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Tailored Activities to Manage Neuropsychiatric Behaviors in Persons With Dementia and Reduce Caregiver Burden: A Randomized Pilot Study

By Kim Warchol | Posted on 03.20.2009 | 0 comments

Source: Am J Geriatr Psychiatry. 2008 Mar;16(3):229-39. Gitlin LN, Winter L, Burke J, Chernett N, Dennis MP, Hauck WW. Center for Applied Research on Aging and Health, School of Health Professions, Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. laura.gitlin@jefferson.edu

A randomized, controlled pilot was conducted in patient’s homes to test whether the Tailored Activity Program (TAP) reduces dementia-related neuropsychiatric behaviors, promotes activity engagement, and enhances caregiver well-being.

Sixty dementia patients and family caregivers. INTERVENTION: The eight-session occupational therapy intervention involved neuropsychological and functional testing, selection, and customization of activities to match capabilities identified in testing, and instruction to caregivers in use of activities. At 4 months, compared with controls, intervention caregivers reported reduced frequency of problem behaviors, and specifically for shadowing and repetitive questioning, and greater activity engagement including the ability to keep busy. Fewer intervention caregivers reported agitation or argumentation. Caregiver benefits included fewer hours doing things and being on duty, greater mastery, self-efficacy, and skill enhancement.

The study concluded that tailoring activities to the capabilities of dementia patients and training families in activity use resulted in clinically relevant benefits for patients and caregivers. Treatment minimized trigger behaviors for nursing home placement and reduced objective caregiver burden. Noteworthy is that depressed caregivers effectively engaged in and benefited from the intervention.


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