13: Activity-Focused Dementia Care: Meaningful Activities

This program will help you:

• Define activity-focused dementia care
• Understand daily activities as personally meaningful occupation
• Identify opportunities for using meaningful activities during the day
• Discuss different types of meaningful activities

• There are no easy answer when its comes to the care of another
• Our hope is to offer you useful information and guidelines for caring for someone with dementia
• These guidelines will need to be adjusted to suit your own individual needs

Activity-focused dementia care

• Incorporates meaningful activities into daily life
• Includes any kind of activity that is meaningful to the person

Person-centered care

• Focuses on individual needs and wants
• Considers personal preferences, habits and routines

Abilities-focused care

• Identify and encourage use of retained skills and capacities
• Compensates for dementia-related problems and limitations
• Allows for successes at the person’s level of ability

MEMBERS OF THE CARE TEAM

• All members of the care team should provide activity-focused care
• There are many members in a care team
• At home
• Family members, friends, healthcare providers, home health providers, assistants, and volunteers
• Long-term care facility
• Activities directors, social workers, administrators, medical and nursing directors, certified nursing assistants, nurses, physicians, therapists, activities specialists, volunteers, and involved family members
• Family members know and understand the person
• Physicians

• Occupational therapists
• Speech and language pathologists
• Recreational, music, art and other activity therapists
• Dieticians
• Administrators of nursing homes

Occupation: all of the major ways in which people meaningfully occupy their time Meaningful activities

• Have a purpose
• Are socially and age-appropriate
• Are voluntary
• Are pleasurable
• Support interest and engagement
• Meet a person’s wants and needs

Why do you think Robert wants to walk outside at night?

• A. Robert enjoys walking.
• B. Robert likes spending time alone.
• C. Walking in nature after dinner has been part of Robert’s evening routine for years.
• D. Walking is one way Robert can get exercise and relax.
• E. All of the above.

Choice E: All of the above, is the best answer.

• The purpose of this example is to convey why even a simple activity such as walking outside after dinner can make a difference in the day of those with dementia and their caregivers
• When a person with dementia wants to do something, it is important to try to understand all of the reasons why that activity is meaningful to her/him
• It is the caregiver’s responsibility to balance this need with the person’s safety

• Activities of daily living
• Productive activities
• Leisure and social activities
• Spiritual activities

Activities that people carry out every day as part of their established daily routines

• Basic activities of daily living (BADL)
• Instrumental activities of daily living (IADL)

Basic Activities of Daily Life (BADLs)

• Self care needs
• Highly repetitive, routine, over-learned and performed automatically
• Combing one’s hair
• Shaving
• Brushing one’s teeth
• Dressing

• Directed outward toward our living environments
• Include caring for our homes and other people
  • Stir ingredients or peel potatoes
  • Sorting change
  • Raking leaves
  • Sweeping the floor
  • Wiping the table
  • Drying dishes
  • Folding towels

• Give people a sense of usefulness
• Major life interests or occupational roles
• Activity-focused dementia care incorporates a person’s personal history of productive activities into present day activities

• Hobbies
• Crafts
• Games
• Planned or spontaneous
• Help people feel connected with others in positive ways

• Most leisure activities involve “active doing”
• Perform physical activities each day to help maintain their physical fitness
• “Being” activities are sedentary
• Key is to balance the active and being activities

• Activities with a spiritual dimension can give special meaning and purpose to people’s lives
• Can help reduce stress and agitation or help cope with difficult issues
• Respect the spiritual preferences of each person
• Include aspects of their spirituality in daily activities

• Meaningful activities are:
  • Voluntary
  • Purposeful
  • Socially and age-appropriate
  • Interesting
  • Engaging
• Activity-focused dementia care can include activities that are:
  • Spontaneous or planned
  • Part of regular routines or special events
  • Social or solitary
• Activity-focused dementia care encompasses the entire day and all the activities that fill it with meaning and purpose
• The very best activity-focused care occurs when all those involved in caregiving participate to provide meaningful activities throughout the day

Written by:
Catherine M. Harris, PhD, RNCS.
Mindy J. Kim-Miller, MD, PhD

Edited by:
Sasha Asdourian

www.LightBridgeHealthcare.com

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