Community occupational therapy for patients with dementia and their caregivers

Occupational therapy can help to improve the ability of people with dementia patients to perform daily activities and can also reduce the pressure on their caregivers, says a British Medical Journal study.

Dementia can have far reaching effects for patients and their caregivers and is a major driver of costs for both health and social care systems across the developed world. The most significant problems associated with dementia are the losses in independence, initiative and participation in social activities – factors which affect the quality of life for both patients and their caregivers and families.

Previous research had suggested that non-pharmalogical treatment could have the same or better effects that drug treatment for people with dementia.

Researchers from The Netherlands set out to measure the effect of occupational therapy on people with dementia and their main carer. A group of 135 patients with mild to moderate dementia and their caregivers were randomly split into two groups. The first group received 10 home-based sessions of occupational therapy - provided by an experienced occupational therapist - over a period of five weeks, whilst the second group received no occupational therapy. The groups were then assessed six weeks and 12 weeks after the therapy sessions.

At both six weeks and three months the patients who received occupational therapy functioned significantly better in daily life than those who did not – with 75% of those in the group showing an improvement in motor skills and 82% needing less assistance in day to day tasks. Primary caregivers who received occupational therapy also felt significantly more competent than those who did not.

The authors suggest that occupational therapy is likely to be more effective than drugs or other psychosocial interventions – as the levels of improvement in their trial outstrip the effects recorded in previous trials of drugs and other interventions.

They add that they ‘strongly advocate' the inclusion of occupational therapy in dementia management programmes; ‘the clinical gains…obtained with occupational therapy for both patients and their caregivers underlines the importance of adequate diagnosis and pro-active management in dementia' they conclude.