Dining Out, Traveling and Enjoying the Arts: Helping People With Dementia Live Life to the Fullest
A variety of services assist people with cognitive impairment — and their caregivers
Joanne Tandler always has enjoyed dining out, but Parkinson's disease and early-stage dementia have made it more challenging to enjoy the simple pleasure that many people take for granted. Tandler has to maneuver through restaurants in a wheelchair and "sometimes," she says, "my brain is a little slower than others."
Isabella Morgia di Vicari and Nancy Dulniak at the Meatball Stoppe
She and her husband, Les, have begun frequenting restaurants in a Central Florida program called Dementia-friendly Dining. The eateries make accommodations ranging from staff training to more private dining experiences. The couple have enjoyed eateries including Oviedo's Town House Restaurant, known for serving breakfast all day, to Rosen Shingle Creek's A Land Remembered, a fine-dining steakhouse in Orlando.
"The wait staff takes a little more time with the menu, explains more things," Tandler says. And because she's dining in areas that aren't crowded, it's easier to relax and move around.
The worlds of people with dementia — and their caregivers — often shrink as the disease progresses. Increasingly, however, restaurants, museums, stores and even whole communities are making changes that help people experiencing cognitive impairment lead fuller lives by keeping them engaged in the world.
When restaurants, stores and other public spaces don't make adequate accommodations, simple outings can turn into difficult experiences.
"Research indicates that maintaining social engagement is crucial for people with dementia, as it can help to slow cognitive decline, reduce the risk of depression and improve overall quality of life," says Elizabeth Edgerly, senior director of community programs and services for the Alzheimer's Association. Nearly 7 million Americans have Alzheimer's, the most common form of dementia. That number is expected to double to almost 13 million by 2050.
When restaurants, stores and other public spaces don't make adequate accommodations, simple outings can turn into difficult experiences, says Teepa Snow, a dementia care expert. Someone in the later stages of the disease might go to the restroom and then wander off, or argue that their restaurant server hasn't brought them food right after they've finished a salad.
Simple Changes
When venturing into the outside world becomes more difficult, caregivers might do it less often or give it up altogether. This social isolation can contribute to a steeper, quicker decline.
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Snow would like to see more businesses, services and communities understand that "there's a lot to dementia besides end-state dementia," where cognitive impairment is profound. "We need to do better at allowing people to live life fully, so end-state is a very short window of time."
"We need to do better at allowing people to live life fully, so end-state is a very short window of time."
Edgerly said businesses and other services can educate staff about topics such as addressing dementia behaviors. Modifications like clear signage, adequate lighting and simplified layouts can make it easier to get around.
The training that Dementia-friendly Dining provides stresses "communication — knowing that they should look the person with dementia at their eye level if they can and smile, and keep a friendly low tone," says co-founder Dennis Dulniak, a retired university registrar who was a caregiver for his wife, Nancy.
Dulniak worked with a local Alzheimer's organization to develop the training he provides with caregiver consultant Toni Gitles.
Toni Gitles and Dennis Dulniak
Before Nancy died in 2021, the Dulniaks often frequented the now-closed Meatball Stoppe, which became the first restaurant to join Dementia-friendly Dining. "It was a safe place where the staff understood she had dementia and paid more attention to her," Dulniak says. It also allowed him to have a more relaxing experience.
Caregivers, like the loved ones they care for, can suffer from social isolation if they don't have opportunities to get out as well. Between 40% and 70% of family caregivers experience clinical symptoms of depression, which can often be caused by isolation and loneliness, according to the Family Caregiver Alliance.
Travel Resources
Elite Cruises and Vacations provides excursions with activities for people experiencing dementia, as well as opportunities for their caregivers to learn, socialize and relax. During its dementia-friendly cruises on Holland America Cruise Line and Celebrity Cruises, caregivers can attend educational sessions, meet others who are caring for family members and relax while their loved ones participate in supervised games and activities.
There is one professional staffer for every three travelers, owner Kathy Shoaf says, and the events are focused on "creating lifelong memories for the caregivers and perfect happy moments for their loved ones."
Fraser Howe took his wife, Debby, on a week-long Elite cruise to the Panama Canal in 2021. Debby had been living in a memory care community. "I think she enjoyed being able to get out and do something different and be around different people," says Howe, a retired civil engineer living in suburban Orlando. "What I got out of it was being able to do something new and unlike anything else we'd done in a long time together, and to be with a group of other caregivers and their loved ones and support staff I could talk to and who understood our situation and were focused on helping us enjoy that experience as much as we could."
Debby Howe passed away in 2023. In 2024, Fraser took another Elite cruise — this time as a support team member.
Travel can be an enriching experience for those suffering memory loss, but it's also more complex and stressful than a night out.
Travel can be an enriching experience for those suffering memory loss, but it's also more complex and stressful than a night out. Airports can be especially stressful and chaotic.
Snow has made a series of educational videos with the Dementia-Friendly Airports Working Group, a collaboration of advocates trying to establish more training and other enhancements to make traveling easier.
At Phoenix Sky Harbor International Airport, people with dementia — or other hidden disabilities — can get "compassion cacti" lanyards signaling to employees they may need additional assistance. It also has dementia-friendly air travel workshops providing helpful travel information to family members and caregivers. "We aim to provide our customers with many convenient options to make travel accessible for everyone who wants to do it," says public information officer Eric Everts.
Arts and Culture Programs
Many programs for those with dementia involve art and music. Such experiences "offer opportunities for conversation, camaraderie and positive engagement," Edgerly says. Because Alzheimer's and other dementia typically affect short-term memory first, she says, a person may be able to recall their love for these types of activities well into the middle or later stages of the disease.
Giving Voice encourages creation of choirs for people with dementia and Alzheimer's, while the SPARK! program provides classes in about 25 museums and cultural institutions in several states. Music, poetry, art and storytelling are geared toward people with early to mid-stage dementia, led by facilitators who are trained by Alzheimer's professionals.
A Dementia Friendly Dining group at A Land Remembered
"SPARK! is about living in the moment and creating new experiences for the families and loved ones," says co-founder Tricia Blasko, who leads a program at the Racine Art Museum in Wisconsin.
Participants include Antonio Rodrigues Pavao. In December, museum staff sang "happy birthday" to celebrate his turning 81 and a middle-school madrigal singer group performed — especially important, his wife Nora says, because he started a madrigal dinner at a local high school years ago. SPARK! "provides a safe space to socialize with people who are experiencing similar types of cognitive decline issues," Nora Macins Pavao says. "It improves his mood and ability to concentrate. It provides an outlet for self expression."
Community Effort
Through Dementia Friendly America, some entire communities are creating enriching environments for people with memory loss — incorporating government, business and faith organizations. Communities commit to creating an action plan and get resources from Dementia Friendly America that include guides for various sectors.
Often communities involved with the initiative have arts-focused programs, or memory cafes – gathering places that offer a variety of activities.
"Our whole effort is to teach people to walk toward people living with dementia, rather than away."
Others have dementia-friendly movies with softer sounds and ambient lighting or grocery stores that provide customers with signs on their carts explaining that they are living with dementia.
Even after a diagnosis, "there's a lot of living that continues to happen," says Mary Ek, Dementia Friendly America's director.
Much of the initiative is geared toward incorporating people with cognitive decline into the community and helping them feel welcomed, she explains.
"Our whole effort is to teach people to walk toward people living with dementia, rather than away," she says.
