Blue Sky Therapy Blog

Role of Therapy in Dementia Patients

by Lana R. Dorffer, M.A. CCC-SLP, DCS
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According to Alzheimer’s Disease Facts and Figures (2019), Alzheimer’s is the sixth leading cause of death in the United States, more than breast cancer and prostate cancer combined.

Alzheimer’s disease affects more than 5.8 million people each year (Alzheimer’s Facts and Figures, 2019). Although there is no cure for Alzheimer’s disease at this point, there are strategies that can be implemented to improve daily function and interaction and help to prevent hospitalizations.

Therapy is one of those strategies. Therapy teams play an integral role in determining the current cognitive stage for each patient and then working with family members and staff on developing a functional program specific for that patient. In order to properly care for patients with dementia and educate the entire interdisciplinary team, Blue Sky Therapy created an abilities program, MIND, that is based on the Dementia Care Specialists premise. Extensive training and education are provided to both the therapists and care partners within a facility to ensure protocols across the board. Our goal is for every resident experiencing dementia symptoms to have a functional program developed that is customized to help achieve the “best ability to function” and decrease “excessive disability”.

 

Below is an overview of the MIND program:

  • Comprehensive interdisciplinary approach
  • Promote independence and quality of life
  • “Best Ability to Function”
  • Collaboration with care partners on approach and methods to address behaviors (positively impact and redirect negative reactions)
  • Development and implementation of customized maintenance plans for each resident
  • Collaboration regarding management of pain and psychotropic medications

 

The MIND program is based on the following objectives:

 

Objective 1: To provide a comprehensive interdisciplinary approach for patient’s in long term care facilities/skilled nursing facilities with cognitive conditions.

Objective 2: To enable each resident of each facility to achieve and maintain their “Best Ability to Function” and promote as much independence and quality of life as possible.

Objective 3: To teach all care-partners what the resident’s cognitive stage is and how to best approach and interact with the resident to better meet their needs and therefore, decrease negative responses.

Objective 4: To provide functional maintenance programs for each resident with a decline in cognitive function, to provide ll care-partners with clear, concise instructions to promote resident independence.

The education behind the MIND program was developed from the Dementia Care Specialist program of “Dementia Capable Care”.

 

Below is the theoretical framework for the approach:

 

Cognitive Disabilities Model (Claudia Allen, OTR)

  • Identifies the Best Ability to Function (BATF)
  • Includes 6 Allen Cognitive Levels (ACL)
  • Each level defines remaining abilities

Theory of Retrogenesis (Barry Reisberg, M.D.)

  • Hypothesizes that people reverse develop due to Alzheimer’s disease
  • Compares stage(s) of dementia to developmental ages
  • Functional Assessment Staging Tool (FAST) and Global Deterioration Scale (GDS) describe cognitive decline

Person-Centered Care Approach (Thomas Kitwood, Ph.D.)

  • Emphasizes placing the person with dementia as the focal point of care giving

 

The emphasis is on a paradigm shift from the negative focus on a resident’s disabilities to a positive focus on their abilities. The program promotes working as a team – rehab, nursing, physicians, maintenance, dietary and housekeeping - to enable residents with dementia to achieve their highest purpose and ability to function. Upon discharge, all patients will have a Functional Maintenance Plan which will be designed by the speech therapist or occupational therapist and shared with the nursing staff. The program will identify the current cognitive stage the resident and enable staff to understand how to best interact with the resident. Our hope is that the emphasis of care will be on those remaining abilities for those patients with dementia in addition to providing strategies and education to all caregivers on how to best care and engage with residents with dementia.

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