FUNCTIONAL ACTIVITIES FOR

PATIENTS WITH DEMENTIA

JESSICA BEAHRS
SLPs have an ethical responsibility to provide
appropriate services that will benefit the
individual and maximize cognitivecommunication functioning at all stages of the
disease process

RATIONALE

Lack of understanding:
- Families
- Social workers
- Doctors
- Patients
- Facility workers (nurses, resident assistants)
- Insurance companies

PROCEDURES
- Supervisor
- Alzheimers association
- ASHA

DISCLAIMER!

This presentation does not take into

consideration any issues related to
dysphagia.

WHY IS IT SO HARD TO UNDERSTAND?

- They want numbers

- We want function and as much
independence as possible

IN ALL STAGES
- Training caregivers about dementia and teaching them
to use strategies to enhance communication
effectiveness:
- contributes to increased caregiver understanding of
communication breakdowns
- more successful conversational exchanges
- improved quality of life for the individual with
dementia

ACTIVITIES SHOULD:
Be meaningful
- Involve something that is of interest of the patient or that
they enjoy
- Or be something that they used to do frequently
- Involve their family as much as possible
- Be easy for caregiving staff to carry over

STAGE 4 EARLY DEMENTIA

Moderate Cognitive Decline
- Difficulty concentrating
- Decreased memory of recent events
- May be in denial about their symptoms (and say they do not need
therapy)
- Easily agitated
- Overall confusion

ACTIVITY FOR STAGE 4

Activity

Target

Leading an activity for

other residents with
dementia (BINGO,
trivia)

Primary goal:
Executive function
(planning,
organization, initiation)
Other targets:
Memory
Attention
Sequencing
Expressive language

Functional
Outcome
-Improved ability to
plan and complete a
task.
-Improved ability to
participate in
activities.
-Improved ability to
communicate with
other residents and
caregivers.

STAGE 5- MIDDLE DEMENTIA

Moderately Severe Cognitive Decline
- Major memory deficiencies
- Need assistance completing daily activities (dressing, bathing,
preparing meals)
- Might not remember major relevant aspects of their current lives
(address, phone number)
- Believes they still have responsibilities
- May be able to form a thought, plan an action, and follow-through
depending on short term memory abilities

ACTIVITY FOR STAGE 5

Activity
Navigating the facility

Target
Primary goal: recall
Other:
Receptive language
(following directions)
and attention
Executive function
Sequencing
Memory
Following directions

Functional
Outcome
- Increased
environmental
awareness
- Improved ability to
independently
navigate the facility
- Increased ability to
participate in daily
activities
- Increased safety

STAGE 6- MIDDLE DEMENTIA

Severe Cognitive Decline
-

Require extensive assistance to carry out daily activities

Begin to forget names of close family members
Little memory of recent events
Remember only some details of earlier life
Difficulty finishing tasks

ACTIVITY FOR STAGE 6

Activity
Getting ready for the
day

Target
Primary goal:
Problem solving
Other goals:
Memory
Executive function
Following directions
Sequencing
Attention

Functional
Outcome
- Improve ability to
participate in activities
in living environment,
ADLs, and care tasks
with increased
independence

STAGE 7- LATE DEMENTIA

Very Severe Cognitive Decline
- Have little to no ability to speak or communicate
- Require maximal assistance with most activities (toileting, eating)
- Lose ability to walk

ACTIVITY FOR STAGE 7

Activity
Washing hands

Target
Primary goal:
Expressive language
Other goals:
Attention
Simple problem
solving

Functional
Outcome
- Improve ability to
express wants and
needs
- Improve ability to
participate in
activities and care
tasks

RESOURCES
1.

Alzheimer's Association. (2009). Dementia Care Practice Recommendations for Assisted Living Residences and Nursing
Homes [Brochure].

2. Butler, L., MS, OTR. Therapeutic Approaches to Dementia. Lecture. In Therapeutic Approaches to Dementia (pp. 28-77). (2005). Nashville,
TN: Cross Country Education.
3. Caring for a Person with Alzheimer's Disease: Your Easy-to-Use Guide. (n.d.). National Institute on Aging.
4. Dementia: Treatment. (n.d.). Retrieved July 14, 2016, from http://www.asha.org/PRPSpecificTopic.aspx?
folderid=8589935289ion=Treatment
5. Help End Alzheimer's. Retrieved July 12, 2016, from http://www.alz.org/
6. Hopper, T., Bourgeois, M., Pimentel, J., Qualls, C. D., Hickey, E., Frymark, T., & Schooling, T. (2013). An Evidence-Based Systematic
Review on Cognitive Interventions for Individuals With Dementia. Am J Speech Lang Pathol, 22(1), 126-145. doi: 10.1044/10580360(2012/11-0137).
7. Hopper, T. (2016). Not Cured But Improved. The ASHA Leader, 21(6), 44-51. doi: 10.1044/leader.FTR1.21062016.44.
8. Zientz J, Rackley A, Chapman S B, Hopper T, Mahendra N, Kim E S, Cleary S. Evidence-based practice recommendations for dementia:
educating caregivers on Alzheimer's disease and training communication strategies. Journal of Medical Speech-Language Pathology 2007;
15(1): liii-lxiv.