Each day there are many things that provide us with purpose and pleasure.
For a person with dementia, the need for a good quality of life is not diminished. Abilities can vary greatly depending on a person’s age or their stage of dementia, but keeping involved and active in the things you enjoy is extremely important.
Many people will continue to live successfully on their own and can still engage in meaningful activities by developing and using strategies, routines and support that best suits their individual needs. Rather than giving up on hobbies, interests and activities that are becoming difficult, it may be possible to modify the activity.
For a person with dementia, it also helps to talk to other people who may be able to help them work out how to continue doing the things they enjoy. Support from family, carers and friends can be of great assistance to people whose ability to achieve purpose and pleasure has become much more difficult.
Below are a range of helpful guidelines that can help in planning appropriate activities.
Ideally, activities for a person living with dementia should:
Consider all that has made the person unique
This means knowing the person’s former lifestyle, work history, hobbies, recreational and social interests, travel and significant life events.
Activities can re-establish old roles
Make use of skills that have not been forgotten, such as washing up, sweeping or gardening. These are also ways in which a person with dementia can contribute to the household and feel useful. Encourage an area of responsibility no matter how small.
Activities can give relaxation and pleasure
It is very important to keep enjoying anything that gives meaning to one's life or provides a sense of pleasure or relaxation. Many people enjoy creative hobbies such as playing a musical instrument, knitting or painting. Others enjoy social contact, so it is important to keep this up as much as possible. A person with dementia may enjoy an outing even if they may not remember where they have been. What is important is that the moment is enjoyed.
Simple and unhurried activities that are meaningful are best
Give the time and space necessary to allow the person to do as much as possible. Focus on one thing at a time. Break down activities into simple, manageable steps. Communicate one instruction at a time.
Prepare a safe working area
People with dementia often have difficulty with visual perception and coordination. Ensure that surfaces are uncluttered with few distractions and noise. Good lighting, without glare, individual seat preferences and correct work heights are all important. If necessary, using plastic containers might help to avoid breakages.
Don’t allow activities to reinforce inadequacy or increase stress
Abilities can fluctuate from day to day. Activities can be adapted and tried another time if not successful or enjoyable.
Use times to suit the person’s best level of functioning
To ensure maximum success when carrying out activities it is best to consider the times of day when the person is at their best. For instance, sometimes walking is best done in the morning or the early afternoon. However for some people who are particularly restless later in the day, or who have had a particularly long or meaningless day, a late afternoon walk may be better.
Don’t over stimulate
Be selective with outings. Some people with dementia find that being among large groups of people can be overwhelming. If this is the case, avoid crowds, constant movement and noise.
Allow an emotional outlet
For many people, music or contact with babies, children or animals provides positive feelings. Excellent memories of past events are often kept and looking through old photos, memorabilia and books enables the recall of earlier times. The opportunity to relive treasured moments can be deeply satisfying. If reading skills have deteriorated make individual audiotapes. Locate picture books and magazines in the person’s areas of interest.
Include sensory experiences
Some sensory experiences that may be enjoyed are:
A sense of movement and rhythm is often retained longer than most abilities
Hire an exercise bike or a walking machine for rainy days. Be spectators or participants at dance classes or walk the dog together. Walkers enjoy the wider world while getting much needed exercises.
Consistency is important
It can be helpful to write out an activities care plan if different people are caring for the person. This will ensure that activities are consistent and are suited to the individual needs of a person with dementia.
Activities play a significant part in the dealing with changed behaviours. Knowing what helps to calm or divert a person when they are restless or distressed is very important. This can be particularly helpful for respite workers.
Don’t give up
It is possible to continue living a good quality life with dementia, despite any challenges that may be faced along the way. Mistakes can happen, so it is very important that you don’t let the person with dementia ever feel like a failure.
Encourage them to keep trying, and to continue engaging in activities that provide a sense of purpose, pleasure and relaxation. It is also important to encourage activities which provide mental stimulation, and promote better health and wellbeing.
Defining leisure, play, and recreation provides us as leisure professionals with a strong foundation for the programs, services, and facilities that we provide. While we might disagree on the standard definition of leisure, play, or recreation, we are all concerned with providing an experience for participants. Whether we work in the public, private nonprofit, or commercial sector, all three concepts are driving forces behind the experiences we provide. Table 1.1 outlines the basic definitions of leisure, play, and recreation.
