Dementia Activities: Six Options to Encourage Engagement

19 Saturday Jul 2014

Posted by Ann Napoletan in Activities for Your Loved One, Books, Caregivers, Children's Toys & Books, Communication, Helpful Resources, Mom, Music and Art, Products, Smiles, Tips

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alzheimers, alzheimers activitiies, dementia, dementia activities, dementia art therapy, montessori

As dementia progresses, it becomes challenging to find activities that encourage mental, emotional, and sensory stimulation. At the same time, we are often in search of ways to connect with our loved one when conversation is no longer an option. Possibilities are as wide and varied as one’s imagination, but here are a few ideas to get you started.

Photographs & Picture Books

My mom enjoyed looking at photos, so I always kept a scrapbook and some photo albums on hand. Later, I added a digital frame that continually scrolled through favorite photographs. Those pictures provided so many smiles, and I have fond memories of sitting next to her on the sofa flipping through the books. It’s impossible to know whether she recognized the people in the pictures – or whether they triggered any memories, but I do know they brought her joy in those moments, and that was the important thing.

Coffee table books full of large colorful images are also a nice option. Think about some of your loved one’s favorite things, and find a book on those topics. Children and animals are always a popular choice, but other potential topics include travel/scenery, cars, food, sports, and many more.

A few examples (all available on Amazon) include:

Dolls & Stuffed Animals

There was a woman at Mom’s first assisted living facility that had a profound and lasting impact on me. She had advanced dementia and struggled to speak. The woman was confined to a wheelchair, and every time I saw her, she was holding the same disheveled baby doll.

It was a poignant sight, and I recall feeling so sad for that woman. At the time, my mom was in the mid/moderate stages of the disease, so thinking of her with a doll wasn’t something I could even comprehend. She would never get to that point…

But, alas, she would and she did, yet when one of the caregivers asked if she could give Mom a doll, I was caught off guard. I remembered that woman from several years back and realized we had now arrived at that place in our journey – a place I never dreamed we’d be.

Mom immediately fell in love with her Dora the Explorer doll. The initial discomfort I felt dissipated instantly as I watched my mom’s genuine, heartwarming interactions with Dora. I was continually astounded at the delight and enjoyment the doll brought.

Dolls and stuffed animals allow our loved ones the unique opportunity to give care instead of receiving it. They also offer a distraction while providing positive sensory stimulation and they can even trigger memories. While there are expensive life-like therapy dolls on the market, in my experience, a regular doll works just as well and costs much less.

Fidget Quilts & Fiddle Boxes

Fidget quilts use a variety of colors, textures, and objects to keep busy hands occupied. Some quilts feature zippers, buttons, and Velcro, but the possibilities are endless. Many people design quilts around their loved one’s pre-dementia interests.

A “fiddle box” is a similar concept; simply a box (or basket) filled with items that provide a variety of tactile experiences. You might also consider your loved one’s hobbies or interests when putting this together. Ideas: buttons, ribbon, shoelaces, keys, marbles, jewelry, photos, small bits of pipe or safe small hardware items, various size paintbrushes, cookie cutters, measuring spoons.

How about a Busy Hands Fidget Apron or a handyman version for the gentleman in your life? Or if neither one of those strike your fancy, consider a Twiddle Muff or a sensory cushion. The Internet is overflowing with creative ideas, and Pinterest is an excellent starting point.

Art

According to the folks at Cognitive Dynamics, “Art therapy is the deliberate use of art-making to address psychological and emotional needs. Its benefits include fostering self-expression, enhancing coping skills, managing stress, and strengthening a sense of self. This translates into improved communication, behavior, and cognition.”

When the ability to communicate verbally is gone, art is lovely method of self-expression and creativity. Like music, art brings people together, and it doesn’t require a lot of fancy materials or special skills. Start with some heavy paper or card stock, a basic set of watercolors and a paintbrush, colored pencils or markers – it’s that simple!

Clay is another fantastic way to encourage creativity, interaction, and hand-eye coordination. I recommend good old Play-Doh since it’s brightly colored and more pliable than some of the modeling clay on the market. Combine the clay with a rolling pin and cookie cutters and you’ve created a form of reminiscence therapy for someone who once loved baking cookies!

Puzzles

My mom loved puzzles; we always had one going during the winter months. However, by the moderate stages of Alzheimer’s, large jigsaw puzzles overwhelmed and frustrated her. I hesitated to buy children’s puzzles, which had fewer (and larger) pieces because the designs were intended for kids. She was declining, no doubt, but still, I was afraid the children’s puzzles might be degrading in her moments of clarity.

