Goal: Keep the brain active, keep the body mobile, maintain confidence, and reduce anxiety.

Short, easy, repeatable.
Total time: 20–30 minutes.

Gentle movements to wake up the body.

• Slow head turns left/right – 10x
• Shoulder rolls backwards – 10x
• Shoulder rolls forwards – 10x

• Arm circles – 10 each side
• Wrist circles – 10 each hand

Benefits: Improves circulation, reduces stiffness, decreases anxiety.

Very important in Stage 1 to prevent future falls.

• Sit, then stand up slowly
• Repeat 8–12 times
  (Use hands if needed)

• Hold a counter, lift heels up, lower slowly – 15x

• Hold a chair
• Lift one foot for 5 seconds
• Do 3x each leg

• Stand arms-length from wall
• Push chest toward wall – 10–15x

Benefits: Builds confidence, leg strength, balance, and independence.

Pick one each day:

• 5–10 minutes at relaxed pace

• 2 minutes marching
• 1 minute rest
• 2 minutes marching again

• Gentle movement
• 1–2 songs

Benefits: Boosts mood, heart health, and memory pathways.

• Reach arms overhead
• Stretch side to side
• Slow calf stretch (Against a wall)

• In through nose 4 seconds
• Out through mouth 6 seconds
• Repeat 5 times

Benefits: Reduces stress, resets the mind, calms agitation.

• Total walking: 60–90 minutes per week
• Strength training: 2–3 times weekly
• Stretching: Daily
• Balance practice: 4–5 times weekly

Chair or gentle floor yoga

Slow, controlled movements improve calmness and stability.

• Folding laundry
• Light sweeping
• Gardening
• Organising shelves

Helps keep the brain and body active.

• Move slowly
• Stop if dizzy or breathless
• Wear supportive shoes
• Use stable furniture for balance
• Best after eating (not on empty stomach)
• Keep water nearby

I can make the following for you, sweetheart:

Just tell me “PDF please” or “One click 

Stage 3 dementia is a moderate stage where changes in memory, communication, and daily functioning become more noticeable. With the right care, calm routines, and emotional support, the person can still enjoy connection, comfort, and meaningful moments every day.

At this stage, you may see:

• Forgetting recent conversations or events
• Increased confusion, especially in new or busy places
• Difficulty following long instructions
• Repeating questions
• Needing help with daily tasks (meals, dressing, appointments)
• Emotional sensitivity, anxiety, or irritability
• Trouble organising thoughts
• Beginning of “sundowning” — late-day confusion or agitation
• Strong response to familiar music, smells, and faces

These changes are symptoms of dementia — not a loss of the person’s identity. They are still the same person inside, with the same need for love, safety, and reassurance.

Routine offers stability.

• Same wake-up, meals, and bedtime
• Simple morning–afternoon–evening structure
• Short, calm activities
• Avoid sudden changes

Predictability reduces fear and confusion.

Communication becomes harder, so keep it gentle:

• Speak slowly and softly
• Use short sentences
• One instruction at a time
• Use gestures and visual cues
• Smile, maintain eye contact
• Offer reassurance: “You’re safe — I’m here.”

Avoid correcting or arguing. Comfort is more important than accuracy.

Feelings can be stronger at Stage 3. Support them by:

• Staying calm
• Avoiding loud environments
• Reducing rushing or pressure
• Offering gentle touch (hand-holding, shoulder pat)
• Validating emotions: “I understand this feels hard.”

Your calm presence makes a huge difference.

Create a safe, peaceful environment:

• Clear walkways
• Soft, warm lighting
• Reduce clutter
• Limit background noise
• Label important areas (bathroom, bedroom)
• Keep harmful items out of reach

A calm environment helps prevent agitation.

Music becomes a powerful tool at Stage 3.

Benefits:

• Reduces agitation
• Supports memory recall
• Helps with transitions (morning, meals, bedtime)
• Calms sundowning
• Improves sleep
• Encourages movement and emotional connection

Use:

• Morning calming playlist
• Midday focus/activity music
• Afternoon anti-sundowning playlist
• Night sleep playlist

I can create your one-click Stage 3 playlist if you want.

Simple activities work best:

• Folding towels
• Colouring
• Light gardening
• Listening to music
• Sorting objects
• Looking through photo albums
• Gentle hand massage
• Watching nature videos

Avoid tasks with many steps or too much information.

Helpful supports:

• Large digital day clock
• Visual cue cards (“Toilet,” “Kitchen,” “Brush Teeth”)
• Simple daily schedule
• Photo memory wall
• Colour-coded storage
• Medication organiser

These reduce confusion and build confidence.

