Can anyone share ideas about what your nursing home or memory care facility does to keep late stage people engaged?

If the staff could get a song list together on an iPod and send it out through a Bluetooth speaker then more than one resident could enjoy it. Someone could download music that the residents would enjoy. Old standards, sing-a-longs, funny songs....I think the residents would enjoy it and if a staff member (from the Activity Dept?) tried to get the residents engaged it could be a really fun activity.

I hope you can help get this together. Music is wonderful therapy and good for the soul.

The challenge of late stage dementia activities is that they have to be (for the most part) one-on-one activities to be able to judge how engaged a person is, the individual abilities of the person, and interests. Nursing homes (by whatever name, SNF, etc) are NOT set up to provide one-on-one activities especially if they are a Medicaid or non-profit placement. Music shared in a general area is probably the best you'll get for a group activity. It's like looking for individual attention for your baby in a group setting - a day care is not going to give each infant one-on-one attention for social stimulation all day long, heck, probably not for more than 15-30 minutes per day.
If you are looking at doing one-on-one for your mom, here's a list I found online and if there's an occupational therapist on-site, they may have some of the materials.
1. Sensory Books--Provide colourful sensory books to look at and touch. Example of alternative - Sensory Lap Quilt
2. Stuffed Toys--Offer stuffed toys to cuddle.
3. Pet Therapy--Provide a real puppy or a cat to pat and spend some time with. This is tricky with allergies and whether your local area has volunteers.
4. Hand Massage--Give your client a hand massage with lotion and a few drops of essential oils.
5.Physical Contact--Brush hair, hold hands.
6.Photo Albums--Look at family photo albums.
7.Sensory Bean Bags--Provide small bean bags made of different fabric textures: cotton, velvet and silk, and filled with different grains.
8.Music & Movies--Foster emotional connections via music, videos, and movies. Clients may only watch/listen for 5 to 10 minutes but if they are engaged you are providing precious quality of life.
Comedy: The Marx Brothers, Laurel & Hardy, Charlie Chaplin and Buster Keaton or Abbott & Costello, Dean Martin & Jerry Lewis
Music: Music of the era when clients were 20 or 30 years old. Swing dance music, Big Bands, Glen Miller, Crosby, The Andrews Sisters.
Note: If your client is younger you would offer 1960's and 1970's material e.g. Australians would love to hear 'The Seekers'.
Movies: Casablanca, Lassie Comes Home, How Green Was My Valley, Waterloo Bridge, Gone with the Wind, Heidi.
9.Scent stimulation--Put a diffuser in the bedroom with their favourite scent. Again, cautions with allergies and safety regulations.
10. Bird watching--Sit in the garden where they can see birds pecking at a seed tray.
11.Sunshine & fresh air--Sit together in the sunshine to enjoy the sights and sounds for 10-15 minutes. Make sure the person has a wide brim hat, and sun lotion on arms and legs. Avoid the sun between 11 and 3 pm. Offer cool drinks.
12.Matching Colours--Break instructions into small tasks, and wait for each task to end e.g. Ask client to pass you the red lids and put the red container nearby and then wait.
13.Read Aloud--Research indicates that people with Alzheimer's Disease may be able to hear until very late into the illness. Read articles in magazines and newspapers that the person enjoyed in former times.
14.Sight Stimulation--Change the visuals inside bedrooms on a regular basis: posters, pot plants, family photographs, fresh flowers, mobiles and celebration decorations to make the person feel loved, and included. Of course, this has to be tempered with individual change anxieties.
15. Watch a game of Sports--Watching sports on TV can still be enjoyable. Decorate the room with the colours of their favourite team. Bring in sporting equipment such as a balls (cricket, baseball, soccer) or a leather glove to touch, feel and smell. Sing part of a sports anthem and see if you get any signs of recognition. Bring a couple of enlarged picture of famous sports people to show and talk about.

The national council on certified dementia practitioners also has a word document available on line with activities for Alzheimers with it broken out by early, middle and late stages. If admin deletes the link you can google alzheimers dementia activity ideas. The facility will never be able to duplicate the individual attention you gave your mom, but you cannot be awake 24/7 to take care of her and have a life, CW.

https://www.nccdp.org/resources/AlzheimersDementiaActivityIdeas.pdf

Thanks for the list and link Guestshop. I know that it is hard to help people who essentially need one on one assistance but there could at least be some effort made, I would be overjoyed if mom got even 15 minutes of attention a day that wasn't focused on her ADLs. I honestly can't understand how so many people who have spent their lives working with the elderly and dementia fail to see the glaring flaws in their normal procedures. Why plan almost exclusively evening entertainment when 90% of them are tucked into bed by 7:00? Does their conscience not twinge when they cluster the residents in front of the TV with movies and programs that they clearly can't follow? Not. One. Person!! Is providing a cupboard full of board games, puzzles, word searches or colouring books that are beyond their capabilities good enough? There is a woman there who is only in her early 60's, is she doomed to aimlessly wander the halls for the next 30 years?

My mom's nursing home was able to provide one-on-one attention through the use of volunteers. For the weekly Bingo games (which many residents seemed to love) the volunteers sat at tables where someone might need help. My mother never did need help, but some people had very slow reaction times in spotting the numbers. They could still play and win.

