EverydayArticle link

Safe Functional Home Exercise program for dementia

Key points

  • The Safe Functional Home Exercise program is the first co-designed exercise program for dementia, created with input from people with dementia, carers, and support workers.
  • It focuses on functional movements like sit-to-stand, marching, and balance exercises that mimic daily tasks and can be done at home.
  • Co-design led to practical improvements like client videos and motivation tips, making the program more acceptable and easier to follow.
  • Regular practice helps maintain physical function and may reduce fall risk, which is critical since one in four seniors has a serious fall.
  • The program is low-cost and scalable because it uses support workers already in the home, but family caregivers can also lead it.
  • Always get medical clearance, monitor for safety, and adapt exercises as dementia progresses to keep the person engaged and safe.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. Start by talking with your loved one's doctor or a physical therapist to get medical clearance for exercise. Ask: 'Is it safe for them to do gentle standing, walking, and balance exercises at home?' This is crucial because some conditions, like heart problems or severe osteoporosis, may require modifications.

  2. Observe your loved one's current abilities for one or two days. Note how they get up from a chair (do they push with arms? need help?), how steady they are when walking, and whether they have any pain or fear of falling. This baseline helps you choose the right exercises.

  3. Choose 2-3 functional exercises from the program, such as: (a) sit-to-stand from a sturdy chair without using armrests, (b) marching in place while holding the back of a chair, and (c) side steps while holding a counter. Do each exercise 5-10 times, with rest between.

  4. Set a regular time each day for the exercises, like after breakfast or before lunch. Consistency builds routine, which helps the person with dementia remember and feel secure. Use a visual cue, like a clock or a specific song, to signal it is time.

  5. Demonstrate each exercise yourself first, using slow, clear movements. Say: 'Watch me. I stand up slowly. Now you try.' Use hand-over-hand guidance if needed, but let them do as much as they can on their own. Praise effort, not perfection.

  6. Monitor for safety throughout. Watch for signs of fatigue, dizziness, or frustration. If they seem overwhelmed, stop and try again later with fewer repetitions. Never force an exercise if they resist—it can lead to falls or agitation.

  7. Incorporate the exercises into daily activities. For example, while waiting for water to boil, do 5 sit-to-stands. While watching TV, march in place during commercials. This makes exercise feel natural and less like a separate task.

  8. Keep a simple log or checklist of what exercises were done and how the person felt. Share this with their doctor or therapist at visits. This helps track progress and adjust the program as dementia progresses.

  9. After 2-4 weeks, review the program with your loved one and any support workers. Ask: 'Is this still working? Are there new challenges?' Adjust the exercises—for instance, if standing is harder, switch to seated leg lifts or arm circles.

  10. If you use a support worker, train them on the program using the co-designed client video (if available) or by practicing together. Support workers can reinforce the exercises during their visits, which enhances carryover and consistency.

What not to do

  • Do not push your loved one to exercise when they are tired, agitated, or in pain. This can lead to falls, resentment, and a negative association with activity. Instead, wait for a calm moment or try a gentler activity like seated stretching.

  • Do not use complex instructions or expect them to remember a sequence. For example, saying 'Do 10 squats, then march, then stretch' is too much. Instead, give one step at a time: 'Stand up. Good. Now sit down.' Repeat as needed.

  • Do not ignore safety hazards like loose rugs, poor lighting, or slippery floors. Falls are a serious risk—one in four seniors has a serious fall. Before starting, clear the area, ensure good lighting, and have a sturdy chair or counter for support.

  • Do not expect the person to exercise alone or without supervision. Dementia affects judgment and balance, so they may overestimate their abilities or forget safety precautions. Always stay within arm's reach during exercises.

  • Do not compare their current performance to what they used to do. This can cause frustration or shame. Focus on the present moment and celebrate small wins, like standing up without help or walking a few extra steps.

  • Do not stop the program if they have a bad day. Dementia symptoms fluctuate. If they refuse, try again later or offer a different activity, like a short walk or seated ball toss. Consistency over time matters more than daily perfection.

Practical tools

  • Client Demonstration Video

    The co-design panel suggested making a short video of the exercises being performed by someone with dementia. You can create your own using a smartphone: film yourself or a support worker doing each move slowly, with simple narration. Play it before each session to remind your loved one what to do. This reduces confusion and builds confidence.

  • Motivation Tips Checklist

    Write down simple phrases to encourage participation: 'Let's do this together,' 'You are doing great,' 'One more, then we rest.' Also list preferred music or a favorite TV show to play during exercises. The co-design panel found that these tips help keep people engaged and reduce resistance.

  • Sturdy Chair with Armrests

    Use a chair that does not slide or tip, with armrests for support during sit-to-stand exercises. Avoid wheeled chairs or low sofas. A dining chair or a firm armchair works well. Place it on a non-slip mat if floors are smooth.

  • Visual Schedule Board

    Create a simple board with pictures or icons showing the daily routine, including exercise time. For example, a picture of a person standing next to a chair. Place it in a visible spot like the kitchen or living room. This reinforces the routine and reduces anxiety about what comes next.

  • Resistance Bands (Light Tension)

    If the person is stronger, use light resistance bands for seated rows or leg presses. Always demonstrate first and supervise closely. Bands are low-cost and can be used for a variety of functional movements. Discuss with a physical therapist before starting to ensure proper form.

  • Fall Prevention Kit

    Assemble a small kit with a non-slip mat, a grabber tool, and a phone or alert device within reach. Place it near the exercise area. Also, ensure the person wears supportive, non-slip shoes (not slippers) during exercise. This reduces fall risk and gives you peace of mind.

Discuss with your clinician

Ask the doctor: 'Is it safe for my loved one to do sit-to-stand exercises if they have had a hip replacement or osteoporosis?'

Ask the physical therapist: 'What specific balance exercises are safest given their history of falls or dizziness?'

Ask the neurologist: 'Are there any exercise restrictions due to their type of dementia, such as in Lewy body or vascular dementia?'

Ask the pharmacist: 'Could any of their medications cause dizziness or affect heart rate during exercise?'

Ask the occupational therapist: 'How can I modify the home environment to make exercise safer, like adding grab bars or removing rugs?'

Related guides

Sources