Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Next article
Short Review

Behavioral and Occupational Therapy for Dementia Patients and Caregivers

Published Online:April 20, 2020https://doi.org/10.1024/1662-9647/a000225

Abstract

Abstract. Occupational and behavioral therapy can support dementia patients and their caregivers in managing cognitive disability, coping with behavioral and psychological symptoms of dementia such as depression and anxiety, and in adapting tasks and roles to maintain activities. We provide an overview of existing manuals and report results of focus groups and surveys as steps toward an interdisciplinary intervention in the home setting. In focus-group discussions, behavioral and occupational therapists discussed commonalities and differences, prejudices, barriers in the public health system, and interdisciplinary cooperation. The therapists welcomed increased cooperation but clearly preferred working in teams to an extensive training in matters of another profession. The results suggest that interventions offered by both professions would help advance dementia therapy.

References

  • Affolter, F., & Bischofberger, W. (1993). Wenn die Organisation des zentralen Nervensystems zerfällt und es an gespürter Information mangelt [When the organization of the central nervous system decays and sensory information is lacking]. Villingen-Schwenningen: Neckar. First citation in articleGoogle Scholar

  • Aguirre, E., Spector, A., Streater, A., Hoe, J., Woods, B., & Orrell, M. (2018). In K. WerheidB. Schraubs-SchmidtEds., Kognitive Stimulationstherapie. Ein evidenzbasiertes Gruppenprogramm für Menschen mit Demenz. Aufbaukurs mit Querverweisen zum Basiskurs [Cognitive stimulation therapy. An evidence-based group program for people with dementia. Advanced training course with cross references to the basic course]. Dortmund: Verlag Modernes Lernen. First citation in articleGoogle Scholar

  • Baharudin, A., Che Din, N., Subramaniam, P., & Razali, R. (2019). The associations between behavioral-psychological symptoms of dementia (BPSD) and coping strategy, burden of care and personality style among low-income caregivers of patients with dementia. BMC Public Health, 19, 1–12. https://doi.org/10.1186/s12889-019-6868-0 First citation in articleCrossref, Google Scholar

  • Bohlken, J., Weber, S. A., Siebert, A., Forstmeier, S., Kohlmann, T., & Rapp, M. A. (2017). Reminiscence therapy for depression in dementia. An observational study with matched pairs. GeroPsych, 30, 145–151. https://doi.org/10.1024/1662-9647/a000175 First citation in articleLink, Google Scholar

  • Cheston, R., & Ivanecka, A. (2016). Individual and group psychotherapy with people diagnosed with dementia: a systematic review of the literature. International Journal of Geriatric Psychiatry, 32, 3–31. https://doi.org/10.1002/gps.4529 First citation in articleCrossref, Google Scholar

  • Deutsche Alzheimer Gesellschaft, Bickel, H. (2016). Die Häufigkeit von Demenzerkrankungen [The prevalence of dementia]. Retrieved from https://www.deutsche-alzheimer.de/fileadmin/alz/pdf/factsheets/infoblatt1_haeufigkeit_demenzerkrankungen_dalzg.pdf First citation in articleGoogle Scholar

  • Deutsche Gesellschaft für Neurologie, Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde. (2016). S3-Leitlinie Demenzen. Stand: 24. Januar 2016 [S3-Guideline dementia. As of January 24th 2016]. Retrieved from https://www.dgppn.de/Resources/Persistent/ade50e44afc7eb8024e7f65ed3f44e995583c3a0/S3-LL-Demenzen-240116.pdf First citation in articleGoogle Scholar

  • Deutscher Verband der Ergotherapeuten e.V. (2012). Definition Ergotherapie [Definition occupational therapy]. Retrieved from https://dve.info/der-dve/der-verband/verbandsziele First citation in articleGoogle Scholar

  • Eichenseer, B., & Gräßel, E. (2015). Aktivierungstherapie für Menschen mit Demenz. motorisch. alltagspraktisch. kognitiv. spirituell [Activation therapy for people with dementia. Motoric. Relevant for daily living. cognitive. spiritual] (2nd ed.). München: Urban & Fischer. First citation in articleGoogle Scholar

