How to Overcome Common Dementia Challenges in Group Activities

How to Overcome Common Dementia Challenges in Group Activities

User Profile By Haley Burress   United States

Found In: Activities Articles Alzheimer's & Dementia

These common dementia challenges can make running your activity department a bit difficult. Here are the solutions and tricks to make it easier on everyone.
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Cognitive decline is a normal part of aging. Even if you do not work in a memory care community, you may need to use interventions to combat common activity challenges that come with cognitive decline. 

Cognitive Challenges Caused by Dementia

Cognitive decline caused by Alzheimer’s disease or another type of dementia leads to confusion, impaired judgment and difficulties in communicating effectively. This means that the person living with cognitive decline can have difficulties following conversations, keeping up with instructions, or being able to understand their environment.

Of course, all of this can lead to “behaviors”, although I don’t like using that word. Residents who have challenges are often trying to communicate with us the best way they know how and sometimes that means they end up wandering, hitting, or crying out.

It can be difficult to run a successful activity when there are disruptions from residents living with dementia. Here are a few common challenges and ideas on how to meet those challenges with dignity and respect for all the residents you serve.

How to Overcome Common Dementia Challenges

All residents are unique, and it is important to remember that not all of these interventions will work in every situation and with every resident. However, with all dementia interventions, it is best practice to have a bunch of ideas on your dementia toolbelt so that you can discover which approaches work best for each person and situation.

Wandering in and out of activities

First, evaluate if the wandering is really a problem during the activity. For example, a resident wandering in and out of a busy social activity may not be a major disruption in all the festivities. However, if a resident is wandering in and out of a presentation and disrupting the speaker or audience, you might deem it an issue.

If you have a resident who is a regular wanderer, you can look for them and offer to walk beside them arm-in-arm, keeping them to the back of the room to minimize disruption.

Not understanding instructions, asking repetitive questions

You can help a resident who has trouble with instructions with any of these interventions:

  • Have a volunteer sit next to them to walk them through the task step-by-step
  • Write down instructions and put the paper near them so you can redirect them to it when needed
  • Pair them with a helpful resident who can direct them to the next step
  • Have them stand with you as your volunteer assistant to lead the group through the activity; they can follow instructions with your assistance one step at a time

Being verbally or physically aggressive during an activity

Everyone can get cranky sometimes, but those without cognitive decline have a decreased capacity to handle situations with grace and patience. If you have a resident who can get verbally or physically aggressive during activities, here are interventions you can try:

  • Work with your social work department to track behaviors and offer insight
  • Sometimes aggression is fueled by overstimulation; give the resident a more calm place to sit during the activity. For example, perhaps have them sit away from the audio speaker or in a small group of 2 instead of 6

Other residents being mean to the resident with cognitive decline

Sometimes, the challenges you must meet as an Activity Professional regarding dementia are not from the person living with dementia at all. Residents without cognitive decline can lose their patience and can say insensitive things to their peers. If this happens, it can be uncomfortable to “correct” the resident, but it is imperative as you maintain the dignity of the resident with dementia. Here’s how you can handle it:

  • Take the resident aside to talk about it
  • Don’t scold the person, instead explain that harsh words are not acceptable
  • Work with social work as needed if the problem persists

5 Truths About Working with Adults with Dementia

When working with adults with dementia, it can help if you have certain truths that you hold tight and share with your team. Here are a few of my favorites:

1. It’s never about the finished product, it’s about the experience. If a resident doesn’t complete their craft project correctly, it doesn’t matter. It’s about the experience of creating the craft project and socializing with others that really matters.

2. Look around to see what the person might be trying to tell you. Remember, many challenges come with the person trying to communicate. Is it too loud where they are sitting? Is the sunlight shining in their eyes from the window? Do they need to use the restroom? Try to discover what they are trying to tell you with their actions.

3. Everyone deserves to participate in activities.It’s our role to find a way for everyone to feel included and to feel successful during any activity. No one should be turned away because of their specific challenges.

4. Your interventions matter because they show other staff members how activities are therapeutic.  Many times in my career, it’s been an activity intervention that becomes the turning point for how an entire staff cares for a specific resident with a challenging behavior.

5. Get creative and keep trying something new. 
Dementia is always progressing, which means we should be too. Remember that what worked yesterday might not work today and that is okay. Keep at it!

Let’s try to help each other in the comments. Share a specific situation you are struggling with regarding dementia and activities. We’ll see if we can crowdsource a few ideas for you. We’re all in this together to provide the best care for those we serve. 

