Six options to encourage engagement.

BY: Ann Napoletan

As dementia progresses, it becomes challenging to find activities that encourage mental, emotional and sensory stimulation. At the same time, we are often in search of ways to connect with our loved one when conversation is no longer an option. Possibilities are as wide and varied as one’s imagination, but here are a few ideas to get you started:

 

1. Photographs & picture books

My mom, who had Alzheimer’s, delighted in looking at photos, so I always kept a scrapbook and some photo albums on hand. Later, I added a digital frame that continually scrolled through favourite photographs. Those pictures inspired countless smiles, and I have fond memories of sitting next to her on the sofa flipping through the books. It’s impossible to know whether she recognised the people in the pictures – or whether they triggered any memories, but I do know they brought her joy in those moments, and that was the important thing.

Coffee table books full of large colourful images are another excellent option. Think about some of your loved one’s favourite things, and find a book on those topics. Children and animals are always a popular choice, but other potential topics include travel/scenery, cars, food, sports and many more. Large picture books like this are often available at deep discounts on bookstore clearance racks.

A few examples (all available on Amazon) include:

• Dogs

• Sweet Dreams: Wishes For Our Children

• Journeys of a Lifetime: 500 of the World’s Greatest Trips

• Life: Wonders of The World

• The Art of the Automobile: The 100 Greatest Cars

 

2. Dolls & stuffed animals

There was a woman at mom’s first assisted living facility that had a profound and lasting impact on me. She was in the advanced stages of Alzheimer’s and struggled to speak. The woman was confined to a wheelchair, and every time I saw her, she was holding the same disheveled baby doll.

It was a poignant sight, and I recall feeling so sad for that woman. At the time, my mom was in the mid/moderate stages of the disease, so the idea of her with a doll seemed implausible. She would never get to that point.

But, alas, she would and she did. Still, when one of the caregivers asked if she could give mom a doll, I was caught off guard. I remembered that woman from several years back and realised we had now arrived at that place in our journey – a place I never dreamed we’d be. It was a startling reality check.
 
Mom immediately fell in love with her Dora the Explorer doll. The initial discomfort I felt dissipated instantly as I watched her genuine, heartwarming interactions with Dora. The affection she felt for the doll was honest and pure, and the pleasure she brought mom was astounding.

Dolls and stuffed animals allow our loved ones the unique opportunity to give care instead of receiving it. They also offer a distraction while providing positive sensory stimulation and they can even trigger memories. While there are expensive life-like therapy dolls on the market, in my experience, any doll serves the same purpose and elicits a feeling of love and tenderness.

 

3. Fidget Quilts & fiddle boxes

Fidget Quilts use a variety of colours, textures and objects to keep busy hands occupied. Some quilts feature zippers, buttons and Velcro, but the possibilities are endless. Many people design quilts around their loved one’s pre-dementia interests.

A “fiddle box” is a similar concept; simply a box (or basket) filled with items that provide a variety of tactile experiences. You might also consider your loved one’s hobbies or interests when putting this together. Ideas – buttons, ribbon, shoelaces, keys, marbles, jewellery, photos, small bits of pipe or safe small hardware items, various size paintbrushes, cookie cutters, measuring spoons, etc.

How about a Busy Hands Fidget Apron or something for the fisherman in your life? If neither one of those strike your fancy, consider a Twiddle Muff or a sensory cushion. The Internet is overflowing with creative ideas, and Pinterest is an excellent starting point for inexpensive DIY projects and patterns.

 

4. Art

According to the folks at Cognitive Dynamics in the US, “Art therapy is the deliberate use of art-making to address psychological and emotional needs. Its benefits include fostering self-expression, enhancing coping skills, managing stress and strengthening a sense of self. This translates into improved communication, behaviour and cognition.” 

When the ability to communicate verbally is gone, art is an ideal way to stimulate self-expression and creativity. Like music, art brings people together, and it doesn’t require a lot of fancy materials or special skills. Start with some heavy paper or card stock, a basic set of watercolours and a paintbrush, coloured pencils or markers – it’s that simple! Adult colouring books have also gained popularity and might be enjoyed by someone in the early stages of dementia.

