Finding suitable activities

Exercise

Exercising together will benefit both the person with dementia and anyone accompanying her. Exercise burns up the adrenaline produced by stress and frustration, and produces endorphins, which can promote feelings of happiness. This will help both parties relax and increase their sense of well-being. Exercise helps develop a healthy appetite, increases energy levels and promotes a better night's sleep. Exercise does not need to be vigorous, strenuous or structured.

Walking is a great form of exercise that provides a change of scene and fresh air. Short walks can make a big difference, even if it is only to mail a letter or go out for a coffee.
Swimming is another good all-round exercise, and the feeling of being in the water can be soothing and calming.
Classes may be suitable if the person wants something more social. Find out if your local community centre offers classes suitable for older people. You may need to attend together to support the person.

Reminders of the past

People with dementia can often remember the distant past more easily than recent events. If you can find a way to help trigger the more distant, pleasant memories, the person may become more animated and interested. Not everyone enjoys reminiscing about the past, but the following suggestions might be useful for those who do:

Talk about the past together, while looking at old family photos or books with pictures, or while listening to music.
Make up a memory or rummage box of objects that the person with dementia might be interested in. Physically handling things may trigger memories more effectively than looking at pictures.
A visit to a favourite place might also prompt happy memories and provide another opportunity to get out and about.
Be aware that talking about the past in this way can sometimes trigger strong emotions in the person you care for, so it's important to be sensitive, to listen, comfort and reassure the person. You may uncover painful memories as well as happy ones.
Dementia damages the memory and the thinking and reasoning parts of the brain, but the person can still express emotion. It is not necessarily a bad thing if the person becomes emotional, but if she does, make sure you allow her to express her feelings, and acknowledge these.
Avoid asking very specific questions that require factual responses and could put the person on the spot; the main purpose is to enjoy the memories rather than to make the person feel tested in any way. For example, instead of asking “Do you remember that day we went to the baseball game?” suggest, “I remember that day we went to the baseball game. It was so hot!”

Walking

Try to involve the person with Alzheimer's disease in a regular exercise program. Walking outside with her can provide stimulation, as can walks in a local mall when it’s too hot or cold outside.

Regular exercise can use up extra energy, and may help her sleep better. Even a short walk to a local store or restaurant, or a trip to the mailbox, can be beneficial.

Safety

Safe physical walking means that a person walks independently, is steady on his feet and has no history of falling. Many people with dementia are physically capable of safe walking until very late in the progression of the disease.

Risks

Many people with dementia are at risk of becoming lost if they are walking alone, even in familiar surroundings. Or they may continue walking without stopping to rest, increasing the risk of falling.

Help reduce risk

Ensure that the person with dementia always wears comfortable, well-fitting shoes that are difficult to remove.

Discretely label personal effects, including wallets and purses and shoes, with the owner’s name, your name and contact details

Consider registering the person with the disease with our MedicAlert^® Safely Home^® program to assist emergency responders to identify the person who is lost and bring the family back together.

Early stage activities

Staying active in the early stage of Alzheimer's disease

People with dementia retain memory for some activities, such as reading, typing or playing the piano, depending on which part of the brain has been damaged.

People in the early stages of dementia will likely continue to enjoy activities they have enjoyed before diagnosis. If you are close to someone in the early stage, be aware of the danger of taking over jobs and tasks too quickly in an attempt to minimize your own stress. For example, if she washes the dishes, accept that it might not get done to the standard that you would normally like. Recognize that she will feel she has made a useful contribution, and that’s what is important.

Other tips

Encourage the person to enjoy activities on his own.
Provide encouragement and reminders.
Put any equipment in a place where the person can see it and reach it easily. If you leave a potato out with a potato peeler, the person might try using it.
When you suggest what to do, use short sentences.
Set aside time in the day when you are going to focus on doing something enjoyable for both of you, away from the normal routines of the day.

Involving others

Consider inviting other people (including paid workers, family members or volunteers) to spend time with the person to do something they both enjoy, such as going for a walk or playing a game of cards. If you are the sole caregiver, you might find it hard to hand things over and trust others, but they may bring a fresh approach that the person may enjoy in new ways. When you are a full-time caregiver, it can be hard to have the energy to always give “quality time” to the person if you are exhausted and stressed.

Activity ideas

Craft activities: These might include simple craft activities, such as creating collages from magazines, or knitting. Someone who has been a skilful knitter may still be able to knit squares for a blanket.
Puzzles: Someone who has enjoyed doing crossword puzzles may still enjoy a puzzle book.
Doing things together: The person may like to play cards or board games, or do some gardening, planning meals or baking together.
Activities around the home: Men and women alike can enjoy helping with washing and drying dishes, setting the table or making beds. Again, the end result may not be perfect, but it can give an important sense of achievement. The person might be surprisingly interested in odd jobs, such as sorting through a drawer or a toolbox.
Music: Even when other abilities are severely affected, many people still enjoy singing, dancing and listening to music. Record a collection of the person's favourite pieces of music or songs for her to listen to, or ask a friend to help you.
TV and radio: Many people enjoy listening to the radio or watching television. Some people with dementia, however, lose the ability to tell the difference between what is real and what is on the screen, and can become distressed. They can also become confused by too much noise. Try watching television together, and choose programs with small sections of action or humour, rather than one with an involved plot. Some people have found using headphones can help them concentrate better.
Communal activities: If the person has a connection with an organization within the local community, whether it is a place of worship, a coffee shop or a club, continuing to visit this place might be very important. It may help if a family member or caregiver has some gentle discussions with other attendees to encourage them to continue to welcome the person with dementia, and to minimize any embarrassment.

Some people with dementia enjoy social situations in a way that can surprise those close to them. Others become daunted by being away from the safety of their own home and avoid going out. If the person seems reluctant to join in, don't always take the first “no” for an answer. People will sometimes just say “no” as the safest option and will actually enjoy themselves if pushed a little to take the step out the door. But don’t force him to do something that he clearly doesn't enjoy.

More information and resources

Heart in Mind: Activation Therapy. VHA Homecare & Centre for Aging and Brain Health Innovation (CABHI). This resource provides information for family caregivers, personal support workers, therapists or other healthcare providers that will support them in engaging people living with dementia in activities.