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Alzheimer’s Disease and Dementia

DementiaWhy emerging? President Barack Obama signed the National Alzheimer’s Project into law in early 2011, which is a national plan to combat Alzheimer’s disease with the same intensity as previous plans to fight AIDS and cancer.1 The Department of Health and Human Services will now coordinate the nation’s approach to research, treatment, and caregiving related to Alzheimer’s disease. Today there are an estimated 5.3 million Americans with Alzheimer’s disease, and the number is expected to triple by 2050.2 Working with clients with dementia is not necessarily new to the profession, but with the estimated growth in cases in the next few decades, and the evidence that occupational therapy can improve the lives of people with Alzheimer’s disease and their caregivers,3the need for occupational therapy services will expand.

Get Involved! For 13 years, Patricia Schaber, PhD, OTR/L, worked in long-term care and home care with people with many types of dementia, the majority of which was presumed to be Alzheimer’s disease. She then worked in a memory clinic, and she now works in academia with a research agenda focusing on early-stage occupational therapy assessment. “We started a memory clinic based on a model where occupational therapy was an essential team member,” says Schaber. “Physicians are realizing that they need the input of an OT on the team and are seeing the value of an OT assessment. We’re an essential piece of the diagnosis.”

Schaber believes that practitioners need about 6 months of working directly with clients with dementia to understand the differences and types of cognitive processes the client is experiencing. “Hands-on experience is invaluable,” she says. “Any type of experience is good, such as in a memory care unit, an Alzheimer’s unit, or working in the community with people with dementia.” Practitioners can work in adult day services, assisted living facilities, free standing memory care units, or do entrepreneurial work such as cognitive care coaches, says Schaber. Practitioners also need educate themselves through continuing education workshops and online training programs, including how to administer cognitive assessments. “You can administer and score a test relatively easily, but accurately interpreting the score is the piece that OTs in the field need to develop, which takes a long time,” She says. Dementia care is an interesting and rewarding area of practice, she says. “The more the families understand what is happening to their family member, the better they are able to care for that person in their natural environment.”

All occupational therapy practitioners working with older adults need to be aware of the signs of cognitive involvement, says Schaber. She has noticed that acute-care therapists are interested in learning more about Alzheimer’s because they are dealing with clients with physical disabilities as well as a co-occurring diagnosis of Alzheimer’s disease, which sometimes is undiagnosed. “With older adults dementia is a possibility, and if there is cognitive involvement it will impact any other intervention approach,” says Schaber. “We should always have cognitive screening tools in the back pocket that we can whip out in an instant and administer, which might be the basis for referral back to the physician or for further OT cognitive function evaluation.”

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References:

  1. Belluck, P. (2011, December 15). With Alzheimer’s patients growing in number, Congress endorses a national plan. Retrieved June 16, 2011, fromhttp://www.nytimes.com/2010/12/16/us/politics/16alzheimer.html

  2. Alzheimer’s Association. (2011, January 4). Generation Alzheimer’s: The defining disease of the baby boomers. Retrieved June 16, 2011, from http://www.alz.org/boomers/

  3. Gitlin, L. N., Winter, L., Dennis, M. P., Hodgson, N., & Hauck, W. W. (2010). A biobehavioral home-based intervention and the well-being of patients with dementia and their caregivers. Journal of the American Medical Association 30(9), 983–991.