Hi. I sympathize with you--I have also had many male patients get agitated when I tried to get them to do pen and paper activities.

Here are a few ideas that address cognition and/or communication:

cooking

gardening (I worked at a SNF that actually built a waist-high planter outside, and all disciplines of Rehab were able to use it; OTs worked on fine motor skills, PTs addressed standing balance while the patient worked on the garden, SLPs worked on having the patient follow commands for planting, or read the directions, etc)

Bingo (I use standard Bingo boards, and make a list of questions, e.g., yes/no questions, questions about preferences, maybe even oral motor commands that have to be completed; whenever somebody gets to mark out a spot on the Bingo board, first they have to answer a question)

Scategories is great for attention and abstract language

Cranium is also a fun game that addresses both cognitive and communication skills

Card games (poker), or Uno; again, these address attention, and also pragmatics like turn-taking; once I worked with a man with behavioral problems and poor cognition; the only activity I found that he liked was having me hold up the cards one by one, and he would say RED or BLACK, and we would split them into piles. I was working on his voice, so I would move my chair further and further away, and make him shout out the words. I was also addressing sustained attention, and by the end of our treatment, he could attend throughout the entire deck, whereas he initially got distracted within ten cards

simple "assembling" projects, like asking a patient to help you change the batteries in a portable amplifying device for another patient, or maybe even putting together a miniature airplane or something like that; these activities will address attention, comprehension (via verbal or auditory commands), pragmatics (turn-taking), etc.

Chores, like wiping down a table, etc, are good for people affected by dementia. Anything familiar and repetitive is good, and addresses attention and following commands.

Have a family member bring in some pictures, and then work with the patient to make an album. S/he can label the photos and glue them on construction boards or colored paper. This will also serve as a memory book.

I've had patients do craft projects to decorate the therapy room. For example, I cut out the letters for "SPEECH THERAPY," with each letter about 10 inches tall. I gave a patient a theme, such as food, animals, or tools, and asked them to look through magazines to find appropriate pictures. Next, we cut out the pictures and glued them onto the letters, so that each letter represented a different theme. (For example, "S" had pictures of food, "P" had pictures of animals, "E" had pictures of vaction places; I varied the levels of difficulty based on the patient I was working with.) The final result looked really neat in the room, and my coworkers loved that it had been made by patients. The patients felt proud that they had helped with the decor. I used this project with patients that were working on thought organization/categorizing, and also attending to tasks (e.g., not getting distracted by the articles in the magazines).

Other craft projects can involve making Christmas or Valentine's cards for family and friends, or even cards to send to patients at the hospital they were once at--the ladies love this. A lot of these projects can be done as joint treatments with OT, so OT can work on fine motor, as you address the cognitive and communication components.

Hope that gives you a few ideas to work with. One of my jobs had a book with activities for Alzheimers patients, and that gave a lot of ideas. Also, if your facility has the materials for the Claudia Allen Cognitive Program, that is a great resource.

Best of luck!