You might think of it in regards to the activities you have going for the weekend - a family outing, errands to run, a movie night. Or if you are parent, you might think of your children's activities - karate, piano lessons, Girl Scouts.
If you are a professional working in a facility, you likely think of the facility's scheduled activities, planned for the residents. Activities for people with dementia has a different meaning than the examples listed. It has a much broader meaning and a much bigger impact.
Dementia Activities - The Cornerstone to Successful Days
When we think of "activities" for people living with Alzheimer's or other forms of dementia, we need to broaden the scope of that word. In fact, as the disease progresses and the person is able to do less, what is considered "activities" for the person, should broaden more.
What is an "activity"?
Activity comes from the word act, or "to do something". So literally, 'activities' = 'doing things'. It is the core foundation of occupational therapy, as 'doing things' also = 'occupations'. So activities can include things like outings, errands, and family events. But it can also include the more mundane things of life, like balancing the checkbook and combing ones hair. To get an idea of all the different types of things we might do in a day (i.e. activities), it is helpful to look at this list of some of our daily living activities, which is used as a guide in occupational therapy practice (Source: Occupational Therapy: Domain and Practice).
- Activities of Daily Living (ADL's) - includes the basic self-cares of eating, bathing, dressing, using the restroom.
- Instrumental Activities of Daily Living (IADL's) - includes the more complex daily tasks like making meals, managing finances and own health care, care of children or others, shopping, and cleaning.
- Sleep and rest - yes, sleeping is an activity, too!
- Work- includes volunteering
- Leisure - includes hobbies, going to concerts or sporting events, etc.
- Social participation - this could be at the community level or with family or a friend
When you think of dementia, which of these areas of daily living, or activities, do you think are affected? Eventually, all of them. The general progression is to lose IADL and work abilities first, followed by ADL and social participation abilities. Sleep and leisure can be impacted at any point in the disease.
The loss of abilities that happens with Alzheimer's and other forms of dementia is pretty well known, I think. But what is not as well known, is that these folks CAN continue to do things, just with modifications and support to make it happen! The modifications and supports that will be needed, will depend on the type of activity and the stage of the disease.
Caregivers can inadvertently take over doing things for the person, even though the person might still be able to do part of the task or do it in a different way. When this happens, the person can become more sedentary and useless and can lose skills at a faster rate. By adapting activities and providing support, there are ways that the person can continue to do things - just in a different way.
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Here is a continuum guide of how to adapt activities in a progressive manner to allow success for multiple stages of dementia
Set-up: The person can complete the activity after the required supplies are set-up.
Supervision: The person requires supervision to help with recognizing errors and solving unexpected problems, so just general oversight.
Prompting: The person requires verbal and/or physical prompts. This could be asking "what do you do next?" or pointing to the next step or an item that is needed.
Direct verbal cues: The person needs more than prompts, but instead needs the caregiver telling him or her directly what to do for each step.
Physical assistance: The person requires your hand over theirs to guide the action.
Here is what this continuum would look like if the activity or task was washing dishes:
Set-up: The soap and dishrag are placed next to the sink of dirty dishes. The person can then complete the task.
Supervision: The correct water temperature is monitored and you check the dishes after to see if any spots were missed.
Prompting: A missed stain is pointed out or "what next?" is asked when the dishes are washed but not dried.
Direct verbal cues: The caregiver fives step by step cues, such as "Put the soap in the water. Rub the plate with the washcloth", etc.
Physical assistance: The caregiver puts their over their hand and guides the motion of washing the dish.
Staying active not only provides benefits for the person with dementia but also can help the caregiver to structure the time of the day and can help with minimizing the person's dementia-related behaviors.
GET 10 TIPS TO MINIMIZING DEMENTIA-RELATED BEHAVIORS
When you think of activities as not just events, but rather as all the things that we do in a day, you are on the first step to helping people with dementia to stay more active. Next, find the activities that the person can - and would like to - continue to participate in, and determine the adaptations and support needed. You can click below to access a very handy guide, our 10 Tips to Staying Active with Dementia.
When you think of activities as not just events, but rather as all the things that we do in a day, you are on the first step to helping people with dementia to stay more active. Next, find the activities that the person can - and would like to - continue to participate in, and determine the adaptations and support needed. You can click below to access a very handy guide, our 10 Tips to Staying Active with Dementia.
Monica is an occupational therapist and creator of the MindStart products, which have been adapted specifically for people with dementia. LEARN MORE ABOUT MINDSTART PRODUCTS
