Alzheimer’s disease and Activity Modification

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There are many ways to keep a person with Alzheimer’s disease or a related dementia engaged in activities. The key is to meet them where they are able to best function with activities that are meaningful to them.

One of the challenges for families is that often the person with dementia cannot do what they used to do and the level of cognitive stimulation decreases. Sometimes the person sleeps more or there can be more restlessness, agitation or sundowning. When asking my patients whether or not they are bored, they often agree. That’s the time I start taking an inventory of their interests, then assess their strengths and what hearing, vision and mobility challenges are present. Once that has been completed it is important to find some of the people in their life who would be available to support creating some activities of interest at a level the person with Alzheimer’s disease can handle.

In the 1980′s I was limited for several years in the activities I could do because of a sensitivity to chemicals in the environment. Talk about boredom since this was before books on tape and I could not handle being around things like books and newspapers. Some days I would play Scrabble by myself while my family was not at home. I finally discovered counted cross stitch which did not create a problem and I found it relaxing, and productive. So when I see someone sitting at home and not doing anything except watching television or sleeping I try to find ways to help them to be part of some level of activity. I remember the frustration but I was able to create options. They cannot and families are often at a loss on ways to make it happen.

Some things to think about:

1. Reminisce with others to discover what the person’s previous interests were from years ago. You never know what might appeal to someone and it is worth a try. It is about entering their world and trying to create some moments of joy. They may not recall what they did earlier but after a few times, when you return, they may remember you brought some joy to their day!
My sister-in-law was amazing in the things she created with her mom once she was in a nursing home. Her mom no longer knew her name but she remembered the love and joy she brought during her visits. When I went back home, I did not know what to expect when I visited and her mom greeted me with that wonderful smile and sense of recognizing something about me. Through the years I had spent a lot time with her and certainly those last years when I was home visiting my mom. Playing Scrabble with the two of them with dementia was more than a memorable experience that I would not trade for anything. My sister-in-law and I brought it to their level and just enjoyed them and were grateful  for that time together.

2. It is important to identify their preserved abilities. Perhaps vision is better than hearing. Maybe they can only do their signature but they can copy printed letters. Reading books or newspapers may have stopped some time ago but maybe they can read at a word level or simple phrases aloud. These are all great starting places and you would be surprised to see how activities can be created around those abilities. After evaluating his mother, I suggested the son of one of my patients write Bible verses on index cards. He enjoyed having her read them to him rather than seeing her sleeping in the chair. Church had always been important to her so this worked for both of them.

3. Identify who could be there for them. Matching up the right person with the activity can mean possible success and enjoyment for all involved. Remember each family member or others close to the person with dementia had a different connection and shared different interests.  Rarely did any of my siblings play Scrabble with my mom. That was our game since I was in grade school and when she had trouble thinking of words or spelling, we modified the rules and just enjoyed the time we spent together. Maybe a grandmother cannot cook now but she might be able to chop nuts or sprinkle cinnamon on the top of the coffee cake. If nothing else she might enjoy tasting the finished product or passing out pieces to guests.

Activities to consider:

1. A golfer who can no longer play may enjoy watching others play miniature golf. Maybe hitting golf balls, watching major tournaments or looking through pictures of famous golfers or golf courses could be an option.

2. A man used to do the crossword puzzles every day and had trouble seeing the smaller print. His granddaughter would make copies in a much larger print size. One of my clients enjoyed some of the puzzles that offered larger print along with hints.

3. One of my patients loved to reminisce but had trouble coming up with specific names of people or places so each family member sent him an album with pictures of happenings from their lives that year. They all sent smaller albums and put the picture on one side and then a short sentence or a few words telling who was in the picture and an interesting fact on the other side.

4. Some families still play cards but have someone pair up with the person with memory problems to give hints.

5. A few women who always did crafts got together once a month and the granddaughter devised something simple they could do together.

6. Everyone has a favorite type of music and some people like to sing along while others enjoy listening to some of the oldies. Watch this segment about an older man with dementia listening to music he enjoyed. It will help you to think about options for your circumstances.

7. Brain games are available at all levels. Providing hints, filling in part of the answers or offering 2 words choices are a few of the ideas that can be used effectively once the correct level of assistance is identified. The object is to help a person feel good about what they are doing while offering assistance without them feeling any less about their ability. Nothing is more rewarding than hearing one of my patients say that it feels good to use their brain again.

Refer to some articles and blogs I previously wrote for many more activity ideas to consider: Creating Time Well Spent: Enhancing Your Visits with Older Adults   BLOGS 

TO DO THIS WEEK: If you were unable to create your own leisure time activities, think about what activities might make your day. In the early stages of memory loss, that is the time to get the person’s story. In the middle stages then you will be able to give them hints or provide some of the information if they are having a problem. Then in the later stages surround them with their stories or tell their story for them.

“If you’ve heard this story before, don’t stop me, because I’d like to hear it again.”
Groucho Marx

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About Kathryn Kilpatrick

Kathryn Kilpatrick received her Master's degree in Speech-Language Pathology in 1968 from the University of Massachusetts. She has worked in a variety of settings, primarily in Ohio, including hospitals, rehabilitation centers, and for decades in the area of home health care. Kathryn is president of Memory Fitness Matters ( and Communication Connection( She offers memory coaching for all ages and has a geriatric consulting practice. She is a national motivational speaker and author of more than 30 products to enhance communication and connection as well as a Memory Fitness Toolkit. Kathryn brings her decades of experience as a speech-language pathologist to all those wanting to enhance their quality of life, particularly when there are communication, memory and cognitive challenges. Her websites offer information on a wide variety of topics related to elder care concerns as well as memory fitness and successful aging.
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