Additional Activities

ADEP Manuel

Alzheimer’s Association – Capital of Texas Chapter

Activity Programming

When providing dementia care, we must redefine our idea of an “activity program.” Organized activities like bingo and collage making are only one way to provide meaningful activities.

  1. Types of Activities
    1. Activities of Daily Living (ADLs)
      1. Normal daily routines take up a large part of the day for all of us. These activities are purposeful and familiar to the person with dementia.
      2. Dressing, grooming, and eating are important activities.
    2. Socialization
      1. Visiting with family, reminiscing with others, and participating in a group activity helps to meet social needs.
    3. Work-related Tasks
      1. Humans have a need to be useful.
      2. Give the person an opportunity to feel pride and a familiar sense of accomplishment.
    4. Quiet Time
      1. Quiet time is also a normal part of daily life.
      2. We must provide our clients free time; an enjoyable place to look out the window, watch birds, or simply take a nap.
  2. A Quality Activities Program is one that:
    1. Is failure-free
      1. Activities must offer opportunities for success.
    2. Is Individualized
      1. An assessment of each person for abilities, interests and past experiences is important. (For example, invite the person that was a hostess to greet people and handout nametags at the ice cream social.)
      2. Social status and gender are important considerations. (Can we expect a former bank manager to enjoy making tissue flowers?)
    3. Has a Purpose
      1. Some programs make arts and crafts more interesting to reluctant participants by having a specific purpose for the finished work, like decorating cards for a staff member’s new baby.
      2. Useful activities such as shelling peas or shucking corn may be more rewarding than “busy work.”
    4. Grouped carefully
      1. Limit group size.
        1. Group size should be small, usually 3-4 people is ideal.
      2. Organize groups according to ability levels when possible.
        1. Break down groups according to the severity of the dementia.
        2. Do NOT place individuals that are cognitively aware with dementia residents.
        3. When groups can’t be segregated there are ways to ensure that all participants benefit from an activity.
          1. Separate activities into steps.
          2. Universally enjoyable activities like music and pets bring pleasure to individuals with varied abilities.
    5. Appeals to Adult Interest
      1. Avoid childlike activities.
      2. Exceptions may occur.
        1. Dementia in its later stages may cause a person to derive pleasure from rocking a doll or looking at picture books.
    6. Makes Use of Former Abilities & Interests
      1. Importance is of essence to get a thorough assessment of the individual’s likes, dislikes, abilities, and interests.
    7. Is Flexible
      1. Example: There is no right way to fold laundry or sand wood.
    8. Is Repetitive
      1. Mastery comes from repetition.
      2. Repetitive tasks can give the person a sense of accomplishment.
    9. Is a Team Effort
      1. Everyone who comes in contact with the person is part of the activity team. The social worker asking, “Can you help me move these cups to the table?” creates a meaningful Social activity.
  3. Planning For success
    1. Scheduling
      1. Schedules offer security to a person with dementia but should allow for individual needs and flexibility.
      2. Schedules with limited number of words and large print can be posted in several places for less severely impaired residents. A clock and calendar posted near the schedule is helpful.
      3. A consistent morning routine might include a walking exercise program at the same time every day, followed by coffee and juice.
      4. Every afternoon should include a snack time with the clients participating in the preparation.
      5. Late afternoons are often difficult times. Walks outdoors, active games, and dining room preparations can be very helpful at these times.
      6. Activities should continue after dinner. Piano music, TV game shows, or a movie classic are just a few ideas.
    2. Availability
      1. Appropriate activities must be available at all times of the day or night.
      2. A rolling cart filled with interesting objects can provide instant activity when needed. Separate drawers can hold scarves to fold or fondle, artificial flowers to arrange, bolts to separate, playing cards to stack or sort. The possibilities are endless.
