Don’t forego interaction: Six tips to keeping dementia patients engaged

Jun 14, 2020
A dementia expert has provided tips on how to engage with dementia patients as their condition progresses. Source: Getty

A person living beyond a diagnosis of dementia doesn’t have to give up the activities that they love. Instead, many activities can be adapted to the person’s ability to help them flourish through their journey and keep them connected with family and friends.

There are many benefits to this purposeful and meaningful engagement, such as helping to reduce unmet needs like agitation, distress, under stimulation and aggression. It also allows a person to feel relevant and valued, reminds them of things they used to enjoy doing, takes them back to a time where they felt joy and pleasure and allows them to experience cherished moments throughout their day.

But, how can you implement this engagement after your loved one has been diagnosed with dementia? And what needs to be done when you notice their condition is declining?

Choose purposeful and meaningful activities

You may notice in the early stages of dementia that the person may withdraw from things they previously found purposeful, like reading books, meeting up with friends or going for walks. However, having an open discussion around any concerns and making slight adjustments can make a huge difference.

For example, a large social gathering may be overwhelming, but the person may be able to interact better in a smaller group. Walking is a good option – it has more benefits than just the exercise. You can turn it into a social interaction by arranging walks with one other family member or a friend.

You could also explore activities that used to be meaningful when they were younger, such as painting or gardening. Meanwhile, books can be tricky, because if the person is living with short-term memory loss, they may not be able to remember the story line, and so they may lose interest in what they’re reading. Instead, you could try shorter stories. However, be aware that reading and comprehension can be a challenge for those with dementia.

Overall, it’s important to remain curious about what a person can still do, adapt, adjust and celebrate the moment. However, as the disease progresses, you may want to introduce more repetitive tasks to keep them engaged.

Relate activities to work life

A former office worker might enjoy activities that involve organising, like sorting documents or mail, or making a to-do list. Meanwhile, a former gardener may take pleasure in working in the garden. Or an accountant that kept a diary and loved structure may like to continue writing things down, having checklists and using similar strategies that they used in their work life through their dementia journey.

Keep the person’s skills and abilities in mind

At times, families may focus on the person’s inability and the things they’re no longer able to do. From my experience, when I meet families they share with me all the things their loved one can’t do anymore, but often, they’re not able to share with me how they adapted or changed the activities so that their loved one can continue to engage.

For example, families will often share that friends have disappeared or no longer contact their loved one living with dementia. This is understandable as socialising with a group of friends can become challenging when multiple conversations are going on in a noisy coffee shop or other busy surrounding.

However, the person living with dementia needs to remain social – it’s important to who they are. So, adapting that activity to a smaller group of people, or even a one-on-one interaction in a quieter coffee shop or grabbing a take away coffee and going to sit in the park can lead to successful social engagement, which doesn’t compromise or change the person living with dementia.

Don’t focus on the outcome, celebrate the process

You should consider if your loved one begins activities without direction and if they initiate discussion. For a person living with dementia, initiating a conversation or an activity can be challenging, however, once supported to start an activity or conversation, they can stay in the moment, engaged and involved.

It’s up to the person engaging them to know when they have reached their limit and when it’s time to move on to the next activity. This moment may differ from day to day, and sometimes hour to hour.

For example, before a meal is a great opportunity to prompt your loved one by saying “are you able to help me set the table?” and then hand them the cutlery. By handing them the cutlery, you’re helping to initiate the activity and then they’ll be able to continue the activity on their own. Try not to focus on the detail of the end result, whether the knives and forks are in the right place, but rather focus on the ability to break down the task and feel relevant and purposeful.

Be aware of physical limitations

Does he or she get tired quickly or have difficulty seeing, hearing or performing simple movements? As a person’s journey progresses with dementia, their brain changes. There will be changes to their sight and hearing, but in a different way. They may see a pen, but forget that it’s used for writing. You may ask them a question, but their answer doesn’t relate to that question. The changes are not necessarily related a deterioration in their vision or hearing, but rather processing and understanding what it is they’re seeing and hearing.

Consider the time of day

 Caregivers may find that they have more success with certain activities at specific times of day, for example, concentration may be better in the morning. At Group Homes Australia, the mornings in our homes are often filled with high energy activities and a buzz throughout the home, like going for walks, gardening, baking and going out to coffee shops.

Whereas the afternoons are a time where we might watch a movie, listen to music, cook dinner, and get a nice hand and head. The purpose of the difference of high energy activities in the morning and low energy activities in the afternoon allows for the residents to exert energy in the morning and start winding down towards the evening. Having had a full day of different types of stimulation helps the residents to feel fulfilled and ready for a full night sleep.

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