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There have been a couple of threads lately asking for advice about activities for those living with advanced dementia and/or physical limitations - this was a peeve of mine while mom was living at the NH because the majority of her day was spent literally on the sidelines of life, and frankly most of the activities weren't very successful for more than a handful of those living there. Maybe if we had a list of ideas that really work at your facility (or home) it would be something we could give to the activities director or family council, and hopefully a step toward improving QOL for those living in our local facilities.

It would be useful!!!
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Fidget quilts!! On Amazon and Etsy.
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How can we make the list an item on the 'care topics' site here? Otherwise all these ideas will be lost!
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Lots of advice, and good, yet Jasmina hit the nail on the head; get yourself involved.

There are too few "hands on deck" for the number of different people at different levels to care for. And the staff there have "other duties" to do. One or two activities directors can't do it all by themselves.

Kids no, but maybe high school students having to earn volunteer hours. Church youth groups?

I went and the staff loved me. So grateful a loved one showed up to be there and help. Not looking for acknowledgement, just saying.
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jacobsonbob: You're right! And why? They are tired.
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Arts & Crafts
Red Hat Clubs for the women
Current Event Groups
Men's Clubs
Games, cards are popular
Pet Therapy

Have the home your loved one is in contact NCCAP (National Certification Council for Activity Professionals). This group certifies activity directors and is a great resource for ideas.
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It's difficult. I think one of the other responders was correct that your expectations may be too high. Everyone in AL is different about what they are capable of doing, and what they will like, people have good and bad days, and peoples' abilities can decline over time. Pet therapy is universally liked, but usually the pets come around for a half hour or so and then they are gone. Art therapy will have mixed results. Music therapy - when someone comes to play guitar or piano or other instruments is usually liked. Some will sing along, some won't. I've seen mixed results with yoga or other exercise. Showing films can be a diversion, but it's difficult to find the right kind of films. You don't want to have violence or depressing topics. Simple stories and relationships are best. Reading stories to the group or even magazine articles can also be a diversion, but it's difficult to find the right stories.
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Good point jacobsonbob.
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It is possible that no matter what opportunities and activities are offered, a large percentage will simply not be interested in them? For example, if 5 out of 50 participate, is that considered a success or a failure? Perhaps 5 others will participate in a different activity, but it may be that no individual activity attracts more than 10 or 20%. My mother, who probably had never played bingo in her lifetime, went to one session, and then told me she was "bored" with it so she never went back. She seems to enjoy watching TV, seeing people walk by in the hallway, looking at old family and travel photos, and when it's dark she likes to watch aircraft coming in for a landing (when she sees their lights through the window); however, she seems to have no interest in any of the group activities.
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Pet therapy
Music therapy
Small puzzles
Audio books
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I hate to say this but it is true. At almost every facility, personal care or nursing homes, there are no worthwhile activities. What is offered is for people with the brain of a child and are suitable for people of grammar school age. God help those who have physical problems but who do have a good brain - there is absolutely nothing for those people, never! I am not surprised that almost all but a few residents simply won't waste time going to these crappy child-like activities. I don't know how to fix this but I know it happens all over the place.
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My aunt’s nursing home had an arrangement with a funeral director to take funeral flowers. They were taken out of their presentation arrangements, and delivered to the common room as large quantities of flowers. The residents chose flowers for themselves. Some of them just looked at them, some picked them to pieces, and some made new arrangements for their own rooms or the corridors. It was quite spectacular and interesting for everyone. A bit of cleaning up afterwards, but not much trouble for the staff. The same might be a go-er for a church that has multiple weddings – often one lot of flowers are taken out and binned immediately so that the next lot can come in.
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If the patient can't get there alone, no one will take them. My mother sat in a wheelchair all day, until it was time for bed. All nursing homes are horrible places.
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Wonderful Idea!!!!!!!!!
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I spent an hour or more at the NH every day, sometimes coming and going more than once throughout the day, so I think I'm pretty aware of what activities (or lack of activities) were/are available there. For those like my mom - essentially none.

Without fail outside entertainment was scheduled in the early afternoon or evening, when people like mom were having their briefs changed and being tucked into bed.

For the rest - 75% of the activities took place on the AL side of the building, once again shutting out all those who were not both physically and cognitively fit enough to get themselves there because the staff was needed on the floor and could not take the time to accompany them.

The snoezelen room highlighted in the brochures was locked and the only time I saw it used was after I brought it up in a family council meeting.

The fenced garden off the dining room was locked to keep those with dementia from accessing it - surely that's why it was fenced?

Pet therapy consisted of a half hour visit a couple of times a month from untrained volunteers.

