Home-Based Occupational Therapy for Adults With Dementia and Their Informal Caregivers: A Systematic Review

Comparing the effectiveness of individual occupation-based reminiscence therapy at home and in a dementia care centre on cognitive function in older adults with mild dementia: a pilot randomised controlled trial

BACKGROUND

The need for research on individual home therapies to promote continued community-dwelling among older adults with mild dementia is growing. This study aimed to compare the effects of individual occupation-based reminiscence therapy at home (IOBRT-H) and individual occupation-based reminiscence therapy in a dementia care centre (IOBRT-DCC) on cognitive function, depression, and instrumental activities of daily living (IADL) among community-dwelling older adults with mild dementia.

METHODS

This study was a randomised controlled trial. Twenty-six community-dwelling older adults with mild dementia were randomised to the IOBRT-H (n = 13) and IOBRT-DCC (n = 13) groups. The intervention was conducted for 10 weeks, with one session a week and each session lasting 60 min for both groups. Cognitive function was assessed using the Allen Cognitive Level Screen (ACLS), depression with the short form of the Geriatric Depression Scale Korean version (SGDS-K), and IADL using the Seoul-Instrumental Activities of Daily Living (S-IADL).

RESULTS

Both the IOBRT-H and IOBRT-DCC groups showed significant improvements in ACLS scores (P < 0.01 and P < 0.01, respectively). The SGDS-K score decreased only in the IOBRT-H group (P < 0.01). Between the groups, the IOBRT-H group had significantly greater improvements in both ACLS and SGDS-K scores than the IOBRT-DCC group (P < 0.05 and P < 0.05, respectively).

CONCLUSION

This study's results indicated the potential for applying IBORT-H as an intervention to improve cognitive function and reduce depression in community-dwelling older adults with mild dementia. We expect the findings of this study to serve as useful foundational data for developing home-visiting cognitive programs.

Perspectives on content and delivery of the ABLE 1.0 intervention programme

BACKGROUND

The occupational therapy intervention programme ABLE 1.0 was designed to enhance the ability to perform activities of daily living in persons living with chronic conditions. There is a need to determine if content and delivery of the ABLE 1.0 are acceptable among occupational therapists (OTs) and clients after having delivered or received the programme, respectively.

OBJECTIVES

The paper reports on evaluation of content and delivery of the ABLE 1.0 among OTs and clients. This, in terms of acceptability of intervention in principle, and perceived value, benefits, harms, or unintended consequences of the intervention.

MATERIAL AND METHODS

Qualitative semi-structured interviews were conducted with OTs having delivered and clients having received ABLE 1.0 in a Danish municipality. Content analysis was performed.

FINDINGS

Two OTs and three clients participated. Analyses revealed six categories related to content and delivery; 'Overall perception of the programme'; 'Potential for implementation'; 'Evaluation, goal setting and clarification of reasons for ADL task performance problems'; 'Intervention: compensatory solutions'; 'Format and duration' and 'Preconditions for delivery'.

CONCLUSIONS AND SIGNIFICANCE

The findings provided valuable information used for further development of the ABLE programme.

Interventions for Care Partners of People With Alzheimer's Disease or Other Related Neurological Conditions to Address Depression (2018-2022)

Systematic review briefs provide a summary of the findings from systematic reviews evaluated in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each systematic review brief summarizes the evidence on a theme related to a systematic review topic. This systematic review brief presents finding related to interventions for care partners for persons with Alzheimer's disease and related dementias.

A scoping review of family-centered interventions in dementia care

Families of persons living with dementia provide varying levels and forms of support to their loved ones and experience changes in familial dynamics, roles, and responsibilities over time. Family-centered care can enable their successful adaptation and participation in meaningful occupations. This scoping review aimed to explore available familycentered interventions for persons living with dementia, with a focus on occupational therapy. Three databases were searched and 31 eligible studies were found. Thirteen family-centered interventions were identified that were mostly multicomponent in nature, of which three involved occupational therapy. These interventions were investigated using a range of study designs and addressed outcomes related to the person with dementia, primary caregiver, and extended social network. With respect to study context, most interventions were developed in the United States and other Western countries with a limited number located in other contexts. The review findings underline the need for developing more family-centered interventions within occupational therapy, particularly for different contexts and cultures, and for translating available interventions to practice.

Occupational therapy interventions for adult informal carers and implications for intervention design, delivery and evaluation: A systematic review

Introduction

Informal carers provide vital support for patients, reducing strain on health and social care services. However, caring can detrimentally affect carers’ health and wellbeing, thus policy advocates for improved carer support. Objective: to establish the published international evidence base regarding interventions for carers delivered by occupational therapists.

Method

English language studies published January 2010–January 2021 were identified against predetermined inclusion/exclusion criteria via searches of MEDLINE, EMBASE, CINAHL, PsychINFO, OTSeeker, Scopus, Web of Science and the Cochrane Library. Supplemental strategies: database alerts, hand-searching, searching of included papers’ reference lists and citations, and contacting key authors. Two reviewers completed critical appraisal and produced a textual narrative synthesis of data using a convergent integrated method.

Results

38 papers were included, reporting 21 interventions. Most were dyadic, home-based interventions for carers of people living with dementia. Common intervention components included: assessment and goal-setting, skill training, education, coping strategies, equipment provision, environmental adaptation and signposting. Interventions improved outcomes for carers, however, intervention design and evaluation require careful consideration to maximise carer benefits and capture intervention effects.

Conclusion

Occupational therapist delivered carer interventions enhance support and improve carer outcomes. Intervention and evaluation designs should include careful selection of outcome measures, avoidance of increased carer burden in dyadic interventions and acknowledgement of known barriers and facilitators to both carer and therapist intervention engagement.