There is debate about how to define leisure. However, there is a general consensus that there are three primary ways in which to consider leisure: leisure as time, leisure as activity, and leisure as state of mind.
By this definition leisure is time free from obligations, work (paid and unpaid), and tasks required for existing (sleeping, eating). Leisure time is residual time. Some people argue it is the constructive use of free time. While many may view free time as all nonworking hours, only a small amount of time spent away from work is actually free from other obligations that are necessary for existence, such as sleeping and eating.
Leisure can also be viewed as activities that people engage in during their free time—activities that are not work oriented or that do not involve life maintenance tasks such as housecleaning or sleeping. Leisure as activity encompasses the activities that we engage in for reasons as varied as relaxation, competition, or growth and may include reading for pleasure, meditating, painting, and participating in sports. This definition gives no heed to how a person feels while doing the activity; it simply states that certain activities qualify as leisure because they take place during time away from work and are not engaged in for existence. However, as has been argued by many, it is extremely difficult to come up with a list of activities that everyone agrees represents leisure—to some an activity might be a leisure activity and to others it might not necessarily be a leisure activity. Therefore, with this definition the line between work and leisure is not clear in that what is leisure to some may be work to others and vice versa.
Unlike the definitions of leisure as time or activity, the definition of leisure as state of mind is much more subjective in that it considers the individual's perception of an activity. Concepts such as perceived freedom, intrinsic motivation, perceived competence, and positive affect are critical to determining whether an experience is leisure or not leisure.
Perceived freedom refers to an individual's ability to choose the activity or experience in that the individual is free from other obligations as well as has the freedom to act without control from others. Perceived freedom also involves the absence of external constraints to participation.
The second requirement of leisure as state of mind, intrinsic motivation, means that the person is moved from within to participate. The person is not influenced by external factors (e.g., people or reward) and the experience results in personal feelings of satisfaction, enjoyment, and gratification.
Perceived competence is also critical to leisure defined as state of mind. Perceived competence refers to the skills people believe they possess and whether their skill levels are in line with the degree of challenge inherent in an experience. Perceived competence relates strongly to satisfaction, and for successful participation to occur, the skill-to-challenge ratio must be appropriate.
Positive affect, the final key component of leisure as state of mind, refers to a person's sense of choice, or the feeling people have when they have some control over the process that is tied to the experience. Positive affect refers to enjoyment, and this enjoyment comes from a sense of choice.
What may be a leisure experience for one person may not be for another; whether an experience is leisure depends on many factors. Enjoyment, motivation, and choice are three of the most important of these factors. Therefore, when different individuals engage in the same activity, their state of mind can differ drastically.
Unlike leisure, play has a more singular definition. Play is imaginative, intrinsically motivated, nonserious, freely chosen, and actively engaging. While most people see play as the domain of children, adults also play, although often their play is more entwined with rules and regulations, which calls into question how playful their play really is. On the other hand, children's play is typified by spontaneity, joyfulness, and inhibition and is done not as a means to an end but for its inherent pleasure.
There is some consensus on the definition of recreation. Recreation is an activity that people engage in during their free time, that people enjoy, and that people recognize as having socially redeeming values. Unlike leisure, recreation has a connotation of being morally acceptable not just to the individual but also to society as a whole, and thus we program for those activities within that context. While recreation activities can take many forms, they must contribute to society in a way that society deems acceptable. This means that activities deemed socially acceptable for recreation can change over time.
Examples of recreational activities are endless and include sports, music, games, travel, reading, arts and crafts, and dance. The specific activity performed is less important than the reason for performing the activity, which is the outcome. For most the overarching desired outcome is recreation or restoration. Participants hope that their recreation pursuits can help them to balance their lives and refresh themselves from their work as well as other mandated activities such as housecleaning, child rearing, and so on.
People also see recreation as a social instrument because of its contribution to society. That is, professionals have long used recreation programs and services to produce socially desirable outcomes, such as the wise use of free time, physical fitness, and positive youth development. The organized development of recreation programs to meet a variety of physical, psychological, and social needs has led to recreation playing a role as a social instrument for well-being and, in some cases, change. This role has been the impetus for the development of many recreation providers from municipalities to nonprofits such as the YMCA, YWCA, Boy Scouts of America, Girl Scouts of the USA, and the Boys and Girls Clubs of America. There are also for-profit agencies, such as fitness centers and spas, designed to provide positive outcomes.