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Summary Occupational Therapy
for People with Dementia
Background and study question
Dementia impairs memory, causes behavioral problems and leads to loss of
initiative and independence. The ability to master the demands of daily living
is negatively affected, as is participation in social activities. Dementia is
a chronic degenerative disease. Dementia progresses in stages and is generally
not curable. Dementia has far reaching consequences for patients and
their caregivers, who are often relatives. Occupational therapy aims to enable
patients with dementia to master activities of importance to them and
to support caregivers. The project aims to analyze evidence for the effectiveness
of occupational therapy for patients suffering from dementia.
Methods
During initial research of the issue it turned out that a (single) recent and
comprehensive review of the evidence for occupational therapy’s effectiveness
for patients with Alzheimer and related dementias was available. These
results are presented with a focus on evidence from controlled trials. In addition
two RCTs on an outpatient program of occupational therapy in the
Netherlands and its implementation in a German context are presented.
Results
In the context of patient and (family) caregiver occupational therapy constitutes
a complex social intervention. These are generally difficult to transfer
between settings and countries. If systematic reviews and meta-analyses
summarize evidence of different interventions from different settings it is
very challenging to draw conclusions on the effectiveness of a particular intervention
in a particular setting. Most of the available evidence on occupational
therapy is from the inpatient sector and shows that certain occupational
therapy interventions may tend to have certain positive effects on patients
and their (family) caregivers. It is unclear which occupational therapy
interventions are the most effective and how often they have to be performed
in order to achieve a given effect.
Conclusion
Research into the effectiveness of occupational therapy for elderly people
suffering from dementia is warranted. A better understanding of intervention
details and of how to calibrate interventions to individual patient needs
is necessary. This research would need to harmonize its methodology in order
to adequately evaluate the complex construct of activities of daily living.
dementia with far
reaching consequences
for patients and (family)
caregivers
question of
effectiveness of
occupational therapy
recent and
comprehensive review
found …
… and presented with
results of 2 outpatient
RCTs
some evidence for
positive effect of
occupational therapy on
dementia …
… details of optimal
intervention, intensity
and setting remain
unclear
further research needed
to understand impact of
occupational therapy on
activities of daily living
of people with dementia
LBI-HTA | 2012 9