Why is it important to stay active after a dementia diagnosis?
Engagement in activities physically and mentally is beneficial for everyone’s health but especially important for those living with dementia or Alzheimer’s. Regular activity engages cognitive function, reducing stress and other depressive symptoms. At the same time, the routine of engaging in everyday, meaningful activities or hobbies provides a sense of safety. This safety and familiarity in routine minimises sundowning, which is adverse later-day confusion in people with mid to late stages dementia.
Physical activity is crucial for heart health, which is especially important for those with vascular dementia at risk of future strokes. Overall, staying active is essential to maintain a sense of normality, independence and good quality of life.
Activities to do outside
Being out of the house has a wide range of beneficial effects for everyone; it’s known to lower stress and increase vitamin D intake, which are both essential for overall physical and mental health. People living with dementia can still do many fun activities outside, from a physical activity like taking a walk, shopping, visiting a park or beach, or just watering the plants in their garden. However, it’s essential to focus on what the person with dementia has always enjoyed or what they wish to do; this way, they will feel more confident and less stressed about leaving the home.
If leaving the house is too difficult and you have access to a garden, gardening has been linked to improving the quality of life for people living with dementia.
GPs sometimes advise gardening for the benefits of its social activity and physical benefits; however, the emotional and psychological benefits are just as noticeable.
Gardening provides stimulation with smells, touch, colour and sounds. For example, planting herbs and flowers can have positive effects such as awakening memories from smells, keeping a routine of looking after the plants as they grow, and using fine motor skills to plant and tend to them. This multisensory stimulation from gardening can encourage feelings of calmness, reduce stress and lower blood pressure.
If gardening for the first time, don’t overdo it. A short burst of activity in the garden at first is best while the body gets used to the work. Ensure time to enjoy the space with breaks, as simply being in a garden has therapeutic benefits alone.
Gardening can be made accessible to avoid too much bending, walking, lifting or confusion. For example, if you are planning a new garden for someone living with dementia, make an easy-to-follow path that loops around and doesn’t encourage decision-making at confusing junctions. Paths should also be flat and clean to avoid any falls or accidents.
Use raised beds, pots or other raised alternatives to avoid kneeling and bending. Raised beds have other advantages, such as controlling the soil type and keeping pests away.
It’s also a good idea to get lightweight tools, long-handled spades, forks and secateurs, kneelers if you have low flower beds, and a wheelbarrow to avoid carrying a lot around the garden. There are dementia-friendly garden centres where you can access helpful tools and equipment for your garden.
Activities to do inside
Many daily activities can be done inside the home with an individual after a dementia diagnosis. Participation in activities that have always been enjoyed is especially important, as a dementia diagnosis changes ability over time but not the person. Doing something that has always been enjoyed will keep self-confidence, encourage independence, and may even delay cognitive impairment.
Cooking: Cooking and eating are social activities for most people. Cooking together can strengthen bonds, encourage teamwork and help with problem solving.Being involved in a team task can also help to elevate a person’s mood. Making familiar recipes can revive memories and engage cognitive function as you move through the routine of making that specific dish.
Cooking is a fully immersive experience that engages all the senses, positively stimulating the brain. As sense is a strong connection to memory, cooking may also elevate mood when someone is reminded of happy memories through tasting and smelling. Cooking also requires focus and concentration, meaning the brain is active and getting a workout.
Arts and crafts: Drawing and painting can help express feelings creatively and safely. Other crafts, such as making collages, can be a great way to bring back happy memories by using old magazines and images from the past, which fit around favourite interests such as fashion, cars, or music. Using play-dough or slippery clay can also work cognitive function due to being able to create different shapes, sizes and textures. For people more interested in DIY than art, painting small items of furniture could be an interesting activity while keeping the personactive in looking after the home.
Music: Listening to music and singing can not only be a powerful way to bring back memories but is often used as a form of therapy to improve overall mental well-being. Choose classic songs from a specific period or sing well-known, easy-to-remember songs like Christmas carols. Use Playlist for Life to create a playlist for someone with dementia; Playlist for life is a music and dementia charity promoting the importance of personal meaning in music to aid people with living dementia.
Alzheimer’s Society runs Singing For the Brain groups for people affected by dementia. The groups sing a variety of songs they know and love, in a fun and friendly environment. They use vocal exercises and familiar songs to improve brain activity and well-being. You don’t have to be a good singer to join, the groups are for expressing yourself, feeling positive, making new friends and improving brain health.
Technology: Technology can aid in making life easier for a person living with dementia, from creating reminders for daily tasks or reading the news and dates out loud. However, it can also help stimulate the brain and keep a person occupied.
Using a computer, tablet or smartphone, you can find many apps, online games and websites designed to help with various aspects of dementia and encourage brain stimulation. For example, some apps offer cognitive, language and speech therapy using fun, challenging and easy brain training games, such as matching games to work on memory recall of participants with dementia. Lumosity is one of the earliest brain training apps with 100 million users and is supported by studies from health professionals that show it improves cognition. Wordle is also a popular online word game, which can be played along with friends and family; Researchers have found that adults who play word games perform better at memory tests, reasoning and attention skills and have seen improvements in their overall brain cognition after they begin playing word games daily.
