Activities for dementia patients, what happens when they are too difficult?

99% of the time dementia patients will not participate in their activities or want to continue to play, when puzzles, memory improvement games or brain exercise appear too difficult.

Some won’t even try, not because they are being stubborn, but because they do not want to fail and feel embarrassed.

Dementia and stroke patients are not always capable of verbally expressing their feelings. We must learn to hear their feelings through their body language.

These are visual signs of doubt, intimidation, frustration, inner conflict and lack of self-esteem. Learn to watch for these key signals in their body language; facial expressions, arms, legs, hands and fingers.

Frustration comes in many shapes and forms.

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I have seen frustration and when you do not or cannot fix the problem, dementia and stroke patients do not want to play the game PERIOD.
Observing their body language will give you a “heads up” on the true feelings of individual and steer off frustration.
Unfortunately, after feelings of fear and intimidation have settled in, is when we usually see and hear more extreme signs of frustration and anger.

Fear occurs when basic needs are threatened and there are many levels of fear, from mild anxiety to blind terror.

The many bodily changes caused by fear make it easy to detect, when you are aware of them.

• pinching face and arms
• scratching their head, neck, face, hands and arms
• nose twitching
• smacking, licking of lips
• unconsciously shaking their head “no” in doubt
• snapping their fingers
• covering, rubbing of eyes, ears or mouth – “I do not want to see, hear or do this”
• jerky movements, wiggling around
• tapping their feet
• blinking their eyes
• placing their palm on the back of neck
• drumming or tapping fingers – person wants to leave; can’t quite figure it out
• sighs and grunts
• wrapping arms around their body – the person is literally holding themselves

Ask yourself these questions if and when you see signs of frustration or hear sounds of frustration.

• Are you playing activity as suggested for patient success?
• Is the activity to difficult for person?
• Is activity, theme or picture age appropriate, if not they feel humiliated.
• Is individual interested in activity, puzzle or memory game?
• Does player understand how to play match game or put the puzzle together?
Can player see pictures clearly?
• Is person close enough to table and comfortable?
• Can player reach puzzle pieces or cards easily?
• Are you playing memory or matching games at users level?
• Does the puzzle have too many pieces?
• Are puzzle pieces thin and difficult to pick up?
• Are you playing matching game with too many cards?
• Are you showing signs of frustration by sighing or lack of patience?
• Are you using the word “no”?

Anger occurs when achievement of goals are frustrated or doubtful. Signs to watch for include:

• neck or face is red or flushed
• clinched fists
• leaning forward
• disapproving frowns
• pursed lips
• clinching of jaws
• quick wide opening of hands of bewilderment
• gripping the edge of the table

Did you know elderly patients mimic our emotions?
• If we smile they are more relaxed.
• If we frown soon they will feel depressed.
• If we sigh they become nervous.
• If we become agitated because they are having difficulty, soon they will not want to do the activity.

Positive signs to look for, many you know but, I will mention them anyway.

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• Peaceful appearance while playing
• Twinkle in eyes, smiles
• Relaxed face
• Relaxed mouth
• Hands have become more relaxed
• Movements are smoother and quicker
• Entire body appears relaxed
• Shoulders relaxed, not tensed upward
• Participation
• More focused


Working with dementia and stroke patients we must learn:

• how to observe their facial expressions
• how to listen
• what causes frustration
• what grunts and sighs meant
• how to work slowly, speak slowly and clearly
• to visually show how or what to do
• how to put a smile on their face

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