Rehabilitation and Therapy Commons^™

Dementia: Incorporating Families And Caregivers In Direct Speech-Language Intervention, Jocelyn Hartley

Online Theses and Dissertations

In a survey, 50% of 1,000 caregivers reported that they received no information on dementia at the time of diagnosis (Thompson & Pulsford, 2012). This statistic provides strong evidence as to why caregivers feel ill-prepared to care for individuals with dementia. The role of a speech-language pathologist (SLP) is suggested to not only treat the individual with dementia, but consider the role and perspective of the caregiver (Watson, Aizawa, Savundranayagam & Orange, 2013). Providing education and training to caregivers of individuals with dementia is within the scope of practice of speech-language pathologists (Watson et al., 2013).

A survey design for …

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

Sensory Closet Program Design For Alzheimer's And Dementia Population, Grace V. Willard

MOT Student Capstones

Background: The prevalence of individuals with Alzheimer's and dementia is growing exponentially in long term care facilities, with restraints and seclusion becoming the method of intervention when behaviors arise (American Occupational Therapy Association, 2015). North Carolina is moving to decrease the amount of physical restraints and psychotropic medication usage in long term care to decrease harm caused to the residents. Project Purpose: This project intends to design a sensory integration closet program for use in a long-term care facility to facilitate a decrease in behavior outbursts and correlating psychotropic medication usage in residents with Alzheimer's disease and dementia. Coinciding training …

Role Of Community Participation In Improving Quality Of Life In Clients With Dementia And Their Caregivers, Mridula Dhamija

Online Theses and Dissertations

Aim: The purpose of this study was to investigate the effects on quality of life for clients with dementia and their caregivers by participating in a community program, the Memory Café.

Method: In this qualitative, cross case study, the Marwit Meser Caregiver Grief Inventory (MM-CGI) was given to caregiver. Data collection was done by interviewing the participants; there was a main question with follow- up questions as needed. All the interviews were audiotaped and transcribed followed by primary and secondary coding. Shortlisting of categories resulted in emergence of themes which were common across cases and unique to each case.

Results: …

Evaluation Of A Sleep Knowledge Translation Strategy For Occupational Therapists Working With Persons Who Have Dementia, Laura Laberge, Blaire Sangster, Cary A. Brown

The Open Journal of Occupational Therapy

Introduction: Sleep deficiency is a significant, largely overlooked issue for persons with dementia (PWD), and is associated with physical and mental health problems, increased caregiver burden, and increased likelihood of institutionalization. Despite the high prevalence of sleep deficiency in PWD, most health care professionals lack knowledge of the relationship between sleep problems and dementia. This project aimed to determine the feasibility of an archived online presentation, a knowledge translation (KT) strategy to increase therapists’ understanding of the impact of blue-spectrum light on sleep in PWD.

Method: Therapists who participated in a previous sleep and dementia survey were recruited via email. …

Novel Advances In Alzheimer's Disease, Jacob P. Naumann

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Alzheimer’s disease, the most common form of dementia in adults, is a progressive degenerative neurological disease that affects memory, cognition, and behavior. Dr. Alois Alzheimer discovered and diagnosed the irreversible disease in 1906 after documenting the famous case of Auguste Deter.¹ Since the discovery of the disease, numerous advances have made it possible to not only better understand the causal factors, but also to improve the medical diagnosis and preventative measures that healthcare providers can implement. For the first time since 1984, the National Institute on Aging (NIAA) and the Alzheimer’s Association (AA) proposed and published new diagnostic guideline …

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 …

Creative Expression And Dementia, Danielle A. Lavee-Dixon

Senior Theses

Art is the expression or application of human creative skills using that individual’s imagination. While most often taught amongst young people, I believe that art is a tool that can be used at all ages to promote reflection, pleasure, and personal passions. As a way to investigate the benefits of artistic expression amongst different groups of people, I have focused on the rewards achieved with art practiced by individuals living with dementia. Highlighting the difficulties a patient with dementia may encounter, and some of the benefits art can have on those patients; I was able to create art workshops that …

An Exploration Of Volition: Caregiver Perceptions Of Persons With Dementia, Christine Raber, Mikel Stone

The Open Journal of Occupational Therapy

The purpose of this study was to understand what formal caregivers know about the volition of older adults with moderate dementia. A qualitative approach was used at one assisted living facility. Semi-structured interviews were conducted with formal caregivers to gain their perceptions of residents’ volition or motivation for occupation. Volition of resident participants was assessed using the Volitional Questionnaire (VQ). Caregiver interviews and resident VQ’s were analyzed using van Manen’s phenomenological approach to examine their congruence with regard to the volitional abilities of residents. Thematic analysis yielded two broad themes: (a) Caregivers possess varying layers of insight regarding the volitional …

Behavioral Implications Of A Cognitive Training Program For Individuals With Moderate Cognitive Impariment, Joseph L.D. Kennedy

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to evaluate the effectiveness of a cognitive training program on behavioral outcomes for individuals with moderate cognitive impairment. A total of twenty participants were randomized into either a waitlist control or an experimental group. Collateral individuals familiar with each participant completed a series of measures of behavioral and emotional functioning at both pre- and post-intervention. Results demonstrated little effectiveness for the cognitive training program in stabilizing or improving behavioral functioning. Limitations and future directions are then provided to enhance future research in this area.

