Susan Berg expert Activities Director shares activity ideas, especially for those with Alzheimer's disease and related dementias.The emphasis is on mind stimulating activities. Also discussed are excellent activity resources
"Memory Lane TV" Soothes Anxiety & Agitation in Dementia
Yet another success oriented dementia game is dice rolling.
You can make the dice with easily handled cardboard boxes or use large foam or stuffed dice.
Higher functioning dementia residents can wrap boxes in white paper. and place circle stickers to make the dice look like regular dice or silly dice.
After the dice ar made or purchased, you are ready to play the game.
You can just have dementia folks take turns rolling the dice. After everyone has had a turn, the highest number in the wins.
This is a no fail activity. Everyone can throw dice, even if you must assist with the throw. Much cheering and congrats accompanies this and it becomes a lot of fun
Here is another dice game for those with dementia. Each player is allotted a colored counter and they roll the dice and move accordingly around the board. On the board I have cards with the first part of well known trivia. (probably about 30) Each alternate Square on the board is marked with the letter "T" for Trivia and if they land on it they have to pick up a card, they or I read it and complete the trivia statement. The first one around the board is the winner. It is very popular
Co-written by Nettie Harper, MSRS and Michael Friedman, L.M.S.W.
"Go away, you thief," Margaret screamed when her son knocked on the door of her room. "You stole my money." He opened the door and entered. "Get away!" she screamed again. She was sitting in her easy chair. A cup of coffee was on the table next to her. She grabbed it and threw it at him.
"Mother, it's me, David," he says. "I didn't steal your money. You don't keep money in the room."
"You're lying, you thief. Get away from me." She was looking for something else to throw.
Stung by her words, he felt anger well up in him. He wanted to scream back, but he turned and left the room, closing the door behind him.
His mother has been living with Alzheimer's for almost a decade. Her memory for names and recent events has diminished more and more over time, as has her ability to deal with situations that diverge from her routines. She can no longer manage her finances, shop, cook or keep herself clean.
David is the child who has stepped in to make sure she has everything she needs and spend time with her. Today's outburst stunned and hurt him. He was uncertain what to do.
David's instinctive reaction to walk away was a good one. Screaming back would have frightened his mother and accomplished nothing. It's even possible that this was a passing moment and that she will forget her suspicions and be herself when he returns to the room.
But if it is not a fleeting experience, what could be happening and what can be done?
It is tempting to think that Margaret's feelings and behavior are the result of Alzheimer's because the condition involves changes in brain function that often make it difficult to contain emotions. But most people with dementia do not behave abusively toward people caring for them, and Margaret and David have had a warm relationship until today. Something must be troubling Margaret today!
It could be that something in the situation itself set her off. Perhaps David's knock on the door startled his mother awake from a nap. Perhaps his voice through the closed door was muffled and merged with something ominous that she was dreaming.
There may be a physical cause. Is she constipated or does she have an impacted bowel? Does she have a urinary tract infection or a toothache? Has she been sleeping enough or possibly too much? Is she having trouble hearing? Has her vision blurred or darkened? Is she taking a new medication? Physical conditions such as these can have a terrible impact on mood and behavior.
David's mother's distrustfulness could reflect distress about a change in her physical or social environment. Has she moved? Has the place where she lives been renovated or rearranged? Is someone she cares about sick? Has someone died? Has there been a change in caregivers? Have eating or other routines changed? Changes in environment or routine can both cause confusion and distress in a person with dementia.
David's mother's anger might be justifiable but aimed at the wrong person. Has something been stolen? Has someone been harsh with her? Has someone hit her? Has she been molested? It may seem a long way from being insulted to becoming convinced that your son has stolen your money, but the mind follows its own path.
Sometimes it is fairly easy to figure out what is going on. Sometimes it may seem impossible. But there is always a reason -- a reason other than, "It's the dementia."
Here are some rules of thumb that may help you when faced with anger.
• Never yell back. A shouting match may succeed in winning a frightened silence, but you will not achieve a change of inner feeling.
• Deal with your own emotions about being distrusted by someone you care for and for whom you are doing your best. It can be very hard to take, but it's probably not something that the person with Alzheimer's can control voluntarily.
• Don't try reasoning ("Mother, you don't keep money in your room.") People with or without dementia who are angry and suspicious are almost never moved by reason and logic.
• If conversation is possible, ask questions about the situation and listen attentively to whatever explanation is given -- sensible or not. You may get a clue to what's going on.
• Avoid disrupting the routines of the person and, if there are changes, get back into the routines as soon as possible.
• If there were only one rule of thumb it would be: Be kind.
