Supporting Participants with Cognitive Changes
In a SilverSneakers Mobility class, we strive to create a welcoming and inclusive environment for all participants—including those experiencing cognitive changes, such as memory loss or dementia. While we are not medical professionals, understanding the common signs of cognitive decline and adapting our instruction can help maintain a safe, engaging, and dignified experience for every individual.
Common Signs of Cognitive Decline
Participants experiencing cognitive changes may show one or more of the following signs:
- Difficulty following multi-step directions
- Misplacing items or class equipment
- Increased dependence on the instructor for reassurance or reminders
- Appearing confused or withdrawn in familiar settings
- Repeating the same questions or comments
- Wandering or becoming disoriented in the facility
- Emotional distress, such as frustration or agitation
- Verbal outbursts or inappropriate comments (often unintentional)
- Physical outbursts or striking out due to fear or confusion
- Increased instability, slower reaction time, or higher fall risk
Instructional Tips for Supporting Cognitive Function
Use these strategies to help participants with cognitive decline stay engaged, safe, and connected:
Speak Clearly & Simply
- Use short, direct verbal cues.
- Break instructions into one-step actions.
Use Visual Cues
- Demonstrate movements and use directional gestures. For example, raise your hand or point when prompting movement on a particular side.
Break It Down
- Simplify movement patterns into smaller parts.
- Allow time to rehearse new movements before progressing.
Incorporate Routine
- Structure classes consistently.
- Familiar warm-ups, music, and class flow help reduce confusion and build confidence.
Engage Through Music
- Select music familiar to their generation. Nostalgic tunes can boost mood, reduce anxiety, and spark memory.
Promote Social Connection
- Use participants’ names. Encourage brief conversations, eye contact, and introductions to help build a sense of community.
Use Call and Response
- Simple rhythmic phrases or counting aloud can improve engagement and focus. Example: “When I say ‘step,’ you step!”
Offer Appropriate Options
- Provide regressions and progressions for each movement. For example, allow seated versions or hand support with a chair.
Encourage a Buddy System
- If possible, suggest that a friend, family member, or care partner join the participant in class to provide support and confidence.
Safety & Escalation
If you observe behavior or instability that poses a safety concern—for the participant or others in class—alert your facility manager or program director. They should be there to provide support and guide you, if needed.
Instructor Self-Care Reminder
Working with participants experiencing cognitive changes can be deeply rewarding, but also emotionally challenging. If you ever feel uncertain or overwhelmed, seek support from your program supervisor or trusted colleagues. You’re not alone, and your role makes a lasting difference
Stay Within Scope
As a fitness instructor, it is important to remain within your scope of practice. Do not attempt to diagnose or offer medical advice. However, you can make a significant impact by adjusting your teaching approach and fostering a compassionate environment.