Dementia is a progressive, degenerative brain disorder that has no effective medical remedy. People with dementia are affected by a myriad of impairments, not just memory loss. It is not surprising therefore that carers too are at risk of depression and anxiety (Mahoney et al., 2005). Wellbeing is the goal of much dementia care – and wellbeing is the responsibility of the wider community, not only the NHS. During lockdown, the impact on many individuals with dementia of the lack of stimulation has accelerated their cognitive deterioration. Prior to lockdown carers struggled to cope with support from a range of sources, and these were decimated by the virus restrictions. As one carer reported in our survey, “My wife was booked in for day-care three to four days a week - this gave her activities and stimulation and me respite - when lockdown occurred - all day care centres were closed to us. Consequently we were left without the said activities and stimulation and respite and my caring workload dramatically increased”.
Outside activities clearly have important functions for carers, relieving them of the physical and emotional stresses of day to day care, if only temporarily. Equally important, they afford carers opportunities to access reliable information, advice and peer support. As for the individuals with a diagnosis of dementia, group activities that bring dyads together play a vital part in helping participants to adjust to the diagnosis and to normalise their experiences. Having fun together can also strengthen the caring relationship, generate new friendships and reduce the sense of isolation that 24/7 caring can cause.
The place of exercise
A scientific review concluded that all things considered exercise was one of the most effective interventions available for people with dementia: “There is good evidence that multi-component exercise with sufficient intensity improves global physical and cognitive functions and activities of daily living skills.” (McDermott et al., 2019) Exercise does not cure dementia, but it can help individuals affected to maintain their physical functioning and in that way to extend their ability to look after themselves at home. It may help to prevent falls and fractures, and thereby avoid distressing hospital stays, which are often a prelude to long-term care admission. It may help with weight control and associated cardiovascular problems. It is likely to lift mood and stimulate cognition. For the carers, exercise may delay or prevent cognitive decline, as well as alleviating depression (Livingston et al., 2020).
Livingston G, et al. (2020). Dementia prevention, intervention, and care: 2020 report of The Lancet Commission. The Lancet 396 (10248) 413-446.
Mahoney R, Regan C, Katona C, Livingston G. Anxiety and depression in family caregivers of people with Alzheimer disease: the LASER-AD study. Am J Geriatr Psychiatry 2005 13: 795–801.
Orii McDermott, Georgina Charlesworth, Eef Hogervorst, Charlotte Stoner, Esme Moniz-Cook, Aimee Spector, Emese Csipke & Martin Orrell (2019) Psychosocial interventions for people with dementia: a synthesis of systematic reviews, Aging & Mental Health, 23:4, 393-403, DOI: 10.1080/13607863.2017.1423031