New research shows that personalized cognitive rehabilitation therapy can help people with early stage dementia significantly improve their ability to engage in important everyday activities and tasks.
This enables them to maintain their functioning and independence, according to researchers at the University of Exeter.
Cognitive rehabilitation involves a therapist working with the person with dementia and a family caregiver to identify issues where they would like to see improvements. Together, they set up to three goals, and the therapist helps to develop strategies to achieve these goals.
The goals participants chose were varied, as dementia affects people in a wide range of ways, the researchers noted.
Some wanted to find ways of staying independent, for example by learning or re-learning how to use household appliances or mobile phones.
Some wanted to manage daily tasks better, and worked with therapists on developing strategies to prevent them from burning their food when cooking meals.
Others wanted to stay socially connected, and focused on being able to remember details like the names of relatives or neighbors, or improving their ability to engage in conversation.
Sometimes staying safe was important, so strategies focused on things like remembering to lock the door at home or withdrawing money safely from an ATM.
“We know there’s a great deal that can be done to support people to live well with dementia,” said Dr. Ola Kudlicka, who managed the trial.
“Our research is about finding out what matters most to individuals and working with them to find strategies to manage important tasks and maintain their interests. Contrary to popular belief, our trial shows that people with early-stage dementia, given the right kind of support, have the capacity to learn and to improve their skills. We aim to support them in their right to live a fulfilling and happy life and be as independent as possible.”
The study involved 475 people across eight sites in England and Wales. Half of them received 10 cognitive rehabilitation sessions over three months, and the other half did not. The group receiving the therapy then took part in four “top-up” sessions over six months.
The researchers found that those who took part in the therapy showed significant improvement in the areas they had identified, after both the 10 week and “top-up” sessions.
Family caregivers agreed that their performance had improved. Both participants and caregivers were happier with the participants’ abilities in the areas identified, the researchers reported.
“We now know that cognitive rehabilitation effectively supports people to achieve the everyday goals that matter to them,” said Professor Linda Clare, who led the research.
“The next step is to quantify benefits, such as whether this approach delays the need for people to go into care homes by supporting them to live independently for longer. This could have important financial benefits for social care. We must also assess whether the therapy can be integrated into how practitioners routinely work, so that more people can have access and are supported to live better lives with dementia.”
The Alzheimer’s Society funded an initial pilot study for this work to make sure that the methods were acceptable for people affected by dementia. It is now funding an implementation study so the researchers can work with NHS and social care providers to adapt the therapy for use in real-life practice.
Source: University of Exeter