  • Flotho, W., & Sibold, C. (2014). HED-I. Häusliche Ergotherapie bei Demenz. Interventionsprogramm für Menschen mit leichter bis mittlerer Demenz und ihre Angehörigen im häuslichen Umfeld [HED-I. Home occupational therapy for dementia. Intervention-program for people with mild to moderate dementia and their relatives in the home environment]. Idstein: Schulz-Kirchner. First citation in articleGoogle Scholar

  • Forstmeier, S., & Roth, T. (2018). Kognitive Verhaltenstherapie für Patienten mit leichter Alzheimer-Demenz und ihre Angehörigen [Cognitive behavioral therapy for patients with mild Alzheimer’s disease and their relatives]. Berlin: Springer. First citation in articleCrossref, Google Scholar

  • Gemeinsamer Bundesausschuss. (2018). Richtlinie des Gemeinsamen Bundesausschusses zu Untersuchungs- und Behandlungsmethoden der vertragsärztlichen Versorgung [Guideline of the Federal Joint Committee on examination- and treatment methods of medical care by contract physicians]. Retrieved from https://www.kvsh.de/db2b/upload/downloads/Richtlinie_Apherese.pdf First citation in articleGoogle Scholar

  • Giebel, C.M., Challis, D., Hooper, N.M., & Ferris, S. (2015). A step-by-step translation of evidence into a psychosocial intervention for everyday activities in dementia: A focus group study. Aging and Mental Health, 22, 323–329. https://doi.org/10.1080/13607863.2016.1262819 First citation in articleCrossref, Google Scholar

  • Gitlin, L., & Corcoran, M. (2005). Occupational therapy and dementia care. The home environmental skill-building program for individuals and families. Bethesda, MD: American Occupational Therapy Association. First citation in articleGoogle Scholar

  • Gitlin, L., Corcoran, M., & Winter, L. (2001). A randomized, controlled trial of a home environmental intervention: Effect on efficacy and upset in caregivers and on daily function of persons with dementia. The Gerontologist, 41, 4–14. https://doi.org/10.1093/geront/41.1.4 First citation in articleCrossref, Google Scholar

  • Graff, M. J. L., & Melick, van M. B. M. (2000). Het ontwikkelen, testen en implementeren van een ergotherapeutische standaard. De standaard voor de ergotherapeutische diagnostiek en behandeling van geriatrische patiënten met niet-ernstige cognitieve stoornissen [The development, testing and the implementation of the guideline for the occupational therapy diagnosis and treatment of older persons with non-severe cognitive impairments]. Nederlands Tijdschrift voor Ergotherapie, 28(4), 169–174. First citation in articleGoogle Scholar

  • Graff, M. J. L., Vernooij-Dassen, M. J. M., Thijssen, M., Dekker, J., Hoefnagels, W. H. L., & Olde Rikkert, M. G. M. (2006). Community based occupational therapy for patients with dementia and their care givers: Randomized controlled trial. British Medical Journal, 333, 1196–1199. https://doi.org/10.1136/bmj.39001.688843.BE First citation in articleCrossref, Google Scholar

  • Graff, M. J. L., Vernooij-Dassen, M. J. M., Thijssen, M., Dekker, J., Hoefnagels, W. H. L., & Olde Rikkert, M. G. M. (2007). Effects of community occupational therapy on quality of life, mood, and health status in dementia patients and their caregivers: A randomized controlled trial. Journals of Gerontology: Medical Sciences, 62, 1002–1009. https://doi.org/10.1093/gerona/62.9.1002 First citation in articleCrossref, Google Scholar

  • Gräßel, E., Stemmer, R., Eichenseer, B., Pickel, S., Donath, C., Komhuber, J., & Luttenberger, K. (2011). Non-pharmacological, multicomponent group therapy in patients with degenerative dementia: A 12-month randomized, controlled trial. BMC Medicine, 9, 129. Retrieved from http://www.biomedcentral.com, https://doi.org/10.1186/1741-7015-9-129 First citation in articleCrossref, Google Scholar

