Why are activities so important for those with Dementia and Complex Care needs?
Activities can slow decline
Activities are essential for us all; the past 12 months have certainly shown us that we all need ‘things’ to keep us stimulated both mentally and physically.
For those living with Complex Care needs, which may include Dementia, Mental health and/or behaviours that may be challenging, meaningful and person-centred activities are essential.
Are you helping too much?
We all want to make sure that our loved one is comfortable and well cared. However, we need to be aware that we may be helping too much!
As we age, we all start to lose skills, not just those living with care needs and the easiest ones to retain are those we can work into a daily routine. Continuing to achieve everyday tasks will help your loved ones to feel a sense of achievement and self-confidence. This may have started to erode due to memory loss, mobility issues or failing sight.
Our Occupational Therapists recommend that instead of automatically supporting them with a task, you could adapt it to continue doing it alone for as long as possible. When this is no longer workable, then adjust again to share the task with them. Yes, it may be quicker to do it yourself, but it helps preserve their independence and stay active longer.
Activities Provide Routine
As someone starts to lose their abilities, their world can become filled with unknowns. Their physical and mental independence may become limited or compromised, and their days unpredictable and unstructured. This can lead them to become stressed, anxious, or even fearful and withdrawn.
Having a daily routine will help them know what to expect and lessen their anxiety and stress levels. Reducing their stress levels will increase their feelings of security, improve appetite, sleep patterns, and help them feel happier and healthier.
A structured day can help the caregiver as well. As it provides stability to their loved ones. Which means they are less likely to be confused, disorientated, and display challenging behaviours.
Achieving goals
We all like to feel that we are achieving our goals. Still, as complex Care needs progress, people become less physically and mentally able to cope. They often feel like they are becoming a burden to their families.
Enabling them to participate in everyday tasks and activities can boost their self-confidence and moods and improve their quality of life.
Reducing behaviours that may be challenging
Activities can also reduce complex behaviours that may be challenging. These could include agitation, repeated actions, or questions, and or aggressive outbursts.
The terms’ challenging’ or ‘complex’ behaviour describe any action by the person deemed distressing or disruptive to themselves or others.
Meaningful activity is one that keeps them engaged and occupied, as well as giving them an outlet for using up their energy positively and enjoyably.
Activities and Adapting
At different stages, people need different levels of care and support. Our occupational therapists have put together some practical advice to help adapt activities to suit your loved one’s ability levels.
As their Care needs progress, you will need to increase the amount of support you give. However, your goal is to build their confidence and help them succeed with their task.
Prepare
Whatever the task is, the basics are always the same, be prepared. Always set up the activity for your loved one.
For instance:
Activity – Folding Laundry
Asking a loved one to help you fold laundry is a good activity. 1. It makes them feel useful and helps them feel that they are contributing to the household. 2. It is something that they can feel successful at. They can ‘see’ a nice pile of folded clothes, giving them a sense of achievement. 3. It is a beneficial exercise and helps them concentrate, separating things into piles.
The set up:
Set up a sorting and folding area – a table with a chair where they can easily reach the clothes.
A basket of assorted laundry – depending upon their abilities, socks can be added or removed. Don’t have an entire washing machine load of clothes; it might be too much for them.
Supervision
As their Care needs progress, they will need a little more help and supervision. As this happens, you will need to adapt the activity so that they still feel that sense of independence and achievement. However, you may need to help them with problem-solving.
For instance:
When you start the activity, you may have a mixed laundry basket with clothes and household items. As time moves on, you can remove items from the basket that your loved one struggles with. For instance, pairing socks can be complicated for someone with Dementia. It takes a lot of concentration and short-term memory recall; these are things that your loved one may struggle with.
They may also have mobility issues with their hands. Some exercise may be welcome, but folding an entire washing basket may be too much. Hand towels and tea towels are both a good size and have very different textures, which are easy to differentiate.
Encouragement
It is very tempting when a loved one struggles with an activity to solve the problem for them. However, they may just need some gentle prompting to help them with the task. It can be incredibly frustrating when people finish your sentences, take over jobs you were doing and generally treat you like a child.
If you can see they are stuck, sit with them for a few minutes and ask if they need any help. You can point out the next step or ask what the next action is.
For instance:
If you can see they are struggling to fold an item, you could sit next to them and get another of the same item, fold it to the same stage and then ask for their help in finishing the process.
Clear instructions
Sometimes prompting isn’t enough, and your loved one may need some clear step by step instructions.
For instance:
- Pick up the hand towel by the short end.
- Lie it down on the table.
- Fold in half towards you.
- Now in half again.
- Roll it away from you.
- Place it in a pile to your right.
You might have to come back and gently guide them through the process again. If they become frustrated with the process, it might time to put this activity to one side and move onto other activities. Not everyone enjoys laundry!
Meaningful Activities
Meaningful and stimulating activities help build their self-confidence and help slow the decline of Dementia and other neurological diseases.
Table laying
At mealtimes, ask your loved one if they would mind helping you by laying the table.
There are a few things you should take into consideration when doing this, for instance, think about colours. Ensure that the tablecloth, cutlery, crockery and glassware are different colours from each item on the table. Matching items might look nice, but they can be challenging to deal with for someone with Dementia or sigh problems.
Adapt: As time progresses, you may want to put all the items they need on a tray or trolly next to the table. Swap out glassware for plastic, cutlery for easy grip etc., if mobility issues are a problem.
Hang out the washing
For those without mobility issues, helping with the washing is a great activity because it gives them a sense of being helpful and getting some fresh air.
Lifting their arms above their heads can be very difficult for older people. It may be better to ask them to hand clothing items or if bending down becomes an issue, giving you pegs.
Adapt: Place a chair by the washing line if standing becomes too much, but they want to help you with the washing. Then you can go to them for pegs.
Tidying up
When you are tidying up, ask if they would like to help you. Pick a room where they will feel confident, like their bedroom or the lounge. A bathroom or kitchen may have too many items for them to deal with.
Ask them questions about where things go in their room as a prompt to help them if they are struggling. A feather duster for books and pictures is always a fun activity. You can stop and talk about the item being dusted, photos of trips, the people in them, books they may have read, etc.
Adapt: You can label up drawers with pictures of what lives in them to make things easier for your loved one to remember where things go. A tidy cady is helpful as well.
Arranging flowers
Flower arranging is an excellent activity for someone who enjoys flowers or gardening. You can cut the stems for them if you are concerned before they start and suggest rooms for the flowers to go into.
Adapt: You can get artificial flowers, a plastic vase, and florist foam, all inexpensively. This way, they can take the arrangements apart repeatedly, and it doesn’t matter if they get knocked over.
Create a memory box
Memory or rummage boxes can help your loved ones feel connected to their past.
Any box is fine; it doesn’t need to be a special box. It’s what you fill it with that is special.
It all depends on what your loved one holds dear; if it is family, then some family photos, perhaps things that were made for them, inexpensive keepsakes from family holidays.
Magazines or books, photos of the area they grew up. If they enjoyed baking some baking items, pictures of from recipes.
Perhaps you could include some different textured items like pinecones, seashells and velvet. Different smells that remind them of people or places, such as their best friend’s hairspray or the perfume, were worn by their mother.
Overall meaningful activities provide those living with complex care needs and/or dementia:
- A sense of purpose and routine.
- Helps to build self-confidence, self-worth and enables the person to feel valued
- Retains their skills and enables them to use them and their life experiences
- Activities encourage social time spent with family, friends and their community
- Opportunity to make decisions and have choice