Bruno Bettelheim spent most of his professional life studying child development. Not all of his work has stood the test of time, but one thing I think he got right is the importance of play. He said once, “The child knows only that he engages in play because it is enjoyable. He isn’t aware of his need to play….”
The need to play or otherwise be active applies to adults as well, including people affected with dementia. The activity, the stimulation, a sense of accomplishment that often goes along with play; all these are beneficial and therapeutic. Toys for people with Alzheimer’s don’t look very different than any other toys. However, it is not inappropriate to give toys to people with Alzheimer’s. They might not be aware of the benefit they are getting from the play, but if you watch them I think you will see it.
Toys have never been just for kids
When we select toys for children, the stage of the child’s development is the biggest factor in making a choice. We don’t bring home a rocking horse for an infant. A 100 piece puzzle is inappropriate for a toddler. And a rattle is not the thing to get for your primary school student.
In a similar manner, when we select a toy for a person with Alzheimer’s we have to consider the abilities of that individual. Cognitive as well as social abilities and perceptual acuity are lost to the inevitable spread through the brain of the plaques and tangles that probably caused the disease.
We like to think about it in this way: as the disease progresses, the person with Alzheimer’s regains those childlike (not childish) qualities that make children see their world as a magical place. Everything is new for children since they do not have much of a past. In the same way, the world of the person with Alzheimer’s can be full of novelty since he is losing his past to the disease. Without the past of his memories, without the future of his expectations, he is alive in the present.
This box full of colorful balls is one of the early toys we brought to Bernice. She had broken her wrist and the cast had been removed recently. She was reluctant to do anything that was even moderately therapeutic to get back the use of her arm and hand. When we first sat down with her new toy, she was very tired; her speech was soft and mostly incoherent.
It was afternoon (not late), and she did tire easily, but that was her go-to excuse when she was unsure. Once she got started she was fascinated. Thirty-five minutes later we had to put them away. She was no longer tired, and she was much more conversational than when we had started. And even she recognized the benefit squeezing these balls had for her mending arm.
Toys for People with Alzheimer’s Disease and Dementia
Toys and games are colorful; they’re interesting; they’re fun. Choose toys that are age- and stage-appropriate; these will do a better job of holding the interest of the person with Alzheimer’s. The right toys will be cognitively stimulating and improve quality of life. (Read more about age- and stage-appropriateness in our Activities for Alzheimer’s post.)
What to consider in a toy
Almost any toy that the person with Alzheimer’s is interested in will be beneficial. Most toys will be effective for more than one purpose. The Tangle featured on this page, invented for a broader audience, is a perfect toy for people with Alzheimer’s. It is manipulative. Twisting and turning the jointed sections provides exercise for the hands and arms at the same time that it is relaxing, almost meditative. The bright colors and varied textures of each segment provide sensory stimulation.
Demeaning or Dignifying?
Probably more than with any other recommendation for Alzheimer’s care, the concern will be raised here about the appropriateness of using toys in treatment, or perhaps of particular toys. This concern is understandable. It is difficult to watch a loved one regress into a childlike state. Unfortunately, that is what is happening. That person’s interests and abilities are changing.
The arguments in favor of toys as therapy center around the patient. It is our firm conviction that stage-appropriate activities, including toys, enhance the quality of life of persons with dementia. They are not necessarily, and should not be thought of, as demeaning or disparaging in any way. The only really valid criterion for rejecting a toy or activity is if the person in your care objects to that particular toy.
An article in the National Library of Medicine agrees with us. From that article:
Play is not used to infantilize and trivialize people living with dementia but as a way to explore potential for expression, meaning-making, and relationship-building in later life.
Alison Mahoney at the Macquarie University, in Sydney, Australia reported that stage-appropriate activities are significantly more effective in bringing about positive outcomes than are age-appropriate activities. You can read more about her study on our Activity post; in essence it means that a toy that was designed for a child might be a better activity than an activity that was meant for a high-functioning adult.
The first time Bernice ever saw a Tangle Toy® was at the dentist’s office. Holly had taken Bernice for a routine examination and gave it to her to occupy her in the waiting room.
Just holding it, Bernice said that it would be “relaxing to move it around in your hand.” And while she moved it around, her creativity came out. She told this story:
“Some man probably invented this because his wife kept hiding everything. This would relax him when he couldn’t find things that she had hidden.”
As she manipulated the toy, Bernice was particularly intrigued with the textures and colors, exploring each section of the Tangle and commenting on or describing them. Holly was particularly intrigued by the flow of creativity manipulating the Tangle inspired in Bernice.
Bernice, like so many people with Alzheimer’s disease, hid things. Hiding things is, in fact, symptomatic of the disease. Also, like so many people with AD, she often forgot where she had hidden them. It is very likely that tendency of hers had something to do with her story.
The great thing about toys is that the pull us into the moment. Once we get involved with a toy, our full attention is taken up with play and exploration. That is true also of toys for people with Alzheimer’s disease and other types of dementia. Anything that engages can’t help but be beneficial, and toys engage both the body and the mind.
The whole category of fidget toys is a wonderful example of toys for people with Alzheimer’s. Along with those other qualities of engagement, they provide a repetitive task or motion that so many dementia patients find soothing and enjoyable. Heck, a lot of people without dementia find fidget toys soothing.
Enjoyment translates immediately to quality of life.
A Controversial Idea
Jean Piaget developed perhaps the best known theory of human cognitive development. According to his theory, the human child develops through four stages, culminating in abstract reasoning. According to Piaget, play is an important part of the process of progression through these stages.
Many have theorized that a person with Alzheimer’s moves backward through Piaget’s stages: Simply stated, the person with Alzheimer’s looses cognitive ability as the disease progresses. Observing someone with AD makes this idea somewhat plausible, though always remember that he is still an adult, with adult experiences and adult sensibilities.
J.Thornbury suggests that not only does this model provide a means for prescribing treatment, but can be helpful in understanding the behaviors of people with Alzheimer’s and dementia, behaviors that can often be disturbing to caregivers and loved ones.
There is an ever-increasing amount of anecdotal evidence reported in the news services and medical publications that dolls and stuffed animals provide comfort and often a sense of purpose to AD patients. Improved behavior, less agitation, better sleep, are all results that have been reported in programs that use these methods.
Indeed, toys for people with Alzheimer’s disease and other dementias can be an important part of an overall therapy regimen.
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WHAT OTHERS ARE SAYING
- Thanks, Appreciate that “extra effort”. Don’t seem to run into that much anymore… and that is a shame. I’m really looking forward to receiving the “toys” for my wife. I pray they will work as good as one of her caregivers told me they would. Ken