The cooking activities I observed consisted of a demonstration by the activities director because there were no facilities to make active participation possible, there were also no extra staff or volunteers there to help.

Even the iPods that were supposedly available for the residents to listen to music were usually missing or needed to be recharged


Yes, there were some activities that were successful, but too few and not nearly often enough. Can you tell I'm a little bitter?
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Most of these ideas are already done in nursing homes. Family is not around to see them. As far as games go, the dementia pts dont have the cognitive ability to grasp these things. They can also get frustrated/ mad bc they know they arent able to comprehend. Sometimes they do have insight. Have you ever seen someone with dementia get really angry and frustrated? They know they cant do it any more. They curse, throw thing, scream, hit etc. You keep them calm.
Giving a list of ideas to an activity director would be like giving a list of ideas on how to increase productivity to nursing staff...

If you want to know more of what they do get involved. Do the activities with your family member. They love to see family involved or volunteer. See how much or little they can tolerate. There are even activity staff working on the weekends. Residents go to activities, lunch, brunch, birthday parties, and church.

Some are looking at this from the point of view from a HEALTHY vibrant individual who has their mental faculties and stamina of a young or middle aged person. You can handle multitasking and activies for up to 12-14hrs. Not the same in a 80s dementia, parkinsons, ms, or cancer pt. Whole nother ball game. They have NO stamina. No muscle tone, no joints that glide easy and fuction like normal. Medically fragile. No mental and visual or even hearing acuity. Its just not there. They are worn out body and soul. Those that participate do the best they can. They are allowed to say no too. My dad said no all the time. You cant force them. They can refuse. Just because you want them up and active means they should or could.

They've had a lifetime full of activities, jobs and raising families. They just dont have it any more.
As for night time activities there is sun downing. They get more confused agitated, forgetful. You dont wind up pts at night. Just like you dont wind up kids with activities b4 bed. After dinner people are digesting, watching tv and relaxing. Most of the residents go to bed very early too. They get up very early. That has been their life. Still looking at it from the point of view of a healthy person with stamina.
There is a huge difference in an elderly person with cognitive abilities, than a person with dementia. If you havent worked with them you dont know. It is called a rest home for a reason.
As far as schools coming in for activities they have to watch that. Kids can bring in colds and flu. There is cdiff and mrsa about. These are medically fragile folks. They dont have immune systems any more. I went to visit dad once. They had to quarantine the place bc of flu. That probably came about from a family member or staff with kids. They also have fragile immune systems. Thats why kids get sick a lot.
So they have to be careful with that.
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I can agree somewhat with Jasmina - if family members can only come at night or certain times of the day, they might not see the activities. However it also can be dependent on the facility itself - as with any organization (or person), how much or little depends on those involved! Clearly you were very into providing the best experiences for all, and that is commendable. I see many activities take place where my mother is, because I tend to go at random times (not working outside the home, but other "duties" get in the way sometimes!) However there are times of the day, such as after dinner, when some/many residents will retire to their room on their own, so it may appear like there are no activities if you arrive at those times. Even mom has mentioned it, if I am there for dinner and the place empties - she'll say everyone has gone home!

One mentioned Mennonites bringing their children at Christmas to sing - why not enlist local school or church choirs to come "practice" in front of a live audience!? The residents would probably like the music AND enjoy seeing children there!

Having children as well as pets visit is also usually a big hit. Of course depending on their age, some children might not understand - preschoolers might be best, so long as they have enough of their own staff/volunteers to keep control! (mini-horse??? yikes, hopefully no 'accidents' or it wears some horsie pampers!) My son brought his son to visit and he was a huge hit with mom and the others, especially during lunch! Lots of smiles and chuckles - who doesn't like cute little kids and the funny things they can say!?!?!?

Bingo is also a big hit, including those who cover multiple cards! They have VERY large cards with the numbers called, so that those with eyesight or hearing issues can still see. They bring in sing-along, have jigsaws, tv with old programs/movies or nature programs. Some art/crafts (pipe cleaner toys, birdhouses, etc.) One thing I have seen them do, which many of the ladies LOVE, is some nail care (buffing, shaping, polishing - I gave them all the polish and a few emery boards, etc I found when clearing out mom's condo!)

They even brought in a balloon twister - you know, the people who make animals and things out of balloons. That seemed to be a big hit. Mom kept hers to give to her mother (:-o)

They do have trivia, but the questions on some of those are fairly difficult, even without dementia (some answers are not even correct - I have checked!) There are some other word games they have played as well. Magazines (mom parks herself and plants her face in the sales flyers, sigh.)