      3. A person can routinely become agitated at nightfall. A soothing one-to-one activity like sipping warm milk in a quiet place might be helpful.
    3. Distractions
      1. Activity rooms should be free from distractions.
      2. Avoid playing music during organized games or discussions.
    4. Duration
      1. Organized activities must be short.
      2. 20-30 minutes is usually maximum.
  4. When a person resists
    1. N0 can mean many things.
      1. I can’t.
      2. I’m afraid.
      3. I don’t understand.
      4. I never liked it and I never will.
    2. Offering lots of reasons why he should probably won’t convince him.
      1. Asking for his help may encourage his participation.
      2. Starting an activity within view of a group of people will often act as a magnet for the curious.
  5. Activity suggestions
    1. Music & Dance
      1. Music is the universal language. Music remains a meaningful activity for many individuals after communication has been lost.
      2. Sing-a-longs are often the most popular activity programs.
      3. Many recordings of popular music from the first half of the century are available. Assess what type of music the individual used to enjoy.
      4. Ethnic music is an excellent way to provide familiar activity for ethnic minority clients. There may be a family member or staff member willing to assist with musical program from their cultural background.
      5. Videos of old musicals or Lawrence Welk Show can provide pleasant entertainment for many older people.
    2. Domestic Chores and Work-Related Tasks
      1. Clients can cut fruit, spread small peanut butter sandwiches, arrange cheese and crackers on a plate, and share in the clean up afterwards.
      2. Sweeping the sidewalk in an enclosed garden area is another possibility.
    3. Reminiscing
      1. For the person with dementia whose life is becoming unfamiliar and filled with -losses, there are benefits of recalling a more pleasant time of life.
      2. One-to-one or small group discussions can center on themes like jobs, families, or travel.
        1. Allow plenty of time for individuals to respond.
        2. Should a topic seem upsetting, acknowledge that it might be difficult and have another idea ready.
        3. Props for reminiscing.
          1. Memory box filled with button hooks, small tools, ladies gloves, hats etc.
          2. Old catalogs. (Sears, Montgomery Ward)
          3. Photos of old cars, planes and houses.
          4. Old-time radio shows.
    4. Possible topics
      1. Asking questions can be too demanding for some persons with dementia. Instead, try more open-ended phrases like “tell me about …”
        1. Your wedding.
        2. Your best friend.
        3. Animals you like.
        4. Your favorite season.
        5. Your school days.
        6. Places you’ve traveled.
    5. Shopping
      1. Shopping can be very comforting well into the illness.
      2. Staff members can escort residents to the gift shop for a short shopping trip.  Another option is to-turn a closet into a “store” with small items like Kleenex, LifeSavers, etc. When the “store” is open, residents can bring their wallets and purses with small amounts of money and buy whatever they fancy.
      3. Shopping trips in public areas can be overwhelming for a confused person. Shopping will be the most successful if treated as an outing, rather than trying to get through a long shopping list.
    6. Physical Activities
      1. Dancing
        1. Line dances, circle dances, and wheelchair dancing can be fun for everyone. One residential care facility held dance lessons at the “ballet bar” along the hallways.
      2. Group exercises
        1. Daily exercise will improve strength and balance and may help prevent falls.
        2. Most exercises can be adapted for participants in wheelchairs.
      3. Sports and games
        1. Floor bowling.
        2. Bean bag toss.
        3. Hallway golf.
        4. Indoor horseshoes.
      4. Gardening and yard work
        1. Raking leaves.
        2. Weeding.
        3. Digging.
        4. Planting seeds.
        5. Watering.
      5. Walking, walking, walking
        1. Indoors or out.
        2. Marching may be fun for some.
        3. Enlist the help of family and visitors if the client enjoys longer walks.

Alzheimer’s Activity Resources

The Alzheimer’s Store
www.alzstore.com

Books available on Amazon:

Movement With Meaning
By Barbara Larsen

The Best Friends Book of Alzheimer’s Activities
By Virginia Bell, David Troxel, Tonya Cox, Robin Hamon

Sunshine & Joy’s Big Book of Alzheimer’s Activities
By Jill Hernandez