I have to compliment Dr. Susan Berg at Dementia Today. She has been running a couple of post series at her site dedicated to dementia. The first was Top ways to enjoy Thanksgiving with those who have dementia (ten parts). The second has been Creativity and dementia which has covered a wide range of creative ideas to share with those close to you who suffer from dementia. This is such an important time for families and in many instances a difficult time to celebrate with those suffering..............read Susan's recent posts on this blog
Activities directors, caregivers, and healthcare professionals,here is some great information Here is a great dementia resource for caregivers and healthcare professinals,
Here is information on being the best caregiver you can be
Veteran’s Day is here. This is a time when we remember all of our fellow man who have served our country.
Many of our veterans are senior citizens.As such their risk of developing or having Alzheimer’s disease or another dementia is greater than the average person. Also engaging in combat and the stress that brings can alsoincrease a person’ chances of developing Alzheimer’s disease or a related dementia.
In addition,many of our veterans were exposed to harmful chemicals.
Any way no matter what the cause of a veteran who has Alzheimer’s disease or another dementia,we should be proud to honot them on Veteran’s Day.
Engage these folks in a meaningful activity on their day.
A jigsawpuzzlecan be defined as an array of differently shaped pieces which, when fitted together, form apictureof some sort. Jigsaw puzzles have been around since the eighteenth century, but they became very popular during the Great Depression because they were an affordable method of entertainment. You can make your ownjigsaw puzzleby following these simple steps:
Step 1-Choose the picture you want to display on your finished puzzle. The picture can be an enlarged photograph or a picture from a calendar, or something similiar. Do not try to use magazine pages as the paper is too thin and it tears too easily. Do not try to use thick posters either as the paper they are printed on is too thick and tends to become fuzzy around the edges.
Step 2- Decide what kind of backing you want for your puzzle. You can use a heavy cardboard backing, foam,or even wood. If you choose to use foam,you will need a large, flat sheet of the material. If you choose to use to use wood for your backing, you will need a thin piece of plywood that is big enough to put the chosen picture on. Note: If you do not have a saw, you can ask someone to cut it out for you. I do not recommend this
Step 3- Next, you will need to mount the picture onto the backing. You can use white glue, but it is not recommended because it it hard to work with. Plus, it takes quite awhile for the glue to dry before you can move onto the next step. Glue sticks are not good to use either because they do not stick as well , and sometimes they tend to come off of the stick in messy globs. Your best bet is a dry mounting spray which is available at your local craft or hobby store.
Step 4- Use the mounting spray by following the manufacturer's directions. Make sure that you mount the picture onto the backing properly. Lay the picture onto the backing perfectly flat with no air bubbles left in between the picture and the backing.
Step 5- Depending on the backing you chose, you will now need to cut the puzzle apart into iregularly-shaped pieces. If you are using cardboard, you may either cut it apart with a utility knife, or, a sharp scissors. It is best for you to do this step. Put the puzzle together to make sure that all of the pieces fit together properly.
Activities directors, other healthcare professionals and caregivers
I love holidays and here we have another opportunity to celebrate one.
I especially love patriotic holidays because most people with dementia identify strongly with patriotism.
Have a program to honor your veteran's. Let those with family members and friends that were veteran's tell about them at this activity
Everyone will feel good. Pass out some sort of certificate to them. Give all who are present some momento as well
As with all patriotic holidays,discuss symbols of patriotism.
I like to have a flag available.
Then I like to ask questions about the flag.
Here are some possible questions
*What color is the flag or are on the flag?
Side question
What other things are:
Red
White and/or
Blue ?
*What shape is the flag?
Side question:
What other things are that shape?
Again if these questions are too hard then………Come back again for the answer and for more ideas
Ask for regular updates from nurses and carers about a parent’s declining health. Digest any changes in behavior, speech, or ability, and modify expectations; help them feel good about themselves.
Keep feelings of guilt at bay. Guilt prevents a person from acknowledging the impact of dementia on the sufferer and accepting the new emerging person.
Visit when you can for their sake. Dementia suffers may be able to recall events less with time, but they continue to respond to human contact and warm touch.
Visit when you can for your sake to see the deterioration first hand. Acknowledge and accept that their ability to manage even simple tasks is declining, and that their mind, body, and language skills are gradually deteriorating.
Ask them to talk about their childhood. Listen without judging or correcting facts. Good memories bring moments of happiness for both elderly parent and adult child.
Invite them to engage in the activity of the day, eg. Watch the Australian Tennis Open on the tv together; listen to orchestral music or sing along with the ‘golden oldies’ on disk; share a meal; or punch a balloon to each other.
Live in the moment. Breath. Laugh. Relax. Take the opportunity to slow down to their pace. Encourage them to interact but be aware of when they are tiring.
Share your feelings with a family member, a friend, or a professional. A problem shared is a problem halved.
One of the best tips for managing your anxiety due to an elderly parent’s dementia is to acknowledge that you may be grieving the loss of your parent as you once knew them. Find ways to feel these feelings of stress, anxiety, depression or malaise mindfully to get through them, and to accept the condition no matter how difficult this is.
