Top ten lists have become one of our go-to support suggestions for MacIntyre teams, especially those supporting a person with dementia.
We first wrote about this in our September 2023 blog ‘Supporting people living with dementia to lead their best lives' when we said:
“While staff are amazing at creating and updating person-centred paperwork and support plans, important tips and advice can sometimes get lost amongst the detail being recorded. Therefore, we are encouraging services to work with the people they support who have dementia to make a one-page ‘Top 10’ list of things that the person finds supportive. These might be activities or interventions, occupations or distractions, always with the caveat that not everything will constantly work and that it’s important to try and tempt the person’s interest rather than using too much encouragement (aka nagging!).”
The concept had been introduced during a service visit when we were creatively exploring support for a gentleman living with dementia who had lost interest in doing many of his previous activities, both recreational and domestic. Top 10 lists are something we’ve gone on to recommend countless times, both within MacIntyre and to the wider sector (most notably at UK Dementia Congress 2024 and the Alzheimer’s and Dementia Show 2025), and we believe it to be a really important step in providing more creative support.
The theory behind top 10 lists
Asking staff to complete more paperwork may sound onerous, but unlike all the more formalised plans we have to keep this is a document any member of staff can complete with the person and continually refine with them and the person’s support team and family to keep the list relevant. It can include anything, from fun suggestions to important needs, can be displayed openly or discreetly, and is designed to help any member of staff know the very best support approaches and ideas.
It’s useful for staff whether it’s their 100th shift or their first, because whether you know someone really well or not, having simple, inspirational ideas readily available in difficult moments - for example, when you are supporting someone who is distressed - can help a support worker respond in the most timely and positive way.
A Top 10 list can also act as a lifeline for staff to set up worry free, no pressure activities during the day that the person can see and decide if they are interested in and want to be involved with. This can be especially helpful when a person is struggling to tell you what they want to do or can’t recall the words for a hobby or activity they once enjoyed .
What would go into a Top 10 list?
Anything can go into a top 10 list but the best entries are the ones that suggest ideas that are most supportive for the person. For example, if Kate finds a certain item, like her teddy Billy, really helpful when she is upset, you’d want ‘Cuddles with Billy’ (with a thumbnail picture of Billy) on your list. Other entries might include a particular piece of music that the person responds positively too, or sounds, pictures, smells, textures, tastes or other important personal items that are supportive for the person.
Occupations and activities are good too. For example, it might be that when Paul, what would help Paul to relax is to open the back door. This helps Paul because he needs to feel there isn't a barrier to him accessing the outside, and he will often immediately sit in the chair just outside the door and have his favourite drink. ‘Open the back door to support Paul with pacing’ could therefore be one entry on Paul’s Top 10 List.
Specific support preferences, like favourite foods and drinks or elements of good support around the person’s routine can be included too, but it’s important to remember that a Top 10 List isn't bullet points from a support plan. It is a document for in-the-moment ideas to provide comfort, stimulation, joy, focus or occupation - the things that make ‘the magic happen’ for the person and that provide instant inspiration for staff.
How do I begin a Top 10 list?
Download our free template and work with the person in a way that makes sense to them to begin jotting down ideas. The best ideas for creating the list might come while you're doing an activity with the person, or when you're out in a café, rather than through a specific ‘meeting’ about doing the list. Be creative and don't badger the person for ideas - this should be a stress-free experience. Gather input from everyone else in the person’s circle of support too.
Don't forget to review the list so you are keeping it current and meaningful. A Top 10 list should never be a static document so change/replace it as often as needed. But above all, don't delay, start today!
