May 092011

I hate Bingo.

There, I said it. That popular activity which people of all ages enjoy at local fire halls, senior living communities and kindergarten classrooms across the country is one of my least favorite ways to pass the time.

As a former assisted living activities director, I can tell you that — in my book — the only thing worse than playing Bingo is calling Bingo. Round and round the cage would spin, as I strained to keep my eyes open so that I might read aloud each numbered/lettered ball that rolled down the ramp. (I’m sure it didn’t help that Bingo was usually scheduled at the peak of the midday slump, around 3 p.m.)

Yes, I enjoyed seeing the residents get excited about winning, or fighting about what constitutes postage stamp Bingo, but as I recall, many of them looked as bored as I was.

Here’s the thing: If you didn’t enjoy Bingo when you were a kid, you probably won’t enjoy it as an adult.

Besides, there are so many other fascinating hobbies and engaging activities that it just doesn’t seem fair to resort to Bingo all the time. Yet I would venture to guess that if you were to compare activity calendars for five assisted living facilities in your town, they would all list Bingo at least once.

And what does Bingo have to do with Alzheimer’s, you ask?

Bingo is an activity. Love it or hate it, it’s an activity that some people enjoy whether they have Alzheimer’s or not.  True, Alzheimer’s may limit full enjoyment of the game, but just because a person is diagnosed with Alzheimer’s doesn’t automatically negate all previous interests.

And in the case of interests, hobbies and activity preferences, an Alzheimer’s diagnosis means nothing.

Unfortunately, too many family/professional caregivers feel that an Alzheimer’s diagnosis means everything when it comes to activities, but it doesn’t. Certainly the way the afflicted individuals engage in these activities may change for any number of reasons (medication side effects, lack of sleep, difficulty with language or motor skills, etc.), but the person in your care has not lost all of his or her history or identity. If your Mom enjoyed gardening all her life, why would a diagnosis change that? If Granddad loved watching the World Series and has fond memories of doing so every year since the age of 5, why should he stop?

Alzheimer’s Is About Adaptation

Those living with cognitive impairments — and their caregivers — are constantly adapting to the changes wrought by the disease. Sometimes, those adaptations are subtly applied and integrated into the daily routine; other times, a drastic adjustment is required of both parties. Nevertheless, adaptation is a regular, recurring part of a life with Alzheimer’s.

When planning for and providing meaningful, stimulating activities for those with Alzheimer’s and related dementias, consult the individual’s personal history for clues about favorite pastimes, and use these as the foundation for program/daily routine design. If and when it is necessary, adapt these activities to fit within the framework of the individual’s abilities. Maybe your mom loves to hike but the risk of wandering is too great. Figure out a way that allows her to hike safely without feeling like she’s a child who can’t be trusted. Find a respectful balance that promotes independence while ensuring her well-being.

If your brother enjoys taking beautiful photographs of the birds that come to his backyard feeders, there is no need to let the Alzheimer’s diagnosis take that away too. You may need to help him develop film, you may not. You may need to remind him where the camera is stored when not in use, you may not. Don’t change a thing unless you have to.

Unfortunately, this method is not 100 percent foolproof. Sometimes, the whims of Alzheimer’s disease prevail, wreaking havoc on an individual’s personality/mood, which might mean they lose interest in things that they had enjoyed previously. If the safety of the individual is at risk by participating in certain hobbies or routines, you may need to discontinue or alter them accordingly. My grandfather, an expert woodworker, was bedbound as a result of his Alzheimer’s, so getting him down to tinker in his workshop was not an option. In other cases, the person can be so depressed about their inabilities that they are paralyzed with frustration when they cannot do what they did so easily before. Be sensitive to this possibility, and don’t push your loved one — or yourself — to continue in a particular hobby if it only brings agitation.

Resources for Activity Planning

There are a wealth of articles and resources out there about meaningful, stimulating activity ideas for those with Alzheimer’s/related dementias. Some are better than others, but if you ask me, it all comes to back this idea of identity, to the fact that the person in your care is still an avid reader, classical music lover, golf aficionado, etc. despite the devastating diagnosis.

Storytelling/journaling, art therapy, pet therapy, intergenerational programs, reminiscing, household chores, baking, gardening, music, dancing, exercise, photography — the list goes on.

