Dementia Gateway: Keeping active and occupied

Why activity matters

What would life be like if there was nothing to look forward to in the day or nobody needed us for anything?

Explore the links below now to read more about this topic:

• 1. Introduction Open

  An activity can be anything we do from the moment we get up in the morning to when we go to bed at night – personal care tasks, eating a meal and spending time with others.

  Many care staff think that activities are not a part of their role – they think the word 'activities' means running a group or organising an outing. However, if we accept that everything a person does in a day is an activity, then all staff have a part to play.

  The most important thing we have to give people with dementia is our time and our attention – if we remember this, we can then help bring activity into all parts of the day.

• 2. Valuing conversation Open

  Sitting down and having a chat with someone while they enjoy a cup of tea is as important as the practical tasks you will do in the day. Many older people really miss conversation, and care staff may struggle to meet this need if they are in a rush and thinking about their next job.

  Even for people with dementia who have difficulty with verbal language, it is important to keep talking normally, whether it is to explain something you are doing or to say something about what is going on that day. For example, 'Mary, would it be alright if I take off your shoes now?', or 'Thank goodness the sun is shining at last. I hope it will be bright for the summer fete this weekend.'

• 3. Valuing observation Open

  Turning a person's chair towards a window can provide many opportunities to watch things such as the changing light of the day, trees and birds in the garden, people or cars going past.

  As a care worker, think about the things you could do in front of the person to give them something interesting to watch, for example folding sheets or pouring tea. It might be easier and quicker to do these things in another room, but you will have missed an important opportunity for the person or people with dementia to enjoy watching you at work and therefore feel involved.

• 4. Why activity matters Open

  Below are some of the physical and psychological changes that can happen if a person remains inactive for long periods of time:

  • muscle strength reduces and joints develop contractures
  • potential for urinary infection increases
  • gastro-intestinal movement decreases and constipation increases
  • decreased alertness and concentration
  • increased irritability
  • depression.

  Supporting a person with dementia to remain active is not just about 'a bit of fun' or an added extra – it is essential to their health and wellbeing.

• 5. A sense of purpose Open

  What would life be like if there was nothing to look forward to in the day or nobody needed us for anything? Many people with dementia have led busy lives. The day can seem very long when there are no jobs to be done and no one depends on us for anything any more.

  By asking someone to participate in an activity, however small, such as helping us to fold a sheet or dry the dishes, we are saying something important: 'You are a person with a purpose. I value your help.' The more we take over all the tasks, the more the person is likely to withdraw and feel that they are not valued.

  Think about these questions:

  • As a staff member am I taking over and doing too much?
  • What aspects could a person do for themselves, for example putting sugar in their own tea, washing their face with a flannel or going to the shop to buy a newspaper?
  • Can I make a personal care activity more pleasurable, for example by singing in the bathroom or looking out of the window and talking about the view or the weather?

• 6. Forcing the issue? Open

  Dementia can affect a person's motivation and their ability to initiate an activity. A person might also say 'No' to everything that is offered because it feels safer not to get involved in what is going on. Many people with dementia also experience depression – this also can reduce a person's confidence in getting involved in activities.

  When thinking about how you ask someone to join in a particular activity, think carefully about how you approach this. If you just ask the person whether they would like to come to the exercise session, garden centre or whatever is on offer, they are more likely to say 'No' as they have been given this option when you say 'Would you like to…'

  However, if you make it into an invitation, it can make the person feel more valued and special: 'Margaret, I have come to invite you to… I would like you to be my guest…'

  It is also worth thinking about who asks the person and possibly how they do this. One person with dementia might respond better to a female member of staff, while another might respond more positively if you offer an incentive for coming, such as a cup of tea or a glass of wine.

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