Time, time, time. Caregivers measure it in minutes, hours, days. But for someone with dementia, time is like a broken clock. It’s a concept that no longer seems useful or needed.
I’m the kind of person who has spent decades running around trying to fit just one more thing into already busy days. One consequence of this habit is that I’m often late. There just isn’t enough time in the universe for me to complete the tasks I set for myself and still be punctual. I sincerely regret the number of times I’ve left good friends waiting for me. But when I’m with my mom, I have the opposite problem. Ever busy me finds it nearly impossible to fill time spent alone with her in a satisfying way.
Usually I tell Mom stories. Sometimes she’s lucid enough to laugh or say yes or offer a one syllable comment. But more often she’s only engaged with me for a few minutes before she goes into Sleep mode — that restful state that resembles your car’s neutral gear. How can you use this time to feel like you’re connecting with someone whose reality is so different from your own?
I often play music to get us both tuned into the same frequency. The sound of Chuck Berry or the Everly Brothers will keep her attention for a little while. Now and then she tries to clap and can occasionally get her hands lined up the right way. But after a song or two, she goes back to her netherworld — unless the music is very uplifting. Tunes that keep her involved include “Rockin’ Robin” and “Happy” by Pharrell Williams. “Happy” is so infectious I have seen it revive a room full of dementia patients for the full four minutes it plays. The song has an almost magical ability to make people smile and move.
Good times come and go but there are still many frustrating moments when you want to pull a dementia patient in and they just stay on their distant planet. What do you do to invite your loved one into your world? What tricks do you use to connect with them when the wires are frayed and their glance keeps moving to some far off place?
Researchers in two different parts of the world — India and Finland — have been conducting studies to see if occupational therapy and hands-on hobbies improve quality of life for dementia patients. The group in India studied more male patients. The one in Finland studied women. Both found improved responses among patients who spent time engaged with different hands-on activities.
Considering these two research projects together, it seems that it can be very beneficial to keep dementia patients busy with activities that involve both their minds and their hands. Here is a laymen’s explanation of this work.
The study in India was led by Prakash Kumar and his colleagues. They used a scale developed by the World Health Organization to complete a Quality of Life Assessment among dementia patients. Then they had a group of participants (80.5% male) engage in a structured program of activities that included:
- Relaxation for 10 minutes which involved alternately tensing and releasing different group of muscles
- Physical exercises for 10 minutes aimed at maintaining strength, mobility, circulation and general health
- Personal activities for 15 minutes which included general care of nails, teeth and hair — and household tasks such as arranging bed sheets, gardening and counting currency.
- Cognitive exercise for 20 minutes included reading, solving picture puzzles, drawing, and clay color activity
- Recreational activity for 10 minutes such as viewing television, playing indoor games, table games, quizzes, Chinese checkers, telling stories, singing, and participating in organized social events.
The researchers wanted patients to do activities that stimulated their physical, functional, behavioral, psychological, and cognitive skills. After five weeks in the program — with two 70 minute sessions per week — patients showed significant improvement in physical performance, sleep quality, and energy for activities of daily living. The Quality of Life surveys also showed that patients had a greater appreciation of life and reduced negative feelings like anxiety and depression.
In the Finnish study, Sinikka Hannele Pöllänen and Reetta Marja Hirsimäki, conducted reminiscence sessions with older women in residential care who had severe symptoms of dementia. These same women enjoyed doing crafts as a leisure activity earlier in their lives. The researchers conducted three reminiscence sessions using different kinds of handicrafts to trigger memories and offer stimulation. Activities that combine several different senses (such as smell, touch, and taste) stimulated verbal reactions, better attention and nonverbal communication among the patients. In this group, the most interesting triggers also succeeded in stimulating the recall of forgotten, pleasing experiences related to doing crafts.
Both of these studies help to make the point that it’s important to try to keep loved ones involved in doing things that combine the work of hands and mind. This isn’t always easy — apathy may make them want to give up before they start. It’s also true that when one is busy cleaning the house, cooking, or doing other essential work, it’s hard to find time to organize an activity for someone with dementia. But if you can make the time, it may be worth the effort to get them involved in a hands-on project that stimulates them during the day, and promotes calmer evenings (and better sleep!) for all.