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by Cynthia D. Steele, RN, MPH Johns Hopkins University Alzheimer's Disease Center
July 8, 2002
First of all, do not expect too much. Finding activities that a person with Alzheimer's disease can do and is interested in can be a challenge. Try to incorporate activities into a normal daily routine. Simple activities are the best, especially if you can find activities that use the abilities the person has retained. Activities that are familiar, such as folding clothes, kneading dough or digging in the garden may be comfortable. Help the person to get started on an activity and break the activity down into small steps. Give praise for each step completed.
Planning activities throughout the day are very important, especially as someone becomes more and more impaired from an illness like Alzheimer's disease. The important thing to focus on there is the process of doing anything that the patient or the person finds pleasurable, not the product that results. So, for example, if they like to do simple parts of tasks they used to be able to do, like, if they would enjoy stirring a pot of food, where in the past they would have been able to do a complex recipe, that's a good thing. You should praise the person for it and enjoy it. Remember that it is the pleasurable moments that are important.
The other thing about activity is that it's important to structure a routine of your day. If you think about it, patients are under a lot of stress, trying to figure out where they are, what they're to do next. So, it helps them a lot if you create a scaffold of activity around them. So basically, you get the person up at the same time each day, you have physical activity, predictable meals, and a bedtime routine as well. Adult day care centers are also a very important resource for families. There, persons with Alzheimer's disease can join with others doing activities that are social and pleasant for them. And that also gives the family member a needed respite break.
Task breakdown is one of the most powerful techniques that caregivers will have in helping someone over the years who is affected by Alzheimer's disease. An important example of that is to think about a seemingly simple activity, like brushing one's teeth, involves really very many steps. So for example, you can still help someone who can do part of it by breaking down the task. For example, you might have to get the toothbrush out. Then they might look at it and not know what to do so you put it in their hand. Next, you put the toothpaste on and you do hand-over-hand cueing. So you actually take the last step, which is actually gently bringing their hand to their mouth and beginning the task.
Source National Institutes of Health
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