Other simple young kid's board games or art/craft projects might work for many, such as Candyland - easy to follow, nothing to read, really. Of course there might be some unintentional 'cheating' that happens ;-)

A lot of good ideas here. If you provide in-home care, but the person is capable of outings, even if a wheelchair, bring them to some of these activities. Senior Centers might have Bingo days or other activities for elders, some schools might have choir practice you can bring someone to. Other "fun" stuff listed above can be brought in to those who cannot get out. Any facility that does not provide activities for the residents is a sad place. Be creative and come up with something even those with advanced issues can manage.

Check with the staff before assuming there is nothing for residents to do though - if you are not there when they have these ongoing, you might not be aware of them! Our place has the month's activities posted in various places and I'm sure you could get a copy!
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We even had a corn shucking activity with those who grew up on farms. The corn was made into creamed corn later. That was a big hit. Plenty of memory activities to stir up fond wonderful memories too.
A shower and bathing activity can knock the wind out of the resident.
They just dont have the mental or physical stamina.
I would love to see a resident with adv dementia get involved in an hour long activity. Its never going to happen. 5- 10 mins is about all they can handle. Good luck.
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I worked as an activity assistant in a nursing home. What family sees is residents sitting doing nothing. That is not true!
If you see an activity board on the wall, those activities are taking place. You just dont see that bc you are not there at that time, or the activity is over. They are done during the day when residents are most active.
We would gather all the residents for the activity. A core group of 5 higher functioning would stay for it. Most could not. Those with advanced dementia were put by the door so they could leave. They grimace, get fidgety, moan, or fall asleep. They could not handle more than a few mins in a crouded active room. That was to much for them.
The biggest activity is bingo. There was a festive attitude and small prizes. Movies were also enjoyed. Church and morning stretch were also bigger drawls for residents. Or holiday acts.
We also chatted to residents 1 on 1 daily. We spent 15 mins to half hr. We couldnt have favorites, and were to visit ALL. Even non verbal. We would find out how they were doing and if there were problems.
We would report depression, etc to the director. These were always taken seriously and addressed with nursing, chaplain, family and dietary. We are part of the care team. Taken seriously. Most family dont even know we are there.
We have professional magazines chock full of crafting/ ideas for the activities. Complete with directions/list of items needed and how to tailor activities up or down for residents. We also had a library, books on tape, and movie they could watch at any time. Even Braille books and music.
I would play music during dinner. Id make it a little louder when they would enter but turn it down during the meal. The rat pack, was a favorite. Any 1940s 50 music was always a hit. They were cds.
You may see residents sitting in the hall doing nothing. But people watching is an activity. Sometimes that is all they could handle. They are not alone. Nursing staff, activities, and the chaplain would all talk to them. They are not just left there ignored.
They are also rounded up and taken to meals. They can refuse, but we like to get them out of their room to socialize. Even lower functioning non verbal residents are included.
Their are plenty of activities they can attend daily. They are always asked. The advanced dementia and parkinsons pts cant handle too much. It tires them out and can make them aggitated. Being in a croud can be too much.
We have many volunteers who visit residents too. Therapy animals and quite a lot of Mennonites would come at different times. At Christmas time they would bring their families and have their children sing Christmas songs. It was quite nice. Residents love seeing the small children. Even some would come and play music.
New residents are never ever ignored! Staff always asks them to activities and checks in with them mult times daily. We had day and eve act assistants. We always let nursing know if depression is a problem, or they are not adjusting. We concentrate more on them to get them involved. They arent left alone. We would visit in their room, show them around, attend acts with them. Take them outside if the weather is nice. We are aware of the su/ overheating. A half hour is usually enough. We befriend them. They werent just residents warehoused.