Explore the possibilities at these links if you’re at a loss, but only after you’ve asked the person in your care what they would like to do first:

1. Activities for People with Alzheimer’s

2. 101 Activities for Kids To Do with a Loved One with Alzheimer’s

3. 50 Activity Ideas for Someone with Alzheimer’s

4. Adapting Activities for People with Alzheimer’s

5. Activities for People with Alzheimer’s from AARP

What I would offer is this: Alzheimer’s has already complicated things in your life. Don’t make activity planning harder than it has to be. Adapt the activities that you/the person with Alzheimer’s has always enjoyed, and go from there. If you follow this rule-of-thumb, you have, by default, selected an activity that is both meaningful and stimulating, and the simple act of providing this activity can be a real source of comfort (to all parties involved) in the chaos that is Alzheimer’s disease.

Today’s guest post comes from’s Michelle Seitzer. Before becoming a full-time freelance writer, Michelle spent 10 years in the senior living and advocacy world, serving in various roles at assisted living communities throughout Pennsylvania and Maryland, and leading the charge against Alzheimer’s as a public policy coordinator for the Pennsylvania chapters of the Alzheimer’s Association. She has blogged for since November 2008 and currently resides in York, Pennsylvania, with her teacher husband and two Boston Terriers.

  23 Responses to “Change and Adapt, but Don’t Stop: How to Provide Meaningful Activities for Those with Alzheimer’s and Related Dementias”

  1. AWESOME article Michelle! And such great advice! I saw the nicest note yesterday at another site telling about a retirement facility that noticed a senior who had always loved gardening was now trying to dig in the ground with a spoon. The caring staff there immediately took steps to provide her what she needed to help her do gardening at the residence. With an easy to use digital camera, they can easily just point and shoot and let you print the pix out on your computer. And there are so many fun and easy crafts for kids that can also be fun for seniors! So many great ideas, and your article is a wonderful place to start. I'm sharing this on Twitter!

    • To Kaye – your compliment means so much. Thank you for the positive feedback! And what a wonderful story about that community which helped foster a gardening passion for a resident. Your ideas are great too!

  2. Michele, I'm with you. I hate Bingo. And as I was reading your article a memory appeared. May, many years ago, I came to check on my Aunt who was later diagnosed with dementia. At this time she was living alone and was in the mid-stage of the disease.

    I took her to the County Fair. She wanted to play Bingo. And so I sat with her, for what seemed like hours, trying unobtrusively to help her. It certainly left an impression.

    Great article. Food for thought for every caregiver and activities director at assisted living and dementia facilities.

    • To Mimi – so glad to know I'm not alone in my dislike of Bingo. However, your story about your aunt is so impressive. What a wonderful memory you shared, even though you had to sit for hours at a game you didn't like! Thanks for the kind compliment too. I do hope as you said it provides food for thought for professionals/family caregivers.

      • Wow, Hi Michelle – am I allowed to respond to this post like 3 years later? LOL

        Anyways – just wanted to let you know I TOO hate bingo. Perhaps hate is too strong of a word, but I strongly dislike Bingo and have since I was a kid. My grandparents, on the other hand, loved the game and I used to spend HOURS playing it with them – and even 'leading' some Bingo games at their senior center in their later years.

        Anyways, this post brought back memories (both positive and negative haha)

        Thanks, and have a great weekend!


  3. My 95-year-old father with Alzheimer's still loves to try to dance and watch dancers on tv. He "sways" now more than "foxtrots," but this is the one activity that gets him to laugh, almost glow again! Also, in his late stage cognitive condition where he can't process language very well, he still loves walking arm-in-arm and sitting shoulder-to-shoulder. The nursing home where he lives now does a great job with this "contact" activity which has served so well to quell his paranoia and agitation.

    • To Donna – wow. Thanks so much for sharing about your Dad's passion for dancing and movement. It's wonderful to know that the nursing home where he is being cared for recognizes the significance of/his need for that soothing, reassuring physical contact. So glad to hear that there are places that seek to provide whatever the residents need!

  4. Mi esposo tiene esta enfermedad y si creo que el caminar y movilizarse le a ayudado mucho.

  5. Acttivities have to be constantly adapted to the patients mood. Often it is a matter of diverting attention from some obsession or delusion that is worrying them at the time.

