Gerontology 130
Working with the Frail Elderly

UNIT 7

Designing Meaningful Activities for the Older Adult

Overview
Designing Meaningful Activities
Required Reading
Online Activities

Overview

One of the great challenges in working with cognitively impaired adults is finding meaningful activities that fulfill their day. Caring for an aging relative at home is a "36" hour job. To obtain rest, the caregiver will let the elderly person sleep until 10:00 or 11:00 a.m. in the morning and will very often use television as the "babysitter". The change in sleeping schedules inadvertently upsets the circadian rhythm which regulates the hours of sleeping and waking. It is not unusual for a person with dementia to be up all hours of the night. In the middle to later stages the television can be a distraction. The person with Alzheimer's may not be able to distinguish between what is real and what is imaginary. Involving the person with dementia in folding wash, or washing dishes is important as it gives him/her meaning and a purpose for being. Many caregivers do everything for the elderly person, and thereby create a situation of "excessive dependency". It is important for the caregiver to encourage the person with dementia to do as much for him/herself as long as possible in order to maintain dignity and personal self-worth.

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Designing Meaningful Activities for the Older Adult

The philosophy of designing meaningful activities is extremely important. Activities for the person with Alzheimer's should be age-appropriate. The philosophy of activity planning can be best summed up by the following:

Activity's purpose is not to kill time,
but to make time live,
not to keep a person occupied,
but to keep him refreshed,
not to offer an escape from life,
but to provide a discovery of life.

The types of activities which provide meaning in our lives include all of the following:

Intellectual Activities—activities which stimulate thinking or memory
Creative Activities—such as music or art which can enhance memory
Personal Care Activities—such as dressing, brushing one's teeth, or brushing one's hair
Functional Activities—such as setting the table, folding wash, sweeping the floor, washing windows
Physical Activities—such as walking, chair exercise
Social Activities—having refreshments, or caring about others in similar situations
Spiritual Activities—singing hymns or listening to music of the 1940's

The purpose of activities are as follows:

Enhance the quality of life
Maintain physical well-being
Encourage socialization
Encourage expression of feelings
Maintain connections with outside world
Bring some fun into the day
Encourage use of remaining abilities
Encourage independence and promote self-esteem
Provide intellectual stimulation

It is important that the type of activities selected are age-appropriate. Helping persons feel empowered by giving them control; over the subject they paint, the games they choose or the activity they participate in, is essential for maintaining self worth. On the other hand, it is important to encourage individuals to participate in activities that they may be reluctant to do, because of fear of feeling foolish. Developing a safe and secure environment, where the person is cared for, will help him/her feel safe and secure, and will encourage individuals to enjoy activities that they might not otherwise try.

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Required Reading

pp. 94-107, Management of Challenging Behaviors In Dementia (2000) Mahoney, Ellen; Volicer, Ladislav; Hurley, Ann. Health Professions Press, Baltimore, MD.

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Online Activities

To find out about the types of activities individuals need and enjoy, research the the following websites or related resources:
- http://www.alz.org/caregivers/daytoday/music.htm
- http://www.alz.org/caregivers/planning.htm
Opportunity for Reflection: Select at least one question for reflection below, and post your answer to Unit 7 Activity Planning on the WebBoard:
- What type of meaningful activities could a person with moderate dementia do at home?
- What type of needs should activities address?
- Why is the "philosophy" of activity planning so important?

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