Ideally, activities should:
- Be the same or similar to what the person with dementia once enjoyed – there’s no reason they need to stop if they can keep doing it with help
- Promote self-esteem – maybe something the person can still do without help, or something that makes them feel good about themselves
- Keep up skills the person has, without learning new ones
- Give the person with dementia an opportunity to enjoy themselves, and have social contact
- Be sensitive to and appropriate for that person’s background
- Help the person to relax and give them pleasure.
Enjoyment doesn’t require memory. A person with dementia may enjoy an outing even if they don’t remember where they have been. What’s important is that the moment is enjoyed. Give them the time and space to do as much as possible, as simple and unhurried activities that are meaningful are best.
Helpful guidelines when planning activities
Use retained skills
Make use of skills the person with dementia still retains, such as buttering bread, washing up, or watering, sweeping and raking in the garden. These are also ways in which they can contribute to the household and feel useful. Encourage an area of responsibility, no matter how small.
Focus on one thing at a time
Break down activities into simple, manageable steps. Ask the person to do one thing at a time. Prepare a safe working area: People with dementia often have difficulty with visual perception and coordination. If there’s a working surface, make sure it’s uncluttered, with few distractions, and that there’s not too much noise. Keep the lighting good, but without too much glare.
Remember that abilities can fluctuate from day to day or the time of day
What worked well one day may not work the next, so stop the activity and try something else if it’s not going well. Also, think about what time of day the person with dementia is at their best and adapt the timing to suit. For example, some people are better having a walk in the morning while others get restless in the afternoon so a walk later in the day may be better.
Allow for emotional/spiritual outlets
For many people, music or contact with babies, children or animals gives them pleasure and enjoyment. Because many people with dementia have excellent memories for long-past events, looking through old photos, memorabilia and books lets them think about earlier times and the positive feelings associated with them. For others, maintaining religious involvement or involving themselves in spiritual activities such as praying or meditation, or even enjoying art or nature can provide a sense of meaning and peace.
Include sensory experiences
These could include hand, neck and foot massage using fragrant essential oils, hair brushing, smelling fresh flowers or potpourri, visiting public gardens or parks, or giving them a rummage box full of things that interested them. Include music and dance: Many people keep their sense of movement and rhythm longer than other abilities, so they still enjoy listening to music and/or dancing. For some, going along to a dance or a dance performance will provide pleasure.
Getting out for a walk (perhaps with a dog) is a great activity, both for the exercise and the extra stimulation from being outside in the world. If it’s rainy, think about hiring an exercise bike or treadmill to keep up the exercise indoors. A walk around a shopping mall can be a good option, it is best to avoid the busy times and go early or later in the day.
Weighing up risk with benefit
Dementia affects each person differently. However, symptoms such as confusion, memory loss and disorientation are common, while problems with mobility and co-ordination can also put their safety at risk. Therefore, as a carer, when you are thinking about keeping the person safe, you need to balance the benefits with the possible risks.
Every day we all take risks, for example cycling to work can be seen as risky, however, the benefit of the exercise and to the environment of not running a car outweigh the risk of getting hurt. For some people the reverse could be true and they would consider cycling too risky. So each situation will be different and unique and needs to be considered with care.
It is important not to be too risk adverse when supporting someone with dementia, and to consider any impact or benefit to their overall wellbeing such as self-esteem, maintaining their independence, mental health and of course physical benefits.
Also, it pays to revisit a situation as time passes, something that was once considered too risky may now be okay, situations change and it is important to be flexible and adaptable. One unfortunate episode does not mean you should never try something again.
Remember, with difficult decisions it is helpful to discuss your options and concerns with other people, canvass their opinions and weigh up what you feel most comfortable doing and what is best for the person with dementia.
Booklet: Supporting a person with dementia
A guide for family/whānau and friends
This booklet gives you information and tips on helping a person with dementia with their personal care, such as washing and dressing, nutrition, sleeping and travelling, as well as communication and ideas for meaningful activities and ways you can look after yourself – which is very important, too.