Rehabilitation and Therapy Commons^™

Promoting Engagement Of Male Individuals With Alzheimer’S In A Memory Day Care, Tara Brophy

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Alzheimer’s and related dementias impact an individual's cognitive, psychological, social, and physical functions resulting in impairments within the engagement of activities. Activities offer many therapeutic benefits including improvements in mood, alertness, communication, socialization, sleep, cognitive function, and quality of life. The focus of this quality improvement capstone project was to address the decreased level of engagement in male members within a memory day care center setting through engaging them in male-tailored activities. The project included the development of a website that provided tailored male-oriented activities and educational resources that were shared with the staff to revise their day care activity …

Alzheimer's Dementia And Occupational Therapy, Sofia Demusaj, Averee Ortiz, Laura Swanson

Client Educational Handouts

This handout is an introduction to Alzheimer's dementia and the role that occupational therapy can have in the treatment of the disease. It contains facts, figures, signs, and symptoms of Alzheimer's dementia. It also contains examples of occupational therapy interventions and assessments for clients with Alzheimer's disease.

Development And Feasibility Testing Of An Evidence-Based Occupational Therapy Program For Adults With Both Down Syndrome And Dementia, Sujatha E. Raj, Shylie Mackintosh, Jocelyn Kernot, Caroline Fryer, Mandy Stanley

Research outputs 2022 to 2026

This paper describes the development of a home-based occupational therapy intervention program for people with Down syndrome who experience early on-set dementia causing a decline in their performance skills and increasing care dependency on their informal caregivers. A six-step methodological process adapted from the Medical Research Council framework for developing and evaluating complex interventions was formulated to develop an evidence-based occupational therapy program for people with both Down syndrome and dementia and their informal caregivers. The first two steps gathered evidence through systematic reviews of the literature and determined the scope of current occupational therapy practice. The gathered evidence was …

Effects Of The Tailored Activity Program (Tap) On Dementia-Related Symptoms, Health Events And Caregiver Wellbeing: A Randomized Controlled Trial, Laura N Gitlin, Katherine Marx, Catherine V. Piersol, Nancy A Hodgson, Jin Huang, David L Roth, Constantine Lyketsos

Department of Occupational Therapy Faculty Papers

BACKGROUND: People living with dementia (PLWD) and caregivers are adversely impacted by lack of meaningful activity leading to worse symptoms and impaired quality-of-life. There is a critical need to develop effective and well-tolerated treatments that mitigate clinical symptoms, engage PLWD and support caregiver wellbeing. We tested whether, compared to attention control, the Tailored Activity Program (TAP) reduced clinical symptoms and health-related events, and improved caregiver wellbeing, and if TAP activities were well-tolerated.

METHODS: We conducted a single-blind randomized controlled trial among 250 dyads recruited from Baltimore-Washington DC (2012-2016) with a dementia diagnosis and clinically significant agitation/aggression. Dyads were randomized to …

Down Syndrome And Dementia:: A Patient And Care-Giver Centered Approach, Mary M. Stephens, E. Adel Herge, Charmaine Wright

Department of Occupational Therapy Faculty Papers

No abstract provided.

Space Retrieval Training For Memory Enhancement In Adults With Dementia, Lauren Camenzind, Molly Kafader, Rachel Schwam, Mikayla Taylor, Zoie Wilkes, Madison Williams

Master of Occupational Therapy Student Critically Appraised Topics

The final portfolio contains 8 research articles from national and international journals. Study designs include one systematic review, one randomized control trial with pretest-posttest design, three small-scale randomized control trials, one quasi-experimental study with no control, one time-series study, and one case study. All studies relate directly to components of the evidence-based practice question and will be used to draft new recommendations for implementation regarding spaced retrieval training for memory enhancement in adults with dementia. Seven out of the eight articles looked at the effects of SR techniques on functional tasks. Articles looked at eating difficulty (1), independent use of …

Sensory Interventions For Older Adults Living With Dementia, William Tigno, Leigh Hayden, Christina Passarelli, Susan Shepley

Publications and Scholarship

This tool maps out existing literature on sensory interventions for people living with dementia. It allows users to select a sensory intervention that might be feasible in their context, produce outcomes that are relevant to them. It is based on a scoping review of the literature. Our scoping review identified what interventions exist to produce particular outcomes, in particular contexts. It did not address effectiveness. As such, this tool will help you identify what others have done in a particular context, and to produce particular outcomes. It will not tell you which options are most effective.

