A diagnosis of dementia needn’t spell the end of an individual’s independence. Occupational therapy can keep people in their own homes for longer with a high quality of life, explains BaptistCare aged care expert Nicole Donohoo.
Living with dementia is a major challenge. Over time, a progressive loss of brain function makes it more and more difficult for people to perform everyday tasks, such as remembering the names and faces of loved ones and thinking clearly. If you suspect your loved one might have dementia, this checklist might be helpful. If they have been diagnosed, please understand that there is hope for them to continue learning.
According to BaptistCare’s Health and Wellbeing Unit Manager Nicole Donohoo, with the right occupational therapy, people living with dementia can enjoy a high quality of life – and even reclaim some of their lost skills.
“In the past, we used to think that once someone had dementia, they lost the capacity to relearn,” says Nicole. “But there’s now some really significant evidence that shows if people concentrate on one particular component of a task and practise it with carer support, they do have the capacity to learn. This therapy approach is referred to as ‘re-ablement’ and has been shown to assist people in improving or re-gaining their independence to do meaningful, everyday tasks such as cooking or cleaning their teeth.”
Assessing and addressing the problem
Nicole explains while the name might suggest therapy for work injuries, occupational therapy (OT) is all about helping people of all ages to return to their regular daily activities after illness or injury.
People with early-stage dementia tend to become forgetful, to lose their train of thought when talking and may have difficulty handling money. Those with moderate dementia might become confused about times and places, may neglect their hygiene and forget the names of family and friends. Late-stage dementia can involve incontinence, the loss of speech and significant memory loss.
Nicole says occupational therapy for people living with dementia typically involves an assessment in the person’s home. An occupational therapist will speak to the person and their carer about what skills and abilities they have lost and then work out strategies to improve the situation.
“For someone who is having difficulty with showering and dressing, the problem might be that they can’t remember where the bathroom is. So, we might put up a sign,” Nicole says. “Or if it’s too unsafe for them to stand in the shower, we might put a shower chair in place. If they can’t remember the sequence of events involved – that they need to get undressed first – they may need to relearn and practise particular steps within a task.”
Memory aids can help
Nicole says often a solution lies in simplifying parts of a process to make it easier for the person living with dementia to manage. “It may be that they can’t undress because they are finding buttons a problem,” she says. “So the use of clothing with zippers may be recommended instead. For a person in the early stages of dementia where memory loss is becoming a problem, we might focus on memory aids. So, we might encourage them to use calendars, medication reminders, and different types of apps if they have a smart phone they are familiar with. So, they might have an alarm go off that tells them to eat or to call their daughter.”
While living with dementia is a challenging experience, Nicole says OT can make a huge difference. “It’s all about keeping people at home, so they can remain in their own environment for as long as possible. Without OT, they might potentially be admitted to a residential aged care facility earlier, which is typically not their first wish.”
Carers benefit too
Occupational therapy can also include providing support, care and counselling to carers. Therapists will provide advice on how to manage changed behaviours, how to safely manage and move loved ones, and how to reassure people with dementia. Carers are also instructed on the benefits of taking a break and respite care – crucial issues given they can be prone to stress, anxiety and depression. “Sometimes, it may not be possible to change the person’s behaviour,” says Nicole. “But we can help the carer through education, support and other services.”
3 OT tips for carers looking after people with dementia
Simplify the environment. Distractions and clutter can confuse people living with dementia. If they are on the way to the toilet and run into a hall table, they can get distracted from that task.
Engage support early. Often carers struggle for a long time by themselves and by the time OTs become involved the person has advanced dementia and the potential for retraining is minimal.
Don’t help out with tasks too early. It can be painful to watch a loved one struggle with a task. But provided there’s no risk to their safety or dignity, allow them to soldier on. They will lose skills they don’t use, reducing their independence and increasing your workload.
If you or someone you love is already a BaptistCare customer, ask your Care Facilitator for more information about BaptistCare’s occupational therapy services for dementia. Otherwise, contact us to speak with a BaptistCare advisor on 1300 275 227 or visit www.youchoose.org.au.