What caregivers can do: Add fun-filled and creative activities to the daily routine of someone with dementia. Help them think of pleasant memories from the past. Add activities they consider useful (meaningful activities) to the day. Encourage them to enjoy what they can still do. Share relaxed and happy moments together.
If persons with dementia get suitable surroundings, they can lead productive and satisfying lives for many years after the diagnosis. They are happier and less likely to get angry or show worrying behavior. The caregivers are also less stressed and can enjoy the company of the person.
- Help the person with dementia feel safe and comfortable.
- Provide a relaxed environment and emotional support.
- Add meaningful activities.
- Add fun-filled activities.
- Spend time relaxing with them and talking to them.
- Do’s and Don’ts for more effective activities.
- See Also….
Adapt the home and adjust the daily routine of the person with dementia so that the person is comfortable and safe. Change how you interact with the person to reduce the frustration the person feels because of the growing dementia problems.
Try to reduce any confusion the dementia person has about the time and space. This can be done using various reality orientation techniques. Help the person have a suitable daily routine that is predictable; most persons with dementia find a day with routines easier to handle than a day full of surprises. Use suitable ways to talk to the persons so that you understand them and they understand you. When helping them, give just the right amount of help so that they feel capable and independent to the extent possible, remain safe, and don’t get frustrated.
Different persons find different things relaxing, depending on their personality, likes, and dislikes. Here are some things to consider:
- Lighting incenses / aromatherapy
- Instrumental music
- A small altar for worship
Dementia persons who are fond of pets may respond well to pet therapy. This is also called animal-assisted therapy. Some experts say that this can help because the unconditional love a pet gives can be very soothing and fulfilling for a person with dementia. But pets are not as common in India as it is in other countries, and many Indians have never owned pets. So the suitability of pets would depend on the person.
Persons with dementia have led useful, active lives before their dementia. Their reducing abilities may make them feel useless and worthless.
Find activities that such persons can help in. Look for activities that make them feel useful and good about themselves. Choose activities depending on the state of their dementia. For example:
- spreading clothes to dry, or picking them up and folding them
- removing stones from daal/ rice
- shelling peas, destringing beans
- making rangoli
- helping in the garden
- placing flowers in the vases
- rolling out dough for gujjiyas
- sharpening pencils, stacking newspapers
- filing newspaper cuttings
- helping children with their craft projects
- explain a recipe to a grandchild
- walking a pet
- giving clothes to the dhobi/ taking them back
- filling filter water in bottles
- re-arranging photos in photo albums
While choosing a meaningful activity make sure it is something the person will feel good about doing. Someone who used to like cooking and was proud of doing housework will be happy if asked to shell peas or roll out dough for gujjiyas. But someone who disliked cooking and considered it an unpleasant duty would not. Persons who always used servants for housework may even feel insulted if asked to do things like fold clothes or remove stones from daal.
Remember that the persons with dementia will make mistakes. Or they may lose interest midway of a task, or be very slow. Do not push them to complete the task. Do not expect them to do it faster and correctly. The purpose of these activities is to make the person with dementia feels useful and a part of normal life.
Select activities depending on the abilities and problems of the person with dementia. In some forms of dementia, persons remain mentally active and capable. Their problems may be in other areas like movement, decision-making and socially correct behavior, emotional apathy, problems with words, etc. Activities suitable for such persons may be very different from what may work for persons with memory and concentration problems.
Do include activities that involve exercise, such as walking or yoga. These activities have health benefits, and they also reduce frustration and aggression because they provide a sense of well-being.
Activity room at Nightingales Centre for Ageing and Alzheimer’s, Bangalore
Persons with dementia can definitely have fun! They can enjoy creative activities, social outings, and games if these are chosen carefully and planned well. While choosing an activity, make sure it is something the person can do and which the person likes.
Persons with dementia often enjoy playing games and painting and other such activities, especially in the company of grandchildren or other family members. Don’t put any pressure on them to be perfect. They may make mistakes and forget rules. Don’t try to “correct” the persons, and don’t insist that they follow a complex set of rules. The idea is to have fun.
Here are some activities to consider:
- Using crayons
- Playing board games like Ludo and Snakes and Ladders
- Simple games like stacking colored rings
Outings can be enjoyable if planned well. Some persons with dementia may enjoy meeting other people and talking to them, or seeing new places. Be careful not to overdo this, as too much newness is usually stressful. Find a suitable balance. Choose times and places that would be interesting for the persons but which do not make them feel any pressure. Some persons may no longer want to eat in a restaurant. They may not be able to handle cutlery. They are more likely to get tired easily, and they may get confused, so keep outings short. Be ready for the dementia person suddenly wanting to return home.
Visitors at home can be a welcome change for someone with dementia, but only if the visitors understand the person’s condition and know how to interact. In India, because dementia awareness is low, unaware visitors often start lecturing persons with dementia and telling them to use “will power.” They say things like “you must do crosswords to improve your memory” or “you should not take so much help from your daughter-in-law; you should do your own work.” Such visits stress the person with dementia instead of providing company and fulfillment.
