By Sylvia Gaspar
When working with people with dementia, the starting point is to recognise the need to meet the person with dementia at the point where they are in their state of awareness and functioning.
Activity is about interaction between people or between a person and their environment. We are told that communication is only in the region of 10% words, therefore 90% is composed of non-verbal stimuli. We know that the person with dementia is losing their ability to use words; the brain function needed to access vocabulary and to form sentences is being lost, though not so the mechanics of speech making until much later. In these early stages, especially what is needed is space and time to do the best they can, accompanied by a patient, listening ear.
As the use of language deteriorates further, the importance of non-verbal communication increases. Body language, facial expression and touch take on greater significance and need to be consciously applied.
Dementia has been described as a return journey through the stages of human development, the independence and functional capacity of mature years diminishing over the course of the condition to early developmental levels. This provides a framework on which to base the choice of activities, although we should avoid therefore assuming a person has ‘returned to childhood,’ which might negate the person’s long adult life story.
As the learned social skills are lost, the person with dementia responds increasingly to more immediate and physically interactive occupations. The bean bag throw, the floor target, the skittles, the bowling, are all very visual, physical and stimulating. A limited concentration span is not over challenged and, if the session is carried out in the right spirit of encouragement and celebration of any success then there is fun to be enjoyed. It is part of the activity organiser’s task to create the ‘atmosphere’ which is stimulating and releasing.
Activities which involve touch, smells, sounds and sight are also important, such as the smells of foods, gardening, whether inside or out, providing opportunities for the feel and smell of damp earth, the texture of soil or the smells of flowers and leaves.
Creativity is also important. The easily prepared fruit salad is creative, as well as stimulating, the flower arrangement makes the room more pleasant for others, the bedding plants outside the window provide new and added colour. Other fail-safe crafts can be offered such as clay or salt dough, painting, stencilling or simple needle work.
Exercise for the body is always essential and going for a walk should feature on care plans more often. The walk to the shops for a few items for the kitchen perhaps, or fresh toiletries, or a walk around the garden is an activity with many benefits. Whilst physically beneficial, people with dementia will also benefit from the stimulation of the change of environment, colours, shapes and smells, the memory triggers of previous.
Everyday domestic tasks such as washing up, dusting, folding laundry, sorting socks and laying tables can also help as in a residential setting there will be some who respond and benefit from being included in the ‘running’ of the home.
The needs of the person with dementia reach beyond making allowances for the physical limitations. To provide an activity programme for people with dementia, the activity organiser must address the inner person; the psychological and the emotional elements of this vulnerable group.
The National Association for Providers of Activities for Older People (NAPA) has more information about activities for people with dementia, or older people in general. Further information on dementia is also available from Dementia UK and the Alzheimer’s Society.
