In this article, we suggest 10 neurorehabilitation activities for working with people with Alzheimer’s.
Alzheimer’s disease involves the development of multiple cognitive deficits, including memory impairment and changes in functions such as language, praxis, gnosis, and executive functions. The progressive loss of these cognitive abilities makes it important to target these areas in order to slow the progression of dementia. Some of the most common symptoms are memory loss, confusion, inattention, and mood changes. These signs help with the early detection of Alzheimer’s, which is vital for slowing its effects as much as possible through cognitive stimulation. Appropriate intervention in the early stages of Alzheimer’s disease by a neurorehabilitation professional stimulates the creation of new neural connections.
NeuronUP’s cognitive stimulation program allows neuropsychologists and occupational therapists to adapt each activity to each user’s specific characteristics and needs, delaying the neurodegenerative effects of the disease. The examples of cognitive stimulation exercises for people with Alzheimer’s described here were developed by NeuronUP professionals and designed to train cognitive skills involved in the main functions of daily life, and they are available to all professionals who work with the neurorehabilitation platform. Remember, too, that these are only examples and, depending on the resources at hand, there can be many variations.
Here are 10 neurorehabilitation activities for working with people with Alzheimer’s
1. Household Objects
What does it involve?
This activity makes the therapist’s job much easier because it is very familiar to the patient. The person is shown pictures of different objects that they have to place in the right rooms of the house.
What does this activity work on?
In addition to maintaining this everyday activity, it works on semantic memory and reasoning.
2. Straighten Up the Kitchen
What does it consist of?
In this exercise, users have to put the kitchen items where they belong.
What does this activity work on?
It works on cooking and cleaning, sustained attention, semantic memory, episodic memory, and reasoning.
Play by levels
At the easier levels, the program gives more prompts to complete the activity correctly, while at the harder levels there are fewer prompts.
Customizing the activity
You can also customize the activity to suit each user’s abilities.
Parameters
You can select the number of items, the type and amount of help you want the user to receive, and the errors that can be made.
General settings
You can adjust general settings such as the number of exercises, the maximum time, whether or not to show a visible timer for the activity, editing the instructions, and more.
3. Get Dressed
What does it consist of?
This is an activity the family will really appreciate you working on with the person with Alzheimer’s. It involves dressing the silhouette appropriately, taking into account both where and in what order each garment goes and the type of situation.
What does this activity work on?
This exercise works on procedural memory, body schema, ideational praxis, semantic memory, and planning.
Play by levels
At the easier levels, there are fewer commands and more prompts from the program to complete the activity correctly, while at the harder levels there are fewer prompts and the clothing requirements are more complex.
Customizing the activity
Parameters
You can select the number of garments, the setting, whether to add any kind of distractor, the errors that can be made, how the garments are presented, and more.
You can also customize the activity to suit each user’s needs and abilities.
General settings
You can adjust general settings such as the number of exercises, the maximum time, whether or not to show a visible timer for the activity, editing the instructions, and more.
Adaptability
Finally, you can choose whether the garments are moved by dragging or simply by tapping on the garment to select it. You can choose one option or the other depending on the user’s functional abilities.
4. Accurate Payments
What does it consist of?
Another activity with clear benefits for daily life. Maintaining the ability to pay in stores, even under the close supervision of a family member or caregiver, is very stimulating for the patient. In the exercise, the therapist encourages the person with Alzheimer’s to select the exact amount of money requested.
What does this activity work on?
It works on working memory, shopping, and planning.
Customizing the activity
You can also customize the activity to suit each user’s abilities.
Parameters
You can select the type of currency, whether to show only whole numbers or decimals, and the range of amounts.
General settings
You can adjust general settings such as the mode of operation, the maximum time, whether or not to show a visible timer for the activity, an inactivity alert, editing the instructions, and more.
5. Objects, places and professionals
What does it consist of?
In this cognitive stimulation exercise for people with Alzheimer’s, the user has to match different objects with the places where they are obtained and the professionals in charge of them. This type of activity allows for many variations, starting with something as simple as changing the places and objects each time.
What does this activity work on?
It works on semantic memory, spatial orientation, and gnosis.
6. Task Sequencing (Picture-Only)
What does it consist of?
