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Improving Quality of Life
While there is currently no cure for dementia, research has shown that there is much scope to improve the quality of life of people living with dementia through management of symptoms and providing a supportive environment.
Alternative Therapies
There are a wide range of non-drug alternative therapies that may be effective for people with dementia. These include therapies aimed at improving understanding and communication as well as therapies aimed at managing behavioural and psychological symptoms of dementia.
Therapies such as validation therapy, reality orientation and reminiscence therapy aim to facilitate understanding and communication, but may also have positive effects on anxiety and mood. Validation therapy uses communication strategies to encourage people with dementia by accepting their reality. Reality orientation provides information about the environment to orientate a person with dementia to their surroundings using aids and prompts. Reminiscence therapy promotes memory and recall by reviewing past events, assisted by multimedia memory aids.
There is some limited evidence that these therapies may be beneficial in improving behaviour, mood, and possibly cognition. However, only a small number of studies have been undertaken in this area and there is not enough evidence to conclusively determine if there is any benefit. More rigourous study is needed to demonstrate the effectiveness of these alternative therapies.
Another alternative approach involves sensory therapies. Sensory therapies use stimulation of the different senses such as touch, smell, hearing and sight to promote wellbeing and reduce stress and anxiety in people with dementia. Sensory therapies include art therapy, music therapy, aromatherapy and touch therapy as well as snoezelen therapy.
Snoezelen therapy is a good example of a sensory therapy that uses a variety of sensory modes. Snoezelen rooms are multi-sensory environments containing different lighting effects, touchable surfaces, music and aromas to stimulate various senses. Snoezelen may have short term effects in promoting positive mood and reducing anxiety, although little research has been undertaken to fully document the approach.
Although relatively little research has established the effectiveness of these therapies, many believe that they can be useful in improving the quality of life of people with dementia. In general, it appears as though a range of alternative therapies may be most useful. However, more research will be needed to examine the role of alternative therapies in improving quality of life for people with dementia.
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Keeping active
There are many interventions which aim to help people with dementia maintain independence and keep active. A recent Dutch study has demonstrated that occupational therapy can assist people with mild to moderate dementia. In the study, participants received in-home occupational therapy sessions over five weeks. The intervention focused on developing strategies to compensate for changes in memory and thinking skills and develop compensatory approaches. Participants who received the intervention showed improvements in the performance of daily activities and required less assistance to perform tasks, suggesting that such interventions can improve management of dementia symptoms.
Other interventions use exercise training or memory training to promote both physical fitness and brain function. In one study, a combination of reality orientation, thinking exercises and training in activities of daily living produced positive effects on both thinking and behaviour. Other studies have indicated that exercise training can positively affect thinking, physical fitness and mood in people with dementia.
Managing Behaviour
Many people with dementia develop behavioural and psychological symptoms over the course of the condition, such as anxiety, depression, aggression, wandering, agitation or loss of inhibitions. A great deal of research is dedicated to examining strategies to assist in recognising the causes of changed behaviours and in managing behaviour.
One such program aims to improve sleep problems in people with dementia. The NITE-AD program (Nighttime Insomnia treatment and education for Alzheimer’s disease) is a sleep education program that develops individualised sleep plans incorporating training in good sleep practices and behaviour management. Strategies included sleep hygiene (regulated timing of bed times and limiting naps) and daily walking as well as regulated light exposure. The program resulted in reduced sleep disturbances such as night time awakenings and depression which lasted for at least 6 months.
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Supporting Carers
Another major element in dementia care research is providing support and training to carers and family members of people with dementia. Carers are often at increased risk of depression and other illnesses and research in this area focuses on interventions that can best support them in a range of ways.
The New York University Spouse-Caregiver Intervention Study has been running for over 17 years to examine the benefits of teaching coping strategies and providing support to carers. The study program includes intensive counselling, support groups and on-demand telephone counselling services. The study has shown that education, support and counselling can improve carer well being, reduce depression, and allow people with dementia to successfully live at home for longer. This study, and others like it, have demonstrated that education and counselling services can enhance communication, problem solving, planning and behaviour management, resulting in increased quality of life for people with dementia, their families and carers. A further study has demonstrated that intensive counseling and support programs for carers reduced depression and stress in carers of people with dementia and led to an average delay in residential care placement by 18 months.
For more information, please see Alzheimer’s Australia Information pages on Family & Carers or Care Links: external related websites.
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Care Links
Dementia Carer Brochure
Information Brochure from the Royal Australian College of General Practitioners
Dementia: The Carer Experience
Guide for carers of people with dementia from the Australian Government Department of Health and Ageing
Caregiving: Alzheimer’s Research Forum
Information on providing care, getting support and personal stories.
Caregiving News: Fisher Center for Alzheimer’s Research Foundation
Current news stories related to care issues
Research into Care
Information about research into dementia care by the UK Alzheimer’s Society
Current Research into Caregiving
Resource by the Fisher Center for Alzheimer’s Research Foundation
Current Research Projects involving Dementia Care Mapping
Research from the Bradford Dementia Group at the University of Bradford, UK
