As Memory Fades.....
The Caregivers Challenge Begins
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Loss Of Meaningful Activities
Activities define who we are. When the patient loses the ability to drive,
work, mow the grass, cook, or perform other meaningful tasks, depression
or anxiety may result. It is important to substitute old cherished activities
with similar simpler activities.
If there is an occupational therapist in your area, talk with either occupational therapist or activity therapist to help design replacement activities. If no therapists are available in the hospital in your area, contact a nursing home and ask for the activity director. If you have adult day programming available, use it. It can provide social contact and meaningful activities for the patient as well as respite for you..
Allow the patient time to talk about their losses. Grieving is normal -- even desirable. If the grieving lasts for more than 3 weeks, affects sleep or appetite, see your doctor about treating the patient's depression. Discuss the disease process with the patient so he/she can understand why activities are being lost and they do not think, "they are going crazy."
If the patient is losing driving privileges either you or a health professional should tell them the reason. If no one discusses the problem with the patient, they are likely to develop paranoid or suspicious ideas.
While you may not choose to use the term "Alzheimer's disease" most patients can understand the idea of "brain disease," or "memory loss problem." The patient may become angry or deny their memory loss.
If this happens, drop the subject for a time. The goal is not to get the person to admit the memory loss, but to help them to understand why these things are happening.
Denial and anger are a normal part of the grieving process. Do not assume that ignorance of the disease process will lead to a happier patient.
Also, do not think that telling the person about the memory loss will "kill them" or cause them to "give up." This is very rarely the case. Trying to hide the illness from the patient becomes increasingly difficult and strains your relationship with the patient. Have the patient help around the house.
Many people can manage simple activities such as dusting, sweeping, table setting, sorting, and helping with simple cooking tasks late into the disease. Think of the activities as therapy.
Do not evaluate the results. If the person's performance is incomplete or sloppy accept it is part of the disease process and recognize that the activity remains valuable for your loved one.
Look at activities that may be too dangerous such as using power tools, hunting, feeding livestock, working with flammable tools, and try to replace them with safer activities. Many men who have not had hobbies are able to learn simple repetitive tasks with supervision such as painting, latch hook rug making, cooking, and simple woodworking.
Pets, gardening, and musical activities often produce a high degree of satisfaction and offer good exercise. Exercise three times each week will help to maintain a positive mood and functional abilities. Exercise may include walking, gardening, dancing, or use of a stationary bicycle.
Reading aloud to your loved one is often a satisfying and reassuring activity even late in the disease. Use videotapes to your advantage. Obtain videos of old television comedies, tape favorite sporting events, and have videos of family members. Avoid stories that include violence, murders, or cartoons.
Supported by: Iowa Scottish Rite Masonic Foundation,
National Caregiving Training Project,
University of Iowa College of Nursing,
Gerontology Nursing Intervention Center
Research Development and intervention Core
Developed by: Geri R. Hall, Ph.D., ARNP, CNS
Gerontology Clinical Nurse Specialist
Mayo Clinic Scottsdale
13400 E. Shea Boulvard
Scottsdale, Arizona 85259
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