Activity Provision for People with Dementia
This article is about activity provision for people with dementia. It is aimed at helping people think about how to provide activities for those with dementia.
What is Dementia?
The term Dementia is a general name for a range of illnesses that affect the brain. Damages to the nerve cells (neurones) in the brain result in messages not being able to be sent to and from the brain properly, which stops the rest of the body from performing normally. Each person with dementia’s experience will be different but five of the most common types are:
- Alzheimer’s disease – the most common form that develops slowly, often through a sticky plaque clogging up the brain’s pathways. Affects short-term memory, speech, mood, disorientation.
- Vascular Dementia – the second most common form caused by small blood clots (haemorrhage or stroke) preventing oxygen reaching the brain. Onset can be sudden and symptoms depend on which side of the brain the damage is on. Can affect memory, speech, reading and writing.
- Frontotemporal Dementia – more common in under 65s, caused by abnormally forming proteins that cause the death of nerve cells and pathways to the brain. Progressively develops and can affect personality with often inappropriate social behaviour. Eating patterns may also change with binging episodes etc.
- Dementia with Lewy bodies – affects around 10-15% of cases. Clumps of protein ‘Lewy bodies’ form inside brain cells. Movement and memory are affected by many experiencing hallucinations and sleep disturbance. May also have tremors and shuffling walk.
- Mixed Dementia – more common in over 75s, and often a mixture of Alzheimer’s and Vascular dementia. Symptoms can depend on which part of the brain is affected but can become more apparent and change is more rapid. The vast majority of people who are diagnosed with dementia are over 65, but there are a growing number of people under this age who are termed as having ‘young onset dementia’. Over 850,000 people are living with dementia in the UK and this is set to rise to over one million. There is a huge amount of research worldwide but a cure is yet to be found.
The vast majority of people who are diagnosed with dementia are over 65, but there are a growing number of people under this age who are termed as having ‘young onset dementia’. Over 850,000 people are living with dementia in the UK and this is set to rise to over one million by 2021. There is a huge amount of research worldwide but a cure is yet to be found.
How does dementia affect people?
One of the most common symptoms of dementia is progressive memory loss. This is often generally experienced in older people but in dementia, it is more pronounced. One comparison that can be made by general memory loss is forgetting where you put your purse, someone with dementia would not only forget where the purse was but what a purse is and is used for. Difficulty in doing things in sequence is another symptom of dementia; they might not remember which order to put clothes on or how to make a sandwich.
Speech can often be affected in that they may substitute strange words in a sentence, writing may become illegible and simple words may be misspelt. This would be more pronounced than forgetting what they are talking about mid-sentence, which is common in older people. Someone with dementia can become easily disorientated in normally familiar places, such as where they live. They may not be able to find their way home from a local shop and may forget how to get into their home. Sometimes night and day get mixed up and normal routines may become muddled.
People living with dementia may experience poor judgement and make themselves vulnerable in that they may not have any sense of danger i.e. leaving a cooking hob on. They might dress inappropriately or even go outside with no clothes on at all. They may become disorganised in running the home, leaving bills unpaid and not eating properly. Their special awareness can be affected too, missing their mouth with a forkful of food or being unable to pick an item up.
Dementia can cause changes in behaviour and moodiness. Some people can become angry and even aggressive for very little reason. Others may be the opposite and become less emotional – e.g. watching a sad film and showing no reaction. People may also become withdrawn, sleeping for longer periods or losing interest in pastimes they would normally enjoy.
For more detailed information about dementia visit Dementia UK
How activities help people with Dementia
Just because a person is living with dementia, it doesn’t mean they can’t enjoy being active and creative. In the early stages, many will be able to continue to work and enjoy hobbies in the same way as before. They may need some assistance but it is important to keep as normal a life as possible.
As the disease develops, it may become more difficult to continue working but it is still vital to keep the brain engaged with other activities such as word searches and other puzzles. Studies show that keeping the brain active can help slow the progression of some types of dementia, therefore playing cards and board games with a degree of skill can be a fun way to use the mind and encourages social cohesion too.
Physical health can play an important part too. Fitness activities can be a good way to keep muscles strong and can be done at any level. Even someone with late-stage dementia can enjoy dancing to music or kicking a large inflatable ball around. It may not be always possible to entice someone into a group exercise activity, but many will be happy to maybe wave a scarf in time to the music from their chair.
Singing and music is a great way to engage people in all stages of dementia. Try to select music that they are likely to remember from the past. There are many CDs that are shorter versions (or medleys) of tracks and are ideal to keep older people engaged. Most people with affected memory will enjoy singing maybe the first verse and a chorus of a well-known song but can lose interest after that. Singing groups have been shown to have many positive benefits on people with dementia; many even in later stages will be able to recall learnt songs, it encourages social interaction with others and the rhythm of clapping along can help with coordination that might otherwise be disappearing.
Many people living with dementia can feel anxious and depressed about what is an increasingly confusing world around them. A comforting soft ‘pet’ to stroke or blanket with attachments to keep hands busy is an ideal activity to keep stress levels low and can be useful to use to calm someone if they get agitated or aggressive.
How to adapt activity provision for those with Dementia
Activity coordinators may often have a mixed ability group of people to cater for, where activities need to be carefully chosen in order for everyone to become engaged and feel they are meaningful. It is important to not assume that everyone with dementia needs the simplest tasks – some may have poor memory skills but are great artists and knitters. Someone with limited communication may still be fit and will enjoy playing a game of badminton or laughing at a comedy film.
Reminiscence can be a great way of combining mixed ability groups. A carefully chosen selection of nostalgic items to pass around can inspire some interesting discussion and enables people to learn more about each other. Someone with dementia may find holding a pastry brush brings back past memories of making pies, or they may even use it as a paintbrush for ‘decorating’. There are many ready-made themed kits that can be used for a variety of discussion purposes.
How to adapt activities for people with Dementia
Craft sessions are an ideal way of giving those who are more able a task that will utilise their capabilities but can often be adapted for those with lesser ability. This can be for anyone with dementia or with other types of disability.
Health and safety must always be the first priority and proper assessments of people’s abilities must be taken into consideration. For instance, when needing to cut up paper etc. activity coordinators could either give ready-cut pieces to assemble or for anyone with poor coordination, use some specialist self-opening scissors for ease of use. Easy-grip chunky brushes can be used or finger paints for art projects and textured card and fabrics can be a fun way to create a group collage.
Fitness sessions can be adapted to suit all abilities too. A game of badminton can be slowed down by using chiffon scarves instead of a shuttlecock. Use a giant lightweight beach-type ball for catching and throwing or for a game of football. The rules can be relaxed so there are no offside areas and a ‘goal’ can be just a taped area on a wall.
People with Dementia may have a limited concentration span, so make activities flexible with no set start or finish. Allow them to wander off and maybe do something else – wall games are a good way to help engage for anyone who needs to walk around. Keep noise levels to a minimum where possible as sudden crashes or bangs can be frightening for someone with dementia. Ensure there is a quiet area to sit if someone shows signs of stress, with a comfort pet to stroke or a hand-held twiddle game to distract them while the others continue.
You might like to review some of the resource books that we have on this topic.
How to talk to someone with dementia
This is a really useful video from Diana Waugh: