Keeping busy stimulates the brains of elderly people with dementia while boosting a sense of usefulness and accomplishment. But they lose the ability to select satisfying activities and follow through on them -- so you need to initiate things to do for the person with dementia you are caring for. Too much idle time can make anyone feel lonely and unproductive, raising the risk of depression, agitation, and anger.
Tips to create successful activities for dementia patients:
1. Build on activities the person with dementia has always enjoyed.
A bridge player may no longer be able to keep up, but she may enjoy holding cards and playing a simpler game, such as Old Maid or Solitaire. But introduce new ideas, too, to see what "clicks."
2. Aim for the "sweet spot" -- not too easy, not too hard.
If an activity is too simplistic or childish (like coloring books for kids), the person might feel insulted or bored. If it requires remembering sequences or is otherwise above the person's cognitive level, it will frustrate and turn her off.
3. Take common changes of dementia into account.
The attention span shortens. Changes in recent memory make it hard to follow activities with multiple steps or instructions (such as cooking). Less self-critical people with dementia may be more open to art. Musical ability tends to be very well retained.
4. Take glitches in stride.
Don't be a stickler for things being done the "right" way or according to rules. If it bothers you that dishes are rinsed improperly, for example, redo them yourself later without comment. The main consideration should be how the activity makes the person feel: involved, purposeful, successful.
5. Look patient, act patient, be patient.
Impatience or anger tends to make the person with dementia anxious or balky. Don't give orders and make suggestions. Watch your body language, too: She'll be more tuned in than you might think to a knitted brow and heavy sighs. What helps: encouraging comments and realistic praise (without talking down or using an exaggerated voice), saying thanks where appropriate.
6. Don't challenge or argue.
Avoid asking "Why" when something goes awry. People with dementia likely don't know why they did something peculiar (like store a paint set in the refrigerator). Gently suggest an alternative: "I don't think the paint should get cold, so let's store it here on the desk." Rational arguments are useless because the person's emotions are stronger than her logic.
7. Make activities routine.
If an activity is a hit, do it every day or two. Or do the same thing, slightly modified: folding towels one day, sheets the next. Pursue categories of activities at about the same time every day (physical or outdoor in the morning, quiet handiwork after lunch) to add comforting structure to the day.
More ways to keep someone with Alzheimer's or other dementias busy and active
- Rinsing and drying dishes or loading a dishwasher
- Folding laundry
- Matching socks
- Watering plants
- Arranging flowers
- Washing vegetables, kneading bread, making salad, stirring pots
- Decorating cookies, cupcakes, cakes
- Simple mending, such as replacing buttons.
- Polishing silver, polishing shoes
- Washing windows (but not on a stepstool or ladder)
- Setting the table. Try providing items one at a time: first all the plates, then all the forks, then the knives, etc.
- Organizing books (by size, alphabetically, by color)
- Organizing a messy drawer
- Clipping coupons (whether you actually use them or not)
- Bringing in the mail or newspapers
- Sorting and rolling coins
- Playing card games, especially old favorites or simple games like War. Consider large-print cards.
- Playing board games, such as checkers or Chinese checkers
- Working word-search puzzles. Look for large-print versions of books.
- Flipping through scrapbooks or photo albums.
- Identifying people in old photos. (Write down what you learn!)
- Reading books and magazines; look for those heavy on images (coffee-table books and magazines on design, travel, photography).
- Attend an enrichment program for people with dementia at a local museum or library, if these programs exist in your area.
- Working jigsaw puzzles. You may need to experiment to find some that challenge without frustrating. On the bright side, you'll be able to use a successful one repeatedly. Consider puzzles designed for dementia patients.
- Playing catch with a softball or beanbag.
- Spending time with animals. Visit a neighbor's dog or arrange to have a child bring one over every day. Visit a pet store. Provide a fish tank or goldfish bowl.
- Going out for ice cream cones. Not having to sit down, as you would at a restaurant, may be less stressful.
- Following an exercise video. Check YouTube.com for that favorite of '60s and '70s housewives, Jack LaLanne, an icon ahead of his time who may be familiar to the person you're caring for.
- Listening to old radio shows (check your local library or alzstore.com).
- Playing dance music and dancing.
- Watching a digital picture frame with rotating images of family members. Set it so pictures change slowly. * Ask open-ended questions about the pictures as you watch.
- Reading old comics. Look for books that are collections of classics from the person's era, like Peanuts, Family Circus, Little Nemo.
- Looking through a personal-memories box. Include such items as military pins, baby clothes, postcards, pictures of old houses, costume jewelry, and other tactile icons that have meaning to the person.
- Caring for a doll. In late-stage dementia, people often find comfort in "taking care of" a baby doll or simply cuddling and stroking a stuffed animal.
Limit activities to a confined area, or provide a watchful eye if the person is prone to wandering.
- Tending a garden: weeding, hoeing, watering, monitoring. (Indoor variations, such as an herb garden, orchids, or a terrarium, also provide sensory stimulation.)
- Raking leaves or sweeping a porch.
- Picking up sticks.
- Watering the lawn.
- Planting bulbs.
- Taking a walk (with a companion).
- Feeding birds, ducks, fish (or watching a bird feeder placed outside a window).
- Stacking kindling.
- Organizing a toolbox or workbench.
- Sanding wood.
- Washing or polishing a car.
- Tightening screws.
- Painting (such as a fence).
- Digging holes.
- Working a lockbox (a wooden box featuring a variety of locks).
- Experimenting with different materials, such as watercolors, clay, pastels, washable markers
- Drawing or coloring. Search amazon.com with the phrase coloring books -- there are many with patterns or adult-friendly themes.
- Creating a family history scrapbook
- Using an electronic keyboard or child's zither
- Singing along to holiday carols or songs from a favorite era
- Listening to audio books
- Listening to a music box at one's bedside
- Stringing popcorn or cranberries (for holiday decorations) or cereal and popcorn (for birds)
- Creating collages. Use leaves, magazine images, tissue paper, buttons, but beware of small choking hazards for people with advanced dementia.
- Stamping to make gift tags, cards, or just for fun. Find supplies at any craft store.
- Singing hymns
- Making crafts together for a charity, which can be more rewarding than making a craft for yourself. Someone who crochets might use a simple, repetitive pattern to make scarves or lap blankets.