Meaningful activity in advanced dementia

Abstract

This article is part of a series in Nursing Older People exploring the nursing care of people living with advanced dementia. When someone with advanced dementia can no longer communicate verbally and has limited movement, activities they once enjoyed may no longer be possible. This limits opportunities for self-realisation and can lead to a preoccupation in advanced dementia care about the routines associated with the maintenance of comfort and nourishment, at the expense of contentment and moments of fulfilment. Such a narrow focus can lead to changes in behaviour, indicating boredom, frustration and distress. Yet there are opportunities for a more creative approach to activity that can be adapted to the person's changing needs and the human desire to feel connected and engaged. Examples of these evidence-informed, creative interventions for people living with advanced dementia care include music, doll-focused activity, animal-assisted interventions, multisensory experiences such as Namaste Care and complementary therapies. These activities can engage the person with advanced dementia in a close connection with another human being through individualised and sensory-based care.

Keywords: advanced dementia; dementia; frailty; neurology; older people.