Interdisciplinary Community-Based Support For Caregivers Of Individuals Living With Dementia, Gina Tucker-Roghi, Jamie Escoubas, Renee Tolliver, Sarah Tucker

Occupational Therapy | Faculty Scholarship

Evidence indicates family caregivers of individuals living with dementia (ILwD) are at risk for diminished physical and mental health; which may decrease their quality of life and directly impact their ability to provide care. An interdisciplinary approach to self-care and skill-building for caregivers is provided in a virtual support group offered by Council on Aging in Sonoma County, CA. As part of the nonprofit’s Adult Day Program, the group is offered to client caregivers and has two goals: First, creating a communitybased, long-term support system for ILwD who are agingin-place; second, fostering a safe and supportive community for family caregivers, …

Development, Reliability And Validity Of The Safe Use Of Mobility Aids Checklist (Sumac) For 4-Wheeled Walker Use In People Living With Dementia., Susan W. Hunter, Alison Divine, Humberto Omana, Ed Madou, Jeffrey Holmes

Physical Therapy Publications

BACKGROUND: Balance and gait problems are common and progressive in dementia. Use of a mobility aid provides physical support and confidence. Yet, mobility aid use in people with dementia increases falls three-fold. An assessment tool of mobility aid safety in people with dementia does not currently exist. The objectives of this study were: 1) to develop a tool for the evaluation of physical function and safe use of a 4-wheeled walker in people with dementia, and 2) to evaluate its construct and criterion validity, inter-rater and test-retest reliability and minimal detectable change.

METHODS: Healthcare professionals (HCP) experienced in rehabilitation of …

Reliable And Valid Measures For The Clinical Assessment Of Balance And Gait In Older Adults With Dementia: A Systematic Review, Jacqueline Baker, Danielle De Laat, Emily Kruger, Sarah Mcrae, Sabrina Trung, Carly Zottola, Humberto Omana, Susan W. Hunter

Physical Therapy Publications

No abstract provided.

A Systematic Review Of The Efficacy Of Cognitive Stimulation Therapy (Cst) On Quality Of Life In Persons With Dementia, R. Babiarz, B. Haden, S. Karlin, J. Mark, A. Williams, M. Ferraro, M. C. Potvin

Student Papers, Posters & Projects

Quality of life (QoL) is an established outcome measure of patients with dementia and is strongly influenced by an individual's environment and mood. While there are many outcomes that can be examined with Cognitive stimulation therapy (CST) interventions, this systematic review focused on quality of life.

Understanding Participation In A Community-Based Art Program, Melody Taban, Otd, Otr, Gabrielle Kains, Otd, Otr/L, Lydia Navarro-Walker, Otd, Otr/L, Namrata Grampurohit, Phd, Otr/L

Department of Occupational Therapy Posters and Presentations

Objectives

1. To understand the perceived benefits of occupational engagement with art for people with dementia and their informal caregivers
2. To understand the art program’s influence on interpersonal relationships

A Systematic Review: Light Therapy For Individuals With Dementia And Implications For Practice, E. Goodman, Ots, A. Milione, Ots, C. Mikus, Ots, E. Jacobs, Ms, Ots, A. Torres, Ots, V. Vu, Ots, L. Kaiser, Otd, Otr/L, M.-C. Potvin, Phd, Otr/L

Student Papers, Posters & Projects

This systematic review seeks to answer the question: is light therapy an effective intervention for sundowning symptoms experienced by individuals who have dementia?

Effect Of Learning To Use A Mobility Aid On Gait And Cognitive Demands In People With Mild To Moderate Alzheimer's Disease: Part I - Cane, Susan W. Hunter, Alison Divine, Humberto Omana, Walter Wittich, Keith D Hill, Andrew M Johnson, Jeffrey D Holmes

Physical Therapy Publications

BACKGROUND: People with Alzheimer's disease (AD) exhibit balance and walking impairments that increase falls risk. Prescription of a mobility aid is done to improve stability, yet also requires increased cognitive resources. Single-point canes require unique motor sequencing for safe use. The effect of learning to use a single-point cane has not been evaluated in people with AD.

