I have written several posts about dealing with the need for adjustments when caring for an elderly person. It is important to find ways to keep activities of interest over time but this means that caregivers have to be creative in engaging older people who have lost some level of capacity. Here are some areas where my mother and I needed to adapt to new realities:

• Knitting. Physically, my mother’s hands are increasingly arthritic, making it more painful to knit. She gave up needlework (e.g., cross-stitch, embroidery, and sewing) several years ago because it took a toll on her hands. She also used to knit with fine baby yarn and small needles, but that also would be challenging for her hands. We adjusted to this situation by increasing the weight of the yarn and the size of the knitting needles. This meant that her fingers did not have to work as hard and therefore it was more comfortable for her. In addition, her cognitive decline has meant that she cannot follow patterns very well. She used to make intricately patterned sweaters or other pieces. Now, she struggles to make a simple hot pad. She adds stitches, drops stitches, creates holes, and otherwise makes mistakes that she would never have made even a few years ago. Over the past 8 years, she has gone from making lap blankets to 24″ square cat mats to 9″ square hot pads. The yarn has gotten bigger and the products smaller. Even with these changes, at some point, I have to undo some parts and fix her work so that she can continue.
• Stories. My mother has always been a reader, though she focused more on fun and engaging books than complex novels. Over the past 8 years, her reading has decreased from books to short stories to sayings and phrases. Part of this is because she has a hard time remembering the story and the characters. That is not to say that she doesn’t still engage in stories. She has moved more toward oral storytelling … she likes to talk with people and have them share their stories with her. She can still read and loves word searches – she knows most of the words, as long as they are commonly used, e.g., she was a bit lost on searching for Greek gods but is good with fruits and vegetables! Sometimes we have to adjust how we define reading and stories. At first, I thought audiobooks would work for her, but the problem is that her hearing loss makes it challenging, so we may need to see if there is a way to adjust for that!
• Jigsaw puzzles. Mom loves jigsaw pizzles and always has. We have always put together jigsaw puzzles. When she moved down 8 years ago, she was still doing 1,000-piece puzzles. After a couple of years, we shifted to 750-piece puzzles, then 500-piece puzzles, then 300 large-piece puzzles. This is where we are now. Her level of frustration means that she has a difficult time doing a puzzle with anyone but me – she yells at people and gets very demanding. For whatever reason, she and I can work together to put a puzzle together and have a civil conversation at the same time! She loves jigsaw puzzles and it’s nice to see her so engaged in finishing a puzzle.
• TV and movies. Mom’s ability to follow plots and identify characters has diminished over the past 8 years. We used to watch lots of dramas (e.g., Downton Abbey, Poirot, Miss Marple, and movies), science and nature shows (e.g., Nature and Nova), light-hearted movies, and sitcoms. Now, even when she has seen something in the past, she has a tough time following the storylines and remembering who is who. Even having closed-captioning on, which used to be a great solution, is no longer adequate – “they talk too fast” is her frequent complaint. We do the best we can and embrace older movies and TV shows that have a slower pace.
• Coloring. My mother used to paint and draw beautifully. She was very detail oriented and made lovely color choices when completing a picture. Now, she is afraid of coloring something incorrectly and, even if we tell her that she can use whatever color she wants, she hesitates until her caregiver or I select something for her. She knows that leaves and stems are green, so a picture of flowers ends up all green – she can’t distinguish flowers from leaves. This loss of creativity is very sad to watch. Creating beautiful things from scratch was always my mother’s gift. The other challenge is making sure she sees that the coloring books are made for adults, as she is insulted if they appear to be made for children. We have tried the pictures where you paint with water and a picture emerges. She seems to be ok for a couple of pictures – amazed at how the water makes the picture appear – but then she seems to get angry with successive pictures, so it’s a limited-time activity!
• Food. Oddly enough, one area in which she has expanded her repertoire is the types of food she will eat. Mom has a limited palate and is not adventurous with food. When I would ask if she would like to order Chinese or Mexican or Indian or Thai food, she would say no. When I asked if she liked butternut squash or broccoli, she would say no. Leafy salads are too hard to eat. Pizza and cheeseburgers and pasta were OK, though. Hopefully her health care provider doesn’t read that! We moved to a new apartment a few years ago and for convenience I used a food delivery service that sent us prepared meals. She tried Chicken Korma and liked it. She tried Chinese food and liked it. She tried quesadillas and like them. So, now when I order from restaurants, I just don’t tell her what it is – she eats it all and really enjoys it. As long as it’s not too spicy and she doesn’t know what it is!