Digital activities in care homes: choosing, adapting and supporting participation

1. Begin with the resident’s purpose and preferences

Ask what the person would like to do before showing the device. Someone interested in gardening might enjoy discussing plant photographs, following a favourite gardening programme or planning an outdoor task. Someone else may want to read current news or try a new drawing technique. Interests do not have to come from the past, and age does not determine the subjects a person will enjoy.

Offer an understandable invitation. Explain the activity, who is present and how the person can leave or change it. A resident may enjoy listening without touching the screen, or wish to use the device independently. Neither choice should be treated as the wrong level of participation. Staff support should follow the person’s needs rather than require everyone to demonstrate a particular gesture.

Information from relatives can be helpful, but it does not replace the resident’s current preferences. A once-loved song may now be unwelcome, and a new interest may not be known to the family. Include friends and other trusted people where the resident wishes. Avoid assuming that every family relationship is comfortable or that every personal photograph is suitable for a group.

For a person who communicates without speech, use their established ways of choosing and refusing. Notice possible signs of interest or discomfort, then seek clarification where possible rather than assigning a definite meaning to each movement. A smile is not blanket consent to continue indefinitely. When decision-making support is needed, follow the applicable local framework and keep the person involved as far as possible.

NICE recommends activities tailored to the preferences of people living with dementia. That principle supports a varied programme; it is not an endorsement of a particular device or commercial application. The activity should remain one option within a life that also includes relationships, movement, rest and everyday occupations.

2. Check access before buying or setting up equipment

Try equipment in the place where it will be used. Consider whether the person can see the screen without glare, hear the content comfortably and reach controls without strain. A larger display may help a group but be awkward for someone who wants privacy. A small tablet may be convenient to carry yet difficult to position. There is no screen size that suits every resident.

Check the whole arrangement, including seating, the support stand and the location of cables. Ask whether the resident can use their preferred hand, maintain a comfortable posture and move away safely. An occupational therapist or other appropriate professional can help where access is complex. Do not assume that imprecise touching reflects poor understanding; the physical setup may be the barrier.

Review the application’s actual controls. Can text be enlarged? Can unnecessary sound be reduced? Is it possible to pause, repeat an instruction or leave the activity easily? A senior-focused label does not guarantee accessibility. Test the current version and avoid promising features such as automatic difficulty adjustment, offline use or account-free access unless they have been verified.

Audio needs its own check. Raising the volume for one person may make the room uncomfortable for others. Headphones may suit an individual who wants them, but can be unpleasant or interfere with communication for someone else. Consider hearing aids and any relevant professional advice. The resident’s response is more informative than the facilitator’s preferred volume.

For purchasing, include maintenance, licences, connectivity, protection, accessibility accessories and staff time. A low purchase price can conceal recurring costs. Begin with a realistic trial when possible, and avoid ordering a complete set of devices before checking whether the proposed activity is accessible and wanted.

3. Choose activities with several ways to join in

A digital activity can involve making choices, telling a story, listening, creating an image or discussing a topic. It does not always need a score or a correct answer. For a group, choose a format where quieter participants can contribute without being put on the spot. A person may prefer to comment after others, point to a detail or simply share the experience.

A picture activity can begin with observation rather than recall. Ask what the scene suggests, what the person notices or whether they would like to see another image. Do not require a name, date or proof of recognition. A resident who does not identify a location may still enjoy discussing its colours, weather or buildings. That response is a valid contribution.

Music can offer listening, conversation, singing or choosing the next piece. It can also evoke grief, discomfort or unwanted memories. Keep the volume manageable and the stop control available. Do not assume that all older people share the same musical taste or that music is calming in every situation. A resident can request silence without needing to explain a personal history.

Creative activities might include drawing, selecting photographs for a private album or composing a message with support. Check that any photographs, recordings or published materials can be used in the intended way. Personal viewing, public projection and posting online are different uses. Staff should follow organisational arrangements for rights and permissions rather than assuming that anything visible on the internet is free to reuse.

Plan a non-digital alternative with the same purpose when useful: a printed image, an actual object, conversation or a familiar board game. This keeps participation available if the device fails or the person decides that the screen is not the medium they want today.

