PRINCIPLE GUIDELINES FOR CHOOSING AN INDIVIDUALISED ACTIVITY
When determining whether an activity is suitable, you must establish the stage of Dementia the person is at and individualize the activity to satisfy the person’s interests, needs and ability. Although this can be a difficult task, there are some useful principles to follow.
1. Assess their skills
Activities should be failure free. Focus on what the person with Dementia can do instead of what they cannot do. Can they sort objects by size or color? Can they button shirts and zip up jackets? Can they follow written commands? Adapt activities to fit the skills of the person with Dementia by making them more or less challenging. If the person does the activity incorrectly, do not correct them. The goal is to connect with them and encourage a sense of success
2. The emphasis should be on the doing not in what is done
The process of the activity is always more important than the result or the end product. It doesn’t matter what the end product looks like or if it has been done properly, so long as the person has enjoyed doing the activity.
3. Activities should relate to past interests and skills
Consider the uniqueness of their life history profile when thinking about activities. People with Dementia retain old habits and abilities longer, so it is beneficial when choosing an activity, to find an activity that they used to do and enjoy. Create games based on their past interests and hobbies. Playing cards or gardening, with a person who never liked those activities in the past, is less likely to be a success, than it would be with a person who used to love playing cards or gardening.
4. Activities should be appropriate for the person’s ability
Activities that are too juvenile in nature can incite frustration, anger or apathy. People with Dementia often respond positively to dolls and children’s toys, but it is important to adapt the activity so as not to infantilize the person. For instance, large piece wooden jigsaw puzzles with photographic pictures of flowers, animals or cars are a favorite activity for many people with Dementia, whereas children’s wooden puzzles with cartoon characters would be too juvenile. There are many children’s toys that are appropriate for people with Dementia, providing they are suitably selected to match the person’s abilities.
5. Activities should recall work history
Our work plays a major role in our lives. Activities that recall a person’s work related past will create a sense of being useful and valued.
6. Doing nothing is doing something
Enjoying quiet time together can be a pleasant activity for people with Dementia. Sit on a park bench and enjoy the ambience of nature or hold hands while watching your favourite ‘classic’ movie on TV.
7. Activities should include physical skills
People with Dementia often retain physical skills including the ability to exercise, walk and also maintain good hand-eye coordination. Balloons and beach balls can be used indoors or outdoors and are a good physical activity that they will enjoy while helping to keep fit.
8. Activities need to be initiated
People with Dementia lose the ability to initiate activities. It is up to us as their carers to get them started. For example, if you are painting a picture, you will need to demonstrate with the paint brush and then hand them the paint brush to continue the activity. Give both verbal and visual instructions when explaining what to do.
9. Activities should not be forced
We are all reluctant to do things we do not want to do. You may find that you have to gently encourage participation and be persuasive, but you must ensure that you are not too aggressive. For practical and ethical reasons, participation in the activity should be voluntary.
10. Intergenerational Activities
People with Dementia adore children and young adults. They often see them as their own and respond positively to their youthful energy. Children and young adults will also benefit from the interaction with their elders.
11. Don’t be afraid to try activities you think will never work
Take chances and try new things. Often finding suitable activities will depend only on how inventive you are.
12. Personal care activities
Personal care (also referred to as ADL’s (Activities of Daily Living)) plays an important part in the role of activity, and is probably the most overlooked. In many cases it is a constant struggle for caregivers in nursing homes to get people with Dementia bathed and dressed when they are struggling to keep up with their workloads at the best of times. Personal care activities ensure dignity and it is important to take the time to help the person with Dementia take pride in their appearance. Dignity is foremost in the care of people with Dementia. Very rarely do you ever see the elderly unkept or wearing wrinkled clothes. A suitable activity of this nature would be to help the person with Dementia choose their outfit for the day ahead and lay it out in the cupboard ready for the carers. Personal care activities could also include brushing hair, shaving or applying make up.
13. Activities can be short and meaningful
Even if you are busy, you can still take a few minutes to acknowledge the person with Dementia in a special way. As people with Dementia gradually lose their ability to participate in work and social activities, they particularly appreciate being acknowledged. All it takes is a gentle touch, a handshake or acknowledging them by name.
14. Activities should satisfy spiritual and religious needs
Everybody has spiritual needs, regardless of whether they have a particular faith. You can celebrate a person’s faith or you can encourage them to stay in touch with their spirit through nature, music and the arts. For instance, being acknowledged fulfills a person’s spiritual need by helping them reclaim their sense of belonging.
If the person with Dementia has more energy in the morning you may choose this time to go for a walk. Perhaps they are more focused in the afternoons and you can try an arts and crafts session. For people in the moderate to advanced stages of Dementia, you may find that they may sundown in late afternoons and early evenings. This can be a challenging time for activities, but the right activity can be a good diversion for redirection and reducing behaviours associated with ‘sundowning’. For more information on ‘sundowning’ click here.
16. Be prepared for alternative activities
What you have arranged as an activity on any given day may not always work to plan. Quite often the person with Dementia will not connect with the activity you have chosen, so you must have an alternative or alternatives ready to try. Persistence is the key and through trial and error you will eventually find activities the person will enjoy. Also remember that an activity that was unsuccessful one day may be a hit the next.
17. Repeat favorite activities and establish routines
Take note of activities that the person enjoys. They may not remember doing them, but may remember the process instinctively. Try to keep the activities fresh, by using the same procedures but changing the content of the activity. For instance, if you are sorting objects, vary the objects and the colors each time.
If you would like suggestions on some activities to try please click here.