activities while talking helps make the atmosphere more relaxed.
- For activities to help promote self-confidence (belief in yourself) and self-esteem (pride in yourself), it is important to find something for them to do as close as possible to the work they once did or enjoyed or were good at. Everyone with dementia can do something and find some enjoyment in it.
Remember: Activities that take a short time and not too much concentration are the best. Also remember to find things for them to do that will provide stimulation but are not too difficult or have too many choices.
Later stages:
- As the dementia gets worse, you may find that people are still able to do the tasks that are very familiar to them and will be more interested in actually doing the task than in the end result.
- Ensure that the tasks given are broken down into small, more manageable tasks, preferably with just one step, such as sweeping.
- The five senses – smell, touch, hearing, seeing and taste – still function. The person may smell a rose and enjoy it but not be able to recognise the perfume as being that of a rose. Rubbing lotion with a perfume on the hands will stimulate the senses of smell and touch. Giving someone different items to touch will also help stimulate the sense of touch. For sight, watching fish in a fish tank or birds in an aviary can be both pleasant and soothing.
- Do not struggle to keep a person busy all the time in the later stages. Rather, give an activity spread throughout the day, to break up the day.
- A time will come when the dementia becomes more severe and the person will not be able to concentrate. Should the person lapse into unconsciousness, the only activity at this stage that will benefit both of you is touch, like just holding hands and stroking her/his skin.
Tips for planning activities:
Daily
- Have some old and new activities
- In the morning do the activities that need thinking
- In the afternoon do the more physical activities to decrease the person’s restlessness.
Weekly
- Use themes that can be repeated e.g. cooking, flower arranging, gardening
- If you are having a group of people each day of the week, choose activities that a few people will enjoy
Monthly
- Introduce a mixture of parties and events such as sing-alongs
- Celebrate local traditions, parties and holidays.