The onset of dementia is usually gradual and coincides with decreased short-term memory, decreased problem solving skills, decreased perceptual skills, and personality changes. Persons with dementia require more assistance from others and may eventually become completely dependent.
An occupational therapist is trained to evaluate persons with dementia to address how the condition affects participation in daily activities. Intervention focuses on compensation and adaptation. Adapting the home environment using supportive modifications is the most frequently used intervention for persons with dementia.
Research has found that environmental factors such as lighting, color, and noise have an effect on the behavior of a person with dementia. Specific home modifications have been shown to be beneficial in reducing behaviors. For example, low levels of light during meals improve eating habits, reducing distracting clutter on countertops and floors, pleasurable music or nature sounds, and removing mirrors and pictures with reflective glass decrease agitation.
The occupational therapist can educate the family members and other caregivers about the stages of dementia. During the early and middle stages of dementia, occupational therapy may provide a home safety evaluation and educate the caregivers how to help the person stay engaged in personally meaningful activity. The therapist will determine what is working well in the daily routine and recommend how caregivers can provide support to ensure the individual’s abilities are maintained as long as possible. For example, setting up a limited clothing selection that is appropriate for the season allows the person to maintain a sense of personal control.
In the later stages of dementia, the occupational therapist will focus on decreasing caregiver burden. The person may be having difficulty with toileting, bathing, and mobility. The occupational therapist can teach safe transfer techniques, skin protection, and enjoyable sensory stimulation. The therapist may recommend durable medical equipment including off-the-shelf or customized equipment to ensure safety for both the person with dementia and the care provider.
For additional information regarding occupational therapy and home modification interventions, contact:
Nancy Dillinger, OTR, SCEM, ATP
AOTA Environmental Modification in SCEM
American Occupational Therapy Association, 2012.