Dementia - carers and activities

Each day there are many things that provide us with purpose and pleasure. For a person with dementia, the need for quality of life is not diminished. Without some assistance from families and carers, however, it is much more difficult for them to achieve purpose and pleasure. There are many ways to plan and provide appropriate activities for people with dementia.

Ideally, activities should:

• Compensate for lost abilities
• Promote self-esteem
• Maintain residual skills and not involve new learning
• Provide an opportunity for enjoyment, pleasure and social contact
• Be sensitive to the person’s cultural background.

Consider all that has made the person unique

Understanding what makes the person unique will help you plan appropriate activities for them. This means knowing the person’s former lifestyle, work history, hobbies, recreational and social interests, past travel experience and significant life events.

Activities can re-establish old roles

Make use of skills that have not been forgotten, such as buttering bread, washing up or watering, sweeping and raking in the garden. These are also ways in which the person with dementia can contribute to the household and feel useful. Encourage an area of responsibility, no matter how small.

Activities can give relaxation and pleasure

A person with dementia may enjoy an outing, even if they do not remember where they have been. What is important is that the moment is enjoyed even though the experience may be soon forgotten.

Simple and unhurried activities are best

Give the time and space necessary to allow the person to do as much as possible. Focus on one thing at a time. Communicate one instruction at a time. Break down activities into simple, manageable steps.

Prepare a safe working area

People with dementia often have difficulty with visual perception and coordination. Ensure that surfaces are uncluttered, with few distractions and as little noise as possible. Good lighting (without glare), individual seating preferences and correct work heights are also important. Use plastic containers to help avoid breakages.

Don’t allow activities to reinforce inadequacy or increase stress

Abilities can fluctuate from day to day. Activities can be adapted and tried another time if not successful or enjoyable the first time.

Use times that suit the person’s best level of functioning

To ensure maximum success when carrying out activities, it is best to consider the times of the day when the person is at their best. For instance, sometimes walking is best done in the morning or the early afternoon. However, for some people who are particularly restless later in the day or who have had a particularly long or meaningless day, a late afternoon walk may be better.

Don’t overstimulate

Be selective with outings. Avoid crowds, constant movement and noise, which many people with dementia find overwhelming.

Allow an emotional outlet

For many people with dementia, music or contact with babies, children or animals provide positive feelings. Excellent memories of past events are often kept – looking through old photos, memorabilia and books helps the person to recall earlier times. The opportunity to relive treasured moments can be deeply satisfying. If reading skills have deteriorated, make individual audiotapes. Locate picture books and magazines in the person’s areas of interest.

Include enjoyable sensory experiences

Some sensory experiences that may be enjoyed include:

• Hands, neck and foot massage
• Brushing hair
• Smelling fresh flowers or pot pourri
• Using essential oils and fragrances
• Stroking an animal or different textured materials
• Visits to a herb farm or a flower show
• Rummaging in a box containing things that the person has been interested in.

A sense of movement and rhythm is often retained

Hire an exercise bike or a walking machine for rainy days. Be spectators or participants at dance classes or walk the dog together. Walkers can enjoy the wider world while getting much needed exercise.

Consistency is important

It can be helpful to write out an activities care plan if different people are caring for the person. This will ensure that the activities are consistent and are suited to the individual needs of the person with dementia.

Activities can be useful in managing challenging behaviours

Activities play a significant part in dealing with challenging behaviours. Knowing what helps to calm or divert a person when they are restless or distressed is very important. This can be particularly helpful for a respite carer.

Don’t give up

Mistakes and failures will happen, but don’t let the person with dementia feel a failure. Keep trying.

Where to get help

• Your GP (doctor)
• Your local council
• Your local community health centre
• National Dementia Helpline, Dementia Australia Tel. 1800 100 500
• Aged Care Assessment Services Tel. 1300 135 090
• My aged care Tel. 1800 200 422
• Cognitive Dementia and Memory Service (CDAMS) clinics
• Carers Victoria Tel. 1800 514 845
• Carer Gateway Tel. 1800 422 737
• Dementia Behaviour Management Advisory Service (DBMAS) Tel. 1800 699 799 – for 24-hour telephone advice for carers and care workers