  • Häusler, A., Krause-Köhler, K., Niemann-Mermehdi, M., Nordheim, J., & Rapp, M. (2014). Psychosoziale Therapie bei beginnender Demenz. Das Unterstützungsprogramm für Menschen mit Demenz und ihre Partner [Psychosocial therapy for early dementia. The support program for people with dementia and their partners]. Frankfurt am Main: Mabuse-Verlag. First citation in articleGoogle Scholar

  • Holthoff, V., Reuster, T., & Schützwohl, M. (2013). ERGODEM. Häusliche Ergotherapie bei Demenz - ein Leitfaden für die Praxis [ERGODEM. Home occupational therapy for dementia – a practical guide]. Stuttgart: Thieme. First citation in articleGoogle Scholar

  • Hopkinson, M. D., Reavell, J., Lane, D. A., & Mallikarjun, P. (2019). Cognitive behavioral therapy for depression, anxiety, and stress in caregivers of dementia patients: A systematic review and meta-analysis. The Gerontologist, 59(4), e343–e362. https://doi.org/10.1093/geront/gnx217 First citation in articleCrossref, Google Scholar

  • Hynes, S. M., Field, B., Ledgerd, R., Swinson, T., Jennifer, W., di Bona, L., Moniz-Cook, E., Poland, F., & Orrell, M. (2016). Exploring the need for a new UK occupational therapy intervention for people with dementia and family carers: Community Occupational Therapy in Dementia (COTiD). A focus group study. Aging & Mental Health, 20(7), 762–769. https://doi.org/10.1080/13607863.2015.1037243 First citation in articleCrossref, Google Scholar

  • Jütten, L. H., Mark, R. E., Wicherts, J. M., & Sitskoorn, M. M. (2018). The Effectiveness of psychosocial and behavioral interventions for informal dementia caregivers: Meta-analyses and meta-regressions. Journal of Alzheimer’s Disease, 66, 149–172. https://doi.org/10.3233/JAD-180508 First citation in articleCrossref, Google Scholar

  • Keough, J., & Huebner, R.A. (2000). Treating dementia: The completing team approach of occupational therapy and psychology. The Journal of Psychology, 134, 375–391. https://doi.org/10.1080/00223980009598223 First citation in articleCrossref, Google Scholar

  • Kim, S.-Y., Yoo, E.-Y., Jung, M.-Y., Park, S.-H., & Park, J.-H. (2012). A systematic review of the effects of occupational therapy for persons with dementia: A meta-analysis of randomized controlled trials. Neurorehabilitation, 31, 107–115. https://doi.org/10.3233/NRE-2012-0779 First citation in articleCrossref, Google Scholar

  • Krueger, R.A. (2002). Designing and conducting focus group interviews. Minnesota: University of Minnesota. Retrieved from https://www.eiu.edu/ihec/Krueger-FocusGroupInterviews.pdf First citation in articleGoogle Scholar

  • Kuring, J. K., Mathias, J. L., & Ward, L. (2018). Prevalence of depression, anxiety and PTSD in people with dementia: A systematic review and meta-analysis. Neuropsychology Review, 28, 393–416. https://doi.org/10.1007/s11065-018-9396-2 First citation in articleCrossref, Google Scholar

  • Kurz, A., Thöne-Otto, A., Cramer, B., Egert, S., Frölich, L., Gertz, H.-J., … Werheid, K. (2012). CORDIAL: Cognitive rehabilitation and cognitive-behavioral treatment for early dementia in Alzheimer disease. A multicenter, randomized, controlled trial. Alzheimer Disease & Associated Disorders, 26, 246–253. https://doi.org/10.1097/WAD.0b013e318231e46e First citation in articleCrossref, Google Scholar

  • Leiner, D. J. (2019). SoSci Survey. (Version 3.1.06). München: SoSci Survey GmbH. Available at https://www.soscisurvey.de First citation in articleGoogle Scholar

