15 Activities for Late-Stage Alzheimer's Disease

15 Activities for Late-Stage Alzheimer's Disease

Found In: Activities Articles Alzheimer's & Dementia

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. Here are 15 Activities For Late-Stage Alzheimer's Disease.
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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.

Related: Alzheimer's Disease vs Dementia

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.

Related: 30+ Sensory Activities for people living with 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.
    Related: The Benefits of Individual Music Activities for the Elderly
    Related: Free Music Playlists for Seniors

  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.

Good Luck!

Related: 20 Practical Activities for People Living with Alzheimer's Disease

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Comments   Post a Comment

Lin 6th Feb 2023 Caregiver
Thank you all sooo very much for your helpful suggestions! I care for a man who has just entered into late stage Alzheimer's disease. His attention span is extremely short and it has become quite difficult to keep him content and engaged.
I plan on trying several of the ideas many of you have mentioned! Thank you again!! This is an invaluable resource!!
Talita 12th Feb 2023
Thank you so much for your feedback Lin, all the best!
Susan 12th Feb 2022 Activity Director
Hi Margo
Thank you for your ideas
Margo 11th Feb 2022
Thanks for the suggestions. I find the best shows are nature shows. When they are sitting in front of old movies and game shows they just seem to stare off but nature shows really engage them.

Also if course show about dogs and cats. Lucky Dog is a good one. The voice tones are always kind and the animal handling by the trainer and the people he delivers their new dog to is very engaging. He just seems like a really good and sincere guy. But anything David Attenborough put out; things like this they love. Even though animals are killed for god it doesn’t seem to bother them like human violence. (Human violence shows bother me too)

In the same level there are children’s shows like Happy Feet and Minions they like (Minions II was really about humans). And on Netflix Tiny Creatures, Penguin Town and Animal. These are somewhat more geared to children but not insulting to adult intelligence either.

angie 25th Feb 2021
Hi Lynn, Due to the Corona Virus we are having a hard time motivating our dementia Unit I would appreciate any ideas. Most of them are late stage Alzheimer's
Susan 26th Feb 2021 Activity Director
Hi Angie
Have you tried the activities listed here suggested by others or in the article??
Are you looking for a group activities or one to one activities??
Susan 16th Oct 2020 Activity Director
Wow Lyn
It sounds like you have some great ideas
Remember those with late stage dementia have a very short attention span so you may have to do short activities but have a rest time to
Food usually is a good tool because most people like to eat
Perhaps you can find some simple recipes or make some simple things like pudding
Lyn 16th Oct 2020
I am a fairly new caregiver with Home Instead. I have a client with severe Alzheimer's. I am looking for ideas to occupy her as she likes to wonder around the house. FYI I worked one day with her and I had her fold laundry. I was a preschool teacher and have ideas, but can use your input. I thought about adult coloring books, shoe matching, containers with lids to match, Legos to match colors and shapes, but I may have to bring whatever I do. I may ask a friend to make me bean bags. There is so much you can do with those, including toss into a basket or box. Music is another thing that came to mind. I asked if she danced, but only learned she liked to visit with her friends. Tomorrow I may try a tea party and include a doll she seems to like. Any ideas would be appreciated.
Susan 16th Oct 2020 Activity Director
Hi Lyn
Why not try a simple cooking activity like making pudding
Christine 31st Dec 2020 Caretaker
Hi Lyn,
I have been working with HomeInstead since March of this year as well. I too have a client with late stage Alzheimer's. I also have been having her fold the small towels. She also likes helping me put the towels and clothing items away. I think it helps her feel like she is still putting in to the household chores. I also will gather the small pictures in the room I am cleaning and spray a little windex on the paper towel and have my client clean them. She enjoys looking at the pictures, we will talk about them and again she feels that she is helping.

