Dementia - carers and activities

Every day, many things give us a sense of purpose and pleasure. For a person with dementia, the need for quality of life is no less important — but without some help from family and carers, it can be much harder to achieve. Suitable activities can make a real difference, and they also play a significant part in managing challenging behaviours.

Planning activities#

There are many ways to plan and provide appropriate activities. Good activities tend to:

• compensate for lost abilities and promote self-esteem
• make use of skills the person still has, rather than relying on new learning
• offer enjoyment, pleasure and social contact
• reflect what has made the person unique

Be sensitive to the person’s cultural background, and take time to understand what makes them an individual. This means knowing their former lifestyle, work history, hobbies, recreational and social interests, past travel and significant life events.

Make use of skills that have not been forgotten, such as buttering bread, washing up, watering the garden, sweeping or raking. These tasks can re-establish old roles and let the person contribute to the household and feel useful. Encourage an area of responsibility, no matter how small.

A person with dementia may enjoy an outing even if they do not later remember where they went. What matters is that the moment is enjoyed, even if the experience is soon forgotten.

Keep activities simple and unhurried#

Give the person the time and space to do as much as they can for themselves.

• Focus on one thing at a time and give one instruction at a time.
• Break activities into simple, manageable steps.
• Prepare a safe working area. People with dementia often have difficulty with visual perception and coordination, so keep surfaces uncluttered, with few distractions and as little noise as possible.
• Pay attention to good lighting (without glare), individual seating preferences and correct work heights.
• Use plastic containers to help avoid breakages.

Try not to let activities reinforce a sense of inadequacy or add stress. Abilities can fluctuate from day to day, so an activity that does not work or is not enjoyed one day can be adapted and tried again another time.

Choose the right time of day#

For the best chance of success, consider when the person is at their best. Walking, for example, is often best in the morning or early afternoon. But for someone who is particularly restless later in the day, or who has had a long or unstructured day, a late-afternoon walk may work better.

Be selective with outings#

Avoid crowds, constant movement and noise, which many people with dementia find overwhelming. Try not to over-stimulate.

For many people, music, or contact with babies, children or animals, brings positive feelings. Memories of past events are often well kept, so looking through old photos, memorabilia and books can help the person recall earlier times. The chance to relive treasured moments can be deeply satisfying. If reading skills have declined, you could make audio recordings, or find picture books and magazines on topics the person enjoys.

Allow an emotional outlet and sensory enjoyment#

Some sensory experiences that may be enjoyed include:

• rummaging in a box of things the person has been interested in
• hand, neck and foot massage
• having their hair brushed
• smelling fresh flowers or pot pourri
• using essential oils and fragrances
• stroking an animal or feeling different textured materials
• visits to a herb farm or a flower show

A sense of movement and rhythm is often retained. You could hire an exercise bike or walking machine for rainy days, be spectators or take part in dance classes, or walk the dog together. Getting out and about provides much-needed exercise as well as enjoyment.

Be consistent#

If different people are caring for the person, it can help to write an activities care plan. This keeps activities consistent and suited to the individual’s needs.

Managing challenging behaviours#

Activities play a significant part in dealing with challenging behaviours. Knowing what calms or distracts the person when they are restless or distressed is very important, and can be especially helpful for a respite carer.

Mistakes and failures will happen, but try not to let the person feel they have failed. Keep trying and don’t give up.

Key points#

• What matters is that the moment is enjoyed, even though the experience may soon be forgotten.
• Good lighting (without glare), individual seating preferences and correct work heights are important.
• Knowing what helps to calm or distract a person when they are restless or distressed is very important.

Where to get help#