Support healthy eating by:

• Offering small frequent meals
• Using easy-to-hold cups and plates
• Encouraging water every 1–2 hours
• Keeping meals calm, quiet, and un-rushed
• Serving familiar foods

Nutrition helps mood, energy, and sleep.

Stage 3 often brings sleep difficulties. Help by:

• Soft lighting in evening
• Calming anti-sundowning music
• Gentle bedtime routine
• Warm drink (no caffeine)
• Keeping nights quiet and peaceful

Consistency improves sleep and reduces night-time anxiety.

Stage 3 can feel emotional for loved ones.
Remember:

• You are doing your best
• Take breaks when needed
• Ask for support
• Look after your own wellbeing
• Celebrate small moments — smiles, laughter, recognition

Your kindness and patience are the most powerful therapy.

Stage 4 dementia is a moderate stage where memory loss and daily challenges become more noticeable. With the right support, a calm routine, and compassionate care, the person can still enjoy comfort, dignity, and meaningful moments every day.

At Stage 4, you may notice:

• Forgetting recent conversations
• Difficulty managing daily tasks (cooking, planning, finances)
• Needing gentle guidance or reminders
• Increased confusion in new places
• Emotional sensitivity or frustration
• Slower thinking or trouble making decisions
• Mild problems with sleep or late-day agitation

The person may still recognise loved ones and respond well to familiar music, routines, and reassurance.

Routine brings security.

• Same time for waking, eating, bathing, and sleeping
• Short, manageable activities
• Avoid sudden changes in schedule

Predictability helps reduce anxiety and confusion.

Use:

• Short, gentle sentences
• Slow, calm speaking
• Visual cues (point, show, gesture)
• Soothing tone of voice
• Reassuring phrases: “You’re safe”, “I’m right here”

Avoid correcting or arguing. Support, don’t challenge.

The person may need help with:

• Dressing
• Bathing
• Preparing meals
• Medication management
• Organising their day

Let them do what they can, and step in when they need help.

Stage 4 requires a safer, calmer environment:

• Remove clutter and trip hazards
• Use night lights
• Install grab bars if needed
• Keep kitchen use supervised
• Label rooms, drawers, and important items
• Store medication safely

A safe home reduces accidents and stress.

Emotions at Stage 4 can be fragile. Support them by:

• Offering gentle reassurance
• Allowing quiet breaks
• Avoiding overstimulation (noise, crowds, busy TV)
• Using calming lighting
• Offering comfort with soft touch or a warm drink

Your calmness becomes their calmness.

Tools that still help at Stage 4:

• Large digital day clock
• Visual cue cards
• Simple lists or reminders
• Colour-coded storage
• Familiar music playlists
• Photo memory wall

These support orientation and reduce repeated questions.

One of the strongest tools for Stage 4.

Helps with:

• Mood
• Anxiety
• Sundowning
• Attention
• Sleep
• Emotional connection

Use:

• Morning gentle music
• Midday familiar favourites
• Afternoon anti-sundowning playlist
• Evening soothing music
• Night-time sleep playlist

(If you want, I’ll make the one-click Stage 4 playlist.)

Choose simple, calming, enjoyable activities:

• Folding towels
• Sorting objects by colour
• Looking at photo albums
• Listening to familiar music
• Watching nature videos
• Painting or colouring
• Short walks or light stretching

Avoid tasks with too many steps.

Help by:

• Offering small meals throughout the day
• Using easy-grip utensils
• Encouraging fluids every 1–2 hours
• Minimising distractions during meals
• Sitting together to create a calm mealtime

Nutrition helps maintain energy and mood.

Improve sleep by:

• Reducing bright light in the evening
• Soft anti-sundowning music
• Warm, calm bedtime routine
• Comfortable room temperature
• Limiting caffeine and long naps

A gentle evening rhythm reduces night-time confusion.

Caring for someone in Stage 4 can be emotional and tiring.
Remember:

• You’re not alone
• Take breaks when you can
• Ask for help
• Look after your own wellbeing
• Celebrate small moments of connection

Your love, patience, and presence make the biggest difference.

Goal: Maintain comfort • Reduce stiffness • Support circulation • Preserve mobility • Reduce agitation

• Short sessions: 5–10 minutes maximum
• Very slow pace
• Instructions kept to one simple step at a time
• Caregiver often demonstrates or gently guides movements
• Stop immediately if there is pain, breathlessness, or fear
• Use chair or bed for full support

Can be done sitting or in bed.

• Open and close hands 5–10 times
• Roll wrists slowly 5 times each direction

• Caregiver can assist
• Roll shoulders forward 5 times, then back 5 times

Purpose: Loosens joints and reduces morning stiffness.

