Stimulation for sufferers

Introduction

Alzheimer ’s disease is a crippling disease to the sufferer. It robs the person of his/her identity and life. It gradually takes away the person’s personality, spontaneity, initiative, enthusiasm and general zest for life. Sufferers tend to retreat more and more into their own world and withdraw from their usual activities and environment.

Sufferers also present with challenging behaviours and symptoms, including agitation, aggression, wandering, anxiety and depression. Many carers of Alzheimer suffers are faced with the problem of ‘what to do’ with their loved ones and what suitable activities they can use to keep sufferers stimulated?

Included in this article is the use of stimulating activities

• Definition of an activity
• Why use activities?
• Values / aims of activities
• Guidelines for planning activities
• List of possible activities to use

Definition of an Activity

The use of one’s physical and mental abilities, time, energy, attention and interest in order to achieve a pre- determined goal

Activities are an integral part of our daily existence and give meaning to our lives.

Why activities?

• A tool to help us relate to residents
• A tool to provide residents with sensory information
• A tool for assessing their abilities – to understand residents better and help them do what they are still capable of doing
• To improve the quality of life of the elderly
• To maintain / improve functioning
• To help to integrate the person socially
• To improve mental and physical status
• Activities play a significant part in the prevention and intervention of challenging behaviours.

Values / Aims of activities with Dementia / Alzheimer residents

• Evaluation of functioning
• Providing socialisation and interaction with others
• Allowing residents to experience pleasure and satisfaction
• Improving long term and short term memory
• Improving concentration and attention
• Improving motivation
• Improving self esteem and feelings of competency
• Improving awareness of abilities
• Decreasing feelings of stress and anxiety
• Providing opportunities to express and explore feelings
• Promoting independence
• Promoting sensory stimulation
• Including physical aspects (co-ordination, motor planning)

Remember these guidelines when planning activities

• Activities should draw on remaining abilities and knowledge.
• Select activities which provide cognitive and sensory stimulation and which entertain
• Choose activities which involve very few steps, and lead the patient through them one by one.
• Try to avoid activities that the patient perceives as childish, but keep in mind that as the disease advances, children’s picture books and games may be used.
• Be creative in devising activities and remember that what works today, may not work tomorrow.
• Don’t feel that you have to keep the patient busy all day.
• Don’t shy away from giving the patient “busy work” if it calms them down and occupies their time.
• Activities must be meaningful to the person.
• Activities should be done at a time which coincides with the person’s optimal level of functioning.
• Prepare a safe work area. Ensure it is uncluttered with a minimum of distractions and noise.
• Activities should re-establish old roles. Make use of habitual, over-learned tasks (cooking, gardening, etc.).

Therefore, when doing tasks together

• Try to focus on familiar skills or tasks.
• Give simple choices where possible. Don’t tell person what to do.
• Allow time to respond.
• Repeat instructions exactly the same way.
• Break down the task into small steps.
• Modify the steps as the person becomes more impaired.
• Praise sincerely for success.

Types of Activities

Sensory Stimulation Activities: smell, sight, touch, taste, hearing, body parts (hand, neck and foot massage, brushing hair, smelling fresh flowers or potpourri pillows, using essential oils and fragrances, the aroma of freshly cooked apples, stroking an animal, the aroma of bees wax or floor polish) Self-care and life skills activities – bathing, eating, dressing, toileting, grooming, baking, walking, TV, music, working with money

Physical exercise: (improves cognitive ability) combined with music, slow and deep breathing, touch and massage, kicking, throwing, catching, bouncing balls, balloons, beanbags, skittles, carpet bowls, dancing, walking to music

Social interaction: reminiscence, photographs, pre-war music, singing, dancing, parties, games, outings, picnics, working together on a task

Music as Activity

• Play old tunes (e.g. from the war years, Frank Sinatra etc.).
• Play classical music.
• Play seasonal or holiday music.
• Play religious music (e.g. church hymns).

Reading / Current Affairs

Read newspaper, poems, humorous snippets to them.

Simple Art & Craft

• drawing,  painting and colouring in
• cutting and pasting onto a collage
• potato printing
• knitting and crocheting
• adult colouring books
• soft clay for moulding (non-toxic),
• seasonal decorations (e.g. Christmas decorations)

Sorting Activities

• buttons, beads, envelopes
• give them a basket of towels and socks to sort out
• match socks
• sort pens and pencils

Cognitive games

• games with words – opposites, spelling, end familiar sayings, general knowledge
• games with numbers – dominoes (floor dominoes are big with pictures)
• table games – snap, snakes and ladders, card games
• games with letters – scrabble, jumbled alphabet
• memory games – matching cards, tray, colours

Psychosocial Activities

• caring for a pet
• doing something for others
• preparing for a part, cleaning up

Normalisation Activities domestic duties

• folding washing,
• separating socks,
• peeling vegetables cooking, baking, gardening, washing and drying up dusting, sweeping, wiping tables caring for pets, sorting items flower arranging putting plastic lids with correct containers

Conclusion

These are just a few ideas that, as an occupational therapist, I have found to work. Try and find which of these work for you and your loved ones. Use your creativity.

Remember: what works today might not work tomorrow and vice-versa, so, keep on trying.

References

Arkmen L (1966) ACSW Alzheimer’s Outreach. Internet article

Bosch J(1997) Highlands House Training Manual for West Wing. Caring for Residents with Dementia.

Burger S & Smith R (19?) Important Guidelines to Remember when dealing with the Elderly.

Frankile S (1996) General activities to share with lower functioning Alzheimer’s patients. Alzheimer’s Outreach. Internet article.

Geriatric Activity programme guide. Compiled by: Geriatric interest group South African Association of occupational therapy, Cape Group (19?)

Occupational Therapy with the Elderly: Chapter 9 Psychiatry in old age: Occupational Therapy and Organic Conditions P87-97

(Information provided by dementiasa.org)