I love this site, it has been a big help in finding great ideas for keeping my clients engaged.
Susan 11th Oct 2020 Activity Director
Hi Susan
How wonderful that you accessed this website
There are many activities here that will help you
Please let me know if you have any questions
Susan Hatfield 10th Oct 2020
I love the ideas, I live in a nursing facility now. I have early onset Alzheimer’s and Iam doing well, right now. I try to stay busy and keep my mind active.
Robin higgins Stephan 6th Aug 2019
Thank you my husband is 66 years old and was diagnosed 6 years ago. Thank you for some of the great ideas for me to help him. He is very close to his late stage frontal lobe dementia. We have been married 44 years this November. And have 2 wonderful sons.I am so afraid of losing him.Even though I know it is going to happen.I wish they would find a cure.
Talita 12th Aug 2019
All the best to you and your husband Robin, it's not easy. I hope they find a cure soon too.
Susan 20th May 2018
I recently lost my mother who lived with dementia for the last 8 or more years. Five years ago, when she was admitted to a dementia care unit, I wanted to start something with her that she could recall when she reached late stage dementia. Each time I visited with her, we sang the same hymn together. After our " I love you's , I always told her a phrase from childhood, "See you later alligator" to which she would reply, "After 'while crocodile. " If she couldn't remember, I prompted her. She answered back during her last days that she was able to talk with me. She could not sing but, she responded to our song, even on her last day on earth.
Talita 28th May 2018
This is beautiful Susan, thank you so much for sharing. It's amazing the effect that music can have on people. All the very best x
Judy 20th Nov 2019 Speech Language Pathologist
Lots of great ideas to use! I like Susan's idea of singing a song and the phrase 'after while crocodile'! I am trying to utilize ideas, at this time, with my mother-in-law who has dementia. I am not sure which stage she is in at this time but she is definitely moving to another stage. Do you have activities lists for the other stages of dementia? I would love to see them too.
Sally 19th Jan 2018 Volunteering
I am going to try these out at the two groups I volunteer with . One is a group that have early/mid stage dementia and the other one is for later stage . I’ll comment how we get in when I’ve tried them .
Thank you
Talita 21st Jan 2018
Thanks Sally, we'd love to hear how you go.
Jen 14th Dec 2017
My mother loves to watch concerts. You can find many on u tube. Her favs are Simon and Garfunkel and Neil Diamond.
Talita 17th Dec 2017
Great suggestion. Thanks Jen.
Teresa 2nd Mar 2017 Activity cordinator
Can you recommend activity for a gentleman who worked in the printing business please.
Julie 23rd Jan 2017
My mum is about late mid stage and rapidly moving to late stage, with the added extra of lung cancer and macula degeneration. Being blessed with a creative/musical family mum not only listens to music from her youth but also the 60's and 70's - she wants the Rolling Stones played at her funeral! So I've bought doco's/music DVDs on Bowie, Dylan, Beatles and the stones, and we watch them often. We also enjoy gardening, ballet and art DVDs. On fine days she sits in the garden while I work there, watching the chickens etc. I've just bought an indoor/outdoor chair with arms so she is comfy and secure. I've made scrapbooks about her life this is very handy when I get Carer respite, as it introduces her life to others and enables myself and other carers to notice memory changes.
Thanks for your ongoing contributions to my caring abilities.
Jackie 19th Jan 2017
Hi I work in a day centre looking after people with dementia. We have various activities going on for people with different stages of the disease.
We have introduced memory boxs, therapy doll, and a breathing cat. These activities work well When service users have become distressed.
I feel it is important to get the individuals personal history so that you can work on this to introduce activities that they would be interested in.
We as a team are always looking at ways to stimulate our service users and any new ideals would be very beneficial.
Solange 19th Jan 2017 Diversional Therapist
Hi, Jackie, thank you for sharing. You are quite right in taking serious the person-centred care. The more you know your client the better the care. Best wishes
Talita 7th Nov 2016
Thank you very much everyone for your feedback, we appreciate it very much!
Mary 6th Nov 2016
My husband has Alzheimer's, he's only 61 and was diagnosed 5 years ago. I'd say he is in the middle stage but close to late stage. Just wanted to recommend a few movies he loves. To Kill a Mockingbird, As Good as it Gets, The Bucket List, Oklahoma and The Sound of Music.
mariatancincoouano 22nd Oct 2016
My 70 yr old sick with dementia.I'm her caregiver.Very hard but challenging.Our country is 3rd world country.No support from our government for they don't know bout dementia.We are financially struggling for support.
K. Stumpf 13th Sep 2016
Using high school students to read to the person or sing (many students need service hours).
Dara 9th Jun 2016
I have found little hand held fans which they can hold themselves ( little amount of guidance needed depending on level of disease) offers a sense of comfort and control of an activity . Thanks for guidance
Solange 4th Feb 2016 Diversional Therapist
Thank you all for the feedback. It is really appreciated. Best wishes.
Kathryn 4th Feb 2016 Care worker
I've just made some hand sized bean bags for our residents at work to use for games or just as a sensory experience, but I hadn't thought of using different materials and different fillings! Will definitely be doing this since they were so easy to throw together with my sewing machine, and I can always ask the kitchen to supply different things for filling them!
Jennifer 2nd Feb 2016 Lifestyle co-ordinator
a good reminder for people with simple basic caring time with people
kay 2nd Feb 2016
Thank you for a very helpful website with lots of interesting ideas
Satomi 2nd Feb 2016 Carer / Activity Coordinator
Back to basics. Thanks for bringing up this topic again. As I'm the only Golden Carers member at my work, I'll show this page at the work computer. Sometimes reading the webpage together has a greater impact and hopefully all refresh how we conduct with the residents who are the late stage of Alzheimer. Thanks again.
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