Recreation Activity Ideas for Alzheimers's and Dementia Patients | Pt 1

I am writing this article in response to a request by my good Hubber Friend Storytellersrus. She has written some great Hubs on Alzheimer’s and she is dealing with the effects of it with her Mom. I just want to preface this with a huge God Bless all of the family caregivers as they undertake the most trying job of their lives. Each of you and All of you are my new found heroes.

I am a Recreation Therapy Assistant; I am not a licensed Therapist. So I cannot make Therapy Assessments, but I do design therapy activities and develop cognitive and fine motor skill metrics in consultation with the Therapist assigned to our Dementia Ward. I work primarily with male patients very few of any my patients are female. I also work in Long Term care, Palliative Care, and Hospice Wards, and currently none of my dementia patients are female.

Recreation Therapy activities start with us finding out what the individual likes to do, and things that they liked to do but maybe stopped as they got older. Then figuring out what we can come up with to keep their interest so they have something to look forward to. The last is the hardest part because of the near or short term memory issues. IF it doesn't click with something they can still remember it can take a long time for the interest spark to take hold. The caregiver key is patience and repetition. So here are some ideas that have worked for me.

Music - Before lunch the more upbeat the better. At lunch tone it down during the meal so its low background noise. Give it a rest in the afternoons Especially between 3-5pm. IF it’s to upbeat during that time sundowning tends to be worse. I play some upbeat 160BPM music (like Swing and Gospel) just before dinner and tone it back down during the meal to easy listening like Michael Bolton, or Bonnie Rait during dinner and later.

Crafts - Keep it simple, and stay away from liquid paints, beads, and crafts that have sharps requirements (think scissors or knives); as fine motor skills deteriorate these items become more problematic. Do the activity one on one where you help her with these things but make sure she retains the creative control. You might however be surprised at how creative your Mom can be given a box of craft sticks and a stick of glue; yep gals do like to build things.

Give her a sheet of Aluminum foil and say something like "Make me a flower" or if she has always had a creative streak just say "Mom make me something pretty." She could make some pretty neat suncatchers, Christmas tree ornaments, gift boxes etc, if you remind her that she is making gifts for sons, daughters, grandkids etc the activity gives her a purpose. That by itself can help increase her ability to focus on task. She still inside needs to be needed, and when things like cooking or laundry are too complex it’s harder to feel needed.

Household tasks, for males - I had a friend of mine ( He passed away in July) that was a retired First Sergeant that had a rapid onset of Dementia and his wife called me one night to ask me what she could do with him to reduce his nighttime agitation, or Sundowning. What folks don't think about is that veterans all had to learn how to fold clothes in Basic Training to the point that it is instinctive, each service has their own way of doing it, but wall locker and footlocker inspections show soldiers how to meet a demanding standard with even the smallest task. So get a laundry bag and fill it with crumpled towels, tell him you need his help and give him the bag of towels and a clear tabletop. You can generally get 30 - 40 mins of calm down time with 20-40 towels. When they are all done thank him for the efforts praise his success, go to another room mess ‘em all up again and repeat the process till he's tired and asks to go to bed. I got a call back the next day to let me know that it had worked and that she was amazed since had she asked him to do that before his illness she was sure she’d have been told with a certainty that he wasn’t gonna do that.

Dusting with a feather duster around the house may be useful for your Gals as well but avoid her using a cloth or sprays. She may dust the same thing many times but the activity and the stand up time is good for her especially in the morning or early afternoon as a sundowning prevention but if she needs something to do at night get out the duster and let her go. Dusting her knick-knacks, or family pictures may bring on good memories and get her talking as well.

Excercise - The Instructor I had in Alzheimer Training for Caregivers, had the mantra, "If its good for your heart its good for your head!" More and more research is bearing that out. When she starts having balance or gait issues get her to the doc and discuss a rollator or walker to keep her ambulatory as long as she can; an evening walk, or even better, chair exercises to music in the mornings, are some of the best activities. FitDeck for Seniors is a great tool for this.

If your Dad was a gardener, think about getting some raised flowerbeds, and growing things he liked to grow. We do horticultural therapy for an hour or so in the evening. This last summer we grew Tomatoes, Cucumbers, Squash, and Bell Peppers. I would remind the guys that they needed to water the plants again in the morning and by the end of the summer one or two of the guys would remember that they needed to do so. The joy was at times child like when they would come out in the evening and discover new tomatoes forming or the size of the cucumbers as they approached harvest time. It would foster discussions of things the guys had grown from pecans to cotton. I got treated to a 35 minute encyclical by one of my patients on the methodology of picking and chopping cotton and peanuts, a job he did as a child with his family in the 30’s ‘before the war’. He is generally categorized as ‘pleasantly confused’ by the caregivers, but during this discussion he was as lucid as a 20year old showing a friend how to do something the best way as to make the most money by being efficient and keeping all your fingers and toes in the process. He detailed hand motions and clearly showed by demonstration, the way to hold the plants and the turns of the wrist. It was his moment and he thoroughly enjoyed it.

You might look for activities that are age appropriate for 8-12 year olds. Many of them can be adapted with good results; I like to have fly nights with foam gliders for my guys. We’ll gather them in the dining room an extra 15-30 mins before dinner and make and fly our gliders. Then after dinner we’ll go outside with those who are able, and fly them some more. Bocce is also a great game for the ambulatory. It is simple to play and great exercise. I also have some R/C car models that my guys like to run in the courtyard. It is a great way to help keep fine motor skills and works their cognitive reasoning in steering and speed control. Remember though that whatever you choose to do keep the joy in the play of the game, not the result.

Indoor activities can be as simple as watching the news together and asking open-ended questions like how did that make you feel or what do you think of that? Many patients in the earlier stages of Alzheimer’s get to the point where they give up an activity like crossword puzzles because of the decline in their cognitive skills they become just too hard and confusing, thus frustrating; so they quietly stop doing them. If your loved one was a ‘puzzler’ than you might suggest word search puzzles. These often will give them hours of fun with no stress since they don’t actually have to write the words, just find them and circle them. Mount some 8X10 pictures on Cardstock paper, cut them up into 15-20 curvy pieces, and let her do the puzzle. Then talk about the subject of the picture.

Outdoor Fun – There is a lot to be said for releasing the inner child. Make some snow angels in the winter, in spring and summer go lay in the grass at the park and watch the cloud animals come and go. Kick piles of leaves in the fall. Hold hands and watch the world go by together. Do not underestimate the power of the touch of a loved one. Hugs, and handholding are great ways to help reduce the anxiety caused by memory loss.

A couple of final thoughts, first consult with your Doctor or a licensed Recreation Therapist about what may be appropriate for your loved one. It may be best to schedule the time with them alone so you can talk freely about capabilities and limitations you have observed.

Second, the hard days will make the good ones better. If you are a full time caregiver take opportunities for respite care to renew yourself. Your tensions and concerns are transmitted to your loved one in countless ways and your time together will be better if you have a positive attitude and a smile for every obstacle. I am telling you as a widower that you have a real opportunity to put some immeasurable quality in your loved ones end of life care. Treasure each of these days you have together.

Disclaimer: None of the above should be construed as medical advice. These are suggestions based on my own personal experience, specific equipment mentioned does not constitute an endorsement by any hospital, practice, agency, or health provider that I work for.

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