A manual for dementia caregivers focuses on building connections using Appalachian culture.
written by DIANE TARANTINI
IN THE STATE OF WEST VIRGINIA, where—according to the Alzheimer’s Association—10% of the population aged 45 and older have some level of cognitive decline, more than 85,000 family members are providing care for loved ones with such impairments. To assist caregivers attending to individuals with similar issues anywhere in Appalachia, a team of researchers at West Virginia University developed the resource known as the “Appalachian Activities for Dementia Manual.”
The original idea stemmed from WVU Professor of Social Work Kristina Hash’s experience as a caregiver for her grandmother with dementia. In addition to teaching at WVU, Hash facilitates the monthly support group for the Alzheimer’s Association in Morgantown and also runs a small clinical practice seeing older adults and caregivers.
Drawing upon psychology, social work, and neuroscience research, the “Appalachian Activities for Dementia” manual offers meaningful and enjoyable activities for individuals with dementia and other cognitive disorders—in particular, those who grew up in Appalachia. The manual draws on the region’s cultural traditions, from recipes to games, and is designed for both one-on-one and group use.
“The goal is to help people feel confident and competent. When you have mild to moderate cognitive impairment, you are losing pieces of information, and you have a hard time recalling information,” Hash says. This difficulty can cause issues regarding the individual’s self-esteem and self-concept, she adds, leading to further struggles with depression and anxiety. “Especially with dementia, the first things in your brain are the last things out of your brain, and the last things in your brain are the first things out. But those early memories are in there, and they’re often tied to culture.”
The manual’s activities, which include crafts, games, music, recipes, and other aspects of Appalachian culture, connect with the senses, such as hearing, smell, and taste. The activities feature strategies for reminiscing or remembering past experiences centered around growing up in Appalachia.
In addition, the activity options help caregivers keep their loved ones engaged and stimulated in a positive way. The project’s team hopes this will decrease some of the stress caregivers experience while providing care.
“It’s one of the toughest jobs in the world. Caregivers don’t know what they are going to be dealing with every day. This is a way to have some tools that they can implement to help their loved ones feel confident and less agitated,” Hash says. The activities help build relationships between staff and patients or caregivers and those with dementia. Hearing stories can connect people one-on-one and in group settings. Each activity listed in the manual contains the estimated time it takes to complete the activity, the estimated difficulty for adults with dementia, and a list of the materials needed. Also included are directions and enrichment activities such as historical facts and questions to ask about each game, craft, or song.
The manual comes with a number of bingo games with associated flash cards to cut out. A game titled “Famous Person Bingo” concentrates on people from West Virginia such as Chuck Yeager, Katherine Johnson, Don Knotts, and Brad Paisley. Another bingo game with flash cards features West Virginia foods like biscuits and gravy, pepperoni rolls, ramps, and buckwheat cakes.
The “Sounds of Appalachia” activity includes links to audio files such as crickets, cicadas, train whistles, and various birds, plus large and small waterfalls. There is also a “Fun with Music” activity that uses flash cards with artists like Hazel Dickens, The Carter Family, and Jimmie Rodgers.
“Neuroscience research shows how music is encoded in your brain and is often untouched by dementia,” Hash says. “Music and food especially are attached to past experiences. These activities inspire stories from the past, which then engages others in sharing their own related stories. It’s really magical.”
Each activity in the manual has the potential to evoke reflections, discussions, and childhood stories—maybe even songs to sing. The activities in the guide can be used in group settings in long-term care facilities or at home with family members. Caregivers can pick and choose the activities they feel might have meaning for the person they are caring for.
Hash has seen the manual used with encouraging results. “I have used some of these activities with skilled nursing facility residents and found them to have positive effects. Reminiscence has been used for many years and has been validated as an evidence-based therapy for persons with dementia.”
The manual may be downloaded for free from the WVU Department of Psychology website, psychology.wvu.edu—search “activities for dementia.”