Adapting Card Games for Residents with Cognitive Impairment

The 1st National Elderly Welfare Facility Conference and Research Meeting, also known as JS Festival in Tochigi, brought together elderly-care practitioners, facility administrators, researchers and suppliers from across Japan. Its programme combined research presentations, practical workshops, networking, study tours and an exhibition of products and services for older people.

One practical session examined the Workshop on Adapting Card Games for Residents with Cognitive Impairment. The focus was how familiar games can retain their social appeal while being reshaped around changing abilities, communication styles and the routines of residential care.

Why the workshop mattered

Card games sit close to the centre of communal life in many aged-care facilities. They offer familiar actions, opportunities for conversation and a low-stakes structure for interaction. However, standard rules, small print and competitive scoring can create barriers for residents experiencing memory loss, reduced attention or impaired motor control.

The workshop treated adaptation as more than making cards larger or simplifying a game. Participants considered the purpose of each activity: maintaining choice, encouraging participation, supporting communication and preserving the relationships that make group activities worthwhile. A resident who cannot follow every rule may still be able to sort cards, choose colours or advise another player.

Cognitive impairment also varies considerably between individuals and from one day to the next. The workshop therefore placed greater emphasis on observing a person’s current abilities and preferences than on assigning a single level of play. This approach supports dignity and avoids treating a diagnosis as a fixed measure of capacity.

Adapting the game without losing its purpose

An effective adapted game retains recognisable features. Changing the aim completely from matching to simple sorting may remove the elements that residents find enjoyable. Instead, facilitators can adjust one or two elements at a time, beginning with the deck and then considering the rules, duration and social expectations.

Useful changes include oversized cards, stronger colour contrast, tactile markings, fewer cards and shortened rounds. Familiar prompts can be placed beside the playing area, while background music and side conversations are reduced. Equipment should remain attractive and enjoyable, since an improvised collection of mismatched materials may not communicate the same sense of occasion as a well-designed deck.

Staff preparation benefits from a simple facilitation plan and a short reflective discussion after each session. Facilitators can consult the PLATO project resources when developing ways for colleagues to review observations, communication cues and possible adjustments. The emphasis remains on understanding the resident rather than perfecting the game.

A practical design checklist for Australian facilities

Facilities can use the following considerations when reviewing an existing activity or preparing a new session for residents with cognitive impairment.

Activity choices

• Start with familiar Australian games such as bridge, euchre, cribbage or patience, then adjust the deck.
• Use oversized cards, strong contrast and large pips that remain visible in ordinary lighting.
• Reduce the choices to a small group of recognisable cards or matching pairs.
• Keep rules consistent, provide one instruction at a time and use clear visual prompts.
• Include games connected with residents’ cultural histories rather than relying on a single house deck.

Facilitation routines

• Allow short rounds of about ten to fifteen minutes, with a clear pause or finish.
• Let residents observe, sort, deal, advise or play according to their preference.
• Reward social engagement rather than speed, perfect recall or a correct score.
• Seat players for comfort, with good lighting and minimal background noise.
• Record useful adaptations in person-centred notes, with consent and appropriate clinical input.

These checks should function as a flexible aid, not a rigid assessment. Staff can record what helped a resident engage and which changes produced frustration or fatigue. Such observations allow the activity to evolve as the resident’s needs change and as staff become more familiar with the game.

Connecting the workshop to Australian aged care

Australian providers can relate the workshop to the National Aged Care Quality Standards, particularly the expectations of person-centred care, dignity, assessment and continuous improvement. The local market includes not-for-profit community and regional services as well as private operators, so any new activity needs durable, washable and affordable materials that rotating staff can use confidently.

Cultural diversity in Melbourne and Sydney adds another important consideration. Many facilities support residents from Chinese, Arabic, South Asian, Mediterranean and other cultural communities. Translated prompts, familiar symbols and card games connected with a resident’s earlier life can make participation more meaningful than assuming one standard deck will suit everyone.

Card play also has established social meanings in Australia. Bridge and euchre may be familiar from community clubs and family gatherings, while patience-style games can be associated with relaxed solo play. Because some older adults connect cards with gambling, facilitators should describe points as participation markers rather than winnings and avoid turning the session into a contest.

Learning within the wider JS Festival

The card-game workshop formed part of a broader professional meeting rather than operating as an isolated activity session. Delegates could compare practical methods with research findings, speak to suppliers at the exhibition and visit facilities during study tours. This setting allowed participants to discuss not only how a game worked, but also how staff time, space and leadership could support it.

A retrospective on cross-regional knowledge exchange describes how the JS Festival connected knowledge from different parts of Japan. That exchange mattered in eldercare because regional differences in staffing, facilities and resident populations shape which forms of engagement are realistic.

The varied programme also created opportunities to examine card games alongside communication technologies, dementia-support practices and accessible environments. Researchers could consider the evidence available, while practitioners could explain the constraints visible in daily care. The resulting discussion was grounded in both measurable outcomes and the experiences of residents and staff.

Making card play part of daily care

A card session works best when it has a place within the weekly programme rather than being presented as a special event. Short, repeated sessions allow staff to learn which residents respond to particular games or prompts. Familiar routines can gradually become more personal and effective without placing heavy demands on any one facilitator.

Evaluation should focus on participation and wellbeing as well as task completion. Staff might observe whether residents initiate conversation, take turns, show enjoyment or become distressed. These observations can guide adjustments to the cards, pacing or setting, while also providing evidence for a facility’s broader person-centred care planning.

Registration for the meeting was handled through an external system, while questions about the event can contact the event secretariat. Its central lesson was not that one deck suits every resident, but that thoughtful adaptation preserves meaning: residents retain choice, recognise the social occasion and share the experience in a way suited to their abilities.