Just the Facts and More:Activities

Daily activities for Alzheimer's patients tend to change as the disease progresses. Alzheimer's disease tends to limit concentration and cause difficulties in following directions. These factors can turn simple activities into daily challenges.

Individuals with Alzheimer's disease often don't start or plan activities on their own. When they do, they may have trouble organizing and carrying out the activity. Many caregivers state that the individual often sits in one area of the room, paces the floor, or searches for familiar objects with little interest in doing the things that had once brought meaning and pleasure to life. By using a variety of activities matched to the person's abilities, the caregiver can help the family member enjoy his current skills and talents. A daily routing of exercise and activities can help the person with Alzheimer's retain his sense of positive self-esteem. To decide which activities are appropriate, start with some of the following ideas.

Action Steps

Take stock.

Examine the person's past activities and hobbies and then figure out how to adapt or simplify these activities to match the patient's abilities.

Build in structure.

Don't be afraid to give activities structure and routing. It is fine if the person does the same thing at the same time every day. If (s)he has a sense of routine, there is a greater chance that (s)he will look forward to an activity with a positive attitude. The person may not remember how many times (s)he has been involved in a certain activity or even if (s)he did the same activity that day.

Offer support.

Focus on offering guidance and supervision and doing things with the person with Alzheimer's disease. In most cases, you will need to show the individual how to perform the activity by providing simple, step-by-step directions. Doing such simple tasks as sweeping or dusting can help the person with Alzheimer's disease experience a sense of accomplishment and satisfaction.

Look for favorites.

Keep in mind that the person who once enjoyed drinking coffee and reading the newspaper in the morning may still find that activity enjoyable. Don't be concerned that (s)he might not be able to make sense of that (s)he's reading. The real point is that it is familiar and (s)he enjoys doing it.

Be flexible.

Adjust to the person's level of ability and look for hidden messages. When a person insists that (s)he doesn't want to do something, it might be his/her way of telling you that (s)he can't do it or fears doing it. If an individual patient has problems with one part of a task such as separating dishes and putting them into a cabinet, you might want to take over part of the task and ask the person to hand you the dishes one by one.

Stress involvement.

Emphasize activities that help the individual feel like a valued part of the household and experience a feeling of success and accomplishment. Examples include gardening, raking leaves or simple household chores. Working along with you on such tasks as setting the table, wiping countertops, folding napkins, or emptying wastebaskets, will help the person feel useful and sociable.

Don't forget the family.

Plan for social activities such as family picnics or birthday parties, but make special allowances for the person with Alzheimer's disease. Allow for frequent rest periods and try to prevent family members from overwhelming the individual.

Focus on enjoyment, not achievement. Help the individual find activities that build on remaining skills and talents. A person who had once been a professional artist might become frustrated over the declining quality of his/her work, but someone who had never pursued art as a career might enjoy a new opportunity for self-expression.

Be realistic and relaxed.

Don't be concerned about filling up every minute of the day with activity. Because of a shortened attention span, the person with Alzheimer's Disease needs a balance of activity and rest and may need more frequent breaks and changes in activities.

Relate activity to work life.

A person who once worked in a business office might enjoy putting coins in holders, doing routing mailings, or making lists on a legal pad or in a notebook. At the same time, someone who had been a farmer or gardener would probably enjoy working in the yard. Activities that relate to a former career are often the most familiar, reassuring and enjoyable for the patient.

Specific activity areas include the following:

• Self-expression and Crafts - Many people enjoy activities that offer an opportunity for self-expression. These activities include painting, drawing, dancing, singing, playing a musical instrument, working with nontoxic clay, or caring for plants.
  
• Exercise - Consider playing catch with a "soft" ball or taking regular walks with the individual to the grocery store or around the local mall. Household tasks such as raking leaves or sweeping the floor also offer the person an opportunity for exercise.
  
• Music and Dancing - Remember that many people with Alzheimer's disease enjoy singing familiar songs or hymns, practicing dance steps learned earlier, or playing a musical instrument.
  
• Playing with Children - Plan activities so that both the child and the person with the disease have a positive experience. Keep in mind, however, you may need to monitor the individual's reactions. Seeing a child cry might worry or frighten the person.
  
• Magazines, Albums, Picture Books - Spend time sitting with the person and looking at pictures. You could also give the individual the opportunity to look through travel magazines and cut out pictures of favorite scenes.
  
• Reading - Try reading stories from a favorite newspaper or magazine, or try reading poetry or favorite stories.
  
• Separation Tasks - People who once enjoyed playing bridge or cards might find pleasure in simple card games, or - depending on ability level - in separating different types of cards. Other possibilities include separating nuts and bolts from nails, sorting buttons and coins.
  
  
• Working with Cloth - Consider giving the person an opportunity to fold or work with pieces of cloth or clothing. Some people might enjoy sorting or sewing together different types of material such as terry cloth, denim, corduroy, or cotton.
  
• Observations and Excursions - Experiment with watching old videos of the 1950s or 1960s or old movies of the 1930s and 1940s. Other individuals may enjoy watching sporting events, riding in the car, going out for lunch, or taking trips to the zoo, park of art museum.

The person with Alzheimer's disease needs activity and exercise that bring about a sense of involvement, accomplishment and well-being. By matching the person's abilities to the level and type of activities you can enhance feelings of satisfaction.

Resources

One of the best places to turn for additional help is the Alzheimer's Association. The Alzheimer's Association has more than 83 chapters and 1,600 support groups nationwide, where family members of people with Alzheimer's disease or a related disorder share their experiences, provide each other with emotional support, hear practical suggestions and learn to rebuild their lives.

The primary resource for this fact sheet was Mary Barringer, RNC, Director, Clinical Services, Center for Alzheimer's Disease and Related Disorders, Southern Illinois University, School of Medicine, Springfield, Illinois; and Lisa P. Gwyther, ACSW, Educational Director, Joseph and Kathleen Bryan Alzheimer's Disease Research Center of Duke University, Durham, North Carolina. Special thanks to the following Chapters of the Alzheimer's Association: Eastern Massachusetts, South Central Michigan, and Cleveland.

Other resources include:

• David L. Carroll. "When Your Loved One Has Alzheimer's Disease: A Caregiver's Guide." New York: Harper and Row, 1989.
  
• Howard Gruetzner. "Alzheimer's: A Caregiver's Guide and Sourcebook." New York: John Wiley and Sons, Inc., 1988.
  
  
• Lisa P. Gwyther. "Care of Alzheimer's Patients: A Manual for Nursing Home Staff."Washington, DC: American Health Care Association, and Alzheimer's Disease and Related Disorders Association. 1985.
  
  
• Nancy L. Mace and Peter V. Rabins, MD. "The 36-Hour Day." Baltimore: The Johns Hopkins University Press. 1991.
  
  
• Carmel B. Sheridan. "Failure Free Activities for the Alzheimer's Patient." Oakland: Cottage Books.
  
  
• Jitka Zgola. "Doing Things: A Guide to Programming Organized Activities for Persons with Alzheimer's Disease and Related Disorders." Baltimore: Johns Hopkins University Press, 1987.
  
  

Compiled by the Lincoln/Greater Nebraska Chapter of the Alzheimer's Association, 1999.