Occupational Therapy Helps Those With DementiaBy Ed Edelson
HealthDay Reporter THURSDAY, Nov. 16 (HealthDay News) -- Occupational therapy
-- training to do simple things around the house -- improved the lives of
people with dementia such as Alzheimer's disease, as well as the people who
care for them, a Dutch study found.
The results of the study, reported in the Nov. 18 British Medical Journal,
could help change the attitude of health insurance companies and Medicare about
paying for occupational therapy for persons with dementia, one expert said.
"I like the validation of what I knew instinctively," said Elicia Dunn Cruz,
an assistant professor of occupational therapy at the University of Texas
Medical Branch, Galveston.
Medicare sometimes refuses to pay for such therapy because of a belief that
people with dementia "don't have a good rehabilitation potential," Cruz said,
an attitude also shared by some, but not all, health insurers. "I think this
article counters that," she said.
In the study, researchers at the University Medical Center Nijmegen divided
135 people 65 and older who'd been diagnosed with mild to moderate dementia
into two groups. One group received 10 home-based sessions with experienced
occupational therapists over five weeks who taught the patients to use various
techniques to cope with mental decline. The people looking after them were
taught methods of coping as well.
Assessments six weeks and three months after the therapy found that 75
percent of the patients who had the training showed an improvement in motor
skills, and 82 percent needed less assistance in day-to-day tasks. The same
sort of improvement was seen in only 10 percent of those who did not get the
training.
Nearly half the caretakers who received the training felt more competent to
do their duties, compared to a quarter of those who did not.
"Because outcomes such as improvements in activities of daily living and
sense of competence are associated with a decrease in need for assistance, we
believe that in the long term, occupational therapy will result in less
dependence on social and health-care resources and less need for
institutionalization," the researchers wrote.
Mary Mittleman, director of the psychosocial research program at New York
University's Silberman Aging and Dementia Research Center, said she knew of no
previous controlled study on occupational therapy for dementia patients.
Mittleman herself just reported a long-term study showing that spouses of
Alzheimer's patients are less likely to place their loved ones in a nursing
home if the spouses receive enhanced counseling and caregiver support.
The study of 406 spouses/caregivers found that those who received sessions of
individual and family counseling, access to telephone counseling and
participation in a support group delayed placing a loved one in a nursing home
by about 18 months, compared to those who did not.
As for occupational therapy, Cruz said that training families to use adaptive
techniques using familiar objects such as clocks and calendars can help people
in the early stages of dementia. "It makes Alzheimer's disease less of a death
sentence," she said.
Families can consult their primary-care physician about a referral to a
rehabilitation clinic that provides in-home services, Cruz said: "There is a
huge home industry, and occupational therapy is very much a part of it. The rub
is that if a patient has a diagnosis of dementia that makes it difficult to get
coverage. The insurers want to cover only people who are going to get well
again. This study may help to change that."
SOURCES: Elicia Dunn Cruz, Ph.D., assistant professor of occuptional
therapy, University of Texas Medical Branch at Galveston; Mary Mittleman,
Ph.D., New York University; Nov. 18, 2006, British Medical Journal Copyright
© 2006 ScoutNews LLC. All rights reserved.
Occupational Therapy Improves Quality Of Life For Dementia Patients And Their
Carers, UK Main Category: Alzheimer's / Dementia News
Article Date: 22 Nov 2006 - 10:00am (PST)
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Occupational therapy can help to improve the ability of people with dementia to
perform daily activities and can also reduce the pressure on their caregivers,
says a BMJ study published today.
Dementia can have far reaching effects for patients and their caregivers and is
a major driver of costs for both health and social care systems across the
developed world. The most significant problems associated with dementia are the
losses in independence, initiative and participation in social activities -
factors which affect the quality of life for both patients and their caregivers
and families.
Previous research had suggested that non-pharmalogical treatment could have the
same or better effects than drug treatment for people with dementia.
Researchers from The Netherlands set out to measure the effect of occupational
therapy on people with dementia and their main carer. A group of 135 patients
with mild to moderate dementia and their caregivers were randomly split into
two groups. The first group received 10 home-based sessions of occupational
therapy - provided by an experienced occupational therapist - over a period of
five weeks, whilst the second group received no occupational therapy. The
groups were then assessed six weeks and 12 weeks after the therapy sessions.
At both six weeks and three months the patients who received occupational
therapy functioned significantly better in daily life than those who did not -
with 75% of those in the group showing an improvement in process skills and 82%
needing less assistance in day to day tasks. Primary caregivers who received
occupational therapy also felt significantly more competent than those who did
not.
The authors suggest that occupational therapy is likely to be more effective
than drugs or other psychosocial interventions - as the levels of improvement
in their trial outstrip the effects recorded in previous trials of drugs and
other interventions.
They add that they 'strongly advocate' the inclusion of occupational therapy in
dementia management programmes; 'the clinical gains - obtained with
occupational therapy for both patients and their caregivers underlines the
importance of adequate diagnosis and pro-active management in dementia' they
conclude.
###
Contact: Emma Dickinson
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