  • Lobbia, A., Carbone, E., Faggian, S., Gardini, S., Piras, F., Spector, A., & Borella, E. (2018). The efficacy of cognitive stimulation therapy (CST) for people with mild-to-moderate dementia. A review. European Psychologist, 24(3), 257–277. https://doi.org/10.1027/1016-9040/a000342 First citation in articleLink, Google Scholar

  • Margraf, J., & Schneider, S. (2009). Lehrbuch der Verhaltenstherapie. Band 1 [Textbook of behavioral therapy. Part 1] (3rd ed.). Berlin: Springer. First citation in articleGoogle Scholar

  • McDermott, O., Charlesworth, G., Hogervorst, E., Stoner, C., Moniz-Cook, E., Spector, A., … Orrell, M. (2019). Psychosocial interventions for people with dementia: A synthesis of systematic reviews. Aging & Mental Health, 23, 393–403. https://doi.org/10.1080/13607863.2017.1423031 First citation in articleCrossref, Google Scholar

  • Nordheim, J., Häusler, A., Yasar, S., Suhr, R., Kuhlmey, A., Rapp, M., & Gellert, P. (2019). Psychosocial intervention in couples coping with dementia led by a psychotherapist and social worker: The DYADEM trial. Journal of Alzheimer’s Disease, 68, 745–755. https://doi.org/10.3233/JAD-180812 First citation in articleCrossref, Google Scholar

  • Ojagbemi, A., & Owolabi, M. (2017). Do occupational therapy interventions improve quality of life in persons with dementia? A meta-analysis with implications for future directions. Psychogeriatrics, 17, 133–141. https://doi.org/10.1111/psyg.12201 First citation in articleCrossref, Google Scholar

  • Orgeta, V., Qazi, A., Spector, A., & Orrell, M. (2015). Psychological treatments for depression and anxiety in dementia and mild cognitive impairment: Systematic review and meta-analysis. The British Journal of Psychiatry, 207, 293–298. https://doi.org/10.1192/bjp.bp.114.148130 First citation in articleCrossref, Google Scholar

  • Phinney, A., Chaudhury, H., & O’Connor, D. L. (2007). Doing as much as I can do: The meaning of activity for people with dementia. Aging & Mental Health, 11, 384–393. https://doi.org/10.1080/13607860601086470 First citation in articleCrossref, Google Scholar

  • Pimouguet, C., Le Goff, M., Wittwer, J., Dartigues, J.-F., & Helmer, C. (2016). Benefits of occupational therapy in dementia patients: Findings from a real-world observational study. Journal of Alzheimer’s Disease, 56, 509–517. https://doi.org/10.3233/JAD-160820 First citation in articleCrossref, Google Scholar

  • Pinquart, M., & Forstmeier, S. (2012). Effects of reminiscence interventions on psychosocial outcomes: A meta-analysis. Aging & Mental Health, 16, 541–558. https://doi.org/10.1080/13607863.2011.651434 First citation in articleCrossref, Google Scholar

  • Polatajko, H.J., Townsend, E.A., & Craig, J. (2007). Canadian Model of Occupational Performance and Engagement (CMOP-E). In E. A. TownsendH. J. PolatajkoEds., Enabling Occupation II: Advancing an Occupational Therapy Vision of Health, Well-being, & Justice through Occupation (pp. 22–36). Ottawa, ON: CAOT Publications ACE. First citation in articleGoogle Scholar

  • Potter, R., Ellard, D., Rees, K., & Thorogood, M. (2011). A systematic review of the effects of physical activity on physical functioning, quality of life and depression in older people with dementia. International Journal of Geriatric Psychiatry, 26, 1000–1011. https://doi.org/10.1002/gps.2641 First citation in articleCrossref, Google Scholar

  • Selwood, A., Johnston, K., Katona, C., Lyketsos, C., & Livingston, G. (2007). Systematic review of the effect of psychological interventions on family caregivers of people with dementia. Journal of Affective Disorders, 101, 75–89. https://doi.org/10.1016/j.jad.2006.10.025 First citation in articleCrossref, Google Scholar

