What is the role of occupational therapy and people with dementia?
What is memory?
Memory is the brain's capacity to store, hold onto, and recall facts and experiences. It is a fundamental cognitive process that enables us to take in new information, recall past experiences and events, and apply this knowledge to decision-making and problem-solving.
There are several different types of memory, including:
The term "sensory memory" refers to a fleeting (less than a second) memory of sensory data, such as what we see, hear, or touch.
Working memory and short-term memory both refer to the memory that we use to hold and process information in the moment. It is typically used to store information that we are currently using or processing and has a limited capacity and duration.
Information is kept in long-term memory for a longer time, possibly forever. It can be broken down into two main categories: declarative memory (explicit memory), which houses information that we can consciously recall and describe, like facts and events, and non-declarative memory (implicit memory), which houses knowledge that shapes our actions and routines, like skills and procedures.
Approximately 597,000 people in Canada living with dementia in 2020. And an estimated 955,900 people are projected to live with dementia in 2030. - Alzhimer Society
We can learn, adapt, and navigate the world around us thanks to memory, which is a crucial aspect of our lives. Additionally, memory is a complicated and multifaceted process that still needs to be fully understood. Researchers are currently looking into how memory functions and how it can be strengthened.
What happens to memory as people get older?
People may notice some changes in their memory as they age. These typical changes do not imply that a person has a particular memory disorder. Typical alterations that could take place include:
Slowing of retrieval: Retrieving information from memory may take longer, and people may have to work harder at it.
Having a harder time learning and remembering new information, especially if it is presented in a way that makes it more meaningful and applicable.
Increased difficulty with mental tasks: Mental tasks that demand a lot of information processing or manipulation, like solving challenging math equations or learning a new language, may be more challenging.
Changes in the capacity for multitasking: Quickly switching between tasks or multitasking may now be more difficult.
Some memory areas