Now there are puzzles designed specifically with dementia patients in mind. Max Wallack’s non-profit, Puzzles to Remember has partnered with Springbok to create puzzles with 12 or 36 large pieces that are much easier for Alzheimer’s patients to manipulate. Themes are adult-friendly, colorful, and pleasing to the eye. The puzzles provide a great way to stimulate cognition while offering your person an opportunity to achieve success!

Sorting & Organizing

Providing a loved one with sorting and organizing tasks is another beneficial way to keep dementia patients engaged and active. On a recent visit to a care facility, I observed one of the residents organizing the newspaper – apparently a daily ritual. Each morning, caregivers take apart the paper and lay the sections out on the kitchen table. With no prompting, the woman sits down and organizes the mess just perfectly, laying each section on top of the one before it about an inch below the last, creating a fan or stair step like pattern.

Consider using brightly colored marbles, several different kinds of fruit, socks, silverware, or various hardware items, such as nuts, screws, and washers. It makes little difference how well these things are sorted; the idea is to keep hands and mind busy, and help your person feel a sense of purpose.

Proponents of the Montessori method for dementia suggest these types of activities can reduce aggression, agitation, and other negative behaviors, improving quality of life.

Follow Their Lead

If you’re looking for other ideas, pick up a copy of The Alzheimer’s Creativity Book, by Jytte Lokvig, Ph.D. The book is full of suggestions to get the creative juices flowing, which in turn improves engagement, provides positive reinforcement, and promotes an overall feeling of well being for your loved one.

As you consider activities, remember this is not a “one size fits all” proposition. There are few things more unpredictable than dementia. Depending on the time of day, level of agitation, and mental status, preferences may vary. In fact, some days no activity is the right activity. Most importantly, don’t force the issue. The key is to offer options, then follow your person’s lead. In the process, you’ll create some extraordinarily beautiful moments of joy.

Please consider sharing your own experience or a favorite activity by leaving a comment!

Caregiver Coping Strategies: Getting away from Guilt and Grief

28 Saturday Jun 2014

Posted by Ann Napoletan in Books, Caregivers, Grieving, Guests, Guilt and Regrets, Helpful Resources, Tips

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alzheimers, alzheimers guilt, caregiving, dementia, grief, grieving, mara botonis, when caring takes courage

I’m happy to bring you Part 2 of a 3-part series entitled The Dangerous Dance with Stress and Guilt, by Mara Botonis. Mara is the author of “When Caring Takes Courage”, available on amazon.com. She is also the founder of Biography Based Care and is a strong proponent of person-centered care. You can learn more about her work at http://biographybasedcare.com

In this second installment, Mara discusses two topics that have likely affected all of us at one point or another – guilt and grief. Perhaps the most important message here, “It’s okay to feel your feelings.”

Caregiver Coping Strategies Part 2 of 3: Getting away from Guilt and Grief

by Mara Botonis

The constant struggle to cope with our grief and our guilt can be just as consuming as all of the actual caregiving responsibilities we have, and often times, far more painful. There are two types of grief, anticipatory grief and ambiguous loss that especially resonate with caregivers of persons with Alzheimer’s and dementia.

Anticipatory grief is defined by the American Medical Association as: “The normal mourning that occurs when a patient or family is expecting a death. Anticipatory grief has many of the same symptoms as those experienced after a death has occurred. It includes all of the thinking, feeling, cultural, and social reactions to an expected death that are felt by the patient and family. Anticipatory grief includes depression, extreme concern for the dying person, preparing for the death, and adjusting to changes caused by the death.” Anticipatory grief may be a more common occurrence in long or protracted illnesses such as Alzheimer’s or dementia as caregivers fight against a progressive disease from which there is no cure.

The other type of grief common for Alzheimer’s caregivers, Ambiguous Loss is; “characterized by the sensation of loss one can feel when the person you care about is psychologically absent, that is, emotionally or cognitively missing. Such ambiguous loss can occur from Alzheimer’s disease and other dementias as a loved one’s mind or memory fades away.” We know this one all too well, the fact that many times, the very person we spend our whole day taking care of often has no idea who we are. Our shared history, common experiences and years of connection have disappeared into a mind we can no longer access. We look hopefully upon a familiar face that we constantly scan for a glimmer of recognition, only to be hurt time and time again when it usually isn’t there.

The sad reality is that we are fighting a disease without a cure and the added challenge of feeling so alone at times when doing so can make being a caregiver of a person with Alzheimer’s or dementia an especially emotionally draining and potentially isolating. Sometimes, it may feel as though these feelings are so strong that they have the power to swallow us up and that if our loved one didn’t rely on us for daily care tasks, it would be easier to simply curl up in a ball under the covers and wish this away or hide from the situation until it goes away.

