Fidgeting is something most of us do from time to time, either unconsciously or from boredom or stress. Some fidgeting may be soothing as the repetitive nature can help ease anxiety or even physical pain. People with Alzheimer’s disease and other dementias often develop repetitive motions or fidgeting patterns, such as shredding tissues. But although fidgeting can be soothing for some people, it can also be distressing and cause anxiety for people with these conditions. “Picking behavior is often altered perception,” explains Dr. Marc Leavey, a primary care specialist at Mercy Personal Physicians in Lutherville, Md. For example, people with dementia may think there’s a bug, a coin or some other small object in front of them and they try to pick it up. They may also misinterpret a pattern or shadow for a solid object and want to feel it or hold it. “Folding is also a task that may be meaningful,” Dr. Leavey says. It may remind them of diapering a baby or closing an envelope, and the action seems almost programmed in and something they take comfort in. Redirecting Fidgeting to Help Alzheimer’s Patients People with Alzheimer's disease who fidget need an opportunity to use their hands and stimulate their senses. Activity tools, such as activity quilts (also called fidget blankets or fidget quilts), vests or aprons, promote this type of sensory stimulation. These articles provide a source of sensory stimulation within easy reach and in a familiar form. They’re simple, low-tech tools specifically designed to help keep hands busy with familiar activities and sensations. For this reason, many day and residential centers now offer activity quilts to people with dementia. Although you can find some to purchase online, most of these creations are handmade by volunteers. The activities on these tools are as diverse as the imagination of the maker and they vary widely in appearance and design. They usually include objects that allow the user to take open-and–close actions, such as zippers, large buttons and Velcro. These fasteners may lead to a pocket that holds a small item, like a stuffed heart or small bear attached to the quilt by a short ribbon. Other activities may include shoelaces for tying and ribbons for braiding, and there may be patches of different fabrics with contrasting colors and varying textures, such as velvet, corduroy, cotton and canvas. Activity aprons and vests are designed to be worn over clothing and allow the wearers to have the tool with them all the time. They’re particularly useful for people who get up and move around, and who may become upset or agitated if they can’t find their activity tool. Aprons and vests can be designed to suit the wearer’s past interests, too. For example, someone who was a carpenter may enjoy wearing a carpenter’s apron that has many pockets in addition to the added objects, while someone who enjoyed sewing would appreciate the familiar sensations of a pin cushion, zippers, and empty spools. Activity quilts are handy for people who use wheelchairs or who may confined to bed. They’re smaller than bed quilts; an average size is about 35 by 35 inches. Ribbons attached to the quilts allow you to tie them to wheelchair arm rests or bed rails, to keep them from falling on the floor. An advantage to activity quilts is the user can also fold and unfold them if they feel the need. Making an Alzheimer’s Activity Tool Activity tools are quick and easy projects regardless of your sewing ability. You can purchase an apron, vest or quilt and add the objects, or you can sew your own from one of several patterns online, many of which are free. The only rule that applies when making an activity tool is to ensure that the objects you attach are securely fastened and that users can’t hurt themselves while manipulating the objects. However, if you would like to make a quilt, vest or apron to donate to a local organization, check to see if they have requirements or guidelines for these tools. They may prefer aprons over vests, for example, or they may have a certain size quilt they prefer. Many facilities often prefer aprons, vests and quilts that are primarily made with 100% cotton because they can be easily washed. The activities or objects you add is up to you, but here are some ideas to get you started: Gloves Hair elastics Key rings Knitting yarn Large beads Large buttons Ribbons Velcro strips Zippers Creating an activity quilt, vest or apron could be therapeutic for the creator as well as for the person who will receive it. The tools themselves don’t take a lot of skill, so anyone can try to make one. Building a personalized gift can provide a chance for friends and family to express support for an Alzheimer’s patient, while also helping their loved one cope with the symptoms of the disease.