A Playful Approach to Dementia

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Sam's dementia diagnosis made him a shut-in. Though he was fully capable of communicating and interacting with others, Sam wouldn't leave the house. One day, his exhausted wife was finally able to convince him to (reluctantly) go to a local dementia workshop.

The idea of attending a seminar entitled "Funshop" wasn't initially appealing to Sam, an opinion he didn't hesitate to express when he was introduced to the leader of the event, John Killick, former Writer in Residence at the Dementia Services Development Center and author of the book, "Dementia Positive."

But Sam stuck it out; staying for the whole session, which included a series of activities aimed at getting participants to engage in playful creative expression. Sam cracked a few smiles, but told John he wasn't sure he'd be back next time.

Despite his doubts, Sam did return, and opened up to John about his work as an amateur artist. Seeing Sam's eyes light up while talking about his passion pretend to be a renowned artist from whom John was commissioning a portrait. John played the role of an absurdly finicky client perfectly, though his increasingly outrageous demands seemed surprisingly incapable of ruffling Sam's artistic feathers. Finally, Sam turned to the audience and deadpanned, "I do not accept this commission." The audience of dementia patients and caregivers responded with hearty laughter and applause for their comrade who'd finally shown his true (comedic) self.

That moment marked the beginning of the end of Sam's self-imposed isolation. He began to enjoy life again, venturing out to meet new people, in spite of his condition. "My attitude has completely changed," he told John.

Arguing for a different approach to dementia

Play and dementia care may seem like an improbable oil-and-water pairing, but anecdotal and scientific evidence in favor of this phenomenon continues to mount.

After working with dementia patients for more than two decades, John has strong convictions about the way society perceives people with the condition. "The unthinking, reflex response with which we are so familiar is that of dementia as a plague, an epidemic, and this enables the Alzheimer's Societies to talk of ‘the fight against dementia.' All of this is totally counterproductive."

He argues that we should seek to see dementia as an opportunity to look beyond our obsession with mental acuity and material wealth, and acknowledge the innate affection and creative spirit inherent in all human beings. "Whatever difficulties people with dementia might have with memory and reasoning, they retain their emotional sensibilities and ability to laugh," he says.

Recognizing these abilities can enhance feelings of efficacy and reduce the sense of loss that so often devastates those affected by chronic cognitive impairment. As John points out, "Every time we show our irritation with someone with dementia; every time we take over from them and deny them the possibility of carrying out familiar social or practical routines, we are increasing their sense of hurt and isolation."

Science in support of play

In the scientific arena, a growing number of studies point to the power of a playful approach in minimizing feelings of loneliness in people with dementia and their caregivers.

New research by Dr. Yvonne Khoo J-Lyn, of the Health and Social Care Institute at Teesside University in the U.K., explores the benefits of incorporating opportunities for holistic, spirited exercise routines into dementia care. She and her team developed a program dubbed "Happy Antics" that combines cognitive exercises, physical activity (e.g. dancing to "The Chicken Dance"), meditation, tai-chi and breathing techniques into a series of 45-minute sessions.

Once a week, for six weeks, study participants—dementia patients and caregivers—attended a Happy Antics session. An astounding 70 percent of people who began the program actually went every week; an impressively high attendance rate for an exercise class of any kind.

Post-participation interviews conducted with patients and caregivers revealed additional insights into the positive effects of play:

"You don't have to be perfect. You only need to do what you can," says Olivia, a dementia patient who also enjoyed the team-like atmosphere of participating in the classes. "No one looks at you if you do something wrong."

Gerry, a caregiver, gravitated towards the laid-back atmosphere of the Happy Antics sessions. "They (the exercises) helped me relax, just a feeling of wellbeing afterwards."

Yvonne believes the opportunity for social interaction is the most potent advantage of these play-focused programs. "We cannot reverse the process of dementia, and many people who live with dementia (either as patients or caregivers) do report feeling lonely and isolated," she says. "The program provided a safe environment for both exercise and cognitive stimulation and the best thing about it is being able to do this with friends and family members who care about them."

Play every day

Both John and Yvonne stress that putting a playful spirit into dementia care is all about altering one's approach to everyday life, not about breaking out a board game or performing a set of specific activities and exercises.

A buoyant attitude can be injected into even the simplest of tasks, such as going shopping or preparing a meal with an older adult with dementia. Yvonne cautions dementia caregivers not to expect anything when engaging in these pursuits. Expectations bring unnecessary and unproductive pressure to a situation, making it more stressful for all involved. In fact, "The fewer expectations you have, the more likely you are to achieve," she says.

And, as with all things dementia-related, patience is key to maintaining a playful spirit.

"Playfulness is a transformative attitude that can inform everything from the most basic domestic process to a special event," John says. His motto is: "Let's start a laughter epidemic!"

Here are some more tips for Creating Meaningful Activities for a Person with Dementia.

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