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If you can help the person with dementia to find activities they enjoy, you will improve their and your quality of life. You will need to be imaginative and flexible in adapting activities to the person’s changing capabilities and to their different moods. Find a balance between activities with meaning, purpose and pleasure. Consider the time of day, as people with dementia often have a ‘best time of the day’.
It is important to choose activities, which the person can manage. All human beings, including people with dementia, have a fundamental psychological need to be occupied. However, the nerve pathways in the brain, which carry motivation, may be damaged in a person with dementia. You may therefore have to help them get started.
Many people with dementia also have problems concentrating. They may be unable to concentrate on anything, such as a TV programme or reading the paper, for very long. This means that activities have to be adapted to meet their very special needs. If one activity doesn’t work, try another.
How activities can help
• Activities can help a person maintain their skills and give them a sense of achievement.
• Activities keep the person in the communication phase for as long as possible.
• Activities can be interesting and fun. They can help the person feel better about themselves and be more alert and interested in what is going on around them.
• Activities may reduce stress in the sufferer.
• Activities can help a person with dementia express their feelings. Talking about the past while looking at old photographs or listening to music may trigger strong emotions and you will need to be sensitive to these emotions.
• It is the memory and the thinking and reasoning parts of the brain which are damaged in dementia, not the emotions. We must always be aware of that.
• Activities help to validate and value their “world”.
• Activities can reduce the need for pharmacological management of negative behaviour.
Gains for the carer
If a person is occupied in a pleasant way they will not get bored or frustrated.
Boredom and frustration can cause some of the strange behaviour which is such a worry to carers. You may find that this behaviour lessens or even disappears as a result of an appropriate activity.
Sharing an activity which you both enjoy may help you find new ways to relate to the person and bring you closer together.
Exercise
• Walking is good exercise. It also uses up adrenaline which is produced by stress and frustration. You will probably both benefit from a walk.
• It is good for you both to get out and about and many carers find ingenious ways of arranging little trips even if it is only to the coffee shop or the local supermarket.
Reminders of the past
People with dementia usually find it easier to remember events which happened when they were much younger rather than those in the recent past. If you can find a way to trigger these far-off memories you may find that the person becomes more lively and interested in what is happening around them.
• Look at and talk about old family photos or books with pictures from the past.
• You may like to make up a memory box of old objects of interest to the person you are caring for. Actually handling articles may trigger memories more effectively than looking at pictures of them.
• Listen to music or watch videos from a time they would remember well.
Early stages
In the early stages of dementia the person will want to do the things they have always done.
When planning activities ask:
- what does the person really enjoy?
- what skills/abilities are left?
- what physical limitations are present?
They will need encouragement and reminders from you .
Make the focus enjoyment rather than achievement.
They will need you to put any equipment in a place where they can see it easily.
Use short sentences when advising the person what to do.
Here are some examples
A person who has been a skilful knitter may still be able to knit squares for a blanket to give to a charity. Someone who has enjoyed doing crossword puzzles may still be able to enjoy doing that.
Include another friend or relative in some other activities – playing cards or Scrabble, gardening or baking, for example.
Men and women enjoy helping with domestic tasks such as washing and drying up, laying the table and making beds. The end result may not be perfect but they can still enjoy the experience of achievement.
Peeling vegetables/making fruit salad and eating it!
The memory for some activities may be retained.
Many people are still able to read even when other abilities have been affected. It depends which part of the brain has been damaged by the dementia.
For example, the ability to type or play the piano may remain intact until the later stages of dementia because it is laid down in a particular part of the brain.
Music is a great resource for people with dementia and their carers. People may still enjoy singing, dancing and listening to music when other abilities are seriously affected. You might like to record a tape of favourite pieces of music or songs for the person to listen to. A relative or friend may like to help you with this.
The person may enjoy listening to the radio – tuned to an appropriate station, but television can be a problem. Some people with dementia lose the ability to tell the difference between what is real and what is on screen and can become frightened and upset.
Too much noise is also confusing. If you watch television together, select programmes with small sections of action or humour, rather than a programme with an involved plot. Even a favourite soap opera may become confusing.
Look for activities which provide stimulation but avoid too many challenges or choices. People with dementia can find it difficult to process several options.
A sense of humour survives in many people with dementia. A good laugh will do you both good.
Activities, which take a short time, are the most satisfactory because of the problem with concentration.
Later stages
As the dementia advances the person will still be able to carry out very familiar tasks. They will probably be much more interested in the process of doing the activity than in the end result. Directions for an activity need to be broken down into small, manageable chunks and should be very simple.
• At this stage, the person will probably enjoy tasks with one step such as sweeping, dusting or winding wool.
• Although the reasoning parts of the brain and language are breaking down in the later stages of dementia, the person’s sense of taste, touch and smell are still functioning. Find ways of stimulating these senses.
• Aromatherapy, hand and foot massages can all be very comforting.
Sensory stimulation/ Pet therapy
• As dementia progresses people find comfort in touching or stroking pieces of fabric or a cuddly toy. The person may find a hand massage, using a scented oil such as lavender, very soothing, while a fish tank or a pleasant view can have a calming effect and be satisfying to look at together.
• No one likes having nothing at all to do. We are all happier being occupied. The secret seems to be in realizing the different type of activities that people can do as dementia progresses and being flexible.
Keep activities on an adult level for as long as possible.
(Information provided by dementiasa.org)