OBJECTIVES: In people with AD and healthy adult controls: 1) examine changes in gait while using a cane under various walking conditions; and 2) determine the cognitive and gait costs associated with concurrent cane walking while multi-tasking.

METHODS: Seventeen participants with AD (age …

A Study Of Music: Music Psychology, Music Therapy, And Worship Music, Jessica Whittemore

Senior Honors Theses

There are three specific fields related to music: the psychology of Music and how it affects human brain and functions, the methodology of Music Therapy and how it affects individuals undergoing treatment, and the psychological effects of Worship Music and how it can be used in music therapy. Music therapy is a growing field in which the therapeutic outcomes greatly benefit the patients. The overall purpose is to create a greater understanding of music and music therapy in order to a provide a system for introducing group worship services into music therapy to ultimately bring spiritual healing to individuals.

Physiotherapy Students’ Attitudes Toward Working With People With Dementia: A Cross-Sectional Survey, Susan W. Hunter, Jessica Armstrong, Mark Silva, Alison Devine

Physical Therapy Publications

Aims: To understand personal, educational and clinical experiences and the attitudes of physiotherapy students towards people with dementia.

Methods: Online survey questionnaire. Physiotherapy students in the last year of a two-year Masters of Physical Therapy (MPT) entry-to-practice degree program (n = 59) were surveyed. Descriptive statistics were used to analyze the data.

Results: Fifty-five students participated (93%). The majority of students (n = 52/55, 77%) had at least one clinical placement working with people with dementia. Overall, 53% (n = 29/55) felt their academic training was sufficient to effectively work with people with dementia. Moreover, …

Implementation Of An Evidence-Based Intervention To Improve The Wellbeing Of People With Dementia And Their Carers: Study Protocol For 'Care Of People With Dementia In Their Environments (Cope)' In The Australian Context., Lindy Clemson, Kate Laver, Yun-Hee Jeon, Tracy A. Comans, Justin Scanlan, Miia Rahja, Jennifer Culph, Lee-Fay Low, Sally Day, Monica Cations, Maria Crotty, Susan Kurrle, Catherine V. Piersol, Laura N Gitlin

Department of Occupational Therapy Faculty Papers

BACKGROUND: There are effective non-pharmacological treatment programs that reduce functional disability and changed behaviours in people with dementia. However, these programs (such as the Care of People with dementia in their Environments (COPE) program) are not widely available. The primary aim of this study is to determine the strategies and processes that enable the COPE program to be implemented into existing dementia care services in Australia.

METHODS: This study uses a mixed methods approach to test an implementation strategy. The COPE intervention (up to ten consultations with an occupational therapist and up to two consultations with a nurse) will be …

The Role Of Adult Day Services In Supporting The Occupational Participation Of People With Dementia And Their Carers: An Integrative Review, Janice Du Preez, J. L. Millsteed, Ruth Marquis, Janet Richmond

Research outputs 2014 to 2021

The increasing numbers of people with dementia places considerable stress on health and aged care services and has resulted in the development of community adult day services. Aim: The aim of this integrative review is to determine the extent to which these services support the occupational participation of people with dementia, and how they impact their primary carers. Method: The mixed-methods appraisal tool (MMAT) was used to identify relevant studies in the period 2011–2016. Results: Nine databases were searched and yielded 16 articles with a variety of research designs for inclusion in the review. Conclusions: Findings …

The Attentional Demands Of Ambulating With An Assistive Device In Older Adults With Alzheimer's Disease, Susan W. Hunter, M Montero-Odasso

Physical Therapy Publications

Ambulation with a mobility aid is a unique real-life situation of multi-tasking. These simultaneous motor tasks place increased demands on executive function in healthy young and older adults, but the demands have not been evaluated in people with Alzheimer's disease (AD). Mobility problems are common among adults with AD, leading to provision of a mobility aid to optimize independent activity. The study objectives were: (i) to determine the dual-task cost (DTC) associated with the use of a mobility aid in straight and complex path walking, and (ii) to evaluate the association between executive function and ambulation with a mobility aid …

