Timing is Everything - Choosing the Appropriate Activity Time

To increase the likelihood of a given activity or program for people with dementia being successful, many factors have to be taken into account. Of obvious importance is that the chosen activity be meaningful to the participant(s) and appropriate for them, but also important is the time of day that the activity is presented.

Brain function is affected by the circadian rhythm (natural alterations in alertness that happen during the course of 24 hours), and some activities are more appropriate than others at a given time of day. For example, energy levels and capacity to do physical activity are greatest early in the day, whereas cognitive alertness occurs a little later. When deciding when to offer a particular program or activity to someone with dementia, it is important to consider these natural rhythms. This applies equally to individual activities at home as well as individual and small group activities in a facility.

Also important is to offer programs that engage the participants in routine activity that is reminiscent of past lifestyles, which helps build on familiar routines. There are often challenges in offering programming of certain types at the times that suit the participant, but it is important to accommodate their needs.

Here is an outline that research shows are the most effective times for each type of program, as described in DementiAbility’s “Checklist for Change”:

Active Programs

  • Examples – chair exercise, stretching, games such as ball toss
  • First program in the morning when most energetic and alert

Cognitive Programs

  • Examples – puzzles, word games, bingo
  • Mid-morning, before lunch when weariness is at bay and thinking is clearest

Creative Programs

  • Examples – crafts, creative shapes activities, music
  • After lunch, when relaxation sets in

Chore Style

  • Examples – sorting cards, polishing silver, sorting laundry
  • Late afternoon when dementia residents in a facility sometimes become anxious and may want to go home or be with their children and people with dementia living at home want to feel helpful

Social

  • Examples – make toast, card games
  • Early evening as participants relax and wind down for the evening