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Comments   Post a Comment

Susan 21st Dec 2021 Activity Director
Hi Zeba
Do any of the organizations you are associated with have a hospice group because they often have a simple dementia courseThat they offer for free
The Alzheimer’s Association also has some for free
Zeba 20th Dec 2021 Senior Coordinator
Thank you for the insight.
Is there any online free course on Dementia?
I am very much interested in doing.
Please let me know.
Thank you.
Seniors Program Coordinator
Talita 21st Dec 2021
There is an online course offered by the University of Tasmani that gets very good reviews:
Vicki 21st Jul 2021 Activities director
Thank you for the great ideas! I have a resident in memory care who screams at other residents and staff when she is talking to them, and says things like “you’re an idiot I don’t understand you, I said I want Diet Coke!! She will scream to other residents to sit down, stop talking, she’s not playing the game right! I have talked to her about using an inside voice, instead of screaming. The care staff doesn’t know how to interact with her, and they get frustrated. Any ideas on how to handle her ??? Thank you!
Susan 23rd Jul 2021 Activity Director
Hi Vicki
I think this article may help you
It gives us many good ideas
Also read the comments
Susan 19th Jul 2021 Activity Director
Hi Virginia
Thanks for sharing this and the good outcome you got
Susan 17th Jul 2021 Activity Director
Hi Virginia
Thank you for sharing this information
Another thing I did when the residents were being unkind is that I would have a kindness activity and will talk about what that means to be kind
They seem to help for a while anyway
Jordan 16th Jul 2021 Activities Director
We have been experiencing a lot of residents lashing out at those w/ cognitive decline in groups. W/in my facility, there are more residents w/ Alzheimers/dementia than without and it can make the individuals who are w/o cognitive decline frustrated at the pace in which group progresses and the repetitive nature. Some of these residents can become particularly hateful/hurtful. Rather than call individual residents out, we have enacted a "No Bullying Rule" in activities and we go over it at the beginning of every activity. My team and I thought this may be the best way to address the behavior w/o calling specific residents out in front of the group. If a resident does say something hurtful/inappropriate after the rules have been stated, we try to redirect them and remind them of why Activities are inclusive to all, but it has been difficult. Do you have any tips for residents who are completely AAO and still extremely hurtful, regardless of going over the rules at the beginning of each group. The last thing we want to do is to have to remove a resident from group but we also want to maintain the dignity of the other residents present.
Susan 16th Jul 2021 Activity Director
Hi Jordan
Yes this can be difficult if you are mixing all types of residents
Have you tried the suggestions in this article
I like Pairing the residents
Also what I did is to do a one to one interaction within the group
That way you can make what you are doing more appropriate to each person
I’d like to do a musical activity because that’s pretty inclusiveThese articles may help you also

Solange 16th Jul 2021 Diversional Therapist
Hi Jordan, this problem is common in care facilities and unfortunately, there is no widespread protocol to deal with it as yet. In some facilities management gets involved and sets up specific guidelines and procedures for reporting resident-to-resident mistreatment. It is important to understand the contributing factors. Have you tried to match the person with mind-like residents in a separate group? Also, observe the resident and praise him/her enthusiastically when you see her doing something nice to another person. Behavior-specific praise is powerful; praise and thanks to the person for what he/she did right. Another strategy is to appeal to her empathetic feelings to ‘help’ you to run a craft/social group session. If everything fails, involve the management. Good luck!
Virginia 17th Jul 2021 Activity Director
Hi Jordan, I had a similar experience with residents being hurtful to others in the group. I then started a group for the alert & oriented with a weekly topic usually about what Alzheimer's and dementia are and what the reality is for those who have this diagnosis. Education on a topic they may not understand can be most helpful. This helped them have more tolerance for those who could not keep up or slowed down the group. They actually started helping with the groups.
Ann 4th Jul 2021 HCA
I absolutely agree that it's about the inclusive experience and sense of achievement and not the finished product ... Thank you for this great site
Mayflor 18th May 2021 Lifestyle
Thanks heaps and salute to all who did these things for us..i love every single activities and information.
Talita 24th May 2021
Thanks so much for your feedback Mayflor x
Susan 23rd Apr 2021 Activity Director
Hi Diane
I agree it’s not the finished product it is the experience or the process
Thank you
Lisa 23rd Apr 2021 Activities for Seniors
This is helpful! Thank you!
Diane 22nd Apr 2021 Music Therapist
I LOVE #1 - it's not about the finished product, it's about the experience - YES!
Linda 20th Apr 2021 Recreation Therapist
Thanks for the insight into disruptive residents during group activities
You state to have instructions written down and placed near the resident as a source for them to return to gain directions to complete the task at hand
This method is ideal if the resident is still capable of reading
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