Authored by Lisa Kikuchi, Community Engagement Provider, Recreational Respite
Lisa is a graduate of Canadore College with a Recreation Therapy diploma, and is an enthusiastic Community Engagement Provider at Recreational Respite, providing tailored one-to-one respite support. She is passionate about her work with older adults with dementia, focusing on person-centred care and improving their quality of life through recreational activities.
Introduction
When people ask me what kind of work I do, I explain that I provide therapeutic recreational activities for older adults with dementia. A common response I get to this statement is “Oh, so you play Bingo with them all day?”. Although Bingo is a great cognitive and social activity, it is far from the only activity they can do, or should even partake in.
- Bingo requires a number of people participating, which may not be feasible for those living alone or if they are not part of a social group.
- Not all individuals with dementia will be able to participate in bingo due to their cognitive impairment, thus won’t be set up for success.
- There should be a healthy balance amongst all 5 domains: to improve their physical, intellectual, emotional, social and spiritual wellbeing. Bingo’s primary domain is cognitive.
- Not everyone loves Bingo! (True fact.)
This article will explain what dementia is, and how respite providers effectively engage older adults with dementia in personalized and meaningful recreational activities that go far beyond Bingo.
What is Dementia?
Dementia is an umbrella term used as an overall terminology used for a set of symptoms that are caused by disorders affecting the brain. It includes memory loss, mood changes, difficulties with thinking, problem solving, and language. Some examples of symptoms include forgetting details from recent events, becoming lost frequently, slurred speech, language problems, unpredictable changes in mood and behaviour, frequent repetition of questions and stories, and difficulty with daily tasks. (Alzheimer’s Society, 2021.)
Providing one-to-one support requires a personalized approach
Offering one-to-one respite support to older adults with dementia requires a personalized plan to ensure activities planned are engaging and suited for them. Recreational Respite’s approach includes our Discovery of Needs – where we identify needs, interests, barriers and goals for each person we serve, and develop a holistic plan for our Community Engagement Provider to meaningfully support them in areas including their social, emotional, physical, spiritual/ vocational, and cognitive well-being.
It is important to know how the person currently spends their free time (i.e. hobbies, interests), but also what they used to enjoy before the disease diagnosis. Dementia will affect their short-term memory, but their long-term memory still remains – thus engaging in activities relating to their past could have a positive effect. This is why many enjoy DementiAbility Montessori activities – purposeful activities that promote independence and improve self-esteem and mood. Some examples of these activities include folding towels and clothes, sorting items by colour/size/type, matching pictures with text, and cleaning. For example, if John is a retired plumber, he may enjoy threading pipes together or sorting them by shape/size, because that is a familiar long-term memory that he finds joy in from his previous occupation.
With any one-to-one respite support client, it is vital for Community Engagement Providers to assess and adapt activities to meet the person’s needs. But it is important to be mindful of how much they are adapted. Although people with dementia have memory impairment, it primarily affects their short-term memory, and their long-term memory is still excellent. Thus, it is important that these activities are as close as possible to how they remember them. For example, if they enjoy word games, it will most likely be more successful if it was done with pencil and paper rather than using an app on an iPad.
Purposeful activities that may be enjoyed by a person with dementia
Social
- Coffee chats at a local cafe or tea house
- Joining local community groups
- Visiting the library, museum, or community centers
- Spectating at local sports games and events
Emotional
- Art and adult colouring
- Fibre crafts and woodworking
- Seasonal outings
- Listening to favourite music
- Reminiscing
Physical
- Chair exercises, adapted yoga or tai chi
- Swimming and active games (eg: Pickleball, Balloon Tennis, Ball Toss, Bean Bag Toss)
- Walks and strolls, such as pole walking, hiking, mall walking, or indoor tracks
Spiritual / Vocational
- Mindfulness practices, meditation
- Hymn singing, prayers, chanting
- Attending religious services, groups or community events
- Volunteering with support (eg. in an animal shelter, or by packing donation boxes for charities, knitting hats, participating in food drive)
Cognitive
- Word and association games (eg: Words that start with “A”, Crossword Puzzles, Scrabble, Alphabet Soup, Fill in the Blank, Finish the Lyrics)
- Book club, history and geography discussions, creative writing
- Carefully selected, adapted skill based activities such as DementiAbility Methods
DementiAbility methods and resources
DementiAbility is an organization that provides education and resources for health care professionals and families to better understand dementia and how to enable the abilities and potentials of individuals with dementia. Resources include short stories that are in large print and simplified materials, colouring pages with black backgrounds to set people up for success, books with conversation prompts that stimulate memories, and many more (DementiAbility, 2020)
Employing recreational activities to address responsive behaviours
Responsive behaviours are behaviours exhibited amongst individuals with dementia that are considered violent, inappropriate, aggressive, or unsafe – such as physical aggression, wandering, exit-seeking, and sexual behaviours. But it is important to note if these behaviours are part of the disease’s progress, or if they are a response to an unmet need? Is it a response to the environment, a person, an object, and/or a specific setting? Is it due to overstimulation or lack of stimulation? Is it due to boredom or frustration from feeling unsuccessful? Many will assume that responsive behaviours are unpreventable or uncontrollable, but with the right observations and approaches, most responsive behaviours can be prevented through engagement in meaningful recreational activities.
One common leading trigger to responsive behaviours is due to boredom. Individuals with dementia will have changes in their behaviour, including increased difficulty in communication. This can affect their ability to communicate certain needs such as boredom. By engaging them in meaningful activities, they can receive the right stimulation and improve their mood overall.
Recreational activities can also be a healthy outlet which can reduce certain responsive behaviours. If someone with dementia is known to exhibit physical behaviours such as hitting, physical activities such as shuffleboard, pickle ball or balloon tennis games may be suited for the individual as a healthy outlet.
Conclusion
As a respite provider, it is crucial to have a thorough understanding of the individual needs, abilities, strengths and interests to focus on their social health and emotional wellbeing, especially for seniors and those with dementia that have a rich history. Implementing tailored one-to-one activities that celebrate their interests and abilities, and are mindful of their cognitive limitations is important for successful and meaningful engagement that goes far beyond Bingo.
Learn more about Recreational Respite’s tailored one-to-one supports for older adults by visiting www.recrespite.com/respite-support or call 1-877-855-7070.
Resources
- What is Dementia? – Alzheimer’s Society – 2021 https://alzheimer.ca/sites/default/files/documents/ASC_What-is-dementia-info-sheet_en.pdf
- DementiAbility – 2020 https://dementiability.com/