People with dementia living in nursing or residential homes often have too little to do. Activities which are available may not be meaningful to them. If a person with dementia has the chance to take part in activities which match his or her personal interests and preferences, this may lead to a better quality of life, may reduce challenging behaviour such as restlessness or aggression, and may have other positive effects.
Purpose of this review
We wanted to investigate the effects of offering people with dementia who were living in care homes activities tailored to their personal interests.
Studies included in the review
In June 2017 we searched for trials that had offered some participants an activity programme based on their individual interests (an intervention group) and had compared them with other participants who were not offered these activities (a control group).
We found eight studies including 957 people with dementia living in care homes. Seven of the studies were randomised controlled trials (RCTs), meaning that it was decided at random whether participants were in the intervention group or the control group. One study was not randomised, which puts it at higher risk of biased results. The number of participants included in the studies ranged from 25 to 180. They all had moderate or severe dementia and almost all had some kind of challenging behaviour when the study started. The studies lasted from 10 days to nine months. In all the studies, the people in the intervention groups got an individual activity plan. Most of the activities took place in special sessions run by trained staff, but in one study, the nursing staff were trained to provide the activities during the daily care routine. The activities actually offered in the different studies did not vary a lot, but the number of activity sessions per week and the duration of the sessions did vary. In five studies, the control group got only the usual care delivered in care homes; in three studies, the control group got different activities that were not personally tailored; one study had both types of control group.
The quality of the trials and how well they were reported varied, and this affected our confidence in the results.
Offering personally tailored activities to people with dementia living in care homes may slightly improve challenging behaviour when compared with usual care, although we did not find evidence that it was any better than offering activities which were not personally tailored. In one study, staff members reported that people in the group receiving personally tailored activities had a slightly worse quality of life than the control group. Personally tailored activities may have little or no effect on the negative emotions expressed by the participants. Because the quality of some of the evidence was very low, we could not draw any conclusions about effects on the participants’ positive emotions, mood, engagement (being involved in what is happening around them) or quality of sleep. Only two studies mentioned looking for harmful effects; none were reported. None of the studies measured effects on the amount of medication participants were given, or effects on carers.
We concluded that offering activity sessions to people with moderate or severe dementia living in care homes may help to manage challenging behaviour. However, we did not find any evidence to support the idea that activities were more effective if they were tailored to people’s individual interests. More research of better quality is needed before we can be certain about the effects of personally tailored activities.