HOME-BASED ACTIVITY SUPPORT FOR DEMENTIA CARE PARTNERS Jennifer L. Womack 1,2
1 Division of Health and Rehabilitation, Department of Health Sciences, Luleå University of Technology,
Luleå, Sweden; jenwom@ltu.se
2 Division of Occupational Science and Occupational Therapy, University of North Carolina at Chapel
Hill, North Carolina USA
Background:
The majority of persons with Alzheimer’s disease and related dementias (ADRD) live at home, either by themselves or with caregivers (Dooley & Hinojosa, 2004; Nygard & Starkhammar, 2003). High levels of stress for caregivers can result as they cope with the difficulties of caring for a person with increasing dependence (Dooley & Hinojosa, 2004; Graff et al., 2006). Persons with ADRD and their caregivers are often involved in medical processes but appear to have less access to are training programs focused on activities of everyday living that take place in the home (DiZazzo et al,2014).
Assessment / Intervention/ Technique:
Strong evidence exists that inter-professional home-based interventions (e.g. occupational therapy and social work) are effective in improving behavioral management as well as BADL and IADL performance of older adults with different functional abilities, including those with ADRD (Zidén, Frandin, & Krueter, 2008). The program described in this session consists of in-home customized activity interventions designed by an occupational therapist with enhanced support provided by social work.
Evaluation of outcome:
In similar programs, older adults with chronic conditions participating in multi-component home interventions had reduced functional difficulties, improved confidence and independence in IADLs, and greater improvement in functional activities as compared to those who did not receive home-based support (Gitlin, et al., 2008, 2006).
Application to practice:
The implementation of a modified in-home activity program in a county in North Carolina, USA, is offered as a model for similar services that could be developed in other locations.
DiZazzo-Miller, R., Samuel, P. S., Barnas, J. M., & Welker, K. M. (2014). ‘Addressing everyday
challenges: Feasibility of a family caregiver training program for people with dementia’ American journal
of occupational therapy, 68, 212– 220.
Dooley, N. R., & Hinojosa, J. (2004) ‘Improving quality of life for persons with Alzheimer’s disease and their family caregivers: Brief occupational therapy intervention’ American journal of occupational
therapy, 58, 561–569.
Gitlin, L. N., Winter, L., Burke, J., Chernett, N., Dennis, M. P., & Hauck, W. (2008) ‘Tailored activities to manage neuropsychiatric behaviors in persons with dementia and reduce caregiver burden: A randomized pilot study’ American journal of geriatric psychiatry, 16, 229–239.
Gitlin, L., Winter, L., Dennis, M. P., Corcoran, M., Schinfeld, S., & Hauck, W. W. (2006) ‘A randomized trial of a multicomponent home intervention to reduce functional difficulties in older adults’ Journal of
the american geriatrics society, 54, pp. 809–816.
Graff, M. J. L., Vernooij-Dassen, M. J. M., Thijssen, M., Dekker, J., Hoefnagels, W. H. L., & Olde Rikkert, M. G. M. (2006) ‘Community based occupational therapy for patients with dementia and their care givers: Randomised controlled trial’ British medical journal, 333, pp. 1196– 1201.
Nygård, L., Starkhammar, S. (2003), ‘Telephone use among noninstitutionalized persons with dementia living alone: Mapping out difficulties and response strategies’ Scandinavian journal of caring sciences, 17: 239–249.
Zidén, L., Frandin, K. & Kreuter, M. (2008) ‘Home rehabilitation after hip fracture. A randomized controlled study on balance confidence, physical function and everyday activities’ Clinical rehabilitation, 22, no. 12, pp. 1019-33.
