Monday, July 16, 2012

How to Entertain People with Alzheimer’s?



Entertainment for people with Alzheimer's and other forms of dementia is not much different than entertainment for the rest of us.

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Entertainment Choice

At Early Stage of Alzheimer’s, you can often share in whatever fun activities the person enjoyed before developing Alzheimer’s. Some games may need to be adjusted, however, to accommodate your loved one’s diminishing mental capacity. For example, you may need to play a child’s card game instead of bridge; checkers instead of chess. Or, if the person previously enjoyed jigsaw puzzles, you may need to find ones with fewer and larger pieces.

At Mid-Stage Alzheimer’s stage, people with Alzheimer’s may have more or less the mental and social skills of a toddler. While it’s excellent to do the standbys – things like looking at old pictures or watching movies together, those are still somewhat passive. With a little thought you can find more active ways to spend time together, such as giving the person toys or other “props” that the two of you play with together. The key words here are “play” and “together.”

Many people with Alzheimer’s enjoy stuffed animals, doll babies and other “props.” If you find some item the person really likes, you can use your imagination, again, to invent simple games to play together with it. It goes without saying that some people with Alzheimer’s cannot be reached by any means, but try experimenting with several of the ideas mentioned here. You may be amazed to find your loved one can suddenly function at a higher level and become happier when involved in these types of activities. And that can bring joy to both of you.

While it can be difficult to see an Alzheimer's patient struggle with activities he once enjoyed, experts insist that it's very important for people afflicted with the disease to stay in touch with their former selves. For example, a patient who was a big basketball fan in his younger years can be entertained with a televised basketball game. Even if the disease has progressed to the point where the patient can no longer keep up mentally with the intricacies of the unfolding match, he will still get a visceral thrill from watching, even if clarity only comes in flashes.

Trial and error is a good strategy to use here. Expose the patient to a variety of activities he once enjoyed, see which ones he responds to best and make any necessary adjustments to maximize his entertainment.

Whatever entertainment format is chosen, be responsive to the needs of the patient. Don't force things that aren't working and move on to something else if a planned activity doesn't do the trick. Someone suffering from Alzheimer's will usually have a short attention span and may be averse to large crowds and public places. The best activities shouldn't take a long time to complete. Choose stimulating activities that can command the patient's attention without frustrating them.

Games

Simple games that promote mental stimulation but don't frustrate the patient can be entertaining and therapeutic. For example, play a name game or a word game with an Alzheimer's patient. Begin by saying a female name and asking the patient to respond with a male name. This structure could be repeated with any number of subjects, including birds, animals, countries, languages, colors and movies. Encouraging the patient to play with clay or paint can provide hours of entertainment. However, experts caution that individuals who had highly developed artistic skills in their younger years may have adverse emotional reactions when trying to use those skills while afflicted with Alzheimer's. Avoid activities that may remind the patients of their failing faculties.

For example, one study reported in the American Journal of Alzheimer's Disease and Other Dementia found that playing Bingo provides mental stimulation that is highly therapeutic to people with cognitive disorders. Individuals participating in the study performed significantly better on measures of cognition. Staff members reported increases in alertness and in awareness in the test subjects for hours after testing.

Bingo has other advantages as a game for dementia patients. It comes not only in the familiar "B-6, N-23" version, but in a number of alternatives that are stimulating on different levels and for different abilities. Players can identify anything from animals to items of food, to body parts. This allows for the game to be played, in one version or another, by patients at different stages of the disease, and to stimulate memories, thought process, or other cognitive abilities.

And it's not just a game for large groups. Games for Alzheimer's should be played for stimulation, not for competition, and can be enjoyed by a group of two or three. Or even one (with a caregiver). Whenever possible, have children play with the older adults. Both age groups enjoy this.

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Physical Activities

Physical activity promotes better health and slows the complications of Alzheimer's disease, and it can provide an entertaining way to pass a morning or afternoon. If the patient has someone to walk with, he or she will find it more enjoyable. If possible, bring a pet with you, particularly if the patient likes animals.