In my work with persons with dementia, I have found Jane Verity's 5 Universal Emotional Needs to be an essential framework for good care:
People with dementia often express themselves in uncharacteristic ways such as a burst of anger, accusations or repetitive actions. Traditional approaches deal mainly with the symptoms, which results in no profound changes to the underlying cause ... [Instead there needs to be a focus] on everything that happens below the surface for the person with dementia where we find the true reasons behind their behavior -- the five universal emotional needs ... These needs are universal and do not change. What does change is the opportunity to have these needs met -- especially for people with dementia or anyone else living in an institution where the focus is on tasks and routines rather than on the social and emotional wellbeing of the individual.
The five emotional needs that need to be met are:
1. Preserving the person's power to choose:
This is the most important need to pay attention to in my experience. In every single one of our interactions, we need to stop and change our stance from single decider to "partner in care," always involving the person in the decision-making. This continues to apply throughout the course of the dementia, including during the last stages when the person may no longer be able to clearly think, or verbalize, or move.
Then comes the art of how to facilitate the person's decision-making process. One good rule of thumb is to stick to small, in-the-moment decisions, and to limit the number of options being presented. It is also important to use simple, direct communication. Would you like to get up now or stay in bed a bit longer? Do you prefer a shower or a sponge bath? Is the water temperature too cold or just right? Which shirt do you want, the red or the blue one? Do you want the music on or off? This way the person's mind can follow, and this gives the person a greater sense of mastery.
#2. Boosting the person's self-esteem:
This need is foundational for all the others. While we could all use some self-esteem boosters, for the person living with dementia, that need is even more critical. First, the person's internal experience of themselves as someone whose mind can no longer be trusted, sends messages of inadequacy, low self-worth and shame. Second is the accumulation of negative messages from the outer world, either passively or in more active forms. The person who is placed in an environment that no longer matches their abilities, keeps being confronted with the impossible task of managing even the smallest tasks.
Conversely, environments that strip the person from the opportunity to exert their remaining abilities have a similar detrimental effect on self-esteem. Also tragic are messages to the person that he or she "should know better" or is not trying hard enough. There are many ways that we, the ones with still relatively intact memories, contribute to such chipping away in our friends hearts. This video from Jane drives home the message:
3. Maximizing the person's opportunities to be needed and useful:
Stop for a second and list all your favorite roles in life. For me, it is being a psychotherapist, a dementia care coach, a writer, a trusted friend, a mindfulness teacher, a social media consultant; so much of our life is tied up into our roles and the sense of meaning we derive from them.
Next, imagine all that these roles are taken away from you. Now, it is just you -- being and no longer doing. You get to watch others around you still very much involved, bustling, doing, working, being thanked. And you are no longer contributing to this world in the same way, or at least not much. You may be sitting in a wheelchair or lying in bed, and they are walking by or standing over you. How would you feel? I know for myself it would not be very long before I start feeling depressed.
This is why it is so important to pay attention to this other essential emotional need of the person living with dementia. Because the ability to initiate task is compromised, it becomes our responsibility to jump start the process often. And also, to not ignore the person's attempts to still contribute, in whatever small ways that may be. I witnessed a resident in an assisted living community offering one of the aides to carry her dirty dishes to the kitchen. The aide declined. "No, you don't have to. It's my job." While it was well intentioned, the aide ended up depriving the woman of an opportunity to feel useful.
#4. Giving the person a chance to care for others, not just to be cared for:
The need to nurture and care for another being is part of our human makeup, and maybe even more so for women. This is why the care relationship should always be thought of as a mutual interaction, and not a one-way transaction as in caregiving. In care partnering, I get to receive care from you, and I also get to care for you or other people.
Let her act as a mother still, and suggest things to you such as, "You are going to be cold; you should be wearing a sweater." And thank her for her kindness. Let him who can't sleep well at night help you keep an eye on other residents. Receive a smile from the one who can no longer speak soothing words or move to offer a gentle touch. Join the woman who is rocking her "baby" and shower the inanimate doll with all the love you can give with her. Every day, I witness many such acts of random kindness from persons with various forms of dementia. And each time, I am moved by the beauty of the human heart.
#5. Letting the person know how much you love them, and be open to receiving their love:
I used to be shy about letting my mother how much I loved her. No longer. Now, every time I call her, I end with a simple "we love you" and I know those words are made even more potent by my mother's lack of memory. Those words get deposited in her bank of good feelings, and will make up a bit for some of the imperfections of her assisted living situation.
I have also learned to take in my mother's affection, all of it. And I have noticed how much that makes her happy.
These five universal needs are almost as essential as food and water to a person's well-being. Next time you spend time with a person with dementia, try to honor those needs. And when the person becomes agitated or withdrawn, ask yourself if maybe one of those needs did not get met, and how can you correct the situation?
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