Caring for an older adult with cognitive difficulties, such as dementia or Alzheimer’s disease, requires patience, empathy, and a thoughtful approach to daily activities. As our loved ones with dementia might have communication challenges, we become more attuned to observing body language and facial expressions. The right activities can provide a sense of purpose, stimulate memory, and improve overall well-being. However, choosing the wrong activities can lead to frustration or confusion. This guide offers practical advice on the dos and don’ts of engaging loved ones with cognitive decline.

Do:        Watch television: many of us utilize television for entertainment but it can often become the primary source of structure and activity for the day.

• Watching cooking shows can be good if you are looking to improve appetite but can also cause overeating.
• Watching nature programs with positive content is engaging, however cycle-of-life or aggressive programming (like natural disasters) can produce anxiety. Baby animal shows can be a particular favorite as there is no plot to follow.
• Watching beloved shows can be nostalgic and comforting, and comedy skit shows also have no plot to follow.
• Consider what types of programs are watched at different times of day – something with no speaking and just photography is good for resting, and sports might spark a desire for more activity.

Don’t:        Allow TV to cause anxiety or be a substitute for activity or personal interaction

• Watching the news can be distressing for some and cause anxiety
• Confrontational talk show formats can be confusing and angry participants may display unwanted behaviors.
• Sitting in front of the TV all day isn’t good for anyone, and this is not engaging in socialization or cognitive stimulation.

Do:        Simplify tasks and break them down into smaller steps.

• For example, if your loved one enjoyed cooking, involve them in simple tasks like stirring ingredients or setting the table. This allows them to participate without feeling overwhelmed by the complexity of the activity.
• Familiar rote tasks can provide a sense of purpose and success i.e.: folding towels or setting the table.

Don’t:        Set up for failure

• Avoid setting high expectations for perfection or completion of tasks. The goal is engagement, not mastery. If your loved one loses interest or struggles with a task, it’s okay to move on to something else without pressure. Try active listening techniques.

Do:        Promote social interaction

• Engage in activities that foster social interaction, like looking through old photo albums, reminiscing about the past, or participating in small group activities. Social engagement is crucial for older adults as it helps combat feelings of isolation and keeps their minds active. Offer prompting open-ended questions to encourage engagement. Consider looking for a local Adult Day Center near you that might offer activities and social interaction.

Don’t:        Overwhelm with large gatherings

• Avoid large social gatherings or unfamiliar environments that could cause sensory overload or anxiety. Instead, keep interactions small and personal, with familiar faces and settings to provide a sense of security and comfort.

Do:        Incorporate music and art

• Use music and art as therapeutic tools. Older adults with cognitive difficulties often respond well to music from their youth or simple art activities like coloring or painting. These activities can stimulate the senses and provide a creative outlet, even for those with advanced cognitive impairment.

Don’t:        Use Activities that require complex decision-making

• Avoid activities that require complex decision-making or too many choices. This can be overwhelming and may lead to frustration. Instead, offer simple, clear options that allow for easy participation. Offer a choice between two things such as menu items or daily clothing choices.

Do:        Accept help when caregiving becomes overwhelming.

• Consider hiring an Aging Life Care Manager.  An Aging Life Care Manager can provide expert guidance, help coordinate care, and offer support in making decisions for your loved one.  You can find one in your local area here www.aginglifecare.org

Don’t:        Set your expectations too high or schedule too full.

• Try to go with the flow and understand things might not go exactly as planned and that’s okay. Schedule in extra time for activities or to get to appointments. If you feel frustrated, step away, regain composure (your loved one if not being difficult on purpose) and try again with a new energy. Read tips on how to deal with caregiver stress.

 

As you consider what activity choices to offer your loved one, consider variety and time of day. Include exercise and socialization, as well as hygiene and rest. Modify, modify, modify. If they seem overwhelmed with an activity, try simplifying to a point they can successfully engage. For example: a puzzle with fewer and larger pieces, simple matching games, and activities to stimulate fine motor skills.

Remember not to infantilize your loved one, but rather adjust to their needs. Be mindful of your loved ones’ response to an activity and be flexible with both them and yourself.

 

About the Author: Lisa Kaufman, MS, CMC, CTRS, C-EOLD is a certified care manager, an Aging Life Care Professional, and a certified End of Life Doula. She has owned and operated SeniorCare Options since 2001, and she is a Therapeutic Recreation Specialist.