How to Simplify Activities for Seniors (with Dementia)
To provide the best activity or motivating support to seniors who aren’t as energetic as they used to be, we as recreational or activity caregivers must adapt our content. Simplifying tasks for seniors or individuals with dementia involves adjusting activities to match the individual’s cognitive and physical abilities while promoting engagement and enjoyment.
Following are some of the more common recreation activities seniors enjoy along with some ideas on how to adapt them to meet changing need:
READING // WRITING // WORD SEARCH // CROSSWORD PUZZLE // PAINTING // COLORING // WORD GAMES // EXERCISE // HOBBIES // MUSIC // GENERAL STRATEGIES
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Illustrated memory book — a treasure to both give and receive!
READING:
Case study: 84-year-old “Doreen” in the nursing home where I work is passionate about reading. However, in the last few months she’s said that texts swim in front of her, and she has to really concentrate to read. I found a large-print James Patterson for her and she was delighted! From that moment she began educating me on what was “good” for her and what wasn’t. Large print books are best, but books with dark text are OK if the font is somewhat large and the text isn’t too dense...
I had my orders! So I visited “Libby,” my local librarian-friend, and explained about Doreen’s passion to read. Libby now saves all the large print books the library pulls from the shelf which opens up space for new releases, and once every month or two I pick up the saved stack for “Doreen!”
Books / magazines:
Large print books and articles (easy to read, support pursuit of personal pleasure)
High-contrast text (contrasting colors help the eye focus more easily)
Sufficient spacing between lines (dense text swims together)
Audio books (when vision declines, audiobooks or text-to-speech provide story entertainment)
Picture or illustrated books (pictures are indeed worth 1000 words!)
Shorter texts (articles, stories, chapters are more likely to be fully read)
Reading apps (font size adjustments can be personalized)
Handouts / materials prepared specifically for seniors:
Simplified language (write materials/directions with short statements and straight-forward language)
Limit paragraph length (dense, long text hampers accessibility)
Familiar topics (easier to engage with relatable content)
Provide discussion questions (reinforces content, or if too difficult, provide multiple-choice or T/F questions)
Group / Collaborative ideas:
Group reading sessions / book clubs (excellent for social interactions)
Host read-aloud events (great for socialization and hearing the rhythm of language while being soothed by the voice of the caregiver)
Relate family stories (personalized anecdotes make great writing material)
Support seniors emotional well-being and give them many chances to reminisce!
WRITING (process):
Case study: “Georgina” used to work in an office where she typed, filed, organized and in her free time scripted long letters and sent cards to family and friends. She LOVED writing and still would love it now except she’s having trouble with arthritis and has developed a slight tremor. If she could only hold a pen …
Large-grip pens (the larger, ergonomic group make handling easier)
Gel pels (offer a smoother glide with less pressure)
Provide a writing slant (the tilted paper eases the need to lean over to write; writing in a relaxed position could reduce some of the tremors)
WRITING (content):
Case study: “Georgina” realizes that she can’t write her thoughts like she used to. She still would love to write some Christmas cards, but she’s having difficulty knowing what to say …
Use templates (use pre-filled forms and guided writing prompts)
Simplify tasks (make complex tasks achievable)
Provide step-by-step instructions (break tasks into simple, sequential steps)
Provide a simple text to reference (allows her “write” her own card text)
Provide materials which require only single word responses (e.g. just fill in the “To (name),” and have only the task of signing her name on a pre-created card)
Group / Collaborative ideas:
Provide a 30-day writing prompt calendar (inspires creative ideas)
Host a writing club (journaling with prompts, template for mystery story)
Short-story competition writing (themed topic: memorable pet …)
Start a newsletter writing committee (collaborative writing and creativity)
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WORD SEARCH:
Case Study: “Jim” used to whiz through two or three word search books a month, but now he is slowing down. He finds completing word searches more and more difficult, but still carries his booklets around and works at them. You decide to experiment with finding or even creating him word search puzzles with more appropriate text and size.