They had live music a couple of times a month, at least. It was at 2 pm. Volunteers saw that everyone had a beverage. One gentleman loved to dance and a volunteer danced with him. (Once I did. My mother approved.)

There was a small stream on the property. On a nice day they held duck races. Using plastic ducks of different colors the race was to see which one finished at the end of the stream first. Each person was assigned a duck and three ducks raced each time. There was cheering for "Go Blue Duckie, go!" and "Oh no, Pink, don't go into the wild flowers!" I'm sure there were residents who had no idea what was going on, but it was nice to be outside, sipping lemonade, and listening to people in a festive mood.

Movies were shown periodically in the chapel (a very multi-purpose room). The selection was always appropriate. The treat was a popcorn item without husks. Wheelchairs were arranged among the regular chairs so everyone could see. I'm sure not everybody followed the plot, but, again, it was pleasant to be in a different environment with people who were enjoying themselves.

Once a month or so they had a spa day. Volunteers did hand massages and applied nail polish.

There was usually at least one jigsaw puzzle being worked on in the fireside room.

There was an effort to pair up people who liked to play the same card games.

Anytime a craft activity was scheduled there would be volunteers to help those who needed it ... to the point where sometimes the volunteer did the entire project, encouraging the resident to pick out the color or hand her the glitter. There was one blind resident who always went to the beading sessions. The volunteer would say, "Today your blouse has light greens and pink. Would you like a necklace to go with that? Here are the three sizes of pink beads. Which one do you want to use?"

There were always stacks of magazines sitting around. Many residents enjoyed looking at the pictures.

They did a little gardening in raised beds. They sometimes did a little baking.

It is not realistic to expect much one-on-one interaction from the overworked staff. But volunteers can make a huge difference.

Of course personal visits are the best way to engage the residents. My mom had at least 4 family visits per week. A couple of us colored with her. Not finding suitable coloring books, I printed coloring pages from the internet. Mom liked to color flowers best. She often pinned the results up in her room. Two of us played cards with her, getting more and more simple as we went along. We all took her for a wheelchair walk around the neighborhood in nice weather. One was in charge of seasonal decorations for her room. Personal visitors are best! But not everyone has that, and the volunteers help make up for that.

Mom's nursing home had mostly Medicaid residents. The building was 50 years old, and left a lot to be desired (like bathrooms you could actually get a wheelchair into). But thinking back over the 2.5 years Mom was there I can see why it had a good reputation.

Wow JG, there must have been a lot of high functioning people in your mom's NH, all those activities might be appropriate for those on the AL side of the building but would be beyond most of the people I see in mom's NH.

Cwillie, about half of the residents in Mom's NH had dementia. They also had a memory care unit for more advanced cases and wanderers.

You really don't have to be very high-functioning to be pushed in your wheelchair to sit near the little stream and watch plastic ducks go down the stream. You just need enough staff and volunteers to get everyone out there and settled with a treat. If you have a volunteer sitting next to you, you don't even have to recognize numbers to put your marker where she points. And since most people have played bingo since childhood the memory of how to play often hangs around. Some of the people who come to listen to live music (which usually included the folks from the memory floor) have their eyes shut. Who cares?

I don't think Mom's NH had a particularly high percentage of high functioning residents. Some, for sure. (The dancer!) But they made an effort to engage even advanced needs people in the activities. Some, of course, didn't participate. Mom's roommate seldom joined in. My mother went to absolutely everything! Even if she didn't throw the big ball at the blow-up bowling pins she seemed to enjoy watching others do it.

If the staff starts from the assumption that "these people are too advanced to do activities," then they won't try to engage them and it becomes a self-fulfilling prophecy.

One thing they did have on the AL side was a monitor showing a cam recording of an eagles nest. We took Mom over there a couple times a week to see the progress of the baby eagles.

By and large the activities at mom's memory care are not stimulating despite the monthly newsletters from corporate which tout their latest new breakthroughs not to mention the recorded message on their phone system actually says they encourage folks to play golf and swim - where? In the fountain in the front yard ?

The one thing they do well is live entertainment on Saturday and Sunday afternoon - music is wonderful and nearly all are happy with it

In the evening, a familiar musical on tv is always a hit too

One reason I brought a private aide in during the afternoon was so mom could have some one on one time since I work and no other family visits her - jigsaw puzzles particularly the larger 60-150 piece ones kept her going for months although she can no longer do them - and many went missing from her closet :(

Her favorite activity remains dessert especially pie

I stopped in yesterday to chat with nursing and saw the usual crowd ranged in front of the TV, volume impossibly low, while PT quietly worked on range of motion with them individually. I suggested music and she switched to a cable music station, OMG there was an instant reaction, resident's who had appeared comatose suddenly perked up and smiled! Mom, of course, was in her room sleeping, but I managed to make some other people a little happier.

Good job, Cwillie !

If you can find a DVD of hello dolly - the song and dance numbers will put a smile on their faces too

Ah yes, the favorite activity of dessert! When Mom lived in her apartment she got Meals on Wheels. She liked it. When we'd ask how was the lunch today, she'd reply, "Oh it was great. They had apple pie." She wouldn't always remember what else was in the delivery, but she did eat it all.

Care centers need to pay attention to desserts!