There isn’t a magic bullet, or easy answer to help us release the guilt or grief, and I’m not sure we need one. It’s okay to feel your feelings.

Here are some tips other family caregivers have giving me over the years to help decrease the stress and guilt and increase their ability to help their loved ones and themselves have better, brighter days.

1) Stop measuring your worth by what you did or didn’t get done. Stop beating yourself up because of what you said, or what you wish you had said instead. Stop focusing on what you think you did wrong or measuring yourself against an imaginary ideal of the “right” way to do things. There is no such thing. Every person, every situation every moment with this disease is different and can’t be defined by an all-inclusive set of never fail instructions. There’s a reason there’s no Martha Stewart of Memory Care. This disease creates a series of unpredictable moments where solutions that may be considered imperfect in other’s eyes are often the best answer for your loved one.

2) Not everything is going to work. A number of activities, in fact, might not. So many factors can impact whether an opportunity to engage your loved one was met with any interest on their part. The timing of the activity, their physical and emotional well-being in that moment (fatigue, thirst, hunger, or anxiety level can have a negative impact on them being in the mood to participate). It’s okay to have more instances when things didn’t go as planned than ones that do, plan on imperfection. Give yourself permission to try new things or modify any activity ideas that you read or hear about to best meet your loved ones needs and capitalize on their interests and abilities.

3) Get a jump start by doing tomorrow’s tasks tonight. At the end of a long day, the last thing on your mind is probably trying to fit in “just one more thing”. Throwing a load of laundry in the washer, loading the dinner dishes and running the dishwasher or even setting the table for breakfast may be worth the extra effort tonight to give you a little extra time tomorrow.

4) Look for ways to save time on chores. Try paper plates to decrease dish washing, prepare healthy crock pot meals and make more than you need, then portion out and freeze them into individual meals that can be thawed when needed. When making something (salads, sandwiches, soups, snacks) always try to make extra if it will keep. If you’re going to go to all the trouble of making it, why not make enough for you both to have get a couple of meals from your efforts instead of just one? When doing laundry, put clothing away in sets or in complete outfits. On one hanger have shirt, pants undergarments and socks draped over the shoulder so dressing can be a grab and go event without having to think about matching or searching for each item.

Eason House 5) Life is a series of these small victories, these shared experiences that connect you both despite the disease. Cherish the times when you laughed, played, shared in something that reminded you of a time before Alzheimer’s. Enjoy any experience where even for only a brief breath of time you were in touch with the life that was lived long before you knew what dementia was. Accumulating more and more moments that matter along the way, is more important now than ever before. Every one of these moments is a precious gift to be nurtured, protected and celebrated.

6) Reach out for help. The Alzheimer’s Association’s 24-hour helpline is a wonderful, anonymous resource that you can reach at: 1.800.272.3900. There are also a myriad of online support groups and Facebook communities such as USAgainstAlzheimer’s, Forget Me Not, and Memory People that offer forums for questions and situation based idea sharing based upon what’s happening at home.

7) Try to remember above all us, that though we may not be able to change the destination that this disease takes us, we can absolutely improve the journey along the way. Putting quality of life now above all else can help make sure that no matter how many days you have left with your loved one, or how many of those days will be good days, you’ll have peace of mind that you did everything you could to make the days you do have together really count. Let go of the little things and look at each day as a chance to connect, a chance to love each other while you still can.

8) Remember your role in making sure things stay joyful in your home despite the devastating impact of Alzheimer’s and dementia. You are the most significant activity “supply” or care “technique” in this whole process. YOU. Your patience, words of encouragement, soothing and supportive tone of voice and loving reassurances throughout whatever task or activity you choose to do will have a far greater impact on whether or not your loved one has a good day than any item you can ever purchase and can be more effective than a lot of medications out there. Your attitude and commitment to making sure that no matter what happens, you’ll make sure it retains an air of calm, and comfort is something that doesn’t cost any money, but in the end is priceless. I know that sometimes this is a lot easier said than done.

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What’s your strategy for dealing with grief and guilt? We’d love to hear from you, so please leave a comment and share your story.

Stay tuned for Caregiver Coping Strategies Part 3 of 3: Making More Time for Moments That Matter. In this third and final installment of The Dangerous Dance with Stress and Guilt series, Mara Botonis will provide tips for finding quality time to spend with your loved one – even in the midst of all the logistical and practical issues you’re dealing with on a daily basis.

Also in the coming weeks, I’ll be giving away a copy of Mara’s wonderful book, “When Caring Takes Courage”.