Our current reality – of Covid-19 related lockdown and social distancing – can be hard and anxiety-inducing for anyone, but carers of dementia patients face considerable additional stresses. Confined to their homes, carers must manage the experience of lockdown and a global pandemic for both themselves and the person living with dementia who may be confused and/or emotionally turbulent.
Claudia Andrews is an Occupational Therapist for Livewell. She is hands-on daily with the residents across a range of abilities and stages of Alzheimer’s Disease and other types of dementia. Plus, a significant part of her job is devising and supervising dementia care therapies for her patients.
“The recommendation is to do cognitive stimulation activities for 45 minutes, twice a day. But I believe it is important that you are patient-led in this. If they are only up to dementia care therapies in short bursts, work with that,” she says. “The truth is that even five to 10 minutes a few times a day can be helpful.”
Andrews knows the struggles carers (professional or not) must tackle, and she’s dug deep into her box of tricks to provide a list of 10 categories of dementia care therapies (with added examples) to keep everyone calmer and distracted while providing cognitive stimulation with only what you have around you right now.
“My general guidelines are to look for dementia care therapies/activities that the person already has an interest in. Were they an accountant before? Or a housewife? Were they keen painters or gardeners? You want to prioritise activities that allow them to express themselves. And ideally, ones where you can also foster an emotional connection with them.”
Andrews says most dementia care therapies can be scaled up or down to meet their abilities, “and incorporating a sensory component is important”. In the kitchen, for example, you can have them assist in baking, or to enjoy the sounds and smells associated with baking. In the garden, high functioning patients may be able to garden with you with minimal supervision all day, or they might only be up to taking in the sensations of the garden – the feel of grass underfoot, the warmth of sunshine.
10 dementia care therapies by Claudia
1. Painting and crafting
Use what you have in the home, anything from actual paints and brushes to finger painting, food colouring (remember tie-dying?!), crayons, pencils, chalk, charcoal, and so on. Make a basic stamp out of half a potato, and use it to stamp patterns on paper or card.
2. Packing and sorting
Your cupboards are probably full of things of different textures and colours. You can ask them to sort clothes by colour or type, or together enjoy the feel of wool, satin, and cotton. Let them get stuck into the Tupperware or utensils drawer. Having an activity with a specific end can give patients a sense of purpose. Socks and coins are handy things for sorting too. “If they go into the cupboards and start unpacking, try not to get annoyed about them ‘messing up your system’,” cautions Andrews. “Rather go with it; It is what they need right now.” And you can always straighten up later, but don’t put yourself under pressure to have it perfect. This is a time to be gentle with yourself as much as the loved one under your care.
3. A treat meal
Putting together and then sitting down to enjoy a high tea is a fun activity for you and the person with dementia. It involves activities that can be broken down into smaller parts and tackled according to time, concentration or ability. For example, mixing the batter for the cupcakes or setting the table with an old familiar tea set. And when it is all prepped, eating the snacks provides an opportunity for describing what you taste or smell, or perhaps what memories the taste of strawberry jam, for example, conjures up.
4. Cook up something scrumptious
As mentioned above, baking simple cakes or cookies can be a fun activity to do together – with lots of sensory engagement along the way, and bonus “pay off” at the end – the delicious food you have put together. When working in the kitchen be sure to let the person with dementia help with safe tasks and avoid chopping with sharp knives or taking things out of hot ovens, rather complete these tasks yourself.
5. Go outdoors
If you are lucky enough to have an outside space within your property, make the most of it. Sit in the garden, in the shade or sun as preferred. Re-pot some plants, or transfer from pot to ground. The seasons are turning and there will be plenty of leaves to rake up. What feels like a simple “chore” can provide something to focus on while engaging spatial awareness and stimulating the senses. If you have a balcony, veranda, or even larger windows, sit by them, enjoy the breeze, talk about what you see and hear.
6. Get digital
Many of those living with dementia struggle with modern technology, but if you can take the lead, there are so many fantastic distractions online. Andrews says several of her patients love to “armchair travel” through YouTube or other videos. Be transported by a 3D tour of the Colosseum in Rome, or a video of sightings in the Kruger Park This is particularly engaging for patients who enjoyed local and international travel before they were diagnosed. It can conjure up memories of places they have been, or times in their lives.
7. TV is not the enemy
Of course, we don’t want to encourage sticking someone in front of the TV endlessly, but a nature documentary or well-loved film can be absorbing and exciting. It might also just give carers a few much needed minutes to pop off to the loo, or decompress for a moment. Andrews describes how this can be expanded into further cognitive stimulation, by reading up on a place or topic together after watching.
8. Repetitive processes
Even the simplest of tasks, using repetitive motion, provide stimulation – such as stringing beads or macaroni on yarn, fishing wire or string. Folding boxes, or if they’re up to it, simple origami.
9. Listen to music
Andrews says that she has found that many Livewell residents find an emotional connection in music. You can stream these online, or play CDs and records if you still have the appropriate sound system. There are even websites that will play popular music from a specific year. This will get toes tapping, and stir up memories (more on that in point 10).
10. Tap into nostalgia
Do you have a family photo album, or a drawer full of old greetings cards? Reminiscing about an earlier time is often a great source of joy for dementia sufferers. Many patients remember the faraway past in more detail than recent events. Together, prompted by the photos, you can tell family stories. If they remember the time differently, just go with it.
Some last words of advice for the carer
Andrews says that caregivers must be cautious in applying their own opinions about what is a “worthy” activity. We don’t want to condescend to a patient, but at certain stages of dementia, simplistic (or what we might consider childish) dementia care therapies can be enjoyable and consuming. “That would include threading pasta on strings, playing with a doll, or colouring in,” Andrews explains. The same goes for repeating activities; you don’t have to think of new ones every day or week.
And she adds: “If they initiate an activity, and we’re feeling stressed, often we try to redirect them to doing something we want to do, but I think it is important that we take that moment, and engage with that activity.”
With all of these, the end result doesn’t have to be pretty or perfect. Rather look to creating an experience for your loved one – and for you. One of the most important things right now is to lessen stress and anxiety, so you can both cope with this tough time.”