People with dementia can still engage in familiar activities—although you’ll likely have to tweak them in some way. Many activities can be done one-on-one in the home environment; others can involve family members, including intergenerational activities.
Prepare any necessary supplies in advance.
Find pastimes that were meaningful to the person prior to the disease.
Engage in activities that pose a reasonable chance of success, by taking into consideration a person’s current abilities.
Tap into over-learned skills, such as appropriate household chores or work-oriented activities.
Plan activities that are short in length and age-appropriate.
Keep the environment free of distractions.
Include activities with a sense of structure, which provides reassurance.
Give directions that are simple and one step at a time, and include non-verbal cues.
Limit choices. If you’re going for a walk around the block, allow the person to decide whether you start to the left or right, for instance.
Keep conversations structured and families, such as holiday celebrations and music icons.
Adjust the activity, based on a person’s verbal and non-verbal responses.
Validate any frustrations and try restructuring the activity.
Take a multi-sensory approach, especially as sensory functions start to decline.
Plan intergenerational activities that foster helping behaviors and are developmentally appropriate for the child and engaging for the person with dementia, and choose a time when both participants will be at their best (for example, after a meal).
Be patient and flexible.
Focus on enjoyment, not achievement.
Strategy: Consider Adult Day Services
Adult day services can be an important part of a care plan for your loved one with Alzheimer’s disease or another form of dementia. This activity can improve quality of life for the person with the disease by providing a safe and stimulating environment, and for you by giving you respite.
Become familiar with adult day services. Adult day services provide supervision, routines, activities and the opportunity for socialization to older adults, individuals with Alzheimer’s disease and other people with special needs. They include: social model programs usually are housed within community centers and offer a variety of social and other support services according to an individualized plan of care; and medical model programs offer health-related services in addition to providing activities and supervision.
Find one that meets your needs. Locate adult day services in your area by contacting an Area Agency on Aging, local office of senior citizen services, or national or local Alzheimer’s disease advocacy organizations. Licensing and certification requirements vary by state. An intake interview and ongoing evaluation will determine if your loved one is a good fit for the center.
Check the operating hours. Most programs follow part or all of a nine-to-five, Monday-to-Friday schedule, but some are open earlier in the morning and later in the evening, and a small percent of them are open on Saturdays and for overnight care.
Evaluate the program. In addition to operating hours, consider the center’s level of care, safety and services, including the availability of recreational activities—such as pet, art and music therapies and mental stimulation exercises—and physical, speech and occupational therapies. Meet the staff, and note the staff’s credentials and the ratio of staff to participants.
Be prepared for possible resistance. People with dementia may be unwilling to attend because of a general resistance to change, they do not recognize their own limitations or needs, do not understand the program’s purpose or feel uncomfortable in a new social setting. Your soft, non-threatening, yet assertive approach may help overcome any barriers. Use words the person can connect to like “center” or “club,” versus “adult day program.” Acknowledge your loved one’s concerns and ask him or her to simply try it. Ask program directors for tips about helping your loved one adjust to the program.
Help with the adjustment. A structured routine in getting ready to go to the center may help. During the drive there, you can experiment with various activities to see which ones have a calming influence on your loved one. For example, try playing music from former years or talk about subjects that trigger memories. Persuasion and logic will not work since dementia gradually damages the center of a person’s brain that performs normal adult cognitive function. If your loved one complains or behaves angrily about the day program, try to receive these actions gracefully and without arguing. As in a variety of caregiving situations, practice this sequence: calm, reassure, distract, redirect.
Inquire about financial aid. The average fee for adult day services is $67 a day, according to the MetLife Mature Market Institute. Medicare doesn’t pay for non-acute, non-medical services like a social model adult day program. But inquire about Medicaid eligibility for adult day services, long-term care insurance policies that pay for this activity, and/or sliding scale fee options or scholarships and grants from the center itself or national and local organizations so that your loved one can attend.
Ask about transportation. Find out whether the program provides transportation and if the fee is included in the program cost. The U.S. Department of Transportation requires paratransit (door-to-door) services for disabled persons; consult with your local Area Agency on Aging for more information about a local paratransit provider. A taxi service or carpooling might be other options, depending on your loved one’s condition.
Check out services for caregivers. Many adult day programs also offer support groups, educational events and other programs for caregivers while their loved ones are attending the center. Support groups can help with possible feelings of guilt about letting go and having your loved one attend the program.