Clay is another fantastic way to encourage creativity, interaction and hand-eye coordination, while creating a tactile experience. I recommend good old Play-Doh since it’s brightly coloured and more pliable than some of the modeling clay on the market. Combine the clay with a rolling pin and cookie cutters and you have created a form of reminiscence therapy for someone who once loved baking cookies!

 

5. Puzzles

My mom loved puzzles; we always had one going during the winter months. However, by the moderate stages of Alzheimer’s, large jigsaw puzzles overwhelmed and frustrated her. I hesitated to buy children’s puzzles, which had fewer (and larger) pieces because the designs were intended for kids. She was declining, no doubt, but still, I was afraid the children’s puzzles might be degrading in her moments of clarity.

Now there are puzzles designed specifically with dementia patients in mind. Max Wallack’s non-profit, Puzzles to Remember has partnered with Springbok to create puzzles with 12 or 36 large pieces that are much easier for Alzheimer’s patients to manipulate. Themes are adult-friendly, colourful and pleasing to the eye. The puzzles provide a great way to stimulate cognition while offering your loved one an opportunity to achieve success!

 

6. Sorting & organising

Providing a loved one with sorting and organising tasks is another beneficial way to keep dementia patients engaged and active. On a recent visit to a care facility, I observed one of the residents organising the newspaper – apparently a daily ritual. Each morning, caregivers take apart the paper and lay the sections out on the kitchen table. With no prompting, the woman sits down and organises the mess just perfectly, laying each section on top of the one before it about an inch below the last, creating a fan or stair step-like pattern.

Brightly coloured marbles, several different kinds of fruit, socks, silverware or various hardware items, such as nuts, screws and washers are all suitable objects for sorting. It makes little difference how well these things are sorted; the idea is to keep hands and mind busy, and help your loved one feel a sense of purpose. If you can incorporate favourite pastimes into the activity, it’s even more meaningful.

Proponents of the Montessori method for dementia suggest these types of activities can reduce aggression, agitation and other negative behaviours, improving quality of life.

 

Follow their lead

If you’re looking for other ideas, pick up a copy of The Alzheimer’s Creativity Book by Dr Jytte Lokvig, or When Caring Takes Courage by Mara Botonis. These books are full of suggestions to get the creative juices flowing, which in turn improves engagement, provides positive reinforcement, and promotes an overall feeling of well-being for your loved one.

As you consider activities, remember this is not a “one size fits all” proposition. There are few things more unpredictable than dementia. Depending on the time of day, level of agitation and mental status, preferences may vary. In fact, some days no activity is the right activity. Most importantly, don’t force the issue. The key is to offer options, then follow your loved one’s lead. In the process, you will create some extraordinarily beautiful moments of joy.

 

Ann Napoletan is an author, blogger and passionate advocate for dementia awareness and research. Having cared for her mother during a decade long battle with Alzheimer’s, she has a special place in her heart for family caregivers. She hopes that by sharing her family’s story, she can help others navigate their own journeys. Ann is the founder and creator of the website The Long and Winding Road: A Journey Through Alzheimer’s and Beyond and has been published in “Chicken Soup for the Soul: Living With Alzheimer’s and Other Dementias” and “Seasons of Caring: Meditations for Alzheimer’s & Dementia Caregivers”.

She has been a featured writer for Alzheimers.net and Caregivers.com and has contributed to a variety of blogs and websites. She is a co-moderator of the USAgainstAlzheimer’s Facebook Support Group, a non-clergy founding member of ClergyAgainstAlzheimer’s, a Purple Angel Ambassador, and a volunteer with her Alzheimer’s Association chapter, in addition to volunteering in a local memory care unit. Ann was also recently recognised on Maria Shriver’s Wipe Out Alzheimer’s Big Wall of Empowerment.

 

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