HUGE list of fine motor skill activities for working with older adults in OT |

Fine Motor Skills: The Ultimate OT List!

I am always looking for new ideas to work on fine motor skills, specifically when working with adults. I tend to resort to my “old favorite” list of fine motor coordination activities that I know work well, along with specific occupations that are important to my patients.

But when I am working with a long term patient, where I need to grade it or am trying to look for fine motor activities that are fun and new, I can get stuck.

So I asked 26 Occupational therapists:

What are your favorite fine motor skill exercises and coordination activities when working with adults?

Below are the fine motor skills examples, activities, and video we came up with – read, print and enjoy!

Get some new ideas with this HUGE list of fine motor activities when working with adults | #OT #geriatricOT


1. Nuts and bolts, lacing beads, using clothespins to pick up Pom poms to paint or just sort, buttons, zippers, snaps, putting marbles or rubber balls on golf tees, making small balls with putty or play doh, sorting jewelry, squeezing water out of sponges or towels, using different types of tongs to pick up small objects – Paula Bradley

2. Drawing a picture graded by changing the size of the paper. Bring in different materials stampers, finger paint, etc – Richard Brown

3. Folding clothes (wash cloths, socks), ADL board (button, zippers bra hooks etc), opening containers (toothpaste, lotion), clothes pins, rainbow rings for crossing midline, velcro board, keys and locks, theraputty, digiflex, beading craft – Jasmine Sohrakoff

4. My bin of various empty grocery containers is my go-to for fine motor control skills to open/close, and having patients reach for them in cabinets/refrigerators/shelves of various heights is one of my favorite gross motor control activities. – Sarah Stromsdorfer from

5. I take them straight to the kitchen and do bathroom stuff! I get them to open their make-up containers, shampoo/conditioner bottles, wearing weights while organizing shelves in the bathroom and or kitchen…make meatballs, bread, pies for meal prep…opening different containers of milk, using the manual can opener. Sorting dry a bag of dry beans for meal prep…decorating cookies and cupcakes. – India Leah Davis


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6. Theraband activities or squeezing a ball are some of my favorite fine motor activities to work on. – Noreena Ishtiaq

7. I had a patient who had a stroke that was a retired banker. I brought in all sorts of coins/dollars he really enjoyed sorting them into various piles, placing them in stacks, etc. – Samantha Kaufman

8. One easy fine motor activity I really like is to take a piece of paper and using one hand, make it into a ball, then spread it out flat.

9. But Rachel Hall, had a suggestion to take it one step farther to grade it by starting with the paper on table then raise it up once in the hand so no “cheating.”

10. My patient cleaned a tray table of shaving cream and told me she liked doing a functional task. – Sharon Leary

11. Graded puzzles (larger piece sizes to smaller); grooming/hygiene tasks – open/close/apply toothpaste, lotion, lipstick; sort through a purse or bag to retrieve a specified item; pulling out a Kleenex or paper towel; open/close food and kitchen storage containers; buttons and zippers; play checkers or arrange on the board; handle money; turn pages of a book or magazine; pull silverware from a dish rack, separate them, and put into silverware tray; spray and wash a window or mirror; turn faucets on/off or light switches. Anything functional! – Monica Heltemes from

12. I’d love to try origami for fine motor activities – Ruby Kopenski

Fine motor skills and motor activity ideas for occupational therapy |

13. We use a weightwell for strengthening and grip (graded). We also have a woodwork and arts and crafts area at work which enables meaningful engagement. – Charlotte Parry

14. I like those fleece blankets you tie together… they can give it to someone. One of my ladies was expecting a great granddaughter – so she was able to give her something she made. She was so excited. – Tonya Gladden


HUGE list of fine motor activities when working with adults | #OT #geriatricOT


15. Making salt dough and using cookie cutters to make shapes. End product is endless – tags for gifts, place cards, add essential oils to dough and make hanger for closet. Stringing beads for tree decorations at Xmas and Mardi Gras.

16. Weaving on a simple table loom – make scarves, placemats, etc. Card making with dye cuts. Silkscreening. Puzzles with the pieces hidden in rotini pasta/beans/black eye peas all dry and uncooked. Adult coloring books. – Jane Ryan

Not feeling confident working with older adults in your OT practice? If you are new to working in SNF or Home Health, we are here to level up your practice! Join the OT Flourish Membership today! |

17. Pony bead necklaces and bracelets, flower pens, sorting beans in a weekday pill tray, letting the patient show you how to crochet if you don’t know how, lacing boards. – Natalie Nunyabiz

18. We removed the line, cleaned, oiled and put a new line on a fishing rod. Box of various nuts and bolts, pennies in piggy bank, placing lots of washers on a long bolt, various locks and keys, buttoning small buttons on a shirt. Have had ladies cut coupons and make cards. – Tammy Lane

19. Therapy apron which has all sorts of buttons, zips, Velcro, buckles and ties. Even typing or musical instrument playing. – Bec Rourke

20. I’ll find out their interests. ADL (example: dressing board), IADL (example: cooking, money management like picking coin) or leisure (gardening, word finding-using pen or computer base). – Vicneas Veloo

21. The game, Topple, is great for fine motor skills. – TerriAnne Zocco Ragonese


22. I love to use cards games and board games: checkers, chess, Sorry, Yahtzee, Jenga, BananaGrams, Sour Apples, Chinese Checkers. Jewelry making. Cooking tasks, like that are related to holiday themes and decorating them by hand with candy decorations and frosting bags. napping fresh green beans, teaching some of the basic sign language letters. Working on the computer. Handwriting, letter writing or card writing and have them address the envelopes as well. Crochet/knit/hook rugs. Have women put on make up or do nail care and have them paint their nails. Put together models of cars or even miniature furniture. – Julie Clark Spuhler

23. I use culturally relevant activity prescription such as cooking. – Jouyin Teoh

24. Making bread and cookies. Model planes, cars and boats. Lego kits and designs. – Sandy Hanebrink

25. It’s always fun to bring a nostalgic type of games as long as they understand why were doing the particular task.  jacks, string games (“Cat’s Cradle”), etc. Simple sport games on the Ipad or Iphone like “swim meet” and “tennis.” – Ylisa Gabay Young

26. I have used woodwork projects and model airplanes – sanded and then painted projects to display in their rooms at the SNF. – Michelle Stoermer

Not feeling confident working with older adults in your OT practice? If you are new to working in SNF or Home Health, we are here to level up your practice! Join the OT Flourish Membership today! |

3 thoughts on “Fine Motor Skills: The Ultimate OT List!”

  1. I took a plastic coat hangar and a bag of clothes pins . I wrote with a sharpie on the clothes pins the alphabet and had my residents or children squeeze the clothes pins and attach them in order onto the hangar to promote fm bilateral coordin pincer grasp sequencing
    Have fun I k ow we did

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