Finding meaningful leisure activities for people with dementia and their families
The idea: Laura is an occupational therapist whose doctoral project addresses the problem of lack of meaningful activity for people with moderate dementia. She feels that caring for someone else and sharing maintained long-term memories can provide motivation to interact and daily purpose.
My name is Laura Poleshuck. I am an occupational therapist from Rochester, NY, USA. I work in a nursing and rehabilitation center, primarily with the long-term care residents.
I am currently working on my doctorate in occupational therapy, and my focus area is dementia. The current working title for my doctoral project is "Client-centered leisure opportunities for families living with dementia: recommendations for evaluation and activity planning." Any ideas/thoughts on this project are encouraged and welcome! I am still at the very beginning stages.
The problem that my project addresses is the a lack of meaningful activity for people with moderate dementia when daily tasks, such as cooking, dressing, crafts, games, reading, etc., become too difficult. Boredom can lead to people becoming depressed and withdrawn and/or agitated. My goal is to create leisure opportunities to help avoid these problems.
Of primary importance to the patients on the dementia unit where I work are nurturing and reminiscence. Caring for others and enjoying comforts from one’s past are common themes in clients' conversations and behaviors. Here are some examples:
- Mrs. H spends her day trying to figure out how to leave the unit to go home and care for her children. She is constantly worried about them.
- Mr. S spends most of her time grabbing onto railings, wheelchairs, carts, patients, and anything else she can get her hands on, frequently disrupting staff routines. When she met a dog at lunchtime, she demonstrated much more sophisticated abilities; she took her empty peach cup container, filled it with meat and beans, and set it on the floor for him. She also bounced a baby doll on her lap.
- Mr. J is most delighted when interacting through a doll, especially if a staff member has a doll (or anything fluffy) and will respond in turn. He enjoys talking to the doll and sharing its reactions.
- Mrs. M will not participate in any activities designed to have her move her arms, but will make every effort to pet a dog placed in them.
- Mrs. H avoids working on way-finding with the occupational therapist unless it is to "help" the therapist find lost papers or to get the thirsty dog a drink in her room.
- Mrs. L spends her afternoons wandering and crying in worry over her son who is ill. She calms to an audio recording from him and to a book of family photographs.
- Many residents have become more engaged during therapy activities when music from their generation is played.
Clients with moderate dementia need constant care, but the above examples demonstrate a need or desire to care for others as well as to reminisce. Caring for someone else and sharing maintained long-term memories can provide motivation to interact and daily purpose, and thus can provide meaningful occupation for people with dementia.
My goal is to create a program conducive to meeting individualized leisure needs of families in which a member has moderate dementia. This program would focus on client participation in nurturance and generational and/or personal reminiscence activities as well as opportunities for families to once again connect with their loved one. An occupational therapist would complete the evaluation and create an activity plan to be carried out by the family. Engagement in meaningful occupation can lead to increased physical and cognitive activity, which in turn can result in improved health as seen in increased strength and balance, and maintenance of cognitive skills.
This idea is targeted to occupational therapists, families, and people with moderate dementia.
Please email Laura with your thoughts on meaningful activities for people with moderate dementia, your ideas for activities, or resources that Laura might look at or contact.