Family only sees tired residents sitting in halls. That is usually after a meal or dinner, b4 bed. A quieting down time. They are always invited to activities! Even less functioning. We would get them to at least 1 act a day. If they tolerate 5 mins it is a good day!!!!! Family never sees what goes on during the day.
So there is a lot happening you never see. If you wish to know more, go to the activities director's office. They can tell you what your loved one likes to do. There is a lot going on. You have to remember they can only handle so much. They get tired so fast. They are not up to a full schedule like a young adult. They tire so easy.
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Therapeutic Recreation is a whole field onto itself with literature and professionals ready to answer this question. You will probably not find a program that appeals to everyone so participation should always be voluntary. My mother's last three months of life were spent in a nursing home and the only things she liked were visits and calls from family and close friends.
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Bean bag cornhole, therapy animals, music programs, art demos and projects, trivia from the 30s and 40s, movie night, youth groups that perform (Irish step dancing, singers),
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It would be nice if these activities could be tailored to the interests of the Nursing Home or Assisted Living residents. For example, for those who used to play golf, maybe the staff could rent videos and movies about golf. (I have to brag, my mom got her first and last hole-in-one, after 4 bouts of cancer, when she was 82, about  5 years before Alzheimer's hit.)  Once, I was at a driving range with her, and a local Senior Adult Day care center had arranged with the golf facility, to have some of the seniors, even in wheelchairs, hit a few balls. Residents might need some prompting (and some props), as to things they might be interested in. The staff might get some suggestions from their family members. If they liked to read, maybe you could get some audio books. Maybe some local authors would be willing to go in and read a chapter or 2 to them. I've given speeches at local Assisted Living facilities to caregiver's groups about my book, "My Mother Has Alzheimer's and My Dog Has Tapeworms: A Caregiver's Tale." Many people have had pets in their lives, so maybe authors of books on animals could give a speech to residents. That might bring back some fond memories for them. Perhaps it could be integrated into other projects, such as art work where the residents could either free draw, or color by number, pictures of animals. That would combine several skills: creativity, auditory processing, paying attention to details, (like numbers), etc. And let's not forget the last but not least thing: sociability. The interaction with others can enhance not only verbal skills, but your overall well-being. The residents could also dictate a few things to staff member, and they could have their own books, either on a  subject that interests them, or perhaps an autobiography. And if their memory is altered  a bit, that's fine. Who cares if they say they got an A in Algebra, when it was really a C.  Also, maybe local schools, from pre-school up to college, could have volunteers come to talk with the residents.  After all, seniors in Nursing Homes used to be seniors in high school or college. Hope this helps.
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Pet therapy day - absolutely! Even better if a few "exotic" animals are available - some people have lifelong fears or aversions to cats or dogs, but may enjoy a rabbit, a miniature horse, a chicken or even a tortoise. I got permission to take my African grey parrot with me (in her travel cage) when I would visit my father in a nursing home. She was very popular with the residents - many of them couldn't remember my name, but they knew hers. She didn't even talk much at the time, but she has a great repertoire of whistles, and I almost think people enjoyed that more.
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Hi... great thread! I go to different homes for my job...here's a few:
Trivia with questions aimed for older generation, like how much did milk cost in 1950, 28 cents or 50 cents? ect., lots of catagories for this one

There's a bingo out th here with pictures of old actors that's popular and easier

Video wheel of fortune

Reading dear abby and having residents offer answers before reading her response

Playing old swing type music, a few can usually get up and dance with staff and the others enjoy watching

Sscrapbooking with old family pics with pre cut scrapbook paper so they dont have to cut anything
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I love this idea of a running list of activities to do with Mom (with dementia) and give to her paid caregivers when I am not around. I would also add a large print 'easy' crossword puzzle book. While my Mom gets frustrated if she tries to do them herself, she enjoys solving them with prompting and help from me or someone else. It gives her a sense of accomplishment when we solve the clues. I think all of these suggestions, that help to exercise her brain and engage her, rather than just plunking her in front of the TV, are truly beneficial.
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Board games, Uno, etc. Then the residents added dominos, with one teaching the others chicken foot (domino game). Trouble was a favorite.

I initially arranged "game night" when my mother was in a nursing home, finding several residents who wanted to participate, and some of them found others. The participants varied, but there were a few "regulars" and every participant really enjoyed it. Some of them even rounded up players themselves in the evenings so they could get started without waiting.
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Before my wonderful mom passed away a month ago, she was in a new memory care AL, for only 3 weeks. Wish I would have found it sooner in our dementia journey. It is one of the residential homes. 3 things I haven't seen mentioned, that I saw the residents engaging in are:
1. After meals, while still around the dining table the 6 to 8 residents each had a book to not necessarily read, but look at the many pictures in each one...different birds, flowers, animals, etc.
2. Most demented elderly remember Lawrence Welk
3. Older movies that they actually may remember.
Good luck. It's a tough path.
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There are special large size dementia puzzles that some enjoy

batting a balloon among a circle of even wheelchair bound residents with foam pool noodles is very fun

music and sing alongs

casino gambling like roulette

water coloring
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I went to sing-a-longs with an elderly friend at her Memory Care that were a highlight of my week as well as hers. The staff got in on the fun too -- I remember one nurse or CNA hilariously vamping to "Pretty Woman". It was great. Even the seemingly very confused people seemed to be having at least a bit of fun. It was usually outside on a patio too, which to me at least made it even more fun.
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OK, I'll list a few

outside musical entertainment was always appreciated by almost everyone.

pet therapy day

sing-a-long

PT games like toss/bounce the ball into the basket and kick the ball around the circle

the memory care where sis works now has a weekly dance and she says the residents love it
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