Lesson 2.4: Supporting Cognitive Needs

Supporting Participants with Cognitive Changes

In class, you create a welcoming and inclusive environment for all participants, including those experiencing cognitive changes such as memory loss or dementia.

While you are not a medical professional, understanding common signs of cognitive change and adjusting your instruction can help support a safe, respectful, and engaging class experience.

Common Signs of Cognitive Change

Participants may demonstrate one or more of the following:

  • Difficulty following multi-step directions
  • Misplacing items or class equipment
  • Increased reliance on you for reassurance or reminders
  • Appearing confused or withdrawn in familiar settings
  • Repeating questions or comments
  • Wandering or becoming disoriented
  • Emotional responses such as frustration or agitation
  • Verbal or physical outbursts related to confusion or fear
  • Changes in balance, reaction time, or overall stability
Instructional Strategies

Use the following strategies to support safety, understanding, and participation:

Speak Clearly and Simply

  • Use short, direct cues.
  • Break instructions into one-step actions.

Use Visual Demonstrations

  • Demonstrate movements clearly
  • Use gestures to guide direction and movement

Break Movements into Steps 

  • Simplify movement patterns
  • Allow time for practice before progressing

Use Consistent Structure 

  • Maintain a familiar class format
  • Consistency in routine, music, and class flow may help reduce confusion and build confidence.

Provide Movement Options 

  • Offer seated and supported variation.
  • Encourage participants to move in a way that feels safe and comfortable

Use Simple Cueing Techniques 

  • Use counting or rhythmic cues to support focus and timing
Safety and Support 

If you observe behavior or instability that creates a safety concern, notify your facility manager or program director for guidance and support.

Stay Within Scope

As an instructor, you should remain within your scope of practice. Do not diagnose or provide medical advice. You can support participants by adjusting your instructions and creating a supportive environment.