4. Use games without turning leisure into assessment

Games can provide an interesting challenge, a shared topic or a way to pass an enjoyable moment. Some residents like competition and visible scores; others dislike them. Ask rather than treating competition as either universally motivating or universally harmful. The important distinction is between a chosen game and a task imposed to prove the person’s abilities.

Before starting, demonstrate only what is needed and let the resident try if they wish. Avoid saying a task is easy: that can make a difficulty feel more embarrassing. If an instruction is unclear, explain it another way or choose a different activity. A facilitator can operate the controls at the person’s request without claiming the resulting performance as independent use.

Do not physically guide a hand to produce an answer unless there is an appropriate, agreed access plan and the person accepts the assistance. Usually, changing the position, offering a demonstration or asking whether help is wanted is a better starting point. Assistance should enable participation and preserve the person’s authorship of choices, rather than manufacture successful responses for a record.

DYNSEO’s senior application SCARLETT is one resource a team can examine for game-based activities. Check its current functions, access requirements and content with the residents concerned. Its presence in a programme does not establish suitability for every person with dementia or Parkinson’s disease, and no application can guarantee that a user will never encounter difficulty.

An activity score is not a cognitive diagnosis or evidence that dementia has improved. The National Institute on Aging cautions that results from particular research training programmes cannot simply be attributed to commercial brain-training applications. Keep any therapeutic intervention, including formal cognitive stimulation therapy, distinct from an ordinary game session and within the appropriate professional plan.

5. Prepare the session so attention can stay with people

Check the device, charge, connection and chosen content before inviting residents. Close unrelated notifications and make sure that private messages cannot appear on a shared display. Have the necessary materials available and know how to stop the application. Preparation cannot prevent every technical fault, but it reduces avoidable interruptions and protects personal information.

Choose the setting and timing with those involved. A quiet corner may suit a conversation; a group may need a larger display and room for mobility aids. There is no ideal time of day for all residents and no universal group size. Consider the activity, the support required and the people’s preferences, rather than grouping solely by a presumed cognitive level.

Explain the invitation in ordinary language: “Would you like to look at these harbour photographs with me?” may be clearer than announcing a technology workshop. Ask where the person wants you to sit. Being beside someone can make joint viewing easier, but a fixed seating rule should not override hearing, vision, comfort or cultural preferences.

During the activity, allow time for responses and avoid filling every silence. If several people are present, help them hear each other rather than directing all conversation through the facilitator. The device should not monopolise attention. A discussion that moves away from the screen may be the most enjoyable part of the session, and there is no need to return to the planned task just to finish it.

End when participants want to stop or when the activity is no longer comfortable. You do not need to obtain a final correct answer first. Ask what they would like next, help with the transition and make a brief note of useful preferences. A meaningful ending can be quiet; it does not require a visible smile from everyone.

6. Adapt support to changing needs, not a fixed label

A diagnosis gives relevant information, but it does not describe every ability, preference or difficulty. Someone living with dementia may use a familiar device confidently and struggle with a new interface. Another resident without dementia may find touch controls inaccessible. Start from what the person can and wants to do now, and adjust support as the situation changes.

For someone who becomes overwhelmed by several choices, offer a clearer presentation and one step at a time. Do not remove all opportunities for decision-making. For someone who enjoys complex discussion, provide material with enough substance. Simplification is useful when it improves access; it becomes limiting when it is based only on age or an assumption about diagnosis.

People with more advanced communication or cognitive difficulties can still be included in activities. The approach may focus on familiar sounds, selected images or a shared experience, but sensory content is not automatically gentle. Movement, brightness or sound can be uncomfortable. Watch for possible distress, seek clarification through the person’s communication methods and be ready to stop or change the medium.

Reminiscence can bring welcome conversation and can also raise painful material. Do not insist on recalling a detail, correct a story as if conducting a test or press for disclosure. Acknowledge distress and ask what would help, involving the care team when needed. Structured reminiscence therapy is a distinct intervention, not a label to attach to every photograph shown on a tablet.

The DYNSEO course Reminiscence: revisiting the past to support the present can be explored as a resource on that particular context. Its use should not lead an activity team to present itself as providing therapy without the relevant skills, arrangements and consent.