Sequencing, a classic in stimulation and neurorehabilitation, is another type of activity that leaves a lot of room for creativity. So many everyday actions can be broken down into sequences! The idea of the exercise is simple: put a series of images in order according to a previously established criterion (time, visual, etc.).
In this example, the person receiving neurorehabilitation has to put in order the different steps needed to wash the dishes.
What does this activity work on?
It is used to work on executive functions.
7. Memorize the order
What does it consist of?
Another sequencing exercise that shows how versatile this type of activity can be. In this case, the therapist asks the user to memorize the order of the animals shown. Then the person with Alzheimer’s has to place them in the boxes in the order in which they appeared.
What does this activity work on?
It works on episodic and working memory.
8. Word Search
What does it consist of?
This activity involves finding hidden words in a grid of letters.
What does this activity work on?
It works on selective attention, sustained attention, and processing speed.
Customizing the activity
For example, you can use the names of the person’s grandchildren, which is ideal for boosting the user’s motivation when looking for the hidden words.
In addition to choosing the words to find in the word search, you can customize other aspects:
Parameters
You can select the size of the grid, the number of words, and the direction of the letters.
General settings
You can adjust general settings such as the mode of operation, the maximum time, whether or not to show a visible timer, an inactivity alert, and the instructions.
9. Personal Data Form
What does it consist of?
Personal Data Form is another cognitive stimulation exercise for people with Alzheimer’s. It’s a realistic simulator for learning to fill in general personal information on a form.
10. Hidden Letters
What does it consist of?
The user has to find only the indicated letter within a group of letters, in this case the letter “Q.”
What does this activity work on?
This exercise works on selective attention and hemineglect.
Customizing the activity
You can also customize the activity to suit each user’s abilities.
Parameters
You can select the size of the grid, the type and number of letters, and whether or not you want different colors.
General settings
You can adjust the mode of operation, the maximum time, whether or not to show a visible timer for the activity, an inactivity alert, editing the instructions, and more.
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Rehabilitation and Alzheimer’s: a necessity
The best-known symptom of Alzheimer’s disease is progressive memory decline. But that’s only the beginning. Little by little, all cognitive functioning becomes compromised, and processes such as language, attention, visuospatial skills, and executive functioning decline noticeably. This decline in cognitive functioning is clearly reflected in the person’s daily life, as they gradually lose the skills needed to cope with the challenges of everyday life. Only a few years may pass between forgetting a random word and no longer being able to eat on your own.
Rehabilitation is a response to the needs of a patient population that already exceeds 36 million worldwide. Its goal is to help people with functional impairments reach an “optimal level of physical, psychological, and social functioning” (McLellan, 1991, cited in Clare L, Woods RT, Cook, Orrell M, and Spector A, 2003). In people with Alzheimer’s, what “optimal” means varies greatly from one stage to another, but there are goals, and cognitive rehabilitation aims precisely to help the patient reach the best possible level of functioning, according to their own abilities.
What is cognitive stimulation in adults and what are its benefits?
Cognitive stimulation refers to the set of techniques and strategies used to improve the effectiveness of cognitive abilities and executive functions, such as memory, attention, language, reasoning, and planning, among others. Today, it is usually applied in cognitive rehabilitation as part of therapeutic interventions for diseases and syndromes characterized by cognitive impairment.
Professional cognitive stimulation is a treatment designed and delivered by neurorehabilitation specialists such as speech-language pathologists, psychologists, and occupational therapists. Each therapeutic intervention is unique, since it depends on factors as varied as the type of impairment, the person’s characteristics and circumstances, and the professional carrying out the intervention.
In diseases such as Alzheimer’s, the goal of cognitive stimulation is to slow cognitive decline and maintain preserved abilities, and it is used as a complement to specific dementia medications. In short, the therapist designs cognitive training aimed at slowing cognitive decline, whether it results from normal aging, or cognitive training to improve performance in activities that require high cognitive abilities.
The professional’s role
This treatment requires the professional to assess the cognitive abilities of the person affected by the disease. Based on the degree of impairment, the patient’s mood, and their social and family environment, the specialist decides which activities each patient should do, how long each one should last, and in what order of difficulty the tasks will be graded to monitor the progression of the decline.
