The Importance of
Meaningful Activity
for those with Dementia
Presented By:
Jennifer Jacobsen, OTR/L
Martha K. Sawyer, OTR/L
All people have a need for activity
Does that change with dementia?
Objectives
1) Understand the need for activity continues.
All persons need a balance of rest and activity.
2) Recognize importance of structure in the lives
of persons with dementia.
3) Understand considerations in determining
appropriate activities for persons with
dementia.
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Let’
Let’s make sure we’
we’re all
on the same page.
What comes to mind when you
think of the word
Dementia??
Definition of Dementia
• A group of symptoms
• Difficulty managing personal affairs (i.e.
finances, making decisions, organizing house,
job, responsibilities, and day); often the 1st
sign but not recognized
• Memory loss
• Inability to complete quality cares in a timely
manner (i,.e. dressing, grooming, meals, etc.)
Those with dementia begin
to have increasing difficulties with
Cognition
A set of skills that work in conjunction with
each other allowing us to think.
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Frustration
Tolerence
Memory
Orientation
Goal-Directed
Sequencing
Initiation
Attention
Span
Judgment
ProblemSolving
Problem
Recognition
We may notice changes by:
• Increased isolating, not wanting to leave their
apartment or room.
• Not attending group functions in the community (i.e.
Bridge Club, church, etc.)
• More anxiety/agitation with group functions or activity
• Increased sleeping during day.
• Watching lots of TV during the day.
• Sitting and doing nothing.
Those with dementia lose the ability to
plan, initiate, and complete activities
on their own, therefore they need
caregivers to plan and execute
activities.
We need to provide:
STRUCTURE
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How does structure look?
• A consistent daily schedule created by an
outside source
• Need a balance between activity and rest
• A delicate balance between stimulation and
over stimulation
What is important in a schedule?
• Routine/consistency
• Same activities at same time
• Same routine 7 days a week
• Same procedure for activities
• Variety is more for caregivers
WHY IS STRUCTURE
IMPORTANT?
• No longer able to plan and execute
tasks.
• Brings order to chaos
• Predictable and reliable
• Helps decrease behaviors
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How to choose activities:
Past History and Interests
+
Current Abilities
Past History & Interests
• Get to know your
patient/resident/client.
• Ask family/friends for information.
• Realize that as abilities change so can
interests. Paradigm shift in what is
purposeful.
Purposeful activity:
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Determining current abilities:
• Get to know your resident/client
• Assessment
• Trial
Occupational Therapists
are skilled in this!
What to Measure in Assessment
• Initiation
• Attention Span
• Number of Steps
• Sequencing
• GoalGoal- direction
• Frustration tolerance
The Allen’s Cognitive Levels
are one method to look at
these skills.
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The Allen’
Allen’s Cognitive Levels
• Developed by an OT named Claudia Allen in the
1970’
1970’s.
• Originally developed for clients with mental illness. In
the last 1515-20 years has been utilized with those who
have dementia.
• Assumes dementia residents function a different levels.
• The levels are a scale of 11-6; where 1 = severe cognitive
impairment and 6 = normal cognitive functioning.
Dementia is Measured in Stages
Early
Middle
Late
At different stages of dementia
activities may look different.
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Early Stage Dementia:
Tasks with a clear purpose
•
•
•
•
•
Reading and writing
OpenOpen-ended conversation
Imagining, able to think more abstractly
Attention span of 45 min. – 1 hr.
Tasks with 44-5 steps
Early Middle Stage Dementia:
Simple tasks with a clear ending
• Some talking, but mostly focused on doing
• Tasks with no more than 4 steps and
30 – 45 minutes in length
• Objects important
• Concrete, clear ending
Middle Stage Dementia:
Familiar tasks
• Tasks with 22-3 steps and 2020-30 minutes in length
• Less able to talk and do
• Needs step by step directions. Must stay with
the person.
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Late Middle Stage Dementia:
Repetitive use of objects
• Tasks with 11-2 steps
• Attention span of 1515-20 minutes
• May begin to misuse objects and requires
constant supervision
Late Stage Dementia:
Sensory
• 5 Senses
– Touch, taste, smell, feel, hear
• Object focused
• 1 step interactions
• 5-10 minute attention span
Meet Mr. S
• Past History and Interests
– John Deere collector, construction worker
• Behavior
– Rummaging through cupboards and drawers
– Going room to room
• Current Abilities
– Difficulty comprehending and expressing
himself
– Difficulty with initiating activities
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Hints for successful activities:
• Environment should be calm
• Caregiver should be present with energy
• Present information in a clear and respectful
manner
• Activities should be concrete
• Success may be different for each person
We can and we should incorporate
meaningful and purposeful activity
into the lives of those with dementia.
Thank You!
[email protected]
[email protected]
www.emeraldcrest.net
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