Current Activities in Long Term Care
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Activities for men with dementia:  Add some
competition to enhance the benefits
By Lorena Tonarelli, M.Sc. Research Reporter

Elderly men with dementia seem to be particularly keen on activities that involve some
“good natured competition,” reports Ellen Tolle, RN, MPS in Activities Director’s
Quarterly for Alzheimer’s & Other Dementia Patients.

It’s therefore a good idea to incorporate competitive sport activities in their program. The
benefits, in terms of well-being and quality of life, will be invaluable. Alzheimer’s
patients who participate in this kind of activity tend to be more sociable, are more
confident and focused, experience increased overall physical strength and coordination
and are generally happier – they laugh and smile more and are more communicative.

An example of such an activity is basketball. This is successfully used by Tolle
specifically with elders in the middle stages of Alzheimer’s disease at the Club, a social
day care center for people with dementia in Hewlett, New York.

  • •Masking tape is placed on the floor in front of an adjustable basketball hoop
    at one step (one-point mark), two steps (three-point mark) and three steps (five-
    point mark) away from it.
  • •Participants compete with each other in teams of no more than eight persons
    per team.
  • •Each elder throws the basketball three times, starting from the furthest mark.
    The team that collect the highest number of points win the game.

“For people in wheelchairs the height of the basket can be adjusted,” suggests Tolle.
“For those who have range of motion difficulties, the basket can be lowered and the
floor markings can be shortened.”

Remember, all participants need to have their doctor’s clearance to exercise. Also,
check their ability to stand and walk, and take appropriate safety measures: make sure
that the floor is not slippery and is free from clutter and/or loose extension cords and
that your elders wear comfortable shoes.

Tolle recommends having three persons to facilitate the activity: one to recover the ball
and two to help the participants. The players should be given plenty of verbal and
behavioral cues according to their individual needs. Each session should involve
elders with the same level of impairment in order to avoid feelings of frustration and

“During these competitive activities, the staff has noticed how supportive the men are of
each other,” says Tolle. “The best time of day for this type of activity is late morning,
when our participants are well rested and more focused. After the game, everyone
washes up and meets for lunch!”

Tolle E. “Competitive sports activities for men,” Activities Director’s Quarterly for
Alzheimer’s & Other Dementia Patients, Winter 2008, 9(1):9-13.

Compassionate caregiving
Are you taking your elders’ feelings seriously?

Validation is an all-important part of being a compassionate caregiver. It means being
able to show understanding for the reality of another person and provide emotional
support and comfort. This is particularly true when caring for older people with
Alzheimer’s disease, as these elders have lost contact with reality, and therefore, more
than anyone else, they need to be reassured that their feelings are taken seriously.

“If people feel that their emotional needs are respected and understood, they are more
likely to be in a state of better emotional well-being over time,” says dementia care
professor Dawn Brooker, of the University of Bradford in the UK. “If distress is met
promptly and emphatically, then, it is likely to dissipate more quickly.”

In particular, Brooker recommends that dementia caregivers:
  • •always acknowledge the feelings of the person in their care;
  • •show sincere concern for the emotional state of their elders; and
  • •never blame elders, or make them feel embarrassed or ashamed, for the
    way they feel.

So if, for example, one of your elders feels sad because she wants to go home to her
mother, avoid pointing out that her mother died years ago. Instead, show that you
understand and support her feelings with affection and love. Say something like, “I
understand what you mean. You must feel a little lonely. Tell me about your mother.
What was she like?” Your approach to the person should be marked by smiles and
genuine warmth.

This not only will make your elders feel reassured, accepted and loved, thus reducing
episodes of agitation and other challenging behaviors, it will also make you feel better,
as you will be more satisfied in your job, and consequently, less vulnerable to stress
and burnout.

Brooker D., Person-centered dementia care – making services better, 2007, Jessica
Kingsley Publishers.