MindStart Offers Tips for Therapists: Succeeding with Reluctant Patients with Dementia

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Patients with dementia may have difficulty participating in occupational or physical therapy programs, due to the complex nature of their dementia. MindStart has released 10 tips for successful dementia therapy, as a guide for therapists and other professional staff.

dementia therapy, dementia activities, patient with dementia, MindStart
MindStart dementia products can be used in therapy for coordination, cognition, and visual-perceptual skills.

Patients with dementia have a risk of falling that is two to three times higher than that of cognitively intact elders. They are also two to three more times more likely to be hospitalized.    Participation in occupational therapy and/or physical therapy can be crucial to prevent falls or to rehabilitate the person after a fall or hospitalization. However, some patients with dementia refuse to participate and might even get angry when approached, because of the complex nature of their condition.

Monica Heltemes, founder and owner of MindStart, an Alzheimer activities product company, is an occupational therapist with an expertise in dementia care. She explains that individuals with dementia are often unable to see their own deficits and cannot reason well. This means that the person may not understand why he or she should 'work' in therapy to improve their condition and functioning. Therapists cannot force the patient to do something they do not want to do, however, they should not give up too easily to find a way to help the patient gain strength, balance, and abilities for everyday tasks through rehabilitation.

To help therapists and other professionals with challenging dementia patients, MindStart has released 10 tips to gain trust and cooperation from the patient to lead to a successful outcome.

1. For the patient with dementia, each encounter with the therapist might seem like the first one. For this reason, therapists should introduce themselves each time. They should speak slowly, give the patient time to respond, and demonstrate what they would like the person to do.

2. If during the first encounter with the patient, the therapist is told to go away, the therapist should not immediately leave and give up. The patient might feel intimidated and not know what is wanted. The therapist should try to talk to the person for a few minutes before leaving, such as asking about pictures in the room, complimenting the person, or asking if he would like a cup of coffee or tea. The therapist can also ask family about the patient's history, all to help build trust and to find a way to connect with the patient the next time.

3. The therapist should use validation when needed. For instance, if the patient tells the therapist they are tired or upset, the therapist should validate what is being said, such as: "It sounds like you have had a difficult day. You must have a lot on your mind." Taking some time to validate what the person is feeling first can show empathy and gain the person's trust. The therapist can then move to the next step, such as "I bet a walk over to that large window would feel good. Let's see what flowers are out there," and so on.

4. The therapist should consider avoiding the word "therapy." This word might turn off the patient, as he might not know what that means. "Let's take a walk," "put on a sweater," "make a snack together" can be better received and can be activities that can meet therapy goals, if set-up correctly.

5. The therapist should incorporate skill-building into functional tasks. Doing rote exercises, including using weights or bands, may be rejected by the person with dementia who is reluctant to participate. Instead, the therapist should adapt the approach, to work on component skills within the context of function. Occupational therapists might incorporate self-care tasks, like dressing, or other life tasks into treatment, such as making a snack or washing dishes. Physical therapists might incorporate walking, playing catch with another patient, or riding a stationary bike into treatment, all of which are functional, life activities that might be used to meet the therapy goals..

6. The therapist can incorporate common hobby items into treatment. This might entice the patient with dementia to participate. For instance, the MindStart dementia activites can be used when addressing coordination, cognitive processes, and visual-perceptual skills when used from a seated position. They can also work on endurance and balance when used from a standing position.

7. The therapist should find the person's good times of the day. Morning is often better for individuals with dementia. Or it may work well to approach the patient when he is already out of the room for a meal or activity.

8. The therapist should try again when a patient refuses. The patient's mood may be different later. Or another therapist can try.

9. The therapist should incorporate the patient's family when refusals are an issue. Often a family member will be able to lighten the mood or provide the patient with security, so that the patient is more willing to work with the therapist.

10. The therapist can speak to the physician. Sometimes the physician can encourage the patient to participate. Or the therapist might show the patient the physician's written prescription for the therapy sessions.

With some patience, empathy, and creativity, therapists can usually gain cooperation from the reluctant patient with dementia, leading to successful therapy sessions and, ultimately, improved function and quality of life for the person.

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