Understanding Dementia: Connecting Through Performance

Performing or interacting with individuals who have dementia is not just about presenting your art, music, or story. It’s about stepping into their world—understanding their experience and using that knowledge to create meaningful, engaging moments. For those living with dementia, every day can feel like navigating a maze of fragmented memories, confusion, and shifting perceptions of reality. However, within this maze, there is room for connection, joy, and expression.

To create performances or activities that resonate with individuals with dementia, we must first understand what they are going through, and how their condition shapes the way they experience the world.

What is Dementia?

Dementia is not a single disease, but an umbrella term for a range of conditions that cause cognitive decline. The most well-known form is Alzheimer’s disease, but there are many types of dementia, each affecting the brain in slightly different ways. What they all have in common is a progressive decline in memory, thinking skills, and the ability to carry out everyday activities.

Some common types of dementia include:

Alzheimer’s Disease:

The most prevalent form of dementia, characterized by memory loss, confusion, and disorientation.

Vascular Dementia:

Often caused by strokes or issues with blood flow to the brain, leading to difficulties with problem-solving, reasoning, and thinking speed.

Lewy Body Dementia:

Known for its fluctuation in attention and alertness, as well as visual hallucinations and physical symptoms similar to Parkinson’s disease.

Frontotemporal Dementia:

Affects personality, behavior, and language, sometimes before memory issues emerge.

Each form of dementia can manifest differently, but the common thread is cognitive decline, which deeply impacts how a person interacts with the world and with others.

Common Symptoms and How They Affect Behavior

Understanding the most common symptoms of dementia is the first step in tailoring interactions and performances. These symptoms often manifest in behaviors that can be confusing or challenging for others to understand. However, with empathy and knowledge, you can shape your approach to create an environment where the person with dementia feels comfortable and included.

Here are some of the most common symptoms:

Memory Loss:

One of the hallmark symptoms of dementia is short-term memory loss. A person may forget recent events, appointments, or conversations, but retain distant memories. This can lead to repetitive questioning or confusion about where they are or why they are there.

Disorientation:

People with dementia may feel disoriented in both time and space. They may not remember what day it is, where they are, or why they are in a particular setting, which can make them feel anxious or unsettled.

Difficulty with Communication:

As dementia progresses, it can affect a person’s ability to find the right words or follow a conversation. They might use vague language, struggle to express their thoughts, or become frustrated with their own communication difficulties.

Changes in Behavior and Mood:

Dementia often brings shifts in behavior and mood, which can seem sudden or inexplicable to those around them. A person might become more irritable, anxious, or withdrawn, or they may exhibit restlessness or agitation. Sometimes, these changes stem from the confusion and frustration they experience in trying to understand their environment.

How to Make Performances Interactive and Engaging for Those with Dementia

Once you understand the world that a person with dementia inhabits, you can begin to shape your performance or activity in a way that is both gentle and engaging. The key is simplicity, familiarity, and flexibility.

1. Keep It Simple and Structured

Performances for individuals with dementia should be simple and clear. Complicated plots, fast-paced dialogue, or highly detailed explanations may be difficult for them to follow. Instead, opt for simplicity in your storytelling, music, or activities.

Familiar Songs and Stories

Nostalgia is a powerful tool. People with dementia often retain long-term memories, even when short-term recall fades. Incorporating familiar songs, stories, or themes from their past can create a sense of comfort and recognition. A classic song from their youth, a familiar childhood tale, or even a shared cultural reference can spark joy and engagement.

Repetition and Rhythm

Repeating simple patterns, melodies, or phrases can help maintain their attention and create a calming, structured environment. Rhythms, whether in music or words, provide a gentle predictability that is often reassuring.

2. Focus on the Senses

For individuals with dementia, sensory engagement is crucial. While cognitive abilities may decline, sensory perception remains strong, and engaging the senses can help ground them in the present moment.

Music and Touch

Music is especially powerful. It stimulates different areas of the brain and often evokes strong emotional reactions, even in advanced dementia. Playing or singing familiar songs can transport a person to a different time and place, bringing joy or comfort. Gentle, rhythmic touch—like clapping hands or tapping along with the beat—can also enhance engagement.

Visual Cues

Bright colors and simple, recognizable images can hold attention. When facilitating a painting or visual arts activity, consider focusing on broad, abstract strokes or familiar scenes. These could include nature landscapes, flowers, or animals, as these subjects are often calming and recognizable.

Tactile Materials

Texture plays a huge role in engaging the senses. Materials like clay, fabric, or textured paper can be used in art activities. In storytelling or drama, consider incorporating props that they can touch, like soft scarves or small objects that relate to the story being told. This hands-on interaction can be grounding for them.

3. Be Patient and Flexible

Many individuals with dementia have shorter attention spans or may become fatigued more easily. Keep activities and performances flexible, allowing for breaks and moments of rest. It’s important to observe your audience closely and adjust the pacing accordingly.

Short, Engaging Sessions

Focus on quality over quantity. A 15-20 minute activity that truly captures attention and is enjoyable is far more beneficial than trying to hold their focus for a longer period. Activities that follow a predictable rhythm, whether through repeating movements, familiar songs, or structured craft projects, offer a sense of security.

Be Prepared for Change

Someone with dementia may become distracted or agitated, or they might disengage for a time. That’s a normal part of the experience. If it happens, gently redirect their attention, or adapt your approach. If a performance becomes too overwhelming, it might be helpful to pause and offer a quieter, more intimate moment of connection.

Encourage Simple Participation

Invite the audience to participate in small ways, but without pressure. This could be as simple as clapping, humming along, or even nodding in response to a question. These little moments of interaction can create a powerful sense of involvement, even if it’s brief.

Performing for an audience with dementia requires patience. You may not always get the expected response, and that’s okay. What matters is creating an environment where they feel safe, included, and connected.

4. Connect on an Emotional Level

Above all, remember that dementia affects cognitive function, but the person remains deeply emotional. Performances that touch on universal themes like love, joy, or nostalgia resonate regardless of cognitive ability.

Empathy First

Approach your audience with warmth and empathy, meeting them where they are. Even if they cannot fully understand the words or plot, they will sense the emotion behind your performance. Speak and perform from the heart, and allow your own emotional authenticity to guide the experience.

Listen and Observe

Sometimes, the most important part of engaging with someone with dementia is listening. Pay attention to their body language, facial expressions, and emotional cues. These signals will help guide your interaction and tell you when to adapt, slow down, or engage more deeply.

Creating Moments of Joy

Focus on the experience of the activity rather than the outcome. A group painting may result in abstract or unrecognizable art, but the joy is in the process—the colors, the brushstrokes, the shared experience. Likewise, storytelling or drama may veer off course, but those moments of laughter or engagement are what truly matter.

Bridging Worlds 

Tailoring performances for those with dementia is about more than understanding symptoms and adjusting your approach—it’s about creating a bridge between your world and theirs. By entering their world with patience, empathy, and a genuine desire to connect, you can create moments of joy and meaning that transcend cognitive barriers.

Understanding their worldview, from the daily challenges they face to the memories they cherish, allows you to shape your performances in a way that uplifts and engages them, offering a respite from confusion and a moment of shared humanity. Through art, music, and storytelling, you bring light into their world—and that’s the beauty of performing for those with dementia.