Daily Activities for People With Alzheimer's Disease
As reported in the November 2012 issue of the Caring Right at Home e-newsletter, the majority of Americans with Alzheimer's disease and related conditions are living at home with the support of spouses, adult children and others who step in to serve as caregivers. Is living at home the best environment for these patients? And how do families cope with their loved one's increasing needs?
Alzheimer's caregivers coordinate their loved one's medical care, taking them to doctor's appointments and making sure medications are correctly taken. Yet most of their time together is spent on day-to-day life. And Alzheimer's changes day-to-day life! Many people with Alzheimer's withdraw from life in response to these changes—and family may withdraw right along with them.
Yet sitting idle in front of the TV all day is the last thing people with Alzheimer's should do! Studies show that engaging in appropriate activities helps reduce some of the troubling behavior changes of dementia, such as wandering, sleep problems and depression, and even may be as effective as medication in reducing agitation and aggression. Remaining active, engaged and socialized has been shown to slow the progression of the disease and help the person cope with and adjust to changes in the brain. For all these reasons, planning their loved one's day is as important for family as is managing medical care.
But coordinating their loved one's day is challenging for many family members. They struggle to balance their loved one's needs with their own work and other responsibilities. These families can’t do it alone. For some, a nursing home or other memory care living environment is the best choice for their loved one. Others choose to keep their loved one at home with the support of professional in-home care. In-home caregivers assist with grooming, bathing and other personal care, housekeeping, meal preparation and medication management. Perhaps just as important, in-home caregivers provide companionship throughout the day.
Here are some questions families can discuss with their in-home caregiver as they craft an activities plan to support their loved one's well-being:
What activities has your loved one always enjoyed? Alzheimer's doesn’t have to mean the end of favorite hobbies and pastimes. It is useful for the caregiver to know what things your loved one has always enjoyed. This includes hobbies (such as sports, art, music, dancing or gardening); favorite books and TV programs; favorite ways to exercise; and ways your loved one socialized with others. Don't forget household tasks. The caregiver and client can spend time doing those little things around the house that provide a sense of purpose.
How can activities be modified to fit your loved one's changing abilities? Many favorite pastimes can be adapted for people with memory loss. For example, if a person formerly enjoyed cooking and baking, but now finds it complex and frustrating, the in-home caregiver can divide tasks into manageable steps: measuring ingredients ahead of time, having utensils at the ready, and providing assistance and reminders as needed. Gardeners may enjoy creating a container garden. What about exercise? With the caregiver's company and encouragement, your loved one can safely continue going for walks outside, lifting weights or perhaps exercising to a simple workout video.
What new activities might be enjoyable? Though people with Alzheimer's lose the ability to engage in some activities, many find joy and a sense of self-esteem in new pastimes. Sometimes the disease takes people in new directions. Many who formerly had little interest in art now find it to be a great outlet for self-expression. Music, too, offers powerful emotional benefits and stirs recollection. Far into the later stages of the disease, patients can be touched and comforted by music. The caregiver can play music for your loved one, perhaps from an iPod or other device loaded with your loved one's favorite choices. Books, games and puzzles geared for people with cognitive impairment also are available. As the disease progresses, sensory activities bring comfort—things that can be touched, smelled or held in the hand.
What programs for people with memory loss are available in your area? Many communities offer activities for people with Alzheimer's disease, including memory-support adult day programs, senior center events for people with memory loss, museum or zoo programs, Alzheimer's exercise classes and "Alzheimer's cafés," where people with dementia and their families can socialize in a safe, nonjudgmental environment. Not all these programs offer transportation, and many take place during normal business hours when family most likely are at work. In-home caregivers can provide transportation for clients and stay with them if a companion is required. Professional home care doesn’t only happen at home!
What safety issues should be considered? Families are advised to modify the home with improved lighting, security locks and putting dangerous items out of reach—and it also is important to modify activities as necessary. Cooking is fun, but care should be taken with a hot stove and sharp knives. Art projects should feature safe materials and tools. Alzheimer’s patients who wander or get lost on walks should be accompanied. During all activities, an in-home caregiver can provide gentle supervision while preserving the client’s sense of autonomy, dignity and self-esteem.
What happens as the disease progresses? People move through the disease on their own individual path. Family and professional caregivers should be alert to signs that a particular activity is causing frustration. If your loved one is no longer enjoying an activity, it is time to make some modifications or try something else. Know your loved one's daily rhythms. Is there a time of day when he or she is prone to agitation? Are noise and distractions causing sensory overload? Plan for more quiet time. Your loved one may enjoy restful conversation and reminiscing with the caregiver, perhaps looking at photo albums or having the caregiver read aloud. Even for people who are losing the ability to speak, a sense of love and connection comes from sharing time with others.
The Alzheimer's Association Enhancing Daily Life Web page includes suggestions for modified activities.
The National Institute on Aging offers tips on adapting activities for people with Alzheimer's disease and instructions on home safety concerns.
Read an article about the Alzheimer's café movement in the New York Times.