through the seasons
Book helps caregivers bond with memory-challenged adults
by Kristin Easterling

Book Cover

For a person in memory care, keeping the mind engaged is vital for physical and mental well-being. Moreover, activities that engage the whole person and acknowledge their dignity are important to ensuring that they participate and find joy in the activity set before them. A new second edition of the book “Through the Seasons: Activities for Memory-Challenged Adults and their Caregivers” lays out 32 experiences for caregivers and memory-challenged adults to try together throughout the year.

The book, from Johns Hopkins Press, was written by Cynthia R. Green, Ph.D., and Joan Beloff, ACC, ALA, CDP. In an interview with HomeCare, Green said the updated edition adds activities that are more culturally appropriate and have updated science behind them.

“When we were first inspired to write the book in 2008, a lot of concepts we saw were very elementary and drew from available resources for children,” Green said. “We felt they weren’t really dignified and didn’t draw on the interests of the person. Person-first engagement was a new concept.”

The book emphasizes cognitive stimulation for older adults with memory difficulties, citing research from the Lancet.

“For cognitive stimulation, we promote a lot of ways to meet someone where they are, whether someone can engage verbally, or if they can craft, or if they enjoy cooking,” said Green, who is an assistant clinical professor of psychiatry and the founding director of the Memory Enhancement Program at the Mount Sinai School of Medicine. “It’s about providing dignity. It’s about continuing to support and communicate with the person you care for.”

Each of the 32 experiences in the book includes a photograph to illustrate the experience, an introductory prompt, a “Let’s talk about” prompt, a “Let’s try” task and a “Let’s make” activity.

“Let’s talk about” encourages patients and caregivers to share cherished memories by talking about Halloween costumes and favorite candies in the fall, or ice cream and family picnics in the summer.

“We had people tell us about these activities that they’ve done. We also look for activities that have a lot of legs,” Green said. “For example, for the holidays, there’s a lot of holidays in winter and a lot of cultural traditions.”

One activity under “Let’s make” is Hungry Ghost Money, a version of the papercrafts that become burnt offerings in Chinese ancestral worship. In that tradition, the craft honors the ancestors and ensures good luck for the future. Projects like that can be approached simply or developed in multiple stages, Green said.

“If someone has the skill and initiative, they can learn more about the tradition, or they can just use it as a craft,” she said. “We look for something robust that can be used across the census by a lot of people.”

Engaging all of the senses throughout the year is important, she said, because as cognitive challenges progress, they may affect one aspect of sensory engagement before another. A person may struggle to grasp complex language or follow multi-step directions, but be able to connect in other ways, such as enjoying art or taking a walk.

“It’s just another way to engage people and making sure there’s a door that works for everybody,” Green said.

For caregivers who face difficulty leaving the house, planned activities such as a baseball game or a trip to a local garden can help relieve anxiety around travel and disrupted routines, said Green. Spring and summer have several suggestions for taking time out, while fall includes a nature walk to look at changing leaves.

The program, she said, is designed to build common ground and help people find joy in a challenging and changing situation.

“This is an opportunity to be together while recognizing the interests, strengths and challenges every one of us brings to the table,” Green said.

Kristin Easterling is managing editor of HomeCare Magazine.