Dorothy Conway, CTRSJames L. West Alzheimer’s Center

Fort Worth, TX

Objectives for sessionBe able to define “meaningful activity.”To identify the therapeutic value of an activity.To identify the criteria for creating success in activity

participation.To identify the four qualities or domains of an activity.List possible appropriate activities for various levels

of dementia.Explain how a variety of staff members can assist in

providing activities.Design a meaningful activity from a simple object and

apply to the four domains based on the functional level of the participant.

“The purpose of life is a life of purpose.” - Robert Byrne

“Purpose serves as principle around which to organize our lives.”

- author unknown

What is meaningful to a person with dementia?Get to know the persons background –

previous interest, career, hobbies. Determine the person’s abilities – what are

they able to do?Be prepared to adapt and adjust.“Meaningful activity” means different things

for different people.

Groups with PurposeTeachers love to interact with students.

Groups with PurposeGardeners like to garden.

Groups with PurposeWoodworkers still like to tinker.

Defining point of meaningful activityMakes the person an

active participant, not an attendee.

The Four Qualities of an ActivityCognitivePhysicalPsychosocialSpiritual

Cognitive qualities of an activity:Enhances memoryEncourages verbalizationFosters abilities to make choicesEncourages sequencing of thought process

Physical qualities of an activity:Promotes well beingPhysical fitnessImprove balancePromotes normal sleep patternsAn outlet for stress and anxiety

Psychosocial qualities of an activity:Provides a sense of belongingProvides feelings of accomplishmentFosters dignity and self-esteemProvides a way to express feelingsProvides a method to distract/change moodProvides feelings of security

Spiritual qualities of an activity:Opportunities to have personal faith journey

upheldOpportunities to be part of a faith communityOpportunities for sacredness in daily living

Practice in finding the qualitiesAttending Chapel Cooking Club

Exercise Group Valentine’s Party

Life is an activity!Common objects and items found in a typical

household can become an opportunity for a therapeutic activity.

Example: flag

*Hands on practice in finding the qualities of an activity in common objects*

Now you know the “Who” and the “What” – How?Understanding who the residents are both past

and present, and knowing the qualities of an activity, you can then focus on enabling the resident’s abilities in a successful way.

For an activity to be successful, consider the following:Modification – the more impaired the person, the simpler

the activity should be. Attention span shortens as the disease progresses.Repetitiveness – does not mean boring! Often the routine, familiar tasks learned in the past, can be meaningful and successful.

Multisensory Cueing – using cues that involve several of the senses (visual, auditory, and touch more effective than visual and auditory only). Emphasis sensory abilities that are still intact.Cultural – is it relevant to the persons past value systems, morals, and life situations? Design activities around the interests of the participants.

Approach and Communication – demonstrate what to do and use appropriate encouragement. Try to group participants with similar functional levels.

Determining the Therapeutic Value in an ActivityWhat is your goal for a particular resident?

Will the outcome be reached in having this participant take part in this certain program?

The therapeutic value of an activity is changeable based on the participants responses, abilities, etc.

Examples of activities and their therapeutic values

Providing Activities by Cognitive Levels:Ideas to promote meaningful and therapeutic

activity based on stages of dementia: Early stage Middle stage Late stage

Early Stage: GDS Stage 4 & 5Games (continues to recognize the concept,

may need cues to go to the next step etc.)Cooking Activities PuzzlesAssisting duties (delivering mail, stuffing

envelopes…)Setting the tableSorting and matchingSmall group discussions (continues to

recognize the group process)

…Late Stage 5 and Early 6Continue to enjoy and function in the same

activity pursuits, but need additional, frequent cuing to be successful.

Changes in vision (depth perception and peripheral vision) may affect participation.

Stage 6Gross motor games (may hit or kick at a

target)Folding laundryMusic programs (with singing, clapping,

swaying)CookingHousehold chores (dusting, washing tables,

stirring)Simple crafts (sanding, coloring)Encourage conversation with scrapbooks, life

story books, photos

Stage 7Tactile stimulation (hand massage, feeling

differing textures…)MusicMay play catch but will not be able to throw

backReminiscing and validating the person

Dorothy Conway, CTRSJames L. West Alzheimer's Center

1111 Summit Ave.Fort Worth, TX 76102

dconway@jameslwest.org