Alzheimer’s disease, vascular dementia, mixed dementia, and other forms of dementia cause much more than just memory loss. Patients may also experience difficulty communicating, wandering or getting lost in familiar places, struggling with everyday tasks, and having problems with posture and balance.

Occupational therapy (OT) can help with many of these problems. Occupational therapists work with patients and their loved ones to offer practical advice and techniques for better and healthier day-to-day living.

However, there are many aspects of dementia that occupational therapy cannot address. At Neural Effects, we believe patients can benefit further by combining occupational therapy with a range of other therapies, such as physical and cognitive therapy. Studies show this combination can delay the progression of symptoms, allowing patients to live independently for longer.

In this post, we’ll cover:

Why occupational therapy is beneficial for dementia patients
How occupational therapy exercises help dementia patients
How occupational therapists modify treatment based on disease stage
Why combining occupational therapy with other therapy modalities is even better

Neural Effects uses the latest evidence-based techniques to diagnose and help dementia patients. We are located in Provo, Utah, and serve anyone in Salt Lake City or the Utah Valley area. We are in network for most types of medical insurance. Schedule your evaluation today.

Is Occupational Therapy Beneficial for Dementia Patients?

Occupational therapy for dementia helps patients in many ways!

Occupational therapy can be an important source of support for dementia patients and their families. In general terms, an occupational therapy practice offers supportive strategies to help patients maintain independence for as long as possible. Therapists work directly with patients and caregivers to make the patient’s habits and environment safer and more conducive to independence.

For patients in the early stages of the disease, occupational therapy involves providing ways to delay the loss of cognitive skills and function, allowing patients to live independently for as long as possible. When independent living is no longer an option, occupational therapists can continue to provide support for caregivers and family members to help them look after their loved ones with dementia.

Occupational therapists may help patients in many ways:

Communicating and expressing ideas
Eating and drinking
Maintaining personal hygiene
Putting on clothes
Bathing
Using the bathroom
Sleeping
Moving
Preventing falls
Engaging in physical activity
Encouraging social interactions
Protecting cognitive skills
Solving problems
And others

Over the past several decades, many clinical trials and research studies have looked at how occupational therapy can help patients and their caregivers combat the symptoms of dementia. The overwhelming majority concluded that occupational therapists are in an ideal position to help dementia patients. Some of the most notable benefits observed across studies and systematic reviews include:

Reduced behavioral and psychiatric problems
Reduced burden on caretakers and/or family members
Improved well-being and quality of life
Slowed cognitive decline
Increased social participation
Helped patients cope with daily activities
Improved physical and motor function
Reduced risk of falls
Improved driving skills (in early-stage patients)
Reduced incidence of delirium (in late-stage patients).

How Can Occupational Therapists Help Patients With Dementia?

Occupational therapists can assist dementia patients either in a care facility or in the patient’s home. According to the American Occupational Therapy Association (AOTA ), the role of occupational therapy for dementia patients can be categorized into four key types:

Modification — This is the most common form of therapy for dementia patients. Occupational therapists suggest modifications and adaptations to the patient’s home and daily activities to ensure a safe and supportive environment for patients.
Maintenance — Occupational therapists can develop ways to support the patient’s routines and daily habits. For example, placing signs on drawers and cupboards or storing seasonal clothing in wardrobes can help the patient find items.
Health Promotion — It’s crucial to maintain the patient’s health as long as possible, including aspects such as physical strength, cognitive awareness, and emotional stability. Occupational therapists are trained to develop strategies to improve or maintain wellness, such as by encouraging regular exercise and promoting a healthy diet.
Remediation — Although remediation (improvement) of cognitive skills is not expected for most dementia patients, occupational therapists use physical and cognitive exercises to delay the progression of symptoms, increase functional mobility, and help restore range of motion, strength, and endurance.

In practical terms, occupational therapists identify the areas where patients are struggling — such as dressing, bathing, or preparing meals — and help them find ways around their problems using a combination of these four strategies. The aim is to help them not only with physical tasks, but also to provide dementia patients with the “tools” to retain their cognitive and emotional functioning for as long as possible.

