Rehabilitation Therapists’ Roles in care of Patients with Alzheimer’s Disease

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Alzheimer’s and Rehabilitation: How Therapy Positively Influences their Patients’ Lives

According to the Alzheimer’s Association (2017), Alzheimer’s disease is rated as the leading cause of dementia, accounting for 60-80% of cases.  Although the DSM-5 (Diagnostic and Statistical Manual, version 5) has relabeled “dementia” with “mild/moderate neurocognitive disorder”, many health practitioners still hold on to the old terminology in order to avoid confusion (APA, 2013).  Despite the diagnostic labels, Alzheimer’s disease still leaves a destructive wake in the lives of those who fall victim as well as those family members and caregivers who have to reshape their lifestyles to accommodate.

Depending on when it is detected, Alzheimer’s disease gradually impedes on the person’s ability to function which goes beyond basic memory loss.  Examples include reduced safety awareness and judgment, decreased problem-solving skills, inability to learn novel tasks, impairment in language expression/comprehension, mood and behavioral instability, and perseveration just to name a few.  The end results of such cognitive changes could include disruptions in routines for personal hygiene, household task completion, community or social outings, self-feeding tasks, and functional mobility.

Inevitably, Alzheimer’s disease worsens and proves fatal for those affected.  However, rehabilitation therapists who are well-acquainted with the disease know the value behind preserving and optimizing the affected individual’s life while they are still alive.  The following methods are ways in which speech pathologists, physical therapists, occupational therapists can carry out meaningful treatment for patients with Alzheimer’s disease:

Advocate for Early Detection

Although obtaining an early diagnosis won’t prevent the disease from occurring, therapists can start programs with their patients during the less impaired stages which can slow deterioration and prepare loved ones for what’s coming. Advocate for your patients by actively participating in research groups, online platforms, and public forums regarding Alzheimer’s disease.  Support and participate in education for families so that symptoms can be identified early.

Discover the Person Behind the Deficit

Conduct a detailed evaluation that assesses the deficits as well as the person: their interests, routines, hobbies, behavioral and emotional triggers, etc. Slow down and listen to what the patient desires for their own care, even as verbal communication fades away. The patient’s capabilities gradually erode as the disease progresses, making it very easy for clinicians and loved ones to focus on the losses.  It is the therapist’s job to redirect the patient to the abilities they still have and the activities of interest that they can still carry out.  A patient may forget how to hold a toothbrush, but if they can still happily knit 20 scarves for family members then the therapist should provide the opportunity to promote a better quality of life.

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Purposely Involve Caregivers

Family members and primary caregivers will know more about the patient than the patient could remember for themselves. Examples include preferred morning or night routines, hobbies that bring them joy, activities that irritate them, or any aspect of life that makes the patient functionally tick. Therapists should make an effort to include caregivers, privy to the patient’s health information, in intervention in whatever setting (home, skilled nursing, inpatient rehab, assistive living, etc.).

Open Interdisciplinary Communication

Therapists who want to positively influence their patient’s rehabilitation need to make sure that everyone on the care team is on the same page: physicians, case workers, nurses and assistants, psychiatrists, and other rehab therapists. Everyone should know exactly what the patient’s and/or caregivers goals are and be making similar, structured steps to attain them.

Skilled rehabilitation therapists are not naïve about deficits a patient faces when they succumb to Alzheimer’s disease.  Instead, they have the unique ability to see past the impairments, acknowledge the person buried under the losses, and to pull them out to participate in what their own lives still have to offer.

REFERENCES

Mild Neurocognitive Disorder (2013). American Psychiatry Association.

2017 Alzheimer’s disease facts and figures (2017). Alzheimer’s Association. 

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