Even people in the most disabling stages of dementia can benefit from therapeutic activities. People with dementia, of which Alzheimer’s disease is just one type, have cognitive disabilities; that is, problems with memory, planning, perception, judgement and reasoning. Therapeutic activities need to be geared towards to the individual so here are 7 tips for caregivers to consider.
1. Your activity should increase their feeling of wellbeing.
New learning will be difficult for most people at all stages of the disease. The aim of your activity is that they help improve communication, increase interpersonal encounters, offer stimulation and increase their feeling of wellbeing.
2. Past behavior is usually a predictor of future behavior.
Finding out what the person used to enjoy and what interest and skills continue to engage them will help your choice of activity or activities. You need to regularly assess their skills and know how their behavior has been interpreted in the past to make good judgements on their wellbeing.
3. Consider the ways in which past activity was enjoyed.
Did the person enjoy company, did they enjoy gossip, were they more observers than joiners, did they like to help others?
4. Give the person with dementia a choice of activities.
Residents of care facilities and people in their own homes are often just presented with something to do regardless of personal preference. People with dementia can make decisions and need to be encouraged to make decisions where possible and when it presents no anxiety. You can do this by placing two or three things in front of them. If there is little or no interest and communication is very limited you can maybe take them outside for gardening or a walk and see if they find that more interesting.
5. The different stages of dementia require a different methods of caregiving
and affect their ability to engage and enjoy the activity. The reversal model of dementia can help you choose what activity will be best suited. Piaget’s model of child development is one many will be familiar with as we saw it in our own children or relative’s children. The model must not make you infantasise the adult with dementia, but it can help you understand the physiological boundaries that the disease has imposed on that person. So briefly:
The early stage of the disease will mean that person will probably benefit for goal centered activities such as cooking, crafts, art, games.
Middle stage means that reflective activities such as reminiscence become increasingly difficult and may provoke anxiety. This is an egocentric period where they see themselves as the center of their world because there is so much that is confusing. One to one activities are often best.
Later stages (later middle and end) mean that it is all about the pleasure of sensation. Aromatherapy, hand massage, soft music, warmth, attention will all contribute to a feeling of wellbeing.
6. Therapeutic activities may be most beneficial when you use their environment to make full use of their senses in their everyday lives rather than be removed to another area for their therapeutic activity
7. Offering group or individual activities will depend on a number of things. The activity type may require more people or need to be presented on an individual. The more debilitated the person the greater the likelihood you need a one to one activity.
Further reading you may find helpful
How to make therapeutic activities work better for people with Alzheimer’s
Alzheimer's caregiving for beginners