Public Release: 

Home-based activity program helps older veterans with Dementia maintain function

American Geriatrics Society

People with dementia often have behavioral symptoms. These include problems with memory, language, and decision-making abilities. People with dementia can also experience changes in mood, such as increased irritability, depression, and anxiety. They often need assistance with their daily activities, such as feeding, dressing, using the toilet, and bathing themselves. These symptoms are often troubling for people with dementia, as well as for their caregivers.

These dementia symptoms can reduce quality of life for people as they age. This can make them dependent on other people, which can lead to caregivers feeling distressed. It may also lead to people with dementia being hospitalized or placed in a nursing home, even if it is not what they would prefer for their care.

There are no effective drug treatments for dementia or its symptoms. Therefore, researchers have been exploring treatment options to improve symptoms that don't involve using medication. A team of researchers studied one of those programs, called the Tailored Activity Program (TAP). TAP matches activities to the interests and abilities of people with dementia. Then it teaches caregivers how to use those activities daily.

The researchers initially reported positive results in a small study of 60 people. They then studied TAP in a larger group of veterans living with dementia. They reported their results in the Journal of the American Geriatrics Society.

The researchers studied 160 veterans diagnosed with dementia and whose average age was 80. The study also included 160 of the veterans' caregivers, who were mostly women around 72-years-old.

TAP included up to eight in-home sessions led by occupational therapists (health professionals who focus on helping us participate in the activities of everyday life). During the first two sessions, these health professionals evaluated the veterans' risk for falls, their daily routines and habits, and their previous and current interests. They also examined the veterans' home environment, including lighting, seating, clutter, and noise. They looked as well at the interests and abilities of the veterans' caregivers. Based on the assessment, the therapists provided an "assessment report" and offered three "activity prescriptions."

The therapists showed the veterans and caregivers how to set up the activities and use them every day. They also provided written instructions for the caregivers. The instructions covered activity goals for the individual veteran and communication strategies for the caregiver. They also instructed caregivers on ways that they could modify the home environment to help the veteran participate in the activity. The therapists worked with the veterans to show the caregivers how to use activities. They had caregivers practice recommended communication strategies. They also provided on-going education to help caregivers understand dementia and its behavioral symptoms.

During the last two sessions, caregivers learned how to simplify activities as the veterans' abilities declined. They also learned strategies to make care challenges like bathing easier.

A control group of caregivers received eight telephone sessions with a trained research team member who offered caregiver education about home safety and dementia. The researchers did not offer information about activities or behavioral symptoms to this group.

After four months, nearly 70 percent of the veterans in the TAP group either eliminated or reduced the frequency and severity of their dementia-related behaviors. This is compared to 46 percent of the veterans in the control group. Also, caregivers in the TAP group reported that the veterans were less dependent on them as they performed their daily activities. Caregivers in the TAP group reported less distress due to the veterans' behaviors, too.

The researchers concluded that TAP offers immediate benefits to the veterans and their caregivers.

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This summary is from "Targeting Behavioral Symptoms and Functional Decline in Dementia: A Randomized Clinical Trial". It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Laura N. Gitlin, PhD; Paul Arthur, PhD, OTR/L; Catherine Piersol, PhD, OTR/L; Virginia Hessels, BA; Samuel S. Wu, PhD; Yunfeng Dai, MS; and William C. Mann, PhD, OTR.

About the Health in Aging Foundation

This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit http://www.HealthinAgingFoundation.org.

About the Journal of the American Geriatrics Society

Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging insights on principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most impactful publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.

About the American Geriatrics Society

Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has -- for 75 years -- worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.

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