‘An activity can be anything we do from the moment we get up in the morning to when we go to bed at night. Activity is essential to human well-being, and will help maintain a person's sense of self-worth and give purpose and enjoyment to the day. Supporting a person who has dementia to remain active and still feel involved in life can be the key to maintaining quality of life even into the later stages of the illness.’
These are the core values underpinning Dementia Active’s work in the community with people who have dementia and their families.
Dementia is an illness which isolates people from former friends who do not understand and who may fear it in their own lives. It can also create a feeling of separation even from their own loved ones. The value of spending time with others who can share this sense of isolation cannot be overestimated:
● There is a sense of community where no one need feel apologetic or uncomfortable about not being able to do those things which in the past would have been straightforward.
● Conversation is encouraged - both socially, particularly when people arrive but also in more structured reminiscence sessions.
● Group activities are opportunities to be playful - sitting in a circle and keeping a balloon in the air as long as possible and by any means possible is very funny for all involved!
● The benefits overall are raised energy levels and improved cognition.
Wherever possible Dementia Active encourages people to pursue interests which might be difficult in their own homes. The initial online referral form asks for information about a person’s hobbies and interests both past and present and this is a discussion topic during the home visit to the person with dementia and their family.
Dementia Active is committed to developing programmes which are based on a person's individual interests, background and level of ability - always seeking to discover their strengths rather than focusing on weaknesses. Cognitive Stimulation Therapy programmes are proving extremely valuable in supporting the maintenance of cognitive abilities.
In the early and middle stages of dementia it is possible to work with people using the techniques presented in a well researched programme of Cognitive Stimulation Therapy developed by Professor Aimee Spector et al, at UCL (University College London). This is now recommended by UK government guidelines on the management of dementia (NICE, 2018) and is the primary psychosocial intervention offered by UK memory clinics. Sessions are designed to actively stimulate and engage people with dementia and encourage social interaction in a relaxed group setting. They include the following structured activities:
● topical discussions
● gentle exercise
● ball/balloon games - for instance catching a ball and naming an object before throwing to someone else.
● more physically active games for those who feel able - football/netball
● arts and crafts
● table games
● digital technology - laptops and iPad apps
● Those who wish to feel part of the running of groups can be given small organisational tasks.
It is often the case that as dementia progresses people will maintain either greater auditory strengths (listening and speaking) or spatial visual strengths and during the first few weeks of membership of a group, a person’s individual strengths and weaknesses will be assessed.
The experience of attending group sessions may often serve to ‘awaken’ people when their families feel that they are becoming unreachable. Activities are playful, non threatening and multi sensory. Crucially in the later stages of the illness it is important to understand and work with those cognitive abilities which are still evident.
● Games such as ball catching and particularly keeping a balloon in the air which elicits an instinctive response.
● Music - delivered if necessary through headphones.
● Activities to stimulate touch and taste.
● Dancing - even those who have never danced will respond to both rhythm and the sense of being part of a group. There is no sense of judgement just togetherness.
● Singing - people whose speech has become limited will often hear a familiar song, remember the words and be able to join in. Singing in a group is a shared experience and the voices of others around them serve as a prompt. Clapping at the end of a song is in itself a form of mental stimulation.
● iPad apps which provide visual stimulation.
In addition Dementia Active provides a programme of monthly entertainment and short trips.
In conclusion, Dementia Active is committed to evolving and being responsive to research outcomes evaluating activity programmes.