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Reminiscence Therapy

Entertainment media provide us with one of our biggest sources of reminiscence therapy. Old movies and television shows, recordings of old radio programs, live performances and recordings of songs and music from the 30s and 40s; any of these could inspire a memory.

Movies and Documentaries

Feature movies are a first choice for many when it comes to distracting us from the routine of our daily life. Older movies are especially good as someone moves into the middle or later stages of dementia. Musicals, comedies, and movies that feature dancing can provide entertainment without the need to follow a complex plot.

Nature documentaries are another option. Many rely heavily on the visual grandeur of their subject to tell the story. In most cases, people with Alzheimer's disease and dementia respond very well to these. One of the favorites could be Winged Migration. It contains very little narration; the birds hold the audiences. You will enjoy watching this with your loved ones or the people in your care. It is as if you are flying with the birds.

Other Video Entertainment

There is a category of movie that is made to bring the world into your home. An undersea reef, the Amazon Jungle, majestic mountains, a Caribbean island; all can be enjoyed in the comfort of your living room. These can be thought of as music for the eyes, and provide a relaxing ambiance whenever they are playing. They are accompanied by relaxing or energizing music, natural sounds, or both.

Old Radio

We've seen nostalgic pictures of families sitting around the radio listening intently. They may have been laughing to an episode of Jack Benny or Fibber McGee and Molly. They may be thrilling to the adventures of The Shadow or riding with The Lone Ranger. To you this may be a quaint image of Americana, but the majority of people who have Alzheimer's disease experienced this first hand. They grew up before television. Radio was for them what TV was for us.

So, many of those classic radio shows are lost, but not all of them. Unfortunately, the quality of these recordings is not always what it could be. For people who likely don't hear as well as they did when the shows were first broadcast, listening to these less than perfect restorations might be more frustrating than anything.

Books

Novels, biographies, and all the other books that we read for our entertainment will eventually lose their appeal to the person with dementia. There are other books, however, that will retain their appeal. The so-called coffee table books fit this bill nicely, especially those that have a nostalgic, geographic, or natural theme. These can usually be found on the sales tables of the larger bookstores, and appeal to many interests.

Another option is illustrated stories. These don't have to be children's books. Stories written or adapted for juvenile readers can be as engrossing as adult novels, and the illustrations that they often contain make them visually stimulating as well.

Music

Music provides wonderful reminiscences, and is an indispensable part of a program of reminiscence therapy. It's something everyone has a deep connection to. Everyone has a favorite song, or several. Everyone has memories that are connected to one piece of music or another, some going back to childhood. More than that, music has the ability, like nothing else, to transport us to a different time or place, to brighten our mood, to relax or stimulate us. Many experts contend that music even has the power to heal.

But music isn't just for listening: Encourage participation. People in later stages of dementia often remember the lyrics of songs that they may not have heard for years. An Alzheimer's patient who has trouble putting a sentence together, who stumbles over words, might sing along with a familiar old song without hesitation or mistake. Not only is this enjoyable, it stimulates the memory. He doesn't like to sing? Maybe he plays piano or another musical instrument: Maybe not well, but that doesn't matter. Or hand him a tambourine or a pair of maracas, and let him keep the beat to recorded music. This can all be done in groups. In residential situations, bring in a leader who has a selection of rhythm and percussion instruments, and experience in encouraging participation.

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Humor

Experts state the humor and laughter therapy is very helpful in preserving positive emotional state and boosting your loved one cognitive processes. Several examples of the recommended activities:
  • Watch or listen to comedy TV shows, movies and old radio shows like “Who’s on first” (Abbott and Costello) and “I Love Lucy.”
  • Start a humor notebook or scrapbook.
  • Laugh over funny family memories (like the time Mom put frozen rolls on the Thanksgiving table).

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Sources and Additional Information:

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Co-Author: Tanya Pekker, Licensed Marriage and Family Therapist in San Mateo, California


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