Alzheimer’s Disease affects people in different ways. Rather than focusing on the disease and impairment, we should aim to identify each person’s strengths and remaining abilities and find activities to support these.

Alzheimer’s disease progresses slowly and typically in 3 stages: early-stage (mild), middle-stage(moderate), and late-stage (severe).

The rate at which the disease progresses varies from person to person. Some may live as long as 15 years with Alzheimer’s Disease whilst others less than half of that. The average life expectancy is around 8 years from diagnosis.

This article concentrates on activities for people living with late-stage Alzheimer’s Disease.

Typical changes observed in late-stage Alzheimer’s Disease

Significant emotional and behavioural changes occur at this stage. Changes include:

  • Vulnerability to other illnesses such as pneumonia
  • Language and reasoning difficulties – minimal or no speech
  • Severe memory loss
  • Impaired walking or rigidity
  • Difficulty with swallowing
  • Lack of focus/concentration
  • Possible unusual behaviour; passive or otherwise

Finding suitable activities for late-stage Alzheimer’s

The care needs for clients living with late-stage Alzheimer’s Disease concentrate on preserving dignity, comfort and quality of life. Activities should focus on the senses: sight, touch, smell, hearing, and taste.

Activities for late stage Alzheimer’s should be stimulating but without challenges. Choose activities that are repetitive and divide them into small tasks. Conduct activities with compassion, patience, sensitivity, and respect.

Realistic expectations are important. Don’t feel disheartened if motivation/engagement is not there when an activity is offered, come back and try again later.

Always consult with clinical senior staff before running activities for clients with late-stage dementia.

15 Activities for Late-Stage Alzheimer’s Disease

The following activities are one-on-one and should be offered in bursts of 15 minutes.

Take into consideration the background of each client to search for themes that might please, alert or engage them.

Consult with clinical senior staff regarding the health status of each client before activity. Be aware that clients may place inappropriate items in their mouths; supervision at all times is necessary.

  1. Sensory Books
    Provide colourful sensory books to look at and touch.
    Related: Sensory Lap Quilt
  2. Stuffed Toys
    Offer stuffed toys to cuddle.
  3. Pet Therapy
    Provide a real puppy or a cat to pat and spend some time with.
    Related: Pet Therapy in Nursing Homes
  4. Hand Massage
    Give your client a hand massage with lotion and a few drops of essential oils.
    Related: Hand Massage & Nail Care
  5. Physical Contact
    Brush hair, hold hands.
    Related: Comfort Activities
  6. Photo Albums
    Look at family photo albums.
    Related: Tips for one-on-one Visits with Seniors
  7. Sensory Bean Bags
    Provide small bean bags made of different fabric textures: cotton, velvet and silk, and filled with different grains.
    Related: Balloon Bean Bags
  8. Music & Movies
    Foster emotional connections via music, videos, and movies. Clients may only watch/listen for 5 to 10 minutes but if they are engaged you are providing precious quality of life.

    • Comedy: The Marx Brothers, Laurel & Hardy, Charlie Chaplin and Buster Keaton or Abbott & Costello, Dean Martin & Jerry Lewis
    • Music: Music of the era when clients were 20 or 30 years old. Swing dance music, Big Bands, Glen Miller, Crosby, The Andrews Sisters.
      Note: If your client is younger you would offer 1960’s and 1970’s material e.g. Australians would love to hear ‘The Seekers’.
    • Movies: Casablanca, Lassie Comes Home, How Green Was My Valley, Waterloo Bridge, Gone with the Wind, Heidi.
  9. Scent stimulation
    Put a diffuser in the bedroom with their favourite scent.
    Related: Vaporisation Activity and Aromatherapy Inhalations
  10. Bird watching
    Sit in the garden where they can see birds pecking at a seed tray.
    Related: Bird Watching
  11. Sunshine & fresh air
    Sit together in the sunshine to enjoy the sights and sounds for 10-15 minutes. Make sure the person has a wide brim hat, and sun lotion on arms and legs. Avoid the sun between 11 and 3 pm. Offer cool drinks.
    Related: Sunshine & Song
  12. Matching Colours
    Break instructions into small tasks, and wait for each task to end e.g. Ask client to pass you the red lids and put the red container nearby and then wait.
    Related: Matching Colours Activities
  13. Read Aloud
    Research indicates that people with Alzheimer’s Disease may be able to hear until very late into the illness. Read articles in magazines and newspapers that the person enjoyed in former times.
  14. Sight Stimulation
    Change the visuals inside bedrooms on a regular basis: posters, pot plants, family photographs, fresh flowers, mobiles and celebration decorations to make the person feel loved, and included.
    Related: Sensory Stimulation with Wind Chimes
  15. Watch a game of Sports
    Watching sports on TV can still be enjoyable. Decorate the room with the colours of their favourite team. Bring in sporting equipment such as a balls (cricket, baseball, soccer) or a leather glove to touch, feel and smell. Sing part of a sports anthem and see if you get any signs of recognition. Bring a couple of enlarged picture of famous sports people to show and talk about.

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