How do you work with a client that has Alzheimer’s disease? She is 76 years old and is so anxious that all she does with me is walk and ride bikes.

If she's "so anxious", perhaps she could benefit from a small amount of something to calm her anxiety a bit? I would not want my mom to be that anxious all the time. Doesn't sound like a good place to be, IMHO.

Get her to check out the senior center with you. She'll quickly see it's not all wheelchairs.

How about cleaning her apartment? Can walk malls or even Target or the grocery store.

Join a gym? Planet Fitness, where I was a member for years, has cheap memberships and she could get the one where she can bring a guest (you!).

Good luck.

For many of us, exercise is the most effective way to reduce stress and anxiety. When the weather keeps me inside, I put on marching band music and March around the house with big arm movements (think drum major). The music lifts my spirits and gets me motivated. Alternatively, I put on favorite dance music and dance. I’m a terrible dancer, so I consider it comedy. All of this is good therapy for me.

Aermay has already mentioned mall walking - I know that going to the mall doesn't have the cachet it used to but for those of us with winter weather it is still a very popular place for seniors to get their exercise (and maybe meet up with others for a coffee at the food court).

Our indoor malls are full of walkers during the summer. Climate controlled, security and coffee after.

It would be reversed if we had nice summers and brutal winters.

Studies have shown learning (or trying to learn) something new can help stave off the effects of dementia. Perhaps finding an interest for her and working on that part of the time can help her be less anxious. You know, like learning a new language, anything to help her focus.

Firstly I'd like to mention this is not denial. The brain gets damaged & yet does not know it is damaged. What looks like denial is *lack of insight*. Medical name Anosognosia. Have a look at the care topics for this if you want to research this.

I would recommend Teepa Snow's approach for care. Plenty of info via Google search & many really interesting videos & talks.

Thr 'emerald' stage in particular describes people who are on the go. Can be on the go go go physically or in a repetitive verbal loop unable to stop. There is a really good video showing how to distract & realign the person to another activity or take a much needed rest. The lack of insight prevents them from recognising when they need to stop or slow down themself, or even other essential self-care requirements eg eat & drink.

ADD (or ADHD) may add another layer of behaviour that is tricky to manage, but not impossible.

Maybe once the lady seems physically tired of walking/riding/using her big muscles - an activity could be introduced to use smaller muscles eg fidget spinners, colouring in, easy jigsaw puzzles.

Is there a Physio or OT on her care team? I think an OT could really help with activities. The Doctor may be able to prescribe medication to lesson the agitation (if appropriate) too.

While some may say, well let her walk all day if she wants.. and I get that.. as a support worker you have some duty of care to protect her from known risks eg over exercion in hot weather & dehydration.

During the winter months you could take her mall-walking if you have a shopping mall in the area.
I see senior walking clubs at the mall near me all the time. A lot of them go with their home/health aides because they need supervision. From what I've seen these people have a good time. They walk the whole place then stop off at the food court for refreshments and to sit for a while.
Call the senior center in your area and talk to them. They might have a mall-walkers club that you can bring your client to.

A yoga class. Inside, exercise, and calming.

How wonderful that she still wants to remain so active! That is a blessing for sure, as so many dementia patients just want to sit around and do much of nothing other than perhaps just watch TV.
You can take her to an indoor mall to walk in the winter months or when the weather doesn't cooperate to be outdoors. She could also go to an Adult Day Care center up to 5 days a week, as they keep the folks there pretty active and as busy as they want to be.
The YMCA could also be a good choice as they offer "Silver Sneaker" classes along with other classes appropriate for the elderly.
Keeping her active will certainly benefit her(and you)in the long run, so just keep her moving best you can.

With my grandson ADD/ADHD is mainly being able to focus. He does very well doing Warehouse work but had a problem in shipping with packaging the orders where there was a set pattern. He also has trouble with looking ahead. Not sure how someone with ALZ would be since these are also signs of the desease.

IMO, you are not going to be able to teach her anything new. Her short-term memory does not allow it.

"colouring in, easy jigsaw puzzles." I have a couple of the wood puzzles that Fisher Price made from 45 yrs ago. A friend was suggested this kind of Puzzle for her husband suffering from ALZ. I loaned her mine. Coloring should probably be the same way. Maybe a coloring book for grade school ages. Personnally, I so hope if I have Dementia, that they don't have me color. Haven't liked to do it since 2nd or 3rd grade when it was "color all the even #s blue and all the odd #s red".😁

I like idea of walking a Mall. Can window shop, eat lunch, have a snack. Maybe an aerobics class.

They used to have exercise tapes, where the 2 of you (along with a doctor's OK), can do these exercises, often set to music. Also, some community groups and houses of worship sometimes have exercise classes for seniors that are open to the community. I took my mom to one, when she had Alzheimer's, and it was wonderful for the both of us: the exercise and sociability. Senior centers often offer similar types of programs. During Covid, some of these were virtual. Now, depending upon the facility, I think some are in person and perhaps some are hybrid.