Preventing decline in Activities of Daily Living (ADLs) for individuals with dementia requires a proactive and holistic approach. This includes cognitive stimulation, physical activity, social engagement, supportive care, and medical management.
A Personal ADL (PADL) assessment should be carried out before starting any exercises to ensure that activities match the resident’s abilities and do not push them beyond their capabilities.
1. Cognitive Stimulation
- Encourage activities that challenge the brain without diminishing self-confidence.
- Match mental exercises to the individual’s abilities, not the other way around. Remember that each person will have their own unique level of ability.
- Suitable activities include word games, puzzles, and crosswords.
- Offer guidance without direct questioning - engage in conversation, chat about possible answers, and avoid dwelling on mistakes.
- Use a gentle, supportive approach - if frustration arises, switch to a different activity.
2. Learning New Skills
- Encourage the learning of new skills.
- Choose low-pressure activities like painting, colouring, or plant potting - these allow creative expression without right or wrong answers.
- Focus on enjoyment and engagement rather than outcomes.
3. Structured Cognitive Training
- For those cognitively able, participation in structured cognitive stimulation therapy (CST) can provide both cognitive and social benefits.
- These programs should be facilitated by trained professionals.
4. Regular Physical Activity
- Activities like walking, strength training, and swimming (if appropriate) can improve balance, cardiovascular health, and overall well-being.
- If mobility is limited, consult an Occupational Therapist (OT) to recommend adapted exercises such as chair yoga or a seated pedal bike.
5. Social Engagement
- Encourage regular interactions with family and friends.
- Meaningful conversations with loved ones help maintain cognitive function and support continued independence in daily activities.
6. Healthy Lifestyle Choices
- Ensure proper hydration and a nutritious diet rich in fruits, vegetables, healthy fats, and proteins.
- The Mediterranean diet has been linked to improved cognitive and physical health.
- Promote good sleep hygiene, as quality sleep is essential for cognitive function.
7. Regular Medical and Medication Reviews
- Schedule routine medical checkups to manage conditions such as hypertension, diabetes, and cardiovascular disease, which can impact cognitive health.
- Review medications regularly to prevent side effects and avoid polypharmacy (the excessive use of medications).
8. Emotional and Psychological Support
- Encourage participation in support groups for emotional well-being.
- If psychological distress is present, consider a referral to the appropriate team, such as Psychiatry of Later Life.
Person-centred Approach
Supporting individuals with dementia in maintaining ADLs requires patience, empathy, and adaptability. By integrating these strategies into daily care, we can help preserve independence, dignity, and quality of life.