  • Soltys, F., & Coats, L. (1994). The SolCos model: Facilitating reminiscence therapy. Journal of Gerontological Nursing, 20, 11–16. https://doi.org/10.3928/0098-9134-19941101-05 First citation in articleCrossref, Google Scholar

  • Spitzenverbände der Krankenkassen. Spitzenorganisationen der Heilmittelerbringer auf Bundesebene [Central associations of health insurance companies, top organizations of health care providers at federal level]. (2006). Gemeinsame Rahmenempfehlungen gemäß § 125 Abs. 1 SGB V über die einheitliche Versorgung mit Heilmitteln [Common framework recommendations in accordance with Section 125 (1) SGB V on the uniform supply of therapeutic measures]. Retrieved from https://www.gkv-spitzenverband.de/media/dokumente/krankenversicherung_1/ambulante_leistungen/heilmittel/heilmittel_rahmenempfehlungen/Empf_125_204.pdf First citation in articleGoogle Scholar

  • Straubmeier, M., Behrndt, E.-M., Seidl, H., Özbe, D., Luttenberger, K., & Graeßel, E. (2017). Non-pharmacological treatment in people with cognitive impairment. Deutsches Aerzteblatt International, 114, 815–821. https://doi.org/10.3238/arztebl.2017.0815 First citation in articleGoogle Scholar

  • Werheid, K., & Thöne-Otto, A. (2010). Alzheimer-Krankheit. Ein neuropsychologisch-verhaltenstherapeutisches Manual [Alzheimer’s disease. A neuropsychological-behavioral therapy manual]. Weinheim: Beltz. First citation in articleGoogle Scholar

  • Williams, F., Moghaddam, N., Ramsden, S., & De Boos, D. (2018). Interventions for reducing levels of burden among informal carers of persons with dementia in the community: A systematic review and meta-analysis of randomized controlled trials. Aging & Mental Health, 23(12), 1629–1642. https://doi.org/10.1080/13607863.2018.1515886 First citation in articleCrossref, Google Scholar

  • World Health Organization. (2008). Internationale Klassifikation psychischer Störungen [International classification of mental disorders] (6th ed.). Bern: Huber. First citation in articleGoogle Scholar

  • Van Bogaert, P., Van Grinsven, R., Tolson, D., Wouters, K., Engelborghs, S., & Van der Mussele, S. (2013). Effects of SolCos model-based individual reminiscence on older adults with mild to moderate dementia due to Alzheimer disease: A pilot study. Journal of the American Medical Directors Association, 14, 528e9–528e13. https://doi.org/10.1016/j.jamda.2013.01.020 First citation in articleCrossref, Google Scholar

  • Vernooij-Dassen, M., Draskovic, I., McCleery, J., & Downs, M. (2011). Cognitive reframing for carers of people with dementia (Review). Cochrane Database of Systematic Reviews, 11, CD005318. https://doi.org/10.1002/14651858.CD005318.pub2 First citation in articleGoogle Scholar

  • Voigt-Radloff, S., Graff, M., Leonhart, R., Hüll, M., Rikkert, M. O., & Vernooij-Dassen, M. (2011). Why did an effective Dutch complex psycho-social intervention for people with dementia not work in the German healthcare context? Lessons learnt from a process evaluation alongside a multicenter RCT. BMJ Open, 1. https://doi.org/10.1136/bmjopen-2011-000094 First citation in articleCrossref, Google Scholar

  • Voigt-Radloff, S., Rühlemann, A., & Hüll, M. (2012). WHEDA - Wirksame Häusliche Ergotherapie für Demenzerkrankte und Angehörige. Behandlungsmanual [WHEDA - Effective home occupational therapy for dementia patients and their relatives. Treatment manual]. Idstein: Schulz-Kirchner. First citation in articleGoogle Scholar

  • Yuill, N., & Hollis, V. (2011). A systematic review of cognitive stimulation therapy for older adults with mild to moderate dementia: An occupational therapy perspective. Occupational Therapy International, 18, 163–186. https://doi.org/10.1002/oti.315 First citation in articleCrossref, Google Scholar