Larger font size (better for readability)
Increased grid size (for more space between letters)
Higher contrast letters and/or thicker font (easier to focus on the text)
Simplified word list (shorter words, fewer words, more familiar words)
Adjust puzzle difficulty (15x15 puzzles are complex with small font; 10x10 puzzles the same measurement can have larger font with fewer words; 7x7 puzzles with the same measurement have few, short, very large words—appropriate for both declining cognition and poor vision)
Limit search directions (horizontal, vertical and diagonal OK but no backward words; to simplify more, only use words left-to-right horizontal and top-to-bottom vertical)
Minimal shared letters (stand alone words can be easier to find)
Provide magnifying sheet (flat so easier to use and larger than a magnifying glass)
Include answer keys (prompts can be stimulating, answers can be instructional)
Highlighting words (mark through words with crayon rather than circle with pencil)
Group / Collaborative ideas:
Make a word search club (provide puzzles with different challenge levels but everyone working together in the same room with the same music)
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CROSSWORD PUZZLES:
Case study: “Marcia” has been a New York Times crossword puzzle buff since college. Over the years she’s become quite the word maven, but recently words are somehow escaping her. Not only can’t she recall them but when she does, she’s no longer certain of their spelling. You notice a stack of New York Times word searches on her bedside table and also notice that her hand-writing doesn’t fit in the small boxes, and then of course you never saw a word spelled “kollekt,” You know from past conversations that “Marcia” very much enjoys her word puzzle games, so you decide to look for modified crossword puzzles that fit some, maybe all of the following criteria:
Use easy, beginner-friendly puzzles (challenging but achievable means enjoyable)
Provide visual clues and hints (visuals contain higher content than words)
Pre-fill some of the words (to eliminate blank-space frustration)
Use large, bold font size and large squares for easy text-fill (easier to see, and easier to write)
Provide answer key for checking and prompting (simplifies complex recall, boosts confidence, reduces frustration)
Group / Collaborative ideas:
Work with a partner (promotes collaboration skills and teamwork)
Create a crossword puzzle club (great for teams and promotes interaction skills)
PAINTING (and drawing):
Case study: “Velma” loves color, shapes, textures! When asked a warm childhood memory, she recalled her aunt giving her a box of watercolors and she painted everything until her paints were gone. That box of paints was her favorite childhood toy. She’s never painted since, but you think she might enjoy it. Velma is a very thin lady without much strength or energy, but painting might be something she can do with introductory steps and adaptations.
Use large brushes (put pencil grippers on the brushes for ease in holding)
Use only a few pre-mixed colors (limits difficult color choices)
Provide pre-printed canvases (simplifies the production process, eliminates stress of drawing/transferring images)
Provide large canvases (good sizes: 8”x10” – 11”x14” – too small requires too much fine motor skill, and too large requires large arm movements)
Offer simple paint-by-number kits (step-by-step instructions provided, color choices are clear and paint ready-mixed—choose appropriate for motor skills)
Use stencils and/or simplified designs (minimal skills needed, ease in creating)
Group / Collaborative ideas:
Host a paint party (encourage team bonding for shared experiences)
Create painting clubs (promoting socializing skills and creativity)
Paint with diptych (a two-picture partner painting encourages collaboration)
Have an art museum outing (social and educational event for learning and comradery)
Tour an art show or art fair (stimulating, engaging, educational and social)
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COLORING:
Case study: “Annetta” or “Annie” has been nicknamed “the coloring goddess” by her grandkids, and for many years she has sent each of them a personally colored picture for their birthdays and Christmas. This year, however, “Annie” feels depressed, and when you talk with her, she admits frustration that she can no longer color pictures for her grandkids. The pictures on her wall are detailed and intricate. They are also done with fine, colored pencil strokes. You tell her you have a package of new broad-tip markers and some simple and super cute animal coloring pages that you think she might enjoy. Would she like to get them a try?
Use large, chunky crayons / broad-tip markers (easy to hold, puts color down quickly)
Use large, simple designs with bold outlines (the overall shape is distinguishable from the details)
Provide colored examples for modelling (eliminates complicated color choices, instructs how to color)
Offer jumbo coloring books (easy lines, fine motor skills not so essential)
Explore alternative coloring tools to replace the fine-tip colored pencils (e.g. (giant) crayons, markers, pastels, graphite chunks)
Group / Collaborative ideas:
Designate a coloring station (retreat space for personal relaxation and self-expression)
Host group coloring sessions (promotes calming, meditative mood)
Hang themed coloring pages on the wall (self-esteem boosting)
Work on collaborative / seasonal projects (for socializing and team-building)
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WORD GAMES:
Case study: “Harrison” thrives on trivia and group interaction activities. He is still quite good at recall games, and he’s good at encouraging his own team and the other in the trivia challenges. Lately however, he’s been edgy and argumentative when he finds out his answer isn’t correct enough for getting a point. You decide to revise a miscellaneous knowledge trivia game to make the answers somewhat easier.
Simplified and/or themed vocabulary (relation words easier to recall)
Use clear instructions and simplified rules (transparency reduces game-play confusion)
Use visual aids (support game play with pictures, symbol clues, computer screenshare, whiteboard)
Offer multiple choice questions (even guesses might be correct answers!)
