Steve won’t let me cook a meal on my own. He has to help me. Sometimes I have to discretely redo something or finish it off, but that’s not important. Once though, I found a bucket of water full of peeled potatoes which had gone off. There was an awful smell. Steve must have decided to really help me and peel them in advance. Still, I appreciate his help a lot. Once when I told him so, he smiled and said, “I just don’t know how you managed before!”
Whether recreational or routine household tasks, activities help structure the day, provide opportunities to socialise and help us to define who we are. Many activities and pastimes of people with dementia are either impossible or limited by memory loss, problems concentrating and physical difficulties. Even if this is not the case, they may lack the initiative or be unable to get started (please see chapter on apathy). As they move about less, this can lead to a general deterioration of their physical condition, as well as boredom. Exercise and activities can be beneficial to the person with dementia in a number of ways. It can help them remain independent, maintain and stimulate their mental and physical abilities, help use up surplus energy and encourage sleep at night. Above all, encouraging the person with dementia to have interests, remain active and exercise can help them lead as normal a life as possible.
How to find activities that the person with dementia can enjoy
Encourage the person to participate in daily tasks
Helping with household tasks can provide the person with dementia with a sense of purpose and importance. Encourage them to do things around the house or garden (e.g. wiping the table, cleaning the car, dusting, brushing up leaves, mowing the lawn, peeling vegetables, folding and refolding bed linen or handkerchiefs etc.) even if the job doesn’t really need doing or will need to be done again. It might contribute to the person’s self-esteem, particularly if you occasionally comment on how you appreciate the help. It can also be a way to do something together. If there seems to be a purpose for the activity, the person with dementia may get more satisfaction out of doing it. As the disease progresses they may have to take a less active role in helping, but will probably find repetitive tasks such as filling containers or folding towels easier.
Try to find a task or activity that the person will enjoy
When looking for something the person with dementia might like to do, think about what they used to like. Apart from activities that you know they enjoy, you might be able to find out about things they used to do when they were younger. If necessary, simplify the task, provide enough assistance to enable them to carry it out or adapt it (e.g. knitting scarves instead of pullovers, cycling on a machine instead of a real bike, baking cakes together, matching playing cards instead of playing a particular game etc.). In this way the person might be able to enjoy doing something which had become too difficult.
Bearing in mind the person’s previous interests and personality, try to find new tasks and activities which they are physically and mentally able to do (albeit with assistance if necessary). For example, someone whose work involved producing things might find that they like to help with cooking; someone who is interested in fine detail and arranging objects might like stamp collecting or flower arranging and someone with an artistic flair might take to painting.
Your choice of activities will obviously depend on the time you have available and your financial resources, as well as the person’s interests and abilities. Try to focus on enjoyment, not achievement. The following ideas might be helpful or trigger other ideas :
- Walking : fresh air, physical exercise and a change of scenery
- Dancing : many people with dementia retain this ability, appreciate the music and enjoy reliving former moments of happiness
- Listening to music : the person might remember the words and enjoy singing along
- Reading books and newspapers or being read to : even stories the person knows
- Watching television (old familiar films) : but beware of causing fear
- Watching home videos of important events such as marriages and parties
- Taking part or being present at traditional, family, national or religious festivals
- Company (including pets and children) : pets can provide comfort as well as something to talk to and play with ; a soft toy can sometimes serve as a substitute
- Society games (bingo, dominoes, backgammon, cards etc.)
- Painting : this can provide an opportunity for self expression and communication
- Looking through photo albums
- Gardening : even inside plants such as tomato plants and potted plants
- Putting on make-up
- Collecting and arranging objects (stamps, dried flowers, cuttings from magazines)
- Listening to songs, watching films or speaking in a foreign language : many people who are bilingual tend to remember their first language the longest
How to prevent discouragement, frustration and boredom
In order to prevent the person with dementia from becoming discouraged or frustrated, try to limit the length of the activity to about fifteen to twenty minutes. Also, try to make sure that they can accomplish the task. Provide assistance if necessary without overdoing it and stop at the first sign of tiredness or frustration. As mental and physical activities use up water and sugar in the blood, it is a good idea to offer the person a drink of water or fruit juice and perhaps a piece of cake when they have a break.
10 exercises for people with dementia and their carers
The instructions should be given slowly, clearly and calmly. The carer and the person with dementia should sit facing each other in a well aired room and do the exercises together. It is advisable to start with 3-4 exercises repeating them 10 times. Slowly the programme can be broadened. The extercises should not last longer than 20 minutes. If the person enjoys them, they can be repeated twice a day, with differenct sets of exercises. The person should be encouraged patiently. Music can also be added to make the exercises more enjoyable. The first results can be expected after 3 weeks – both in carers and people with dementia.
- Spread your arms : breathe in; Arms down : breathe out.
- Left shoulder up : breathe in; Shoulder down : breathe out Do the same with your right shoulder Both shoulders up : breathe in; Down : Breathe out.
- Tilt your head back : breathe in; Tilt it forward : breathe out. Turn your head to the left : breathe in; Turn it to the right : breathe out.
- Bend your upper body to the sides : breathe in - breathe out; Bend it to the front : breathe in - breathe out; Turn your upper body to the left and right : breathe in - breathe out.
- Sitting march: Lift your right knee up : breathe in; Put your foot down: breathe out; Lift your knee up: breathe in; Down: breathe out.
- Stretch your legs out: Left leg: breathe in - breathe out; Right leg: breathe in - breathe out: Both legs: breathe in - breathe out.
- Exercise your feet: Cross your legs; Rotate your foot : to the left - to the right.
- Exercise your hands: Rubbing, massaging, pressing, bending your fingers; Rotate your wrists.
- Take a deep breath in : then a long and slow breath out. Take a deep breath in : then a quick and forceful breath out.
- Stand on your tip-toes : breathe in; Bend your knees until you are squatting : breathe out.
Devised and written by Dr. Hanna Jedrkiewicz
Last Updated: Thursday 06 August 2009