Putting mirrors in unexpected places and keeping old photo albums handy might just make life a bit easier for people with Alzheimer's and those who live with and care for them.
They're among suggestions offered by occupational therapists as ways to modify daily life as the degenerative brain disease takes its course.
"In some cases, occupational therapy has been overlooked for Alzheimer's disease, but it can make such a difference in keeping people at home when you learn how to set up the environment for success and safety," said Chad Morton, an occupational therapist who's managing director of therapy services for Amedisys Home Health Services in Baton Rouge, La.
According to the American Occupational Therapy Association, occupational therapy can help people with Alzheimer's and their caregivers by:
- Helping the person with Alzheimer's do things independently.
- Keeping the person with Alzheimer's safe.
- Preventing falls and other injuries.
- Safeguarding against wandering.
- Helping families maintain an emotional connection.
"Our primary objective with occupational therapy is to keep people as independent as possible and doing their activities of daily living, like eating, bathing, dressing and grooming," Morton said. "We can attempt to rehabilitate anything that's important to a person.
"It's important to identify what remaining abilities they have. In most cases, they aren't going to be able to learn new things, but you can prolong their ability to self-care by using procedural memory."
That means setting up patterns and routines that need to be the same every day. Then, with cues, the person taps into his or her procedural memory, explained Jill Dennis-Perez, an occupational therapist and clinical specialist at the Center of Excellence at the New York Visiting Nurse Service.
"Once you learn how to ride a bike, you always know how to ride a bike," she explained.
"We do the same thing over and over again in the same manner. So when someone is getting dressed, they need to do it in exactly the same order every day. Blouse first, then trousers, then socks, then shoes. It's the same sequence every day. An external cue, like an alarm clock, can remind them to do certain tasks, instead of a person having to tell them what to do."
The more experience an occupational therapist has, the better your chance of gleaning some unusual tips about caring for someone with Alzheimer's. For example, Dennis-Perez said that a simple way to help prevent wandering, a common issue with the disease, is to place a mirror on the doors that lead outside. It's unexpected and may distract the person long enough to forget the original idea of going outside.
Both Morton and Dennis-Perez emphasized the importance of altering the home environment to accommodate the person with Alzheimer's.
"Being able to go to the home and see the home environment is so important," Morton said. "Sometimes, adapting the environment is as simple as removing throw rugs and installing grab bars in the bathroom. If you can keep them as independent as possible, it will improve their quality of life, and it will ease the caregiver's burden."
Other tips? When someone with Alzheimer's gets flustered or agitated, which is another common occurrence, "if they're in a safe environment, walk away for a few minutes," suggested Dennis-Perez. "When you come back, they may have forgotten why they were mad."
She also suggested using audio or video monitors, designed to watch newborns, to "help you keep an eye on the person with Alzheimer's but still let them feel independent."
To help maintain an emotional connection, which can be especially hard when a parent or grandparent no longer remembers who you are, both occupational therapists recommended looking at family pictures, especially older pictures, and asking them to talk about the people in the pictures.
"They can remember things from 30, 40 or 50 years ago, so sitting down with old picture albums and reliving those shared interests with them can make a huge impact on quality of life for both the patient and caregiver," Morton said.
It's also important to help people with Alzheimer's engage in activities they enjoy and to give them tasks that help them feel they're doing something worthwhile, Dennis-Perez said. "Some tasks can do double duty," she said. "If they take out the trash, it helps give their day meaning while it's helping them maintain walking strength and balance."
But occupational therapy isn't just for the person with Alzheimer's, Morton noted.
"We can teach caregivers to do things as simply as possible," he said. "A lot of times, they're going about caregiving tasks in a difficult way. We can teach them adaptive techniques. Our main goal is to decrease caregiver burden."