Participatory Action Research To Improve Caregiver Education Based On Cognitive Performance Test Results For Persons With Alzheimer's Disease Or Mild Cognitive Impairments, Terrianne Jones

Occupational Therapy Program Student Theses, Dissertations and Capstones

The aim of this study was to make changes to how occupational therapists in a transitional care unit setting provide education about Cognitive Performance Test (CPT) scores to caregivers of those patients with dementia or suspected dementia. Caregiver education for this population is important, as the incidence of persons living with Alzheimer's disease and other dementias is expected to grow dramatically in the coming two decades. This study used a Participatory Action Research (PAR) approach to gather input from occupational therapists and caregivers of patients evaluated with the CPT. Interviews of caregivers indicated that they were unhappy with the education …

Efficacy Of A Cognitive Training Program For Individuals With Moderate Cognitive Impairment: Evaluating Cognition, Erica Catherine Johnson

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of the current study was to evaluate the efficacy of a cognitive training program among those with moderate cognitive impairment. A total of 23 individuals participated in the study and were randomly assigned to a wait-list control group or a cognitive training program that consisted of 24 cognitive classes for a total of 12 weeks. The cognitive training classes aimed to activate the six primary cognitive domains impacted with dementia, reaction time, attention, memory, language, visual-spatial skills, and executive functioning. All participants were evaluated with a battery of neurocognitive assessments pre-and post-treatment. The findings tentatively support the use …

The Effects Of Sustainability As A Positive Attribute On Equine Therapy Design: An Interdisciplinary Study, Andria Sinclair

Williams Honors College, Honors Research Projects

Interdisciplinary studies have brought benefits to introducing new solutions to the traditional environment and traditional therapies. Sustainability in relation to design has been suggested in 2006, by the Center for Building Performance and Diagnostic (CBPD) at Carnegie Mellon University to incorporate daylight, solar, heat and ventilation of the natural environment combined with the innovations of current technologies (Whitmore, 2011). This paper will look at how sustainability plays a key role of benefits including those that are health associated with equine therapy design and its relationship to the patient, or end user. Interdisciplinary research in the therapeutic value of equine-human bonding …

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 …

A Community Grant Application To Support People With Dementia And Their Caregivers, Jessica Montomery

Occupational Therapy Capstones

In upcoming years, the population of older adults with dementia is expected to rise exponentially, with the expectation that the majority of these individuals will choose to age in place with increased caregiver support (AARP, 2011; National Alliance for Caregiving, 2009; Vincent & Velkoff, 2010). Without adequate education to prepare for the caregiving role, education, instruction, and support, informal caregivers are at an increased risk for caregiving burden, stress, and mortality rates (Morimoto, Schreiner, & Asano, 2003; Schulz & Beach, 1999; Thinnes & Padilla, 2011). The goal for this scholarly project was to create a home and community-based program for …

Is Horticultural Therapy A Safe And Effective Treatment In Reducing Agitation For Dementia Patients In Nursing Homes?, Renee J. Chiodo

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not horticultural therapy is a safe and effective treatment in reducing agitation for dementia patients in nursing homes.

STUDY DESIGN: Review of three English language primary studies published between 2008 and 2010.

DATA SOURCES: Two randomized control trials and a case series, which compare horticultural therapy to the use of traditional therapy methods.

OUTCOMES MEASURED: The primary outcome measured in all three studies focus on the level of agitation in dementia patients. Secondary outcomes also included efficacy of sleep as well as level of cognition. …

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. …

Intraspinal Tumor Associated With Hydrocephalus: A Casereport, Sheng-Hsiang Su, Kuo-Sheng Hung, Jen-Wen Hung

Rehabilitation Practice and Science

Intraspinal tumor associated with hydrocephalus is a well known but uncommon phenomenon. It is difficult to diagnose accurately if clinical hydrocephalus symptoms are presented, comprising unsteady gait, urinary incontinence, dementia, headache and papilledema. The patient in this study was a 77 years old male whose main problems included impaired walking, dementia and delirium. He received V-P shunt because of brain CT disclosing communicating hydrocephalus. Patient consciousness improved following operation, but bilateral lower limb weakness became worse. Following spinal MRI examination, an intraspinal tumor at L1 level was noted. The patient underwent laminectomy and partial tumor removal, but metastatic intraspinal adenocarcinoma …

Cognitive Rehabilitation In Occupational Therapy For Individuals With Dementia, Sheila Kemnitz-Hartje, Michelle Theis

Occupational Therapy Capstones

No abstract provided.

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 …

Dementia Management: An Occupational Therapy Home-Based Intervention For Caregivers., Mary A. Corcoran, Laura N. Gitlin

Department of Occupational Therapy Faculty Papers

This paper describes an occupational therapy intervention designed for family caregivers of persons with dementia. The intervention, based on the framework of a competence-environmental press model and the principle of collaboration, was implemented during 5 home visits. Each visit was designed to build caregiving skills through collaboration in identifying problem areas, developing and implementing environmental strategies, and modifying management approaches. A case vignette illustrates the therapeutic process and outcomes. The theoretical rationale and structure of the intervention and innovative documentation for evaluation of the theoretic process are also presented.