Familiar words (familiar or common words easier to recall/relate to)
Simplify scoring (rules softened to promote scoring and satisfaction)
Group / Collaborative ideas:
Announce a trivia challenge (boost energy and promotes teamwork)
Host word game parties / events (challenging, stimulating, interactive and dynamic mood created)
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EXERCISES:
Case study: “Zoe” is a kinesthetic learner. She responds to music with movement, she does crafts with energy and enthusiasm and is constantly moving while creating. For her wedding reception, she took ballroom dancing so she could float with grace across the reception room dance floor and since she has experimented with tango, salsa and jazzercise. Unfortunately, her once lithe body has become quite fragile and now she moves around in a wheelchair, energetically, with her legs constantly taking small steps pulling her forward. She still has energy but there’s not much she can do with her weakened bones and inability to stand. You decide to create a safe yet energetic chair dancer-cise activity for her considering the following adaptations:
Use seated exercises (safe exercise from a balanced, seated position)
Incorporate resistance bands (builds muscle strength which strengthens bone)
Focus on low-impact activities (decreased risk of joint stress, sustainable exercise)
Use skill-appropriate, follow-along videos (step-by-step functional fitness)
Use hand-held objects (balloons, swim noodles, tambourines, streamers, objects and music that encourages involvement)
Adapt for physical and cognitive abilities (exercises made accessible, lowers stress and improves flexibility/mobility)
Keep sessions short (30-minute limit, achievable, sustainable mood booster)
Group / Collaborative ideas:
Start a morning exercise group (establish continuity, build healthy habits)
Create a walking club (socialization, encourages independence)
Create exercise classes for specific abilities / interests (skill development, personalizes care, boosts satisfaction)
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JIGSAW PUZZZLES:
Case study: Since hubby died, “Lizzy” has found joy in working jigsaw puzzles alone. Every week she sets one out and over the course of the week, she gradually works the puzzle. With dear hubby, she worked many 2000 and 1500 piece puzzles, and after he died she worked her way through a stack of 1000 and 500-piece puzzles. That is, until last year when a 300-piece puzzle was only what she could achieve in a week. Of late though, concentration and eyes-focusing have become issues. “Lizzy” holds a puzzle piece for long minutes but hardly moves. Her daughter “Laura” gets on Amazon and wants to find some puzzles that her mom still “remembers” how to work. What criteria could Laura hope to fill?
Large, easy-to-handle pieces (fewer and larger choices, gross motor skills dominate)
Simplified designs with bold colors (image more easily recognizable, bright colors appealing)
Large print puzzle boxes with full reference image (easy follow-along image)
Familiar or nostalgic scenes (relatable content; custom-made family picture made into a puzzle is fabulous!)
Various large piece sizes (variety reduces the difficulty of only image reference)
Color-coded edges (easy to identify shapes and colors to connect)
Limit number of puzzle pieces (9, 12, 24, 48, 50, 60-pieces)
Additional assistance and/or promptings:
Edge pieces first (sorting is fun and easy, sort by shape recognition)
Pre-sorting (flip all pieces face up; then sort pieces by color and/or shape)
Group / Collaborative ideas:
Set up a permanent puzzle table (encourages independent choice, provides continue stimulation and personal space for creativity)
Have small-puzzle competitions (promotes fun, teamwork, socialization)
HOBBIES:
Case study: “Emery” was a fantastic cabinet maker and woodworker. Even after retirement he custom-designed wooden rocking horses, ornate doll houses and garden swings. His hands are gnarled and arthritic from years of activity and injury, but he still loves to play with wood. Phyllis, his wife and designer of the yarn hair on the rocking horses and decorator of the doll houses would also like to “have fun” with dear Em again and create like in the good ol’ days. She still holds a darning needle well and is quite proficient at crafts. Em uses a walker and Phyllis still walks but only for short distances. What would you suggest for this dynamic couple to do together?
Simplify projects to be enjoyable and achievable (fosters individual choices)
Kits prepared and pre-organized (minimizes stress, maximizes opportunity)
Provide visual, step-by-step instructions (aiding ease and confidence for task completion)
Lean toward gross motor skill activities (lower complexity lowers stress and increases achievability)
Make activities interactive (improves social engagement and mental well-being)
Adapt hobby to cognitive and physical capabilities (personalizes activities)
Group / Collaborative ideas:
Start a craft corner group (fosters a sense of community)
Visit local hobby stores / artisan shops (educational, boosts creativity, enhances reminiscing and hobby exploration, community integration)
Hold skill-share sessions (fosters socialization and cultural appreciation, fosters mutual respect and learning, enhances sense of self-worth and pride)
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MUSIC:
Case study: “Mason” used to talk, but he doesn’t anymore. Mason used to play the piano and his family said he enjoyed the violin and cello in his youth. He doesn’t do much now and hasn’t for a long time. He watches people, answers with single word replies to direct question, but not much else. You have noticed, however, that he seems less agitated with classical music. His hands unclench and his shoulders relax. You’re pretty sure he does in fact like classical music! Now you’re wondering what other music he might like, and so start experimenting with some of the points mentioned below.
Play familiar tunes (activates memories, enhances nonverbal communication)
Incorporate music and movement (supports motor coordination and timing)
Use music-based games, e.g. name that tune (stimulates cognitive recall)
Engage simple rhythm patterns with music (stimulates brain areas for memory, language and emotion)
Use music with storytelling (evokes emotions, fosters greater engagement)
Music in games, e.g music bingo, music trivia (experience more meaningful)
Keep soft background music flowing (sensory stimulation, structured environment reduces confusion and anxiety)
Group / Collaborative ideas:
Arrange live music performances (provides rich sensory experience)
Host easy karaoke sessions (creates an expressive outlet, promotes community and shared experiences)
Create music sing-a-longs (facilitates group interactions, reduces feelings of isolation