Cognitive stimulation is based on the premise of brain neuroplasticity, that is, the brain’s ability to change and adapt in response to stimuli from the environment. This ability of the brain to reorganize itself, creating and strengthening neural connections, is the key to recovery. The brain itself can activate its neuroplastic systems, but they need to be stimulated and modulated through appropriate therapeutic intervention to optimize results. To do this, the activities must be motivating and create a suitable environment. That’s why, in some specialized centers, treatment is often delivered in groups because of the added benefit of social interaction, which helps prevent patients from dropping out and boosts their motivation to stick with treatment.
Types of intervention
Anyone can benefit from cognitive stimulation activities, but in a professional setting there are two types of intervention:
- Neuropsychological rehabilitation, which aims to restore the person to the highest possible level of physical, psychological, and social functioning. It is intended for people who have suffered brain injury or who have neurodevelopmental disorders, intellectual disabilities, or mental illness.
- Cognitive stimulation, which aims to slow cognitive decline and maintain preserved abilities. It is used in neurodegenerative diseases and normal aging.
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Summary of cognitive stimulation techniques and activities
There is a wide range of activities that neurorehabilitation professionals can use to train the user’s brain, from classic workbooks and worksheets like those offered by NeuronUP to more dynamic, innovative formats such as the brain training games at the core of NeuronUP. Less accessible techniques, such as neurotechnology, neurofeedback, or transcranial magnetic stimulation, can also be used. Below is a summary of the first 2 types of techniques, since they are the most widely used because of their accessibility and make it possible to carry out most of the cognitive stimulation exercises for adults and children that we’ll see later:
Cognitive stimulation workbooks
First, there are cognitive stimulation workbooks, which are very useful for working on executive functions and cognitive abilities such as memory, attention, orientation, reasoning, and problem-solving. They are very easy to get, since they can be bought in bookstores or even downloaded online. These workbooks are usually available in different difficulty levels so that anyone who wants to strengthen their mental abilities can complete them.
Some of these workbooks are available for free online, such as the Esteve cognitive stimulation workbook or the Consorci Sanitari Integral (CSI) cognitive stimulation workbook for strengthening memory, although their content is generally limited in appeal and variety. For professional intervention, the ideal option is to get NeuronUP’s paper worksheets through the website or by calling +34 941 287 238.
Brain training
NeuronUP also offers cognitive stimulation activities commonly known as “brain training games.” All of these activities have high ecological value, are based on daily life, and are grounded in a theoretical framework. They are a set of activities intended for professional use, and their results have already been tested in academic research with excellent outcomes. It’s important to note that, for cognitive stimulation to be effective, it must be adapted to each person’s cognitive level and potential, and the intervention must always be supervised by a professional. The exercises and activities should be motivating and challenging for the user. Sessions should be designed with all these parameters in mind to improve self-esteem, perceived self-efficacy, and mood, and to increase the chances of a successful intervention.
What is Alzheimer’s?
It’s a neurodegenerative disease caused by the progressive formation of senile plaques and neurofibrillary tangles in the cerebral cortex, along with neuronal and synaptic loss. The dementia causes memory decline and the development of other cognitive deficits in areas such as language, praxis, gnosis, and executive functions. The progression of the disease is inevitable, so the appropriate intervention is cognitive stimulation, since it can slow cognitive and functional decline.
References for the article 10 cognitive stimulation exercises for people with Alzheimer’s
- Bahar-Fuchs, A., Clare, L., & Woods, B. (2013). Cognitive training and cognitive rehabilitation for persons with mild to moderate dementia of the Alzheimer’s or vascular type: A review. Alzheimer’s Research & Therapy, 5(4), 35. doi:10.1186/alzrt189
- Clare L, Woods RT, Cook, M., Orrell M, & Spector A (2003). Rehabilitation and cognitive training for early-stage Alzheimer’s disease and vascular dementia.
- Haskins, E. C. (2012). COGNITIVE REHABILITATION MANUAL(First Edition ed.). ACRM Publishing.
- Kelly, M. E., & O’Sullivan, M. (2015). STRATEGIES AND TECHNIQUES FOR COGNITIVE REHABILITATION.
- Olazarán, J., Reisberg, B., Clare, L., Cruz, I., Peña-Casanova, J., Ser, D., … Muñiz, R. (2010). Nonpharmacological therapies in Alzheimer’s disease: A systematic review of efficacy. Dementia and geriatric cognitive disorders., 30(2), 161–78. Available at https://www.ncbi.nlm.nih.gov/pubmed/20838046
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