Technology can also help a person with dementia stay socially connected by speaking to loved ones through video calls and voice notes, while sharing photos can encourage memories. However, sometimes people with dementia can become confused or frightened by video calls, as video calls look like TV images and people don’t expect the TV to interact with them.
Activities in the later stages of dementia and Alzheimer’s
In the stages of advanced dementia and Alzheimer’s, people may have a lower activity level, meaning they can no longer communicate with words or move independently. In this case, you may think that all priority should be put on making sure the person is physically comfortable, particularly if they spend a lot of time in bed. However, brain stimulation is still vital as people can experience loneliness, boredom and frustration even in the late and advanced stages of dementia.
Quality time: Many people in advanced stages of dementia are still aware when a person is in their presence; therefore, when you cannot think of anything to do with them, just being in their company can be beneficial. Eye contact and hand touches can signify that they have your attention while verbally responding to noises they make or anything else they might do. They may sometimes respond with their eyes, smile or a grip of the hand. Due to symptoms of dementia, there will be times when the person doesn’t respond visually; however, this doesn’t mean they don’t appreciate you being there so trust that your company is still important.
If the person has a pet, make sure the pet is close by, as this can provide comfort and reassurance. Pet therapy has been shown to improve the quality of life in people living with dementia, and animals are an overall powerful tool of love.
Music: Music can be a powerful memory tool for most people, so it can be vital for helping those with limited verbal communication. It has been noted that musical memories are well stored even in those with advanced stages of dementia, and individuals can still show emotions when hearing a favourite song. For someone who is often in one room, invest in a music player that will play music from the person’s culture, period or favourite genre. A helpful tool can be radio shows with talking segments, so the person feels less lonely. You could also find podcasts aimed at an older audience who will have familiar guests for the person living with dementia.
Sight, taste, smell, touch, hearing: Engaging senses is essential when people are no longer fully communicating verbally.
- Thinking about what a person can see and consciously changing their visual experience can reduce stress and boredom. For example, decorating their room with bright flowers or pictures (If they’re in a care home, try discussing the benefits of visual experience with the carers there). Transfer the person between beds and chairs, so they’re not looking at the same spot all day, i.e. putting them in front of a window or on a porch. However, add these changes slowly, as changing too much in one go may cause distress, confusion or other negative reactions.
- Even when a person cannot swallow as well anymore, eating and drinking stronger and sweeter flavours are easier to sense, while cold drinks are also easier to discern than tepid. Always tell the person what they’re drinking and eating.
- Touch is one of the most important senses to engage, so the person knows they’re not alone. Stroking the face, holding hands, and giving hugs can reduce the person’s loneliness and stress.
- While spending quality time with the person, you could read aloud to them, as they can still hear and may find the steady tone of a story comforting. You can choose a book or magazine they enjoyed in their life.
How to Choose suitable Activities for a person with dementia and Alzheimer’s
You may be feeling anxious about making the right decision for someone with dementia, and it will be normal to worry that you may pick activities that aren’t the best for the person or their health.
- Consider the person’s level of functioning. For example, you may be able to do more stimulating activities outdoors for someone with moderate dementia than you would for someone in more advanced stages. Also, consider at what time of day the person is more high functioning, are they a morning person? Do they get restless in the late afternoon? When considering activities, it’s most important to consider the individual first, rather than their diagnosis.
- Who are they? What did they do for work? What hobbies did they most frequent? What is their cultural background, and how did they lead their lives? Being sensitive to these unique aspects of a person can help you choose an activity they’re more likely to enjoy.
- Skills that haven’t been forgotten can help you with what activities to choose and encourage the person with dementia to use these skills. For example, if they can still read, ask them to read a newspaper out loud to you while you’re washing up. If they can still chop vegetables safely or like to bake, ask them if they’d like to help with lunch. Using their skills to help the household will give them a sense of purpose and accomplishment.
- Avoid stressful situations, and arrange activities you know the person will find simple and unhurried. If one day they struggle with something they usually find easy, don’t try and insist they do it. Come back to the activity another day when you think they’re in better form.
- Always break down activities into manageable steps and communicate clearly. Avoid overstimulation. For example, if at home, try to keep areas clean and uncluttered, as often people with dementia have trouble with visual perception and coordination. When outside, try to avoid large crowds, as people with dementia can often find large groups stressful.
- Routine and consistency help avoid stressful situations for the person with dementia and can help the person caring for them. It is good to know what causes problems, what helps calm a person and what encourages positive emotions.
- Keep going, there will be tough days with dementia, and many people may experience caregiver distress or caregiver depression from time to time; these challenges may feel frustrating, but a good quality of life with dementia is possible, and you must never feel like you’re a failure when caring for a loved one. You will find activities that provide a sense of purpose and enjoyment in life.
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