Occupational therapy in special respite care: a new multicomponent model for challenging behavior in people with dementia

Abstract

People with dementia experience a cognitive and functional decline and besides Behavioral and Psychological Symptoms (BPSD). BPSD represent the main cause of the dramatic deterioration in the quality of life and stress for patients and their families. BPSD can benefit from psychosocial and environment approach; in particular the tailor made treatment has proved the best results in literature. The intervention of Occupational Therapist (OT) at home (CotiD-Method) and in Nursing Home on elderly people with moderate dementia can improve BPSD. OT is the trigger figure that can understand the intricate relationship between person, environment and occupation that is required for successful task performance. Our prospective cohort study analyzed a sample of 14 People (aged 82±5.88) With moderate-severe (MMSE mean 9.29/30 sd=6.88) Dementia (PWD) and severe BPSD (NPI=31.79±7.62) in a Temporary Special Respite Care (SRC) in Modena. We test how a multi-professional approach and a Personal Care Planning including occupational therapy could be effective in challenging behaviors. The method includes formal and informal caregivers reflecting CotiD method. Our results show that occupational therapy can significantly improve BPSD and quality con life in PWD. The multiprofessional approach permitted to reduce number of psychotropic drugs and also falls. The general positive mood reflects on professionals working in SRC in the sense of improvement,even if not significantly, of psychological load and personal fulfillment. In the same way even formal caregivers who assist PWD at home, learned skills in managing the exacerbation of BPSD.