According to the Alzheimer’s Association, “Treatment of dementia depends on its cause. In the case of most progressive dementias, including Alzheimer’s disease, there is no cure and no treatment that slows or stops its progression.”
Therapy services can be beneficial to a person with dementia at all stages of the disease. Occupational, physical and speech therapy can be provided throughout the disease process to help maximize independence, manage day-to-day activities and assist with caregiver training. Although remediation of cognitive performance is unlikely, therapy can determine the recommended approaches, adaptive equipment and modifications necessary to help a person function at his or her highest level of ability. Each therapy discipline has its area of expertise to support patients through the different stages of the disease.
• Occupational therapy provides activity analysis of day-to-day activities to determine an individual’s strengths, impairments and areas needing intervention. An occupational therapist can determine what is working well within a daily routine and provide support to ensure that skills are maintained for as long as possible. Modifications, environmental changes and adaptive equipment are used to ensure safety through the daily routine. OT can provide caregiver training to assist with challenging behaviors that are common with bathing, dressing and toileting during the mid-stages of dementia.
• Physical therapy benefits individuals by keeping them active, which in turn, improves overall physical function, mood, stress, restlessness and agitation. A physical therapist assesses an individual’s ability to walk safely and addresses concerns with balance, muscle strength, mobility, pain management and fall risk. PT can provide safe physical activity, including exercise, to improve mobility, as well as getting out of a chair or a car. A person does not need to remember having participated in an exercise program to reap the benefits of the activity. During the later stages of the disease, a physical therapist can determine wheelchair and cushion recommendations to maximize comfort and function for seating and positioning.
• Speech and language therapy assesses cognitive, communication and swallowing abilities to determine appropriate strategies to help manage difficulties. A speech therapist addresses the cognitive aspects of communication, such as attention, memory, sequencing and problem solving, and makes recommendations to preserve communication and cognitive functioning for as long as possible. The use of written cues, memory books and training caregivers on how to best communicate are ways that speech therapists help individuals function at their highest level. A speech therapist also assesses swallowing and can alter a person’s diet to minimize choking risks.
Nathalie Descheneaux and Christel Lewis-Brown are Maine-based, registered, licensed occupational therapists.