Help for Dementia Patients, Caregivers
Tailored, In-Home Occupational Therapy Helps Both Patients and Caregivers, Study Shows
Nov. 16, 2006 -- Occupational therapy tailored to individual needs improves
the lives of dementia patients and their caregivers, a Dutch study shows.
Patients with mild and moderate dementia lose the ability to perform many of
the tasks that earn them pleasure, a sense of accomplishment, and the
appreciation of others. This loss of ability frequently frustrates and often
exhausts their caretakers.
In-home, individually tailored occupational therapy can help, find Maud J.L.
Graff and colleagues at University Medical Center Nijmegen in the
Graff and colleagues developed an occupational therapy strategy that targets
dementia patients as well as their caregivers.
The therapists spend time with each patient/caregiver pair. They offer
specific education, set feasible goals, and help the patient/caregiver adapt to
or change their physical environment.
They also work with the pair to change dysfunctional ways of thinking about
the patient's behavior and the caregiver's role.
The process takes time. Treatment consists of 10 one-hour sessions over five
Does it work? Graff and colleagues tested the program in 135 over-65
patients with mild to moderate dementia and their primary caregivers.
The patient/caregiver pairs were randomly assigned to treatment or no
treatment (those in the no-treatment group received treatment at the end of the
Both six weeks and three months after treatment, three-fourths of the
patients had improved motor skills. More than four-fifths required less
assistance in daily tasks.
And the caregivers felt significantly more competent that those who did not
participate in treatment.
This effect is larger than that seen in any drug trial or other psychosocial
intervention, Graff and colleagues say.
"We believe that the benefit was sustained because a component of the
intervention was to train caregivers in providing the supervision patients
needed," Graff and colleagues say.
"The intervention also provided individualized support to caregivers,
which earlier studies have also shown to be effective," the researchers
Though the therapy is time-consuming, Graff and colleagues suggest it pays
off in delayed institutionalization and lower need for health care
The study appears in this week's online edition of BMJ, formerly
the British Medical Journal. A case history and detailed description
of the therapy appears in the November issue of the journal Dementia.