7. Support contact with others while preserving privacy

For a video call, agree who the resident wants to contact and whether the other person is available. Explain who will be visible or audible and help choose a private setting where possible. A call placed in a communal room can expose other residents, staff conversations and personal surroundings. Position the camera with care and avoid recording by default.

Ask how much assistance the person wants. Some may need help establishing the call and then prefer to speak privately. Others want someone nearby throughout. Explain any limits created by safety or support needs, and follow the relevant local decision-making framework where necessary. A relative’s request for access does not automatically override the resident’s wishes or the privacy of others.

Plan for an unsuccessful call. The contact may not answer, the sound may fail or the resident may become tired. Offer an alternative without blaming anyone: a voice call, a message or another time. Video is one possible form of contact, not proof that a relationship is being maintained adequately. It should not become the only option simply because it is convenient for the service.

For photographs and personal content, decide where files are stored, who can open them and whether they appear in other residents’ activities. Use approved accounts and processes. Personal staff phones, uncontrolled shared folders and automatic cloud uploads can create avoidable exposure. Seek advice from the organisation’s information-governance lead rather than inventing a local consent form for every new platform.

A record agreed with the resident and relevant staff can support agreed communication about preferences and practical arrangements. It should not carry unnecessary private messages or detailed health information to everybody involved in an activity. Residents remain people with private lives, not a collection of content available to the care home.

8. Organise staff support, upkeep and a realistic budget

Assign responsibility for practical tasks: charging, updates, access settings, approved accounts, content selection and equipment checks. Make instructions accessible to colleagues across shifts. One enthusiastic activity coordinator should not be the only person who knows the password, can connect the display or understands a resident’s preferred setup. At the same time, access credentials should not be posted where anyone can use them.

Shared equipment needs cleaning and safe handling in line with the manufacturer’s instructions and the home’s infection-prevention procedures. Check that protective cases and accessories are included in those arrangements. Do not select a disinfectant or cleaning method solely from general advice about tablets; inappropriate products may damage the device or fail to meet local requirements.

Teach colleagues the activity as well as the controls. They need to know how to invite participation, respond to refusal and notice when the setup is not working. Volunteers can contribute within a defined role, with suitable support and privacy guidance. A family member’s skill with technology does not automatically make them responsible for managing a group or interpreting a resident’s difficulties.

The course Cognitive stimulation for older adults: practical ideas and everyday use is a resource to examine for relevant staff learning. The DYNSEO tools catalogue also offers supports that may fit particular activities. Check the current content and purpose rather than describing a tool as a validated measure of clinical progress.

Funding and procurement depend on the service and jurisdiction. Include recurring charges, replacement equipment and staff support in the budget. Do not assume that a digital activity is automatically eligible for a health or prevention grant. A modest pilot with a clear purpose can help determine actual needs before a larger purchase, without promising that it will save staff time.

9. Review experience and respond to concerns appropriately

Use feedback that relates to the activity’s purpose. Did residents have a genuine choice? Could they hear, see or operate the material as they wished? Did the session support the conversation or interest they wanted? Ask about their experience in accessible ways. Attendance and time on a device are not sufficient measures of enjoyment, inclusion or wellbeing.

Record useful adjustments, such as a preferred topic, a troublesome sound or a better screen position. Distinguish observation from interpretation: “turned away when the music began” is different from “dislikes all music”. A brief, accurate note helps the next facilitator offer an informed choice without fixing a permanent label on the person.

Report new health concerns through the care home’s clinical procedures. Sudden confusion requires immediate medical attention; it should not be treated as a poor game score or managed by trying another activity first. Other new difficulties also deserve appropriate assessment. An activity coordinator can describe what changed without diagnosing the cause or waiting for several sessions to see whether it resolves.

When reviewing the programme, consider people who rarely attend as well as regular participants. They may want another medium, a different time, individual support or an activity unrelated to the current selection. Success does not require universal enthusiasm for technology. It requires a programme that remains responsive to the residents who live there.

Keep the option to stop using a tool that does not serve its purpose. Equipment already purchased should not determine a person’s day. The wider Supporting older adults through play and shared activities resource can help teams consider the activity context, with digital and non-digital possibilities selected around the person.

Frequently asked questions