Mona Lisa & the Art of Good Alzheimer`s Care


Activities as a Path for Culture

Change – The Best Friends Approach

David Troxel, MPH

Dr. Alzheimer

Auguste Deter

November 25, 1901, 51 years old

Problems with every day tasks

Jealousy, delusions


• “I have lost myself”

Be a Best Friend

Being Person Centered

Daphne Gormley, Santa Barbara

• Dx at 59. Credits dementia meds with helping.

• Uses water soluble crayons and felt tipped markers for my paintings. “Rather than limiting my artwork, my Alzheimer’s seems to have unleashed a whole new area of creativity for me.”

• Emphasizes process rather than outcome.

• Ambitious, motivated.

• Daphne continues. . .

• “One of the benefits of my art for me is that it provides me a way of communicating without words.

The colors I use are colors I find to be joyous. This is a way for me express my joy in painting and in my life. AD has really taught me to concentrate on the things I can do not on the things I can no longer do.”

Develop “the Knack”

• Knack is the “art of doing difficult things with ease.”

• Or, “clever tricks and strategies!”

• Helps in unstructured moments.

• Humor

• Flexibility

• Patience

• Respect

• Being in the moment

• Creative activities


Moving Toward Quality Care

We Know how to Create a Quality

Dementia Care Program

Purposeful chores

Creative activities


Learning & growth

Using the Life Story





Being outside

Skilled, Empathetic Staff who Build Relationships

Supporting Staff

• Knowing that we cannot treat staff badly and expect a badly treated staff to treat residents well.

• Showing appreciation

• Giving them the tools to succeed.

Programs that Embrace the

Life Story

• Bullet Cards

• 1-100 Campaigns


• Resident Jeopardy

• Monthly focus

• Shadow box beauty shows

• Putting Life Story to work in activity creation.

• Name tags

Person Centered Activities

• Here are some principles of Activities from a Best Friends Approach

It’s not in what is done, it’s in the doing

Should be individualized and tap into past interests and skills

Should be adult in nature

Should recall a person’s work related life

Should stimulate the senses

Sometimes doing nothing is doing something

Tap into remaining physical skills.

Should be initiated by others.

Should be voluntary

Intergenerational activities work!

Personal care is an activity.

Activities can be short

Should fulfill religious

& spiritual needs.

Activities are everywhere.

Remarkable programs create signature programs

“Hope is the thing with feathers, that perches in the soul, and sings the tune without words, and never stops at all.”

Emily Dickinson



Music Fills the Room

Exercise at Atria

Longwharf Theater

Ideas for your setting

• Signature activities • Just for Men

• Exercise

• Evenings & Weekends

• Creating theme rooms

– the beauty parlor or

“Susie’s Salon?”

Ideas for your setting

• Visiting:

– Flower arranging

– Gift wrapping

– Mail order shopping

– Organizing

– Reminiscing

– Movie musicals

– “chit chat”

– Outdoor time.

• Make it Memorable!!


• Create a Dementia

Care Study


• Consider a monthly or quarterly focus.

• Embrace Life Story work even for short stays

• Innovate in activities

– Adult Learning

– Music

– Exercise

– Spirituality


• Embrace creative and effective training

– Monthly focus

– Role plays

– Mini 5 or 10 minute in-services

• Follow up and model as a leadership team.

Activities you think won’t work sometimes do

• Failure Free Activities???

• How many of us lead failure free lives?

• From failure comes growth and planned activities that go in a different direction are sometimes the most fun.

Classroom ideas

• Apples

• The State of Indiana

Activities as a path toward

Culture Change

• Allow all staff to recast their work in light of activities

• Embrace 30 second activities

• Teach activities in your staff training programs

• What’s the cook doing in the activity room?

30 Second Rule

Teaching staff (and families) that it only takes 30 seconds to be a little less task oriented and a little more person centered.

The Impact of Best Friends