These maintain blood flow and reduce risk of pressure sores.

• Point toes up and down
• 10–15 repetitions

• Sitting: lift one knee slightly
• Bed: bend knee toward body
• 5x each leg

• Straighten knee, hold 2 seconds, lower
• 5–8 times each side

• Lift arms to shoulder level
• What they can do comfortably
• 5 times

Purpose: Preserves strength, movement range, and circulation.

All done very gently, caregiver supported.

• Tilt head slightly to each side
• Hold 5 seconds

• Straighten leg, pull toes toward body
• Hold 5 seconds

• Hands together, reach forward
• Hold 5 seconds

Purpose: Prevents tightening, reduces discomfort, supports posture.

Helps reduce agitation (“sundowning”) and anxiety.

• Gentle hand massage
• Swaying together to soft music
• Slow breathing: in for 3 seconds, out for 4 seconds
• Soft tapping on shoulders/arms for sensory reassurance

Purpose: Regulates the nervous system and reduces behavioural stress.

Only with a strong caregiver hold or walker support.

• Stand for 10–20 seconds
• Return to sitting

• Lift heels while holding support
• 3–5 times

Purpose: Maintains bone and leg strength and prevents worsening balance.

• Never rush
• Stop if there is confusion or fear
• Avoid any exercise if unwell, tired, or in pain
• Provide constant reassurance
• Keep posture supported with pillows
• Best time: morning or after a calm activity
• Keep sessions short but regular

✓ Morning: 5 minutes gentle hands, wrists, shoulders
✓ Afternoon: 5 minutes ankle pumps, leg lifts, arm raises
✓ Evening: 2 minutes soothing movement + calming breathing

Consistency is more important than intensity.

• Reduces agitation
• Helps sleep
• Supports digestion
• Prevents stiffness and pain
• Maintains dignity
• Improves mood and emotional expression
• Keeps some independence for longer

Goal: Ease discomfort • Prevent stiffness & pressure sores • Support circulation • Maintain dignity • Reduce agitation

• Sessions: 1–3 minutes, very short
• Completely caregiver-assisted
• Absolute focus on comfort, calm and safety
• Slow, predictable, soft movements
• No standing or unsupported sitting
• Stop immediately if there is pain, fear or resistance
• Speech may be minimal — touch, tone and softness matter more

These movements prevent painful joint tightening (contractures).

All movements: 3–5 times only, slow, gentle.

• Support elbow and wrist
• Lift arm slightly outward
• Lower slowly

• Bend and straighten
• Support the joint fully

• Open/close hand
• Lightly move each finger

• Bend knee toward chest gently
• Straighten leg slowly

• Up/down movement
• Soft ankle circles

Purpose: Prevents stiffness, pain, and pressure-area damage.

Changing body position protects skin, lungs and comfort.

• Side → back → other side
• Always use pillows for support

• Pillow under calves (keeps heels off bed)
• Soft cushion under arms
• Keep head slightly raised for breathing and swallowing

• Gently position shoulders back
• Helps breathing and prevents tight curling

Purpose: Prevents pressure sores, improves breathing and comfort.

Touch helps reduce fear and agitation.

Choose one:

• Warm lotion
• Soft circles on palm and fingers

• Slow, rhythmic, comforting

• Light stroking of hair or forehead

• Move hand slowly to calming music
• Helps connect emotionally

Purpose: Reduces anxiety, supports emotional comfort, improves connection.

Speak softly:
“Breathe in… breathe out…”
Even if they cannot follow, the tone soothes them.

• Light tap on shoulder or hand
• Slow, steady rhythm
• Comforting and grounding

• Slow instrumental, hymns, or familiar songs
• Helps regulate their breathing naturally

Purpose: Helps settle agitation and makes the person feel safe.

Repeat this small cycle 2–3 times daily:

• Passive arm & hand movements
• Hand massage

• Leg/knee PROM
• Repositioning
• Calming music

• Shoulder/neck comfort stretch
• Slow breathing support
• Reposition for sleep comfort

Small, frequent comfort movements are more helpful than long sessions.

• Never force movement
• If there is resistance, stop
• Keep voice low, soft and soothing
• Warm hands before touch
• Move joints slowly and in natural directions
• Check for pain signs: facial tension, moaning, stiffening
• Keep skin clean, dry, moisturised
• Always support all joints
• Ensure room is warm and calm

Even in late dementia, gentle movement:

• Prevents painful contractures
• Reduces pressure sores
• Improves sleep
• Helps breathing
• Reduces agitation and restlessness
• Increases emotional comfort
• Supports dignity and love through touch