Characteristics of care methods for daily life disabilities in Alzheimer's type dementia that respect autonomy and independence.
Sayuri Suwa, Akiyo Yumoto, Mari Ueno and 3 others
PMID 31367416WHAT IT FOUND
Experienced dementia care practitioners rated autonomy-preserving ADL care as beneficial by Alzheimer's severity.
Mild: simplified necessities and next-step verbal prompts. Moderate: verbal task opportunities, visual marks, environment arranged together. Severe: step-by-step demonstration, preventing non-starts, slowly confirming intention.
Key findings
01For mild Alzheimer's cognitive impairment, beneficial care methods clustered around simplifying necessities and telling the person what to do next.
02For moderate impairment, beneficial care methods clustered around verbal opportunities to complete tasks, visual marks, and arranging the environment together.
03For severe impairment, beneficial care methods clustered around step-by-step explanation, preventing non-starts and interruptions, and slowly confirming intention.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The survey had a low response rate: 568 of 2,156 targeted practitioners responded, so the results may reflect only those who chose to reply. The findings are practitioner ratings of possible benefit, not patient outcomes, so they do not show that these methods improved function, autonomy, or independence. Respondents were asked to rate care for many people, not for a specific patient, and the study did not capture actual care delivered. The study did not consider detailed cognitive impairment, anti-dementia drug treatment, or behavioural and psychological symptoms of dementia, so it cannot guide care for individual patients with those factors. Very few therapists were among respondents: 4 physical therapists, 1 occupational therapist, and 0 speech therapists.
Declared interests
The authors declared no conflict of interest. No funding source is reported.
The easy way to misread this
Do not treat these clusters as proven care methods. The study asked practitioners to rate potential benefit on a 4-point scale and did not test whether any method improved daily function, autonomy, or independence in patients.