Many people assume that anyone with dementia cannot think clearly. But the decline in abilities depends on which part of the brain is affected. This varies from person to person. Some retain their ability to do crosswords and sudoku and can spend hours in solitary pleasure with them. Some even enjoy trying out new gadgets, like the latest mobile’s features. For example, Sir Terry Pratchett continued writing fantasy novels and doing new things for many years in spite of his dementia. Keep this in mind when selecting activities.
Caregivers often forget to spend relaxed time with loved ones who have dementia. Yet, if you can set aside the need for being correct, you can spend time in a relaxed way with the person, just talking or maybe sharing memories. Dementia persons have gaps in their memories, but in a relaxed setting, they are often able to remember many things of the past. They usually enjoy such sessions.
Appropriate use of music can be particularly powerful for many persons with dementia. Pleasant memories of the past may be easier to trigger by using music popular in the older days, childhood jingles and poems, bhajans, lullabies, and stories that often told to children. Often, persons with dementia may even start singing along, even though they seemed uninterested and uncommunicative earlier. Select music depending on what the person seems to enjoy. Often persons with dementia like the music of their teens or early youth, but this may vary. Film songs are often easy to remember. Many Indians enjoy bhajans and classical music. Consider playing music to a schedule rather than all the time. Softer, slower melodies may be better in the evenings as they can be relaxing and don’t make people want to sing along. Also, music can soothe pain and reduce agitation. Cheerful music can be used to make people feel active. Selection and use of suitable music in suitable company is key to effective use. Some explanations and practical suggestions for effective use of music for dementia are also available in an article listed in the references below.
Smells of spices or the aroma of favorite foods can also help. Discuss with other family members about what can trigger pleasant memories for the person with dementia.
Some ways the family can spend time together:
- Listen to old music and talking about favorite songs
- Watch old movies together
- See family albums, or re-arranging photos in them
- Share anecdotes from the past
The idea again is to relax together, not to be accurate and complete in the memories. If the person with dementia starts talking of things that did not happen, don’t try to correct them. Just listen and try to appreciate their reality, while also remembering that they may say something totally different tomorrow.
Reminiscence therapy has been used successfully with persons with dementia. A project of Pam Schweitzer has shown that the long-term memories of people with dementia are sometimes better than their relatives think. The project used weekly meetings with groups of people with dementia and their family carers (from 12 – 18 weeks) to revisit their shared past experience. This was explored using creative ways such as music, drama, art, objects, multi-sensory stimulus and non-verbal communication.
The above discussion covers several types of activities that can be considered to improve the quality of life of people with dementia. In practice, some families are able to use activities successfully, while others are not. This is often because families have very high expectations about what they can achieve with activities. These expectations interfere with the basic objective of activities: improving the quality of life of the persons with dementia. Here are some general do’s and don’ts to keep in mind when introducing activities.
- Do use the time together for interesting/ relaxing activities and to increase a sense of participation and togetherness
- Do adjust the activity to make sure it balances the sense of achievement and a need for challenge for the persons with dementia. It should not seem condescendingly simple. It should not be so complex as to be frustrating.
- Do let persons with dementia do the activities at their own pace and interest level
- Do select something that the person finds meaningful
- Don’t monitor the activity or supervise it like a task the person has to do “correctly”
- Don’t hurry dementia persons or force them to do the activity/ complete what they started
- Don’t assume the activities will “improve” skills or memory, or expect that the “dementia will reduce” the underlying disease (this is a faulty understanding of dementia)
- Don’t use activities where mistakes can hurt the person or cause loss or irritation
- Don’t get tense or bossy
- Don’t point out mistakes or grab control of what the person with dementia is doing. Support them, but don’t rush them
- Don’t laugh at their mistakes or feel amused.
- Don’t suggest activities that are obviously trivial or may be seen as condescending by the person with dementia.
Resources/ references from Dementia Care Notes and related sites
Pages with caregiving discussions related to above
Some relevant interviews on this site:
- Tips on improving quality of life, including rummage boxes, fiddle mats, many others: Interview of a nurse
- Ideas on keeping someone with dementia engaged and happy: A dementia caregiver’s wishlist
- Outings, if planned well, can relax people with dementia and their caregivers: A volunteer describes taking dementia patients for outings
The full list of interviews is here: Voices: Interviews with dementia caregivers, volunteers, and experts
External links related to above page on topics like music, art, and reminiscence therapy
Discussions on use of music for persons with dementia
- A detailed interview, full of practical tips, on using music for persons with dementia is here: Music Therapy in Dementia: How Effective is it? .
- Pam Schqeitzer’s project on reminiscence therapy and a related newspaper interview from her visit to India .
Most books on dementia care discuss the usefulness of “activities” that can be fulfilling for persons with dementia and their carers. One particularly useful book is mentioned below.
When a Family Member Has Dementia: Steps to Becoming a Resilient Caregiver(Susan M McCurry): This book discusses changes a caregiver can make to be more supportive and also enjoy more activities with persons with dementia, to be more resilient while coping with the difficulties of dementia care. The book focuses on improving quality of life by using the tools explained, nurturing oneself, and being open to creativity and enjoyment. For the paperback version, see Amazon.com, or, if you are in India, see Amazon.in or Flipkart or any other vendor.
Page/ post last updated on: September 26, 2016