Activity resources and approaches for dementia

A number of different approaches within dementia care offer helpful ways to develop meaningful activity and improve quality of life for people with dementia.

Some depend on using a particular practical resource, some emphasise skilful assessment before planning activities. Others promote a programme, philosophy or therapeutic intervention.

In this feature, we’ll look at some examples of each.

Practical activity ideas and resources

If you are keen to provide more of a range of activities to people with dementia, find out what resources are out there to purchase, such as reminiscence books, games, quizzes, sensory items and so on.

At the end of this feature, you can see a list of companies and organisations that produce catalogues of products and resources that could inspire you.

You might also be keen for a ‘recipe book’ style of activity book that guides you through specific activity ideas (see ‘Further reading and resources’ below). However, remember that you don’t necessarily have to spend a lot of money to find things which stimulate an activity. Some things – such as hats, kitchen equipment, old coins, postcards or old calendars with large photographs – can be found at home or purchased from charity shops.

The Best Friends approach was developed in the mid-1990s by Virginia Bell and David Troxel in the United States. Simply put, the model suggests that what a person with dementia needs most of all is a friend, a ‘Best Friend’.

This can be a family member, friend or staff member who empathises with their situation, remains loving and positive and is dedicated to helping the person feel safe, secure and valued. You can download two documents (‘A best friends approach to activities’ and ‘Thirty (more) things to do in thirty seconds or less’) that summarise the philosophy in relation to activities and offer practical ideas.

The Spark of Life Club is an approach developed in Australia which is designed to improve the social, emotional and spiritual wellbeing of people with dementia.

Membership of the club gives access to a range of practical resources and publications.

The focus of the approach is on providing meaningful activities that don’t have to be structured but do need to stimulate the senses, encourage participation, boost self-esteem and fulfil one or all of the five universal emotional needs.

Assessment tools

To be successful, an activity has to match the personal interests of an individual and be pitched at the ‘just right’ level of challenge: too easy and it may be boring, too difficult and it will be frustrating.

Simple assessment tools can help staff to understand the types of activities that might benefit a person with dementia. Two of the best-known examples are the Pool Activity Level (PAL) Instrument (Pool, 2007) and the Cardiff Lifestyle Improvement Profile for People in Extended Residential Care (CLIPPER) (Powell, 2007).

The PAL Instrument is a set of tools for activity providers developed by Jackie Pool, an occupational therapist specialising in dementia care. PAL asks users to develop a profile of a person’s interests and likes and dislikes and complete a simple checklist that reveals the level of ability of an individual. This information can then be used by activity providers to plan how to present activities to the person at the ‘just right’ level.

The CLIPPER assessment tool was developed by Jennie Powell (2007). It considers 41 activities that could occur during a typical day. Caregivers note which activities occur, how often, and how the person seems to feel about each activity.

This provides a unique profile of an individual’s likes and dislikes. A care plan can then be carefully tailored to create the best possible quality of life for that individual. CLIPPER is published within Jennie Powell’s 2007 book, Care to communicate (see ‘Further reading and resources’ below).

A programme approach

Cognitive stimulation therapy, or CST, involves 14 sessions of themed activities which run over a seven-week period. Sessions aim to actively stimulate and engage people with dementia, while providing a positive learning environment and the social benefits of a group. CST groups can be led by anyone working with people with dementia, such as care workers, occupational therapists or nurses, and can take place in settings including care homes, hospitals or day centres.

Practitioners can learn to provide CST for people with dementia by following the CST manual by Spector et al (2006) or attending CST training (see www.cstdementia.com).

An emphasis on philosophy

The Eden Alternative is based on the belief that growing old is a natural part of life, not a period of decline. It teaches how to combat loneliness, helplessness and boredom: the three things that cause so much suffering for older people. Creating a positive, vibrant atmosphere where things are happening – for example, children from a local school are visiting, animals are being cared for by care home residents – helps to put meaning back into people’s lives. It also allows care staff to be creative and enjoy their work more.

The three steps to introducing the philosophy into a care setting are vision, education and implementation. The Eden Alternative UK offers education, national and in-house training and supports staff teams to achieve these steps.

A therapeutic approach

While individuals may have different views on the use of dolls and children’s toys with people with dementia, it is now widely recognised that dolls can offer a very powerful therapeutic benefit if used at the right time and in the right way.

Contact with a doll or a soft toy fulfils the human needs for comfort and attachment and provides a focus for the person to be able to nurture and protect something else. There are also many reported benefits of enhanced communication between a person with dementia and staff members through the introduction of a doll.

However, it is not uncommon to find relatives, other older people, managers and staff members resistant to the idea of using dolls, because they think it seems patronising or demeaning in some way for the person, or they are worried about outside visitors’ reactions.

There are a number of articles and studies in this area which can be helpful if you are finding some resistance in your care setting. These can help you to explain the benefits and ensure that you are approaching the issue sensitively (see James et al, 2006 and Mackenzie et al, 2006).

Get to know NAPA

The National Association for Providers of Activities for Older People (NAPA) is a membership charity that promotes the importance of activity for all older people. It offers members regular bulletins full of practical activity ideas including quizzes, discussion topics and art activities.

Membership of NAPA also offers valuable discounts on activity products from some key catalogues. Getting involved with NAPA can offer anyone with an interest in improving activities the support, encouragement and training they need to keep going.

NAPA runs an NCFE distance learning course – Intermediate Certificate in Provision of Activities in a Care Setting – and also offers open and in-house courses on a range of topics, including massage and seated exercise. Other further education colleges also offer the NCFE course.

Contact NAPA on 020 7078 9375 for more information about becoming a member.

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