Strategic Planning for Caregiving

Caregivers of people with dementia often ask: “Why does my husband sit for hours doing nothing?” or “Why does my mother sleep so much? Dementia is a disorder in which there’s a decline in mental abilities severe enough to interfere with a person’s daily functioning.

Memory loss is a common symptom of dementia along with problems with language and communication, short attention span and decreased judgement and reasoning skills. Losses are seen in the ability to express interests, to identify and plan activities and to carry out the steps of an activity.

People with dementia often appear passive with an inability to get started. The opposite can also be true with increased irritation and frustration — and a tendency to say no to usual or new activities. Both behaviors are common for people with dementia beginning in the early stages of the disease. This presents significant challenges for family caregivers. Caregivers must provide structure and routine to the day. Having strong, established daily routines can help your loved one participate at his or her highest level.

When planning activities, it helps to think about the following factors:

Past History, Interests

Consider your loved one’s likes and dislikes for group or solo participation. What is she passionate about? Sports, work, animals, history? Former interests are a good place to start, but as abilities change, so can interests. Observe what makes your loved one engage: When does he look happy or immersed in an activity?

Current Abilities

Assessing ability is more difficult. Professionals, such as occupational therapists, can be a resource for helping you determine a person’s functional strengths and abilities. Occupational therapists are experts at working with people with dementia and helping caregivers learn skills and approaches for designing activity plans. This type of service is usually covered under medical insurance.

Meaningful Activities

Activities structure our time and use our abilities in meaningful ways. Participation in meaningful activities plays a key role in our health and happiness, and researchers and clinicians even support the value of activities as a treatment for dementia. Remember, it’s the quality of the experience for your loved one — not so much the type of activity.

Focus on enjoyment, not achievement. Choose activities that provide a sense of meaning, opportunities to assist others, and nourishment and stimulation for the body, mind and spirit. Build in activities that are social, use communication skills, enhance self-esteem and provide pleasure.

Get Creative

Activities and tours designed for people with dementia and their caregivers are excellent choices. Just a few local resources to explore include artsmia.org, walkerart.org and minnesotahistorycenter.org.

Creative arts programs for non- artists don’t rely on memory. Rather, they use imagination and allow self- expression without the use of words. Try familiar and new activities. Food-related activities are one of the most pleasurable and highly social events. Involve your loved one in shopping, prep work, cooking and eating.

Take “long cuts” instead of short cuts (such as baking cookies from scratch) to lengthen the time and provide opportunities for sharing special memories. Enjoy the product together and deliver it to a friend. Doing things for others is an important role that’s often lost for people with dementia. Provide opportunities for your loved one to continue to give to others.

Stay Active

Be active together. Build physical activity and exercise into the day. Take daily walks. Open up your senses to the experience: Enjoy natural surroundings together. Turn on some favorite music. Dance and sing together. And ask for help with daily chores. Simplify the steps as needed.

Find, and Accept, Support

As a caregiver it’s important to know your own strengths and limitations. You can’t be all things, including your partner’s activity director 24/7. Reach out for help. Learn about community supports such as adult day centers and make multiple sources of support a part of your plan. See Wilder's Caregiving Services, alz.org, leadingagemn.org for caregiving support and ideas.

Susan M. Ryan is an occupational therapist with the Adult Day Health program at the Amherst H. Wilder Foundation in Saint Paul.

This blog post was originally published in Minnesota Good Age magazine, which is available online.