There’s a massive difference between keeping an eye on someone living with dementia-related brain changes and offering them opportunities for life enrichment.
Engagement done well enables our people to experience less anxiety and agitation, and a higher sense of well-being wellbeing overall.
“It is going to cause the person to feel more productive,” says Edith Gendron, Founder and CEO of DementiAbility, LLC. “And it gives them that sense of control, and control is critical. We know that if someone has a measure of control about their life and about their decisions, they do better.”
Life enrichment, whether it takes place in a home setting or memory care facility, is about infusing one’s daily routine with value, purpose, satisfaction and pleasure, says Dementia Care Specialist Teepa Snow.
“If it doesn’t contain all those elements in adequate amounts, they are surviving, not thriving,” she says.
Wendy O’Connor, an independent consultant and former executive director, says that while coordinating activities might feel contrived at times, life enrichment is about building around an individual’s daily routine, and keeping their day as normal as possible.
Purpose can be injected into simple experiences like setting the table, and using phrases like, “I could use your help,” or “Your thoughts matter to me,” or even “I could use your eyeballs on this.”
For instance, if the person navigating brain changes was someone who liked working on cars, we might invite them to look at our speedometer and see how many miles we have on the car, or listen for a particular sound while driving around the block.
These moments ultimately invite the understanding that they matter and bring value to a situation.
If our person used to be a prolific painter and we live in Central Florida, perhaps we bring them to the Orlando Museum of Art’s offering “Art’s the Spark.”
According to the website, the program “gives those living with memory impairment, or any other neurological impairment, such as early stage Alzheimer’s disease or Parkinson’s disease, and their healthy caregivers a fun experience, an expressive outlet, and an opportunity for adult discussions.”
The day involves an intimate gallery tour before the museum opens and an art-making activity.
The person living with brain changes can still be impacted by being in the presence of art, Gendron says.
Other area offerings include the Alzheimer’s & Dementia Resource Center’s Embrace the Moment Excursions, and Central Florida’s Dementia-Friendly Dining.
Restaurants that participate in the program pledge to “provide friendly, safe and enjoyable places where families and friends may bring their loved ones who are living with Alzheimer’s and other forms of dementia,” the website states. “Key criteria among dining establishments is for a private dining area, a quieter time and day and willing management and staff who will receive training for providing quality services that meet the special needs of clientele with dementia, and their families.”
And even if Care Partners don’t go to a Dementia-Friendly designated eatery, they can still offer their people a sense of control by giving them two or three options instead of the entire menu, says Robin Rountree, the Director of Communications and Media for ADRC.
Similarly, even the task of getting dressed provides enrichment when we offer the essence of control by selecting two shirts, for example, and allowing our person to select which one they want to wear.
O’Connor says that even with the best intentions, we tend to oversimplify or overcomplicate things – both of which can backfire.
It’s best to keep things simple, and look for opportunities to create layered sensory experiences where possible.
For instance, maybe the Care Partner has a crockpot of meatballs on the stove. She might encourage reminisce by talking about a trip to Italy, looking at photographs, or even putting on soft Italian music in the background.
Similarly, the Care Partner might water and harvest herbs with her person, sprinkling the basil over the salad they’ll have for lunch.
It’s important to keep in mind that visual and olfactory changes do occur as we navigate these brain changes, and sensory programming should be responsive to those shifts.
“Our sorrow is the result of longing for that which we cannot have,” Gendron says. “We want our person to be the way they were.”
Our goal might be a “true gut-heart acceptance that this is not my mother of the past, this is someone who I love and care about today, and I am going to accept them for who they are and what they can do today,” she adds.
Another change we might observe is that what was interesting for 20 minutes in the past might only hold our person’s attention for five or so minutes today.
What might feel meaningful changes, too. A fidget blanket might be perfectly engaging for someone sensory seeking, depending on where they are on the journey.
“When we have progression, Care Partners tend to underestimate how many engaging activities or events that they need to have in their little bag of tools,” Gendron says.
ADRC Director of Arts and Wellness Ashley Gravatte says that it’s helpful to have an activity box at home for this purpose. This might include things like a photo album, or a deck of cards for sorting, or even a Music Box – a free resource which can be ordered through Gravatte.
Important Points for Memory Care Facilities…
If you are considering a memory care facility, it’s critical that you examine the life enrichment department.
“Do you walk into a room and see 30 people sitting around a television set?” O’Connor asks.
Do they offer chair yoga, dance? How is music used? Is there an accessible outdoor area? Does programming include layered sensory experiences? Are there programs that cater to both introverts and extroverts?
“Group activities are rarely as universally healthy as we want to think they are,” Gendron says. “They’ve got to be able to do what enriches the experience for them at their level…. What individualized engagement activities are being used for varying abilities?”
Gravatte suggests asking what kind of engagement residents receive if they opt out of a group activity.
And Snow recommends asking how the community determines which residents will attend pet therapy, yoga classes etc.
“Come on the weekends and come on the evenings and see what kind of programming is going on over the weekend,” she says. “What happens after 5? What time do they get put to bed? What time does breakfast run?”
A key indicator of a high-quality program is if they take into account the types of dementia that their residents are navigating.
If you have further questions, contact ADRC at 407.436.7750.
