Instead of a flat quilt you could consider making it into an apron. It can be tied around their waist so it doesn't slide off their laps. I had a former client whose caregivers tied an apron on her and she enjoyed playing with all the attachments.

I made my mom a quilt and placed a request that I would launder, I was declined, evidently it is state law that items are required to be laundered in a specific amount of time after soiled, they did not, could not rely or depend on me to wash in there time frame.
Point being--place items on the quilt that will survive institutional laundering.

While my mom was in the nursing home I would hang door decor for each season, per mom this is how she knew where she lived. Every door was white in every hallway. This would be absolutely confusing for a person with dementia, mental fatigue, senior moment...

A piece of crinkly plastic and/or a marble inside a stitched closed "pocket" for safety? (Second hand stores are a good resource for games that have little pieces to put inside for the permanent pockets.. )

http://www.quiltingboard.com/main-f1...s-t275540.html
http://www.quiltingboard.com/main-f1...tia-fingering-
http://www.quiltingboard.com/picture...s-t275297.html

I made one for my mother in law. I put a zipper on it, some various size and texture buttons, a little fabric book, and some beads, since I was told she likes rosary beads but they don't give them to her all that often. I made it the size of a placemat with fleece backing so it wouldn't slide off her lap. Father in law says it is great. Hard to know what my dear poor mother in law thinks.

There's more topics on our search function if you put in fidget quilts.

Good luck with yours.

Great ideas!! My granddaughter is the foster mom to an autistic and blind eight year old girl. I need to make her a quilt and needed ideas for the texture items for the top. You all have given me some wonderful ideas to include. Thanks.

Clear vinyl could be used to enclose something flat to look at like buttons or small plastic toys. Make sure all items can take the high heat of a dryer first.

I have made some figit quilts. I try to have different textures and activities in fabrics that might be interesting to adults (corduroy, velvet, fleece, satin, flannel, upholstery fabrics, themed or patterned fabrics, etc.) I like to make doors with surprises behind them and zippers that have something behind them. There are many ideas on Pinterest. Some people simply use fabrics that are interesting to touch. The important things are that they should be small (they are not blankets) and they must be machine washable and machine dryable. My mom had Alzheimer's and she loved flipping pages in books.

I would choose Minky for the backing. There is just something so soothing and calming about the soft texture. I use it a lot and have no trouble with it when quilting.

How about velcro [bottom section sewed down completely top section loose at one end ] a d ring or key ring with and without keys, shoelace knotted in middle belt buckles, piece of braided fleece, other textured material[suede velvet silky leather etc.] appliqued or sewn small squares of fabric with pictures of dogs, cats, babies, children,families ,etc.]Or other easily identified objects,Boats, cars ,water etc. Diane C.