In The Information Age, Do Dementia Caregivers Get The Information They Need? Semi-Structured Interviews To Determine Informal Caregivers’ Education Needs, Barriers, And Preferences, Kendra Peterson, Howard Hahn, Amber J. Lee, Catherine A. Madison, Alireza Atri

Dartmouth Scholarship

Most patients with dementia or cognitive impairment receive care from family members, often untrained for this challenging role. Caregivers may not access publicly available caregiving information, and caregiver education programs are not widely implemented clinically. Prior large surveys yielded broad quantitative understanding of caregiver information needs, but do not illuminate the in-depth, rich, and nuanced caregiver perspectives that can be gleaned using qualitative methodology. We aimed to understand perspectives about information sources, barriers and preferences, through semi-structured interviews with 27 caregivers. Content analysis identified important themes

Impact Of Garden Spaces On Dementia Residents: Translating Evidence-Based Research Into Clinical Practice, Angela Ko, Jenna Williams

School of Occupational Therapy Master's Capstone Projects (2016-2021)

The research addressed the following focused question: “Do garden spaces decrease the incidence of behaviors such as combativeness and agitation, psychiatric medication use, depression, falls, cognitive decline, and sleep disturbance in clients with dementia in a residential facility?” The research team collaborated with staff at a skilled nursing facility in an urban area of the Pacific Northwest. Appraisal of existing research revealed multiple potential benefits of residents’ with dementia utilizing garden spaces for wandering and/or therapeutic activities. Based on these findings, the research team recommended implementation of an on-site garden. To support the implementation of these findings, the research team …

Dementia In The Context Of Disability, Rosanne Dizazzo-Miller, Fredrick D. Pociask

Department of Health Care Sciences

Patients and caregivers often associate dementia with devastation and a loss of productive contribution to society. People with dementia are often depicted as confused individuals struggling through embarrassing episodes, followed by a loss of independence. The burden and devastation of the diagnosis on the families of people with dementia is exacerbated by their assumption of the role of caregiver with inadequate preparation or training. Disability scholars, in contrast, offer physical and occupational therapists a nontragic view of disability that recognizes the importance of countering the stigma and discrimination that too often accompany dementia. This case example of a woman diagnosed …

Motoric Cognitive Risk Syndrome: Multicountry Prevalence And Dementia Risk, Joe Verghese, Cedric Annweiler, Emmeline Ayers, Nir Barzilai, Olivier Beauchet, David A Bennett, Stephanie A Bridenbaugh, Aron S Buchman, Michele L Callisaya, Richard Camicioli, Benjamin Capistrant, Somnath Chatterji, Anne-Marie De Cock, Luigi Ferrucci, Nir Giladi, Jack M Guralnik, Jeffrey M Hausdorff, Roee Holtzer, Ki Woong Kim, Paul Kowal, Reto W Kressig, Jae-Young Lim, Susan Lord, Kenichi Meguro, Manuel Montero-Odasso, Susan W. Hunter, Mohan L Noone, Lynn Rochester, Velandai Srikanth, Cuiling Wang

Physical Therapy Publications

OBJECTIVES: Our objective is to report prevalence of motoric cognitive risk syndrome (MCR), a newly described predementia syndrome characterized by slow gait and cognitive complaints, in multiple countries, and its association with dementia risk.

METHODS: Pooled MCR prevalence analysis of individual data from 26,802 adults without dementia and disability aged 60 years and older from 22 cohorts from 17 countries. We also examined risk of incident cognitive impairment (Mini-Mental State Examination decline ≥4 points) and dementia associated with MCR in 4,812 individuals without dementia with baseline Mini-Mental State Examination scores ≥25 from 4 prospective cohort studies using Cox models adjusted …

Dementia And The Role Of Occupational Therapy: American Occupational Therapy Association Fact Sheet, Regula H. Robnett

Occupational Therapy Faculty Publications

Dementia results from impaired cognition, due to damage to the brain. The majority of dementia cases (60% to 80%) are classified as Alzheimer’s disease (Alzheimer’s Association, n.d.). The signs of dementia generally include, but are not limited to, decreased short term memory, decreased problem solving skills, decreased perceptual skills, and personality changes. The onset of dementia is gradual, and the course of the disease spans several years or more. In Alzheimer’s disease, the person progresses through several stages that roughly coincide with reverse developmental levels, with those in the final stages being completely dependent on others. Occupational therapy practitioners, through …

