One of my more demented patients can get quite agitated and verges on the boarder of becoming violent at times. When I see her agitation rising, I park my med cart next to where she sits by the nurses station while I do med pass and I softly being to hum or sing a song. She ALWAYS picks up on it and starts singing away. She actually has a lovely voice and I enjoy seeing her smiling and singing. She gets quite loud while singing but I'd rather the volume of her voice be loud and singing than just loud and screaming. She has her favorite song that she and I will sing together..over and over and over and over....LOL
A basket full of clothes/wash clothes towels etc for our lady residents who are worried about getting home to their families works most times.
A stack of papers to sort, write on etc for our gentleman residents who always speak of busines meetings etc they must attend.
A deck of cards for those who seem to have a repetitive behavior that keeps them calm...a few sit for quite a while, quietly sorting cards, looking at them, arranging them into patterns etc.
I have one resident that is like our "sentry". I will ask her to "keep an eye" on my cart. She will shooo away residents who are known to take all the cups, straws etc. If she hears a chair alarm going off, she will gently say to the resident "its ok, Jane, sit down now" and Jane always listens to her. My "sentry" will sound the alarm so to speak if residents she knows aren't supposed to try to go out the door and into the elevator. she will divert their attention until a staff member gets to the escapee.
What I have found in my many years working in LTC (both as a nurse and CNA) is most of them just want a "purpose", something that they feel is a needed "service" even if they are a bit demented or confused.
I had one lady who would never fold towels/wash cloths if you gave them to her and asked her to do it, but if you walked by with a stack of them and "accidentaly" dropped them near her and gave a heavy sigh and said more to yourself but loud enough for her to hear "ohhh brother, i just folded these, I have so much to do and now I have to refold these towels again..I am going to be so late" she would graciously offer to do it for you. when she was done, I'd pick them up, thank her profusely and take a step or two and "drop" them again, because she was so confused, she didn't catch on to my little ploy.