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Therapy-Based Interventions: Occupational Therapy for Dementia Patients

February 8, 2022Neelem Sheikh

Occupational therapy, also referred to as OT, is a branch of healthcare that aims to help individuals of all ages who have cognitive, physical, or sensory impairments. Occupational therapy utilizes assessment and intervention to support individuals with everyday tasks, or Activities of Daily Living (ADLs). While often used as part of rehabilitation after an injury or illness, it has also shown promising outcomes supporting dementia patients, their families, and/or caregivers.

Below, we detail basic information about occupational therapy for dementia patients, including the potential benefits, the types of occupational therapy for dementia, and how this therapy-based intervention may differ based on dementia stages.

Benefits of Occupational Therapy for Dementia Patients

Over the past several decades, there have been many research studies and clinical trials assessing the efficacy of occupational therapy for dementia patients. The overwhelming majority of studies and trials conclude that occupational therapy may be an effective intervention to assist in maintaining cognition and functionality while reducing psychiatric symptoms in dementia patients. A summary of the most notable benefits observed across studies and trials is listed below.

  • Reduced behavioral problems
  • Reduced burden on caretakers and/or family members
  • Improved daily functioning, overall well-being, and quality of life
  • Improved cognitive stability
  • Increased social participation

Types of Occupational Therapy for Dementia Patients

Occupational therapists can assist those with dementia either in a senior living facility or in the patient’s home. Throughout the continuum of dementia care, occupational therapists can intervene to help patients retain existing function as well as provide wellness programs, educate caregivers, and promote patient safety and well-being. Occupational therapy interventions can be categorized into four key types:

  • Health promotion: This type of intervention primarily focuses on promoting the wellness of both patients and caregivers to achieve maximal performance in preferred activities.
  • Remediation: While cognitive impairments are not expected to be restored through occupational therapy, mental activity may be suggested to help maintain current cognitive function. Occupational therapists may work towards remediating functional abilities by incorporating regular exercise into a patient’s intervention to improve functional mobility, strength, and endurance, and consequently, improve the performance of ADLs.
  • Maintenance: Maintenance-focused intervention provides support for the routines and habits that are currently working well for dementia patients, allowing patients to maintain independence.
  • Modification: Modification is one of the most commonly used occupational therapy interventions for dementia patients. It aims to ensure safe, supportive environments for patients via adaptation and compensation. 

What to Expect for Each Stage

The type of occupational therapy and associated strategies vary based on the stage of dementia the patient is currently in. A series of assessments are typically performed to determine the optimal type of intervention and create a personalized plan to meet patient and caregiver goals.

Early-Stage Dementia

In the early stages of dementia, patients may be able to function in a job or their normal activities but may misplace objects, miss appointments, or forget to take medications. Occupational therapy interventions for early-stage dementia patients may include the use of memory aids, such as calendars, reminders, alarms, or checklists.

Middle-Stage Dementia

Middle-stage dementia patients will have more pronounced symptoms. They may show a more significant decline in memory and overall cognitive function, and they may struggle to complete basic ADLs, such as dressing, bathing, and toileting, on their own due to decreased sequencing abilities and motor planning. In this stage, occupational therapy interventions may include retraining ADLs and balance and functional mobility, which can help increase or maintain patient independence while reducing caregiver burden.

Late-Stage Dementia

In the later stages of dementia, patients will likely not be oriented to person, place, or time and will likely be highly dependent on caretakers for the majority of daily activities, such as feeding, bathing, and toileting. In addition to cognitive impairments, late-stage dementia patients may have a severe loss of motor control and functional abilities. Late-stage occupational therapy for dementia patients may include educating caregivers on safely transferring patients, exercise programs for contracture management, support groups for caregivers, and other methods for improving the patient’s quality of life.

Monitoring Brain Health Throughout Occupational Therapy

In addition to monitoring improvements or changes in behavior, mood, and quality of life, providers and caregivers will likely want to assess overall brain health over time to determine whether the intervention is helping the dementia patient retain brain function from both a cognitive and functional perspective.

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