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Best Therapeutic Activities for Mild, Moderate, and Severe Alzheimer's

Medically Reviewed by Carol DerSarkissian, MD on August 10, 2022

Activities of everyday life – whether they’re planned or unplanned – are therapeutic for people with Alzheimer's disease. They can make people happier, more relaxed, and healthier. “Therapeutic activities” is a broad category. It includes everything from being there for a person physically and interacting with them socially to doing arts and crafts projects or playing with pets.

These activities are important because they can improve mental functioning, which also improves a person’s ability to do day-to-day tasks. Activities can help people with Alzheimer’s reduce the risk of getting emotional disorders. And they improve or help keep their quality of life, which also benefits caregivers.

Effectiveness can be hard to measure exactly. There’s no easy way to come up with a specific “dose” of this kind of therapy among people with Alzheimer’s. Plus, responses to therapeutic activities are different for different people.

Getting Started

People with Alzheimer’s may start to ignore or stop doing normal activities before it’s actually necessary. They may ask or allow others to do things they once did. With that in mind, the person with Alzheimer’s – as well as their caregivers, family, and friends – should start to look for ways to keep their lives active from the earliest stages of Alzheimer’s. You can even create a customized activity plan for the person with Alzheimer’s, based on their interests, challenges, and ability. (It’s a good idea to regularly test hearing and vision to make sure you have good communication about and during these activities.)

Best Therapeutic Activities Based on Stages of Alzheimer’s

The types of beneficial activities – and how challenging they should be – changes over the course of Alzheimer’s, based on the person. Different combinations of activities can also change depending on the stage of disease. At every stage, you can pick (and combine) activities that are mental (cognitive), physical, social, expressive, and memory-based. Don’t forget: It's important to praise and compliment the person during therapeutic activities.

The types of beneficial activities – and how challenging they should be – changes over the course of Alzheimer’s, based on the person. Different combinations of activities can also change depending on the stage of disease. At every stage, you can pick (and combine) activities that are mental (cognitive), physical, social, expressive, and memory-based. Don’t forget: It's important to praise and compliment the person during therapeutic activities.

Stage: Mild

In the earliest stage of Alzheimer’s disease, people may:

  • Misplace things
  • Ask the same question again and again
  • Forget words
  • Forget something they just read
  • Be unable to remember names when meeting new people
  • Have a hard time making plans or organizing projects

During this stage of Alzheimer’s, these therapeutic activities may be helpful:

  • Cognitive (thinking) activities. Things like trivia, word searches (puzzles), and card and board games.
  • Physical activities. Try fitness routines and whatever gets someone moving like walking, dancing, gardening, and flower arranging.
  • Social activities. Talking with friends and loved ones storytelling are examples.
  • Expressive activities. They may like painting, playing or singing music, journaling, and writing letters to loved ones.
  • Remembering activities. These include scrapbooking, cooking and baking favorite recipes, and holiday traditions.

Ideas for customizing:

Where you are. If the person with Alzheimer’s lives close by, family members can visit and participate in the activities. If they live farther away, ask nearby friends or other caregivers to help.

Age. Adults and teenagers can easily join the person with Alzheimer’s in activities like walking or cooking. Younger children may not be able to. But kids may enjoy activities like board games, dancing to music, or telling stories.

Stage: Moderate

In the middle stage of Alzheimer’s disease, people may:

  • Forget details about themselves
  • Have trouble cooking meals or ordering from a menu
  • Get confused about what kind of clothes to wear
  • Forget details about time, seasons, dates, and locations
  • Have a strong emotional need to have a purpose or care for something
  • Have problems with sleep
  • Develop hygiene issues and incontinence (loss of bladder control)
  • Need help starting or continuing activities

During this stage, these types of activities may help:

  • Cognitive (thinking) activities. These are daily living tasks such as folding laundry, washing dishes, and sorting socks.
  • Physical activities. Choose something easy to follow, like dancing to familiar music or guided walks.
  • Social activities. Try pet play-dates, or talking with friends about familiar or interesting topics.
  • Expressive activities such as taking arts classes, watercolor painting, and singalongs.
  • Remembering activities such as looking through photo albums, watching an old movie, holding a beloved doll or stuffed animal, and aromatherapy.

Ideas for customizing:

Sorting. Grouping items together is a great way to provide meaning and purpose to activities. This can include sorting playing cards by suit or dominoes by color. It can also include sorting socks, office supplies, utensils by size, tools, or jewelry.

Cooking. Many people at this stage can enjoy cooking and preparing meals. Try to have ingredients and tools (bowls, mixers, etc.) ready before you begin.

Stage: Severe

During this stage, the person with Alzheimer’s has limited ability to communicate and almost total memory loss. They might:

  • Mistake a person for someone else
  • Recognize faces but not remember names
  • Have delusions, like thinking they need to go to work even though they don’t have a job anymore
  • Need to hold on to something for comfort
  • No longer recognize when they’re thirsty and hungry
  • Need help with all activities of daily living, even basics such as eating, walking, and sitting

During the severe stage, activities can be changed to focus on the five senses:

  • Cognitive (thinking) activities. These are things that encourage hygiene, like washing hands to familiar music, and simple activities that can stimulate their senses, like watching a wall clock or bird feeder, for example, or listening to wind chimes.
  • Physical activities. These can include gentle, simple stretches and slow movements.
  • Social activities. Examples include interacting with pets, human touch (hand massage or just holding hands), love (hanging out, being present), listening to audiobooks, or reading to the person.
  • Expressive activities such as listening to music or activity pillows.
  • Remembering. Things like looking at photos (including older photos that can be stored on tablets or phones), watching an old movie, and hugging a stuffed animal or toy are examples.

Ideas for customizing:

At this stage, quality of life is important. Focus on activities that take advantage of the person’s vision, hearing, touch, smell, and taste. This may include gazing at familiar or enjoyable scenes, like a fish tank, favorite photos, or art. It could include using aromatherapy to appeal to their sense of smell, with scented candles or lotions (lavender is a good choice), or the smell of just-baked cookies or cakes.

Online Resources

The Alzheimer’s Foundation of America offers support services for caregivers, including:

Show Sources

SOURCES:

Alzheimers.gov: “Tips for Caregivers and Families of People With Dementia.”

Alzheimer’s Association: “50 Activities.”

Alzheimer’s Foundation of America: “Therapeutic Activities for 3 Main Stages of Alzheimer’s Disease,” “Alzheimer’s activities, brain exercises for dementia,” “Caregiving Resources.”

National Council of Certified Dementia Practitioners: “Activity Ideas for Alzheimer’s/Dementia Residents.”

National Institute on Aging: “Adapting Activities for People With Alzheimer’s Disease.”

Dementia: A NICE-SCIE Guideline on Supporting People With Dementia and Their Carers in Health and Social Care: “Therapeutic Interventions for People with Dementia — Cognitive Symptoms and Maintenance of Functioning.”

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