Why activity matters for people with dementia
An activity can be anything we do from the moment we get up in the morning to when we go to bed at night, for example, 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. Many dementia care specialists prefer the concept of ‘being occupied’ which is something that all human beings need at some point in their day – even if it involves something relaxing like lying in a bath!
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 to bring activity into all parts of the day.
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.’
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.
Why activity matters
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
- the potential for urinary infection increases
- gastro-intestinal movement decreases and constipation increases
- decreased alertness and concentration
- increased irritability and 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.
A sense of purpose
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 anymore.
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?
For more on these ideas, you might like to look at the section on Getting to know the person with dementia.
Forcing the issue?
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.
Access and download additional resources
Further reading Open
Counsel and Care (2007) 'Not only bingo: A study of good practice in providing recreation and leisure activities for older people in residential and nursing homes', London: Counsel and Care.
Hurtley, R. and Wenborn, J. (2005) 'The successful activity co-ordinator: a learning resource for activity and care staff engaged in developing an active care home', London: Age Concern Books.
Knocker, S. (2013) 'Taking part: Activities for people with dementia', London: Alzheimer’s Society. Originally published in 2002 as The Alzheimer’s Society book of activities.
National Association for Providers of Activities for Older People, ‘Why activities are important’, London: NAPA.
Perrin, T. (2005) 'The new culture of therapeutic activity with older people', London: Speechmark Publishing.
Useful links Open
The Alzheimer’s Society produces over 80 factsheets on all sorts of topics related to dementia, including Staying involved and active (505), Exercise and physical activity (529), and Mobility strategies. The Society’s website also includes Dementia Connect, a webpage for searching for information about local services and support groups for people with dementia and carers.
Arts 4 Dementia
This charity works with arts organisations around the UK to develop opportunities for people with dementia and their carers to participate in a wide range of arts activities. Arts 4 Dementia offers training for arts facilitators, advice, online resources and seminars.
As easy as ABC: Care UK’s top 100 hints and tips for activity-based care
Care UK’s activity teams share what they have found to be helpful when supporting people with dementia in everyday activities, arts and crafts, maintaining independence, special occasions, health and wellbeing, and reminiscence.
Living well through activity in care homes
This free online resource from the College of Occupational Therapists sets out a wide range of practical ideas on how to support care home residents to continue day-to-day activities that are important to them. The resource includes free training materials and audit tools to review and evidence aspects of care such as personalisation and choice.
Using technology to support people with dementia
Technology has so much to offer people living with dementia and their carers; access to information, advice and entertainment as well as reassurance for a carer who does not live near a loved one. Used sensitively and thoughtfully, technology enhances rather than replaces human relationships and interactions.
Related pages from this section Open