Are Scores On The Ppt Useful In Determination Of Risk Of Future Falls In Individuals With Dementia?, Mary K. Farrell, Richard A. Rutt, Michelle M. Lusardi, Ann K. Williams

All PTHMS Faculty Publications

Individuals with dementia or Alzheimer’s disease (AD), exhibit both a progressive decline in cognitive function and accumulating difficulty with physical function.¹ As cognitive impairment begins, individuals will initially demonstrate difficulties with short-term memory and with instrumental activities of daily living. As the dementia progresses, individuals will increasingly demonstrate difficulties with long-term memory, communication, and basic activities of daily living.

Test-Retest Reliability And Minimal Detectable Change Scores For The Timed "Up & Go" Test, The Six-Minute Walk Test, And Gait Speed In People With Alzheimer Disease, Julie D. Ries, John L. Echternach, Leah Nof, Michelle Gagnon Blodgett

Rehabilitation Sciences Faculty Publications

Background. With the increasing incidence of Alzheimer disease (AD), determining the validity and reliability Of Outcome measures for people with this disease is necessary.

Objective. The goals of this study were to assess test-retest reliability of data for the Timed "Up & Go" Test (TUG), the Six-Minute Walk Test (6MWT), and gait speed and to calculate minimal detectable change (MDC) scores for each outcome measure. Performance differences between groups With mild to moderate AD and moderately severe to severe AD (as determined by the Functional Assessment Staging [FAST] scale) were Studied.

Design. This was a prospective, nonexperimental, descriptive methodological study. …

A Preliminary Study On The Reliability Of Physical Performance Measures In Older Day-Care Center Clients With Dementia., Vince Salazar Thomas, Patricia A. Hageman

Journal Articles: Physical Therapy

BACKGROUND: Decline in physical functional ability is an intrinsic component of the dementia syndrome. Reductions in muscle mass and strength represent a major factor in the loss of functional ability Although resistance exercise has been studied as a method for maintaining/recovering function in populations of frail older adults, people with dementia have been systematically excluded because of uncertainty about the reliability of outcome measurements.

OBJECTIVE: The purpose of this study was to determine the test-retest reliability of a battery of established performance-based measures of strength and function among subjects with dementia.

SETTING: A hospital-affiliated adult day-care facility.

SUBJECTS: Twelve of …

Providing Services To Family Caregivers At Home: Challenges And Recommendations For Health And Human Service Professions, Susan Toth-Cohen, Laura N. Gitlin, Mary Corcoran, Susan Eckhardt, Pamalyn Kearney, Rosalyn Lipsitt

Department of Occupational Therapy Faculty Papers

The home represents a relatively new arena for practice for most service providers, especially those working with families of persons with dementia. This article describes four key factors to consider when working with caregivers of persons with dementia in their homes. The authors also discuss seven common challenges of service provision in the home and recommend strategies for addressing these challenges.

Role Perceptions Of Occupational Therapists Providing Support And Education For Caregivers Of Persons With Dementia., Susan Toth-Cohen

Department of Occupational Therapy Faculty Papers

OBJECTIVE: This pilot study explored occupational therapists' perceptions of their roles as interventionists providing education and support for caregivers of persons with dementia. The intervention was provided in caregivers' homes as part of a larger funded study.

METHOD: Interviews were conducted with four occupational therapists to elicit their reflections on practice and their views on occupational therapy services on the basis of their experiences providing support and education for caregivers in the funded study.

RESULTS: Key themes consisted of the contrasts between the therapists' roles in the study and their customary practices and the professional and personal impact of their …

Gender Differences In Dementia Management Plans Of Spousal Caregivers: Implications For Occupational Therapy., Mary A. Corcoran

Department of Occupational Therapy Faculty Papers

Occupational therapists treating older people with Alzheimer disease know that they must also consider the others who are affected by the disease, the informal caregivers. Intervention is most effective when it enables both the impaired person and the primary caregiver to manage the secondary symptoms of dementia. Unfortunately, little is understood about how caregivers approach and carry out their tasks and about why male and female caregivers respond differently to their caregiving role in terms of depression, burden, stress, and substance abuse. This paper discusses the effects of gender on dementia management plans of spousal caregivers. Husbands and wives have …