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The child knows only that he engages in play because it is enjoyable. He isn't aware of his need to play....
    ~ Bruno Bettelheim    This can apply as well to people affected with Alzheimer's disease and Dementia. The activity, the stimulation, the sense of accomplishment are all beneficial and therapeutic. |
When we select toys for children, the stage of the child's development is the biggest factor in making a choice.
As Alzheimer's disease progresses, the patient goes through very similar stages as a growing child, but in reverse. Cognitive as well as social abilities are slowly lost as the plaques and tangles spread through the brain. 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 don't 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.
Toys and games are colorful, they're interesting, they're fun. They will hold the interest of the person with Alzheimer's. They are cognitively stimulating and improve quality of life.
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.
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. This is understandable. No one likes to see a loved one regress into a childlike state. Unfortunately, that is what is happening.
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. Toys for Alzheimer's patients should be considered as a part of a complete care program unless they are objected to by the patient herself.
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 toys, Bernice was particularly intrigued with the textures and colors, exploring each section of the Tangle and commenting on or describing them.
Bernice, like so many victims of Alzheimer's disease, hides things. This is, in fact, symptomatic of the disease. Also, like so many victims of AD, she often forgets where she has hidden them. It is very likely that this inspired her story to some degree.
This colorful item provides visual and auditory stimulation as well as cognitive stimulation in the form of tactile exploration. Bernice was initially a little apprehensive when given her Explorer Ring, but she eventually spent an hour and a half learning how each of the gates and valves worked. She was mesmerized it is one of her new favorites.
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 the 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 very 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 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.