Western New York’s Dementia Resource

Mental Function in Older Adults with Dementia

Buffalo Occupational Therapy

 

Dementia and Alzheimer’s | Buffalo NY | Buffalo OT

Michelle Eliason, MS, OTR/L, C.D.S., CKTS

 

Did you  know that an occupational therapist can address MANY areas of mental function and cognition in older adults with Dementia????

In an article published by the U.S. National Library of Medicine entitled, “The Role of the Occupational Therapist in the Management of Neuropsychiatric Symptoms of Dementia in Clinical Settings”, research states,  “Neuropsychiatric symptoms (NPS) of dementia include aggression, agitation, depression, anxiety, delusions, hallucinations, apathy, and disinhibition. NPS affect dementia patients nearly universally across dementia stages and etiologies. They are associated with poor patient and caregiver outcomes including increased health care utilization, excess morbidity and mortality, and earlier nursing home placement, as well as caregiver stress, depression and reduced employment. There are no FDA-approved medications for NPS, but it is common clinical practice to use psychotropic medications such as antipsychotics to control symptoms; however, antipsychotics show only modest efficacy in improving NPS and have significant risks for patients, including side effects and mortality. Non-pharmacologic treatments are considered first-line by multiple medical bodies and expert consensus, show evidence for efficacy and have limited potential for adverse effects. Ideally, non-pharmacological management of NPS in clinical settings occurs in multidisciplinary teams where occupational therapists (OTs) play an important collaborative role in the care of the person with dementia” (1)

Related to dementia/cognitive evaluation and intervention Every occupational therapist has a different approach to treatment execution, and every patient is different. Because occupational therapy is highly client-driven and treatment plans are made in collaboration with patients and, often times, their caregivers, therapists are constantly learning, adapting, and gaining new competencies as relates to mental function and cognitive therapy for older adults.

OCCUPATIONAL THERAPY SCOPE OF PRACTICE IN MENTAL FUNCTION AND COGNITION

HIGHER-LEVEL COGNITIVE

“Judgment, concept formation, metacognition, executive functions, praxis, cognitive flexibility, insight.”

OT PRACTICE FRAMEWORK (2014)

ATTENTION

“Sustained shifting and divided attention, concentration, distractibility.”

OT PRACTICE FRAMEWORK (2014)

MEMORY

“Short-term, long-term, and working memory”

OT PRACTICE FRAMEWORK (2014)

PERCEPTION

“Discrimination of sensations (e.g., auditory, tactile, visual, olfactory, gustatory, vestibular, proprioceptive)”

OT PRACTICE FRAMEWORK (2014)

THOUGHT

“Control and content of thought, awareness of reality vs. delusions, logical and coherent thought.”

OT PRACTICE FRAMEWORK (2014)

MENTAL FUNCTIONS OF SEQUENCING COMPLEX MOVEMENTS

“Mental functions that regulate the speed, response, quality, and time of motor production, such as restlessness, toe tapping, or hand wringing, in response to inner tension.”

OT PRACTICE FRAMEWORK (2014)

EMOTIONAL

“Regulation and range of emotions; appropriateness of emotions, including anger, love, tension, and anxiety; lability of emotions,”

OT PRACTICE FRAMEWORK (2014)

EXPERIENCE OF SELF AND TIME

“Awareness of one’s identity, body, and position in the reality of one’s environment and of time.”

OT PRACTICE FRAMEWORK (2014)

CONSCIOUSNESS

“State of awareness and alertness, including the clarity and continuity of the wakeful state.”

OT PRACTICE FRAMEWORK (2014)

ORIENTATION

“Orientation to person, place, time, self, and others.”

OT PRACTICE FRAMEWORK (2014)

TEMPORMENT AND PERSONALITY

“Extroversion, introversion, agreeableness, conscientiousness, emotional stability, openness to experience, self-control, self-expression, confidence, motivation, impulse control, appetite.”

OT PRACTICE FRAMEWORK (2014)

ENERGY AND DRIVE

“Energy level, motivation, appetite, craving, impulse control.”

OT PRACTICE FRAMEWORK (2014)

Occupational therapy was founded in mental health approaches in 1917. Although occupational therapy practice has transitioned into the medical model, much of an occupational therapist’s training is in neurological topics, psychosocial approaches, and cognitive therapy. How does movement affect the mind. Because OT is a generalist rehabilitative specialty, a clinician is able to view a patient in whole. What will be the best activity-based treatment approach to help the entire patient including mental faculties. 

 Older adults facing non age-related memory deficits may present with a variety of signs and symptoms. 

Michelle Eliason, MS, OTR/L, C.D.S, CKTS  is both an occupational therapist and CARES Dementia Specialist. She has been an elder care professional for 7+ years. Working in various aspects of the elder care industry has given her a generalist skill set and a broad knowledge base of elder care approaches and resources. Michelle is passionate about influencing the elder care industry advocating against nursing home negligence and elder abuse, and working with older adults to enable them to live in their own homes throughout the aging process.

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