A few examples include…

Help patients complete daily tasks

Occupational therapists can suggest a range of activities to help patients continue their everyday activities, such as dressing and meal preparation, as their condition advances.

Therapists consult with patients to identify areas where they are struggling and help to find ways around these. Examples include using detailed, step-by-step instructions written on a whiteboard or setting up reminders on their mobile phone. Occupational therapists also aim to provide practical advice, techniques, and strategies to train family members and caregivers directly.

To help with daily tasks, therapists may also recommend physical exercises to help maintain mobility, endurance, range of motion, and strength.

As the disease progresses and patients can no longer live by themselves, occupational therapists can help find ways to make them feel useful and set up simple tasks at home, such as folding towels or helping set the table.

Suggest home adaptations

Occupational therapists also work with patients and their families to make their environment a safe place.

Therapists can suggest adaptations or modifications with useful equipment like dementia clocks, grab bars for the bathroom, or a power-riser recliner chair. In the long term, therapists may also suggest ideas to ensure the patient’s home will meet their needs both now and in the future. This will include considering adaptations such as stair lifts or an outside ramp if the patient is likely to need a wheelchair.

Develop strategies to help with memory

Occupational therapists also manage short-term memory loss. This may include reminiscence therapy, where patients are encouraged to share life stories to connect with family members and friends. As the disease progresses and patients start to struggle to talk, occupational therapists can help patients find ways to communicate with their loved ones.

Help plan a routine for the patient

Having a strict daily routine can help structure the day and provide stability for the patient. An effective routine helps make sure patients do what they need, such as taking meals and medications on time.

Occupational therapists assess what works for the patient and provide support to caregivers to ensure that the person’s skills are maintained for as long as possible.

Help with behavioral problems

Performing daily tasks becomes increasingly difficult as the disease progresses. Not surprisingly, patients get easily frustrated and irritated. It may also lead to embarrassment, aggravation, and anxiety. Those feelings can sometimes lead to a meltdown or aggressive behavior.

Occupational therapists can help simplify tasks or find alternative ways to do them to reduce the levels of stress, agitation, and anger.

Reduce care needed

While occupational therapists can’t cure a patient’s decline in cognitive skills, they can help delay the progression of symptoms through a variety of ways, such as breaking tasks down into smaller chunks or reteaching life skills.

When occupational therapists provide structure to help the patient perform even simple tasks, the caregiver needs to be less involved. For example, the therapist may recommend a bench for the bathroom so that it’s easier for the patient to come out of the shower. This reduces the amount of time that the caregiver needs to spend helping with hygiene.

Promote social participation

Dementia can be hard on relationships. It’s common for patients to lose contact with friends and family and isolate themselves at home because they’re too afraid of making mistakes in public.

Occupational therapists can look at how this behavior affects the patient and recommend possible solutions. For example, if the patient is embarrassed after a fall, the therapist may suggest some physical exercises to improve strength and fitness.

Help and support family and friends

On top of practical advice and guidance for the patient, occupational therapists also work with caregivers and family members. Many people who end up in a caregiver role have little to no experience but need to care for a loved one. It’s also common for caregivers to experience chronic stress, emotional and physical exhaustion, and reduced social interactions.

Occupational therapists can provide support and teach care providers how to cope and manage stress, how to improve their caregiving skills, and how to improve their own quality of life. It’s vital that caregivers realize that they need to take care of themselves and make themselves a priority too.

Occupational Therapy Changes As Symptoms Progress

Occupational therapy interventions for dementia patients vary greatly depending on the stage of their condition. Dementia care in the early stages of dementia will be different from care in the later stages of dementia.

Early-Stage Dementia

During the early stages of dementia, patients are usually able to function in a job and carry out their everyday activities. They may start to notice that they forget simple things, such as where they left the car keys or whether they’ve taken their medication. Patients may feel they don’t need much help, but this is the ideal stage to integrate occupational therapy into their lives.

