Occupation Based Treatment Interventions for Patients with Dementia Molly Ganow COTA Patricia Trujillo OT, DCCT Diane Dismukes OTR Cognitive Disabilities Model -Claudia K. Allen, MA, OTR, FAOTA (Top 100 Influential OT’s) Identifies Best Ability to Function Includes 6 Allen Cognitive Levels Defines remaining ability at each level Theory of Retrogenesis -Barry Reisberg, M.D. Loss of Function in reverse order as learned Global Deterioration Scale Functional Assessment Staging Tool Determines Stage of Abilities to Developmental age Inverse order of stages to Allen Levels Person-Centered Care -Thomas Kitwood, PH.D. Person with dementia is the focal point of all caregiving process Person with dementia’s interests, roles and performance Significance of Occupational Profile: Obtaining information regarding the patient’s past/current occupations and leisure activities/interests is key in using this approach to meet the patient with dementia’s goals. Montessori Approach -Maria Montessori, M.D. An individuals desire to learn & complete activities that are of interest and at the appropriate level for the person Montessori Hierarchy: Vertical Programming: Downward Extension: Decreased level from original task Upward Extension: Increased level of difficulty from original task Horizontal Programming: Activity of similar level of difficulty “Achieving health, well-being, and participation in life through engagement in occupation…” (AOTA OTPF, 2014)
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Occupation Based Treatment Interventions for Patients with ... · GDS 1 ACL 6 GDS 4 ACL 4 GDS 5 ACL 3 GDS 6 ACL 2 GDS 7 ACL 1 GDS 3 ACL 5 GDS 2 Mild Alzheimer’s, early stage Moderate
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Occupation Based Treatment Interventions for Patients with DementiaMolly Ganow COTA Patricia Trujillo OT, DCCT Diane Dismukes OTR
Cognitive Disabilities Model
-Claudia K. Allen, MA, OTR, FAOTA
(Top 100 Influential OT’s)
Identifies Best Ability to Function
Includes 6 Allen Cognitive Levels
Defines remaining ability at each level
Theory of Retrogenesis
-Barry Reisberg, M.D.
Loss of Function in reverse order as learned
Global Deterioration Scale
Functional Assessment Staging Tool
Determines Stage of Abilities to
Developmental age
Inverse order of stages to Allen Levels
Person-Centered Care
-Thomas Kitwood, PH.D.
Person with dementia is the focal point of all
caregiving process
Person with dementia’s interests, roles and
performance
Significance of Occupational Profile:
Obtaining information regarding the patient’s
past/current occupations and leisure
activities/interests is key in using this
approach to meet the patient with dementia’s
goals.
Montessori Approach
-Maria Montessori, M.D.
An individuals desire to learn & complete
activities that are of interest and at the
appropriate level for the person
Montessori Hierarchy:
Vertical Programming:
Downward Extension:
Decreased level from original task
Upward Extension:
Increased level of difficulty from original task
Horizontal Programming:
Activity of similar level of difficulty
“Achieving health, well-being, and participation in life through
engagement in occupation…” (AOTA OTPF, 2014)
GDS 1 ACL 6
GDS 4 ACL 4
GDS 5 ACL 3
GDS 6 ACL 2
GDS 7 ACL 1
GDS 3 ACL 5
GDS 2
Mild Alzheimer’s, early stage
Moderate Alzheimer’s, middle stage
Severe Alzheimer’s, late stage
Stages of Dementia
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Carson, V. B. (n.d.). Revisiting the theory of retrogenesis. Retrieved fromhttp://www.nahc.org/news/revisiting-the-theory-of-retrogenesis/
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O’Neil, M. E., Freeman, M., Christensen, V., Telerant, R., Addleman, A., & Kansagara, D. (2011). Asystematic evidence review of non-pharmacological interventions for behavioral symptoms of dementia. Washington, DC: Department of Veterans Affairs (US). Retrieved fromhttp://www.hsrd.research.va.gov/publications/esp/Dementia-Nonpharm.pdf
Rogers, H., & Lasprilla, J. C. A. (2006). Retrogenesis theory in Alzheimer’s disease: Evidence and clinicalimplications. Anales de Psicología, 22(2), 260-266. Retrieved fromhttp://www.redalyc.org/pdf/167/16722211.pdf
Sclan SG, Reisberg B. Functional assessment staging (FAST) in Alzheimer's disease: reliability, validity, and ordinality. Int Psychogeriatr 4 Suppl 1: 55-69, 1992.
Stetka, B. S., Isaacson, R. S., & Glazer, H. P. (2014, June 4). More data on diet and dementia. Retrievedfrom http://www.medscape.com/viewarticle/826064
Why the Montessori Method is becoming a Popular Treatment for Dementia. Alzheimers.net Blog, May 27, 2014