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Choosing which activity to present to someone with dementia or Alzheimer's is only the beginning to a successful interaction. Equally as important, or perhaps more so, is how the activity is presented to the person. These article in this section provide some suggestions and techniques to make activities more meaningful and effective.
In 2008 a group of researchers presented a workshop titled “Beyond Bingo and Painted Nails: Meaningful Activity for Persons with Dementia” at the American Association for Geriatric Psychiatry Annual Conference. The somewhat cynical title was chosen to suggest that the all too common activities of playing bingo and painting residents’ fingernails was perhaps not the most effective way to engage residents with dementia or Alzheimer’s.
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 we offer an activity to someone with dementia, we should do everything we can to ensure their success. We generally focus on the person's abilities when deciding if an activity is appropriate, but other factors are also important. Vision is one such factor.
Even without any underlying problems, our vision deteriorates as we age. Disorders such as age-related macular degeneration or cataracts can make matters far worse. Before choosing an activity, it is important to ensure that the person's vision will not hinder them in being successful.
Jigsaw puzzles are a popular activity for people with dementia, and rightly so. Not only do they offer many benefits for the person, they are fun to do! Unfortunately, many people with dementia or Alzheimer's stop doing jigsaw puzzles because they find them too challenging and difficult to finish. This doesn't have to be the case.
When we bring home a new puzzle and show it to the person they are excited to open the box and get started. We dump the pieces on the table and the person digs right in sorting through the pieces. They find a few that they are looking for, but then the excitement starts to wear off. They slow down in their searching, start to get distracted by other things. They lose interest in the puzzle. Is it that they aren't really interested in doing puzzles or is there another reason?
You have selected an activity, made sure that it is suitable for the person and that it meets the requirements of a proper Montessori dementia activity. What next?
Of most importance is your mindset. You have to be ready to coach the person, observe how they handle the tasks involved, give them the time they need to complete the tasks, and celebrate their successes with them. If everything comes together, if your hard work pays off, you will be rewarded beyond your expectations with the moment of accomplishment that you will share with together.
When you present an activity to someone with Alzheimer's or dementia, it doesn't always work out exactly as expected. Sometimes that doesn't matter. You may have expected the person to sort the red cards to the left and the black cards to the right but they did it the other way around. That's not a problem. They are still handling the cards which helps with dexterity and they are sorting the cards which helps with cognitive skills. Over time you can coach them to do it the "correct" way, but it really doesn't matter.
That's a phrase that anyone who has taken the "DementiAbility Methods: The Montessori Way" workshop is familiar with.
Research shows that the performance of people with dementia improves with repetition. They may not recall having done the activity before, but they do it better.
What this means is that repetition is good. The first time a person with dementia is exposed to an activity, they likely will not be able to complete it from start to finish. That's not unexpected and should not be of concern. The first time the person is introduced to the materials they are becoming familiar with the activity and components and with proper direction they will associate it with positive emotions. With each further exposure, they will build on their past success and become more engaged in the activity.
Word Search is a familiar and popular pastime for many people. It is engaging and offers cognitive challenges as well as providing positive feedback finding the hidden words. Depending on the person, it can often be done with little supervision. Unfortunately, people with Alzheimer's or dementia often stop doing puzzles such as word search because they find the puzzles too challenging and have difficulty completing them. This does not have to be the case.
Using puzzles specially designed for people with dementia that have larger print and fewer words may allow the person to regain their enjoyment in doing the puzzles. The key is to start with easy puzzles to allow the person to be successful, moving to more difficult puzzles only if the person completes the easier puzzles with minimal assistance. There is no benefit in “pushing” the person, it is much more important that they successfully complete the puzzle independently.