How To Improve Dementia Care Management; Let’s Start With The Care Givers
At the time of writing this post, the Australian Government has announced a Royal Commission into Aged Care, no matter where you see this announcement politically, it represents an opportunity to improve dementia care management.
For many people living with dementia, they don’t reside in an Aged Care Facility but in the home, often with family and loved ones supporting them, stride by stride as the condition plays out for that family unit.
Dementia, isn’t just an experience of memory loss, but a host of symptoms which may commonly impact behaviour and function. You see, a change in behaviour can be a significant challenges and a source of stress for the family and carers. That’s where a dementia occupational therapy assessment can help.
Behavioral and psychological symptoms of dementia (BPSD) are often considered to be the greatest challenge in dementia care, leading to increased healthcare costs, caregiver burden, and placement into care facilities. For family at home carers, there’s a reported increase in stress and depression and reduce overall quality of life.
The host of medications that a person may take as a result include anti-psychotic, antidepressants, mood stabilizer, sleep or sedative medication. However, research is painting a very clear picture that environmental, behavioral and activity approaches are more efficient especially as they are tailored to the person and their unique needs.
So what can we do to improve dementia care management?
According to Helen Kales of Programs For Positive Ageing, has a model called D.I.C.E.
DICE is an acronym for a behaviour management.
- D- Describe a behavior, thinking about what happens and the context in which it occurs
- I – Investigate its possible causes
- C- Create and implement a plan to address the behavior
- E – evaluate the results to determine what worked
Dementia Australia has a similar recommendation about identifying triggers, investigating the triggers or antecedent conditions then implement tailored solutions and see if they work. But is that it? The problem of most programs is the breakdown of identification to the tailoring of the right, personalised program. A thorough OT dementia assessment should initial identify this and where required, go deeper.
That’s where new programs are emerging, and showing positive results for people living with dementia as well as their caregivers.
The Use of Purposeful Activity To Improve Dementia Care Management.
The use of purposeful activity as a non-pharmacological intervention for people with dementia has shown promise for enhancing quality of life (QOL) and reducing behaviors such as agitation and depression.
In particular, activities tailored specifically to a person’s own interests and functional level generate greater levels of engagement.
Implementing the Tailored Activities Program for people with dementia and their caregivers living at home – i-TAP (Australia) is drawn from the inspiring work of Gitlin and associates, who showed that TAP intervention had positive impact to both the person living with dementia and also their caregiver.
iTAP involves an occupational therapist (OT) working with both the caregiver and the person with dementia through tailoring activities (which could include leisure activities or activities of daily living (ADLs) depending on the individual) to the capacity, interests, and roles of the person with dementia. TAP also involves working closely with caregivers for effective implementation.
The key here is personalisation, goal orientated and meaningful. Meaningful to the extent that it matters for the person with dementia and their caregiver.
This aligns to our Better Skills At Home Program– which is a goal oriented program of targeting certain activities in the home, working with caregiver and client living with dementia. An approach which fuses a lifestyle, activity and caregiver skill development for the goal of improve quality of life and greater self efficacy,
The benefits observed by caregivers and clients using TAP and similar programs include:
- Increased self efficacy
- A sense of increased mastery by all involved
- Meaning there is a great time for the person living with dementia engage in meaningful tasks rather than being distressed and seeking continual verbal, environmental and physical support.
There is no doubt a significant need to see the expansion of these programs given the current state of our aged care system in the home and the distress that many family’s experience.
We’d like you personally see programs to be not only adapting to the changes in people but also offering lifestyle and evidenced based dementia therapy as well.
Interested in an Occupational Therapy For Dementia Consultation?
Get in touch with us today on 1300 783 200 and arrange a time to speak with a senior therapist. Alternatively, get in touch by filling out the contact form here. Scheduling a free phone consultation helps determine right away if our services will be of assistance to you and your situation. If you’d like more information regarding our OT Dementia Assessment Services where this article outlines what you can expect as we offer in clinic, at home and online dementia assessment consultations
- Predicting Care giver burden and depression in Alzheimer’s disease. https://www.ncbi.nlm.nih.gov/pubmed/10728125
- Use of the Tailored Activities Program to reduce neuropsychiatric behaviors in dementia: an Australian protocol for a randomized trial to evaluate its effectiveness: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4091660/
- Dementia Support Australia: https://www.dementia.com.au/
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