How to Plan Activities for Someone With Dementia

Physical and mental activity promotes health and well-being, regardless of someone's cognitive status. While activities are a crucial factor in preventing the decline in physical and mental status, they also significantly affect the health of someone with cognitive impairment or a diagnosis of dementia. Planning those more significant activities requires knowledge and guidance to maximize the experience.

Dementia is a general term that describes a syndrome associated with the loss of memory and functional abilities. Dementia is a progressive condition with no known cure, but some medications may slow disease advancement. Yet, apart from drugs, there is evidence that both physical and mental activity may not only slow the progression of cognitive impairment but can improve a person's mood and sense of well-being as well as reduce anxiety associated with responsive behaviors.

Dementia & events – things to consider:

Social relationships can affect a person’s behavioral and mental health positively. When you have a special event to attend with your loved one, you want to ensure it is an encouraging experience. This is equally important for a routine activity, either on their own or with you as their caregiver, to encourage them. Adequate preparation for any activity is essential for someone with dementia, so considering their current status and promoting healthy lifestyle routines will help to plan for an optimum experience.

Time of day

The time of day may significantly affect how well your loved one responds to the activity. Each person is unique in the time of day they are “at their best.” Most often, the mid-morning to early afternoon hours are optimum in most stages of dementia.

In the moderate to severe stages, a condition known as Sundowner's Syndrome may affect people in the later afternoon or early evening, resulting in responsive behaviors. Therefore, avoid busy activities at this time of day and keep the activity quiet and relaxing if possible. Reducing the amount of stimulation later in the day for someone prone to Sundowner's syndrome will reduce the risk of a negative response.

Personality

Dementia results in declining abilities, but you may also notice changes in your loved one's personality. Things they may have enthusiastically enjoyed in the past may now cause them distress and anxiety. It's always essential for you, as the caregiver, to be mindful of those subtle changes in your loved one's responses to maximize the positive impact an event could have on their mood and self-esteem.

Attention span

Someone with dementia may have a shortened attention span based on their stage of decline, but it is often evident in the middle to later stages. Gauge any activity based on their level of ability to focus on a task. You may want to plan several short activities to keep your loved one engaged. You may need to limit the number of options offered, as decision-making may be complex and confusing.

Stay tuned to your loved one’s actions since they will likely tell you when they have had enough. When the activity is an event such as a family gathering or wedding, the time you and your loved one spend at the venue will depend on their attention span and if they are easily overwhelmed.

Routine

As much as possible, try to keep to your loved one's daily routine schedule, such as when they have meals, go to bed, etc. While there will always be days when disruption is inevitable, keeping the day fairly predictable will only increase your loved one's sense of security.

Sleep patterns

Being well-rested increases the probability of someone benefiting from an activity or outing. Ensuring your loved one has adequate rest the night before an event will aid in that process.

Promote the practice of good sleep hygiene on a routine basis by reducing or eliminating caffeine and “screen time” before bed. Exercise and sunlight during the day and keeping the bedroom dark at night will also help.

While a nap in the afternoon may help your loved one recharge, too many naps can further disturb the sleep-wake cycle, which is already a factor in dementia. You may note that your loved one is awake more often at night when they oversleep during the day.

Hydration

Many older adults have an inadequate fluid intake, and even more so in someone with dementia, who may “forget” to drink. In addition, adequate hydration is necessary to maintain good kidney health, brain function, cardiac volume, and cognitive status.

Dehydration is a risk factor for urinary tract infections (UTIs) that can result in delirium in older adults. Offer and provide drinks and fluid-rich foods such as watermelon and Jello regularly during the day. If your loved one is reluctant to drink water, add flavor enhancers to the water to make it more palatable. Avoid alcohol and caffeine as a source of hydration.

Nutrition

Like hydration, older adults with cognitive decline may not eat an appropriate diet. While appetite often decreases as we age, people with dementia also may “forget” to eat. Ensure your loved one eats a regular, balanced diet. Consider adding nutritional drinks such as Boost or Ensure to supplement their daily intake if needed. Have healthy snack foods such as granola, fruit, and cheese placed in sight around the home as a visual trigger to eat.

Environment

Ensure your loved one's living space promotes a healthy and peaceful environment. For example, keeping noise to a minimum or playing soft music can reduce stress while resting or enjoying low-key activities. In addition, encourage fresh air, sunlight, and exercise by going outside with your loved one daily, weather permitting.

While each person with dementia is unique regarding their stage of cognitive decline, they can still enjoy daily activities and special events if you, as their caregiver, consider thoughtful planning. People in the earlier stages will still be able to participate with minimal difficulty, while those in the middle to later stages will require a more tailored plan.

Optimizing an everyday healthy lifestyle practice that includes improvements to diet, fluids, and adequate rest can also increase the possibility that the planned activity will benefit your loved one's physical and mental well-being.