Occupational therapy interventions for these patients typically include learning how to use memory aids, such as calendars, reminders, alarms, or checklists. These help the patient get in the habit of using compensatory habits and tools. If they can establish a routine at this stage of the diagnosis, they are more likely to maintain their cognitive abilities and remain independent for longer. There is some evidence to show that involving caregivers in this process improves patient independence and reduces caregiver burden and stress.

Middle-Stage Dementia

As the disease progresses to the middle stage, patients will start to have more pronounced symptoms. They will experience a more significant decline in memory and cognitive function, and they may start to struggle with activities of daily living, such as dressing, bathing, or going to the toilet.

During this period, occupational therapists will focus on retraining ADLs, as well as balance, posture, and mobility, to help the patient maintain independence and reduce the burden on caregivers. Repeating the same activity, same sequence, same time, and same place can help patients to remember better. If possible, performing personal care training in the patient’s own living area is also more beneficial than doing simulated activities in the gym.

Therapists will also advise family caregivers not to take over and help with everything, as this doesn’t allow the patient to keep their routine and may lead to a faster decline of cognitive abilities and basic self-care skills. Instead, caregivers must encourage the patient to do as much as possible to protect their independence.

Late-Stage Dementia

In the later stages of dementia, patients will show not only a severe decline in cognitive skills and functional abilities but also will have lost any sense of space and time. This means patients will be highly dependent on caregivers for the majority of daily activities, such as feeding, bathing, and toileting.

Late-stage occupational therapy services focus mainly on providing positive sensory stimulation for the patient and increasing their comfort, as well as teaching caregivers about gentle exercises to do at home with the patients and ways to avoid skin breakdown if the patient is bed-bound.

In addition, it’s not unusual at this stage for caregivers to experience stress, depression, and exhaustion. Occupational therapists can recommend support groups with other families who are going through the same situation.

Treatment at Neural Effects

Example of an exercise at Neural Effects

At our clinic, we primarily treat patients with mild cognitive impairment (MCI) and early stages of dementia.

Before treatment starts, patients undergo a neuropsychological exam (also called a neurocognitive evaluation) to find out what kind of cognitive and memory problems they have. This examination looks at memory, attention, executive function, and many other cognitive skills. All patients need to complete this assessment even if they already have a diagnosis.

Our healthcare providers also carry out a physical examination to assess reflexes, eye movements, balance, posture, and how well your senses are working, as well as a mental health evaluation to check if you’re experiencing any signs of anxiety, depression, or stress.

Once all these exams are completed, you and your caregivers will meet with our team to discuss the results and treatment possibilities.

While we recognize the value of occupational therapy for dementia patients, we also know it’s more effective in combination with other types of therapy, especially in the early stages of the disease. At Neural Effects, we offer a treatment program which uses multiple therapies — including occupational therapy — to offer better long-term results for patients and further delay the progression of symptoms. Therapies we use during treatment include:

Cognitive therapy
Neuromuscular therapy
Occupational therapy
Vision therapy
Vestibular therapy
Physical therapy.

Our therapists are trained to offer a variety of games and activities. Patient visits include sessions of aerobic exercise on a treadmill or stationary bike, followed by word and number games, balance exercises, or activities to improve or maintain cognition.

For example:

Our therapist may ask you to make up a short story from a series of picture cards, then test your ability to remember them in order.
You can play a word guessing game, where our therapist thinks of a four letter word, and then you try to guess it by suggesting your own four letter words. For each word you suggest, our therapist will tell you how many letters are correct and how many are in the right position. The game continues until you correctly guess the word.
Our therapist may ask you to read a short text or look at some images. Afterward, you will have to answer questions about it.
You can play a card game to sort all four suits into piles. You need to memorize the sequence of suits, then turn the first cards face-down, and sort remaining cards into piles while remembering which ones go where.

Caregivers and family members can attend your sessions with you so that they can learn the exercises and help you at home. At the end of each session, our therapist will meet with you to give you exercises to do at home. Completing these exercises will significantly improve the overall effect of therapy.

Finally, all of our staff are extensively trained to help dementia patients and can offer advice and answer any questions you may have about your diagnosis and treatment. We keep informed about new developments in neuroscience and will convey any helpful and further information to our patients and their families.