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Dementia > Intervention in Dementia > Flashcards

Intervention in Dementia Flashcards

1
Q

It is important to consider which model when working on intervention in dementia to ensure you are focusing on the person as a whole?

A

the WHO Model of Body structures/ functions, activates and participation

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2
Q

What are the objectives of intervention for individuals with dementia

A
  • feel useful
  • purposeful use of time
  • give a sense of control
  • use residual skills
  • maintain current abilities
  • promote verbal and non-verbal communication
  • meet social needs
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3
Q

In general what are the two types of approaches to intervention in dementia?

A

direct/ internal strategies

indirect/ external strategies

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4
Q

Describe direct/ internal strategies

A
  • work directly on memory system
  • rely on active memory search to RECALL info
  • requires conscious effort
  • has to be introduced early in disease (while episodic memory still intact)
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5
Q

Describe indirect/external strategies

A
  • based on automatic processing
  • rely on RECOGNITION of info based on experience and practice
  • external monitoring of info
  • physically present in the environment
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6
Q

List some possible direct (internal strategies)

A
  • mnemonic devices
  • face-name association
  • localization method
  • imagery (sounds, sights, smells)
  • memory games
  • rehearsal
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7
Q

what are three types of rehearsal methods?

A
  • repetition
  • elaboration
  • association
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8
Q

What are the two subtypes of repetition strategies?

A
  • repeated exposure

- spaced retrieval

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9
Q

Describe spaced retrieval

A
  • repeat same stimulus with increasing space between each exposure
  • if patient fails to recall response, info is provided and pt repeats (error full)
  • relies on non-declarative memory systems, which are thought to be spared in AD
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10
Q

What are the strengths of spaced retrieval?

A
  • can be incorporated within other task in pt’s routine
  • clinician can control the type of response being trained, duration of time intervals, overall # of recall trials, and activities taking place between recall trials
  • highly flexible because response can fe verbal or nonverbal
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11
Q

What is errorless learning?

A
  • ensures pt always responds correctly, involves the use of cues and prompts
  • i.e. vanishing cues, and forced choice
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12
Q

How can errorless learning apply to dementia

A
  • learning new info
  • relearning forgotten info
  • face and name associations
  • biographical info
  • using calendar and electronic memory aid
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13
Q

What are the strengths of errorless learning?

A
  • actively engages participant in learning process
  • participants experience success through the learning process
  • can be combined with other strategies such as spaced retrieval
  • reduces or removes errors
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14
Q

Results from an errorless learning study in class show what?

A
  • sig improvement in performance on trained items
  • maintenance at 6 months follow up
  • better results for cued recall
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15
Q

Indirect intervention, external memory aids can either be _________ or ________

A

high tech

low tech

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16
Q

What are some examples of high tech memory aids?

A

Watch reminders, clock radios and timers, automatic medication dispenser, amplified photograph telephone, electronic diary, neuro pager, pill organizer etc.

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17
Q

What are some examples of low tech memory aids

A

Calendars, notes, information boards, schedules, labels, pictures, strategic object placement, memory book/wallet, etc.

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18
Q

Memory aids are objects that are utilized to decrease cognitive load and assist with deficits in which three areas?

A
  • Memory (recording, retrieval and recall)
  • Executive funciton (planning, organization, execution, verification)
  • Language (semantics, pragmatics, syntax, phonology)
19
Q

What should be included in memory books/wallets?

A
  • biographical info
  • collection of pictures and artifacts
  • descriptions of events
  • provide recognition cues, through visually accessible topics that facilitate and support communication
20
Q

Who benefit from memory books?

A
  • mild, middle, and late stages of AD

- individuals with language deficits

21
Q

Why should we use memory books?

A
  • increases positive verbal behaviour and decreases non productive verbal behaviour
  • provides thematic structure and increases # of ideas produced
  • enriches convo
  • portable and easily modified
22
Q

What is one problem with memory books and AD?

A

some people will refuse to use them as they believe they don’t need them

23
Q

What scientific evidence has been found supporting the use of memory books

A
  • increase in factual statements and fewer ambiguous utterances
  • improvements in quality of info content
  • decreased unintelligible and perseverative utterances, and increased efficacy of cueing strategies
24
Q

What are some limitations of memory books?

A
  • often forget to include desirable content

- requires: organization skills and commitment, visuospatial skills, fine motor skills, memory and reading skills

25
Q

What are neuropagers?

A

Small electronic pager that reminds individuals of an appointment, event or daily activity

  • audio or vibrotactile signals
  • simple to operate
  • *BUT has to be preset
26
Q

What are limitations of the pager system

A
  • requires high level of self motivation
  • people with cognitive difficulties often forget to record and to access info that is already recorded
  • may have diff using electronic aids
  • requires recall: what the pager is, what it does, to carry it at all times
  • cost and access barriers
  • batteries?
27
Q

Other than external aids, list some indirect therapy strategies

A
  • reminiscence therapy
  • reality orientation
  • validation therapy
28
Q

What are the two components involved in reminiscence therapy? what is the purpose of each component

A

a) life review - therapeutic purpose

b) discussion group - pleasure, entertainment and socialization purpose

29
Q

Describe reality orientation

A
  • purpose: orient the patient to reality -> improve memory and cognition
  • use visual and or verbal reminders
30
Q

What are some examples of multi sensory interventions in dementia

A
  • exercise/movement/dance therapy
  • music therapy
  • art therapy
  • pet therapy
  • toy therapy
31
Q

Dance therapy is typically used to promote patients abilities to _____________

A

communicate

32
Q

What are the pros of dance therapy?

A
  • people with dementia are more active and spontaneous when using dance
  • can be combined with other communicative skills (humming, sounds, words) to express thoughts and feelings
33
Q

What are the cons of dance therapy?

A
  • physical abilities

- not optimal for patients who are more reserved

34
Q

T or F: music therapy is a powerful therapeutic tool with documented positive physiological and behavioural effects, as ell as cognitive effects

A

true

35
Q

Music therapy has been shown to improve _____ fluency

A

semantic

36
Q

What are the pros of music therapy

A
  • low cost & meaningful approach
  • induces improvement in areas of language and behaviours
  • improves QOL
  • positive impact on caregiver
37
Q

Cons of music therapy?

A
  • questions remain about lasting effects
  • song selection difficult with multi-cultural groups
  • some training required
  • facilitator needs music education
38
Q

Results of study looking into art therapy?

A
  • positive change in mental function, sociability, calmness and physical engagement
  • improvement in depression scores
39
Q

Pros of art therapy

A
  • meaningful & engaging approach
  • provides sensory stimulation
  • behavioural and cognitive improvements
  • tangible outcomes
40
Q

Cons of art therapy

A
  • can be expensive

- may be intimidating for those who feel ‘talentless’

41
Q

Pros of pet therapy

A
  • animal assisted therapy (AAT) is especially effective with severely impaired patients with AD
  • no verbal interaction or training required
  • Pets take on role of initiator
  • Improves QOL
  • positive impact on caregiver
42
Q

Cons of pet therapy

A
  • animals may not be of interest to all patients

- staff need to be comfortable with animals

43
Q

What are the guiding principles of a Montessori program

A
  • from simple to complex
  • break task into parts and train one part at a time with external cues to reduce errors and failure
  • use real-life tangible materials (functional and aesthetically pleasing)
  • emphasize auditory, visual, and tactile discrimination through activities
  • developed to address difficult behaviours

Dementia (10 decks)

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