    • To James – absolutely. Activities have to be adapted to mood, environment, ability and more…and it's a great way to divert afflicted individuals who are dealing with delusions or paranoia.

  6. My name is Valeriya and I recently started an internship at ARIS at home in Oak Park, IL. ARIS provides quality, compassionate, non-medical home care. I am studying Business Administration and although I am a business intern at the company, I did a lot of research on Alzheimer's because ARIS specializes on providing caregiving services to Alzheimer's clients. The caregiver supervisor gave me a link to this website: 101 Activities for Kids To Do with a Loved One with Alzheimer’s (which is one of the links that was listed in this entry). It is a very resourceful and useful website that helped me understand the disease better.

    Thank you for this blog entry and the advice that was given from all the comments!

    • To Valeriya – that is so exciting! Congratulations on your work with ARIS, and my very best to you in your studies. I'm so pleased to hear that the article was helpful, but especially to hear of the Alzheimer's research/work on activities and caregiving that you're doing. Keep it up – it's such a needed focus!

  7. This is an excellent article! I have had the most difficult time finding a good qualified caregiver for Alzheimer's, the best resource I have found so far is Are there any other good websites?

    • To Laura – thanks so much! Glad you liked the article. Finding a good, qualified caregiver for Alzheimer's is very difficult. Have you tried, or The Alzheimer's Association also offers a great tool: Best to you as you seek out these resources!

  8. Thank you to Kaye, Mimi, Donna, Marta, James, Valeriya, and Laura for your kind comments, and please forgive my delay in responding!

  9. great article and advice. thanks for taking the time to write it.

  10. Michelle, I hope I can still talk to you even though this was originally posted so long ago. My mother has Alzheimer's and we moved her in with us 3 months ago. Before that she wasn't going to her normal activities like choir and bible study and we thought it was because of depression, maybe. Now I believe she makes excuses not to go because of many reasons: she is concerned about embarrassing herself if she makes a mistake, can't always follow along, and doesn't remember any of it afterwards. I'm not sure if we should continue to take her and just hope for the best or if and when she should stop being involved in these activities. Please help

    • Jill, I'm so sorry to have replied to this message more than a year later. I'm not sure if you still need guidance. If so, please feel free to email me directly at michelleseitzer(dot)writer@gmail(dot)com.

  11. I am a caregiver for the Alzehiemer's clients and some times I feel the stress even though I am not family is this a normal feeling?

  12. This sight has been very helpful. The lady I sit with is 88 and in stage 5.she loves to get out and walk, but with winter it is now not safe for her.But, after her breakfast we play at least 3 games of scrabble and she does up the dishes before her lunch arrives. After lunch, we get her showered and changed. we then watch a little tv, play yahtzee then we listen to books that i dowload to my laptop. Her anxiety levels are through the roof and she goes through some depressive states at which times she naps. Her biggest problems seem to happen after I leave at five. Another always leaves me and stays until 10pm. She is always talking about being alone and cries and gets uncontrollably upset! My observance and just plain listening leads me to believe she is scared of dying.

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  15. My wife Jean is middle-stage Alzheimer's, age 91. Added to that are severe arthritis, which makes walking more than a few steps impossible. Also near blindness, macular degeneration in both eyes. Former activities are physically impossible or something she never much cared for. She's been button-challenged for many years, and that includes knowing when to press an alarm button if needed. Bingo, scrabble, computer games hopeless.
    I care for her at home, with 20 hours/week help from a great caregiver. She likes plays, concerts, activities with other people, and we do that once or twice each week.
    She very much wants to help with cooking, cleaning, etc. around the house, thinks she can do it, but physically/mentally cannot, or is dangerous to try.
    But it is filling in the days at home with something she would be interested in doing that is a problem. I also have a life of my own, with many activities, e.g. supporting a local Democratic club as treasurer, membership manager and more. I take her to club affairs, but they are only two evenings/month.
    I'm ready to send her to Brookdale (San Jose, CA) which appears to have a great daily program of activities for persons like her. Costly, so I need to work out how to finance it. I am 87, and am showing a few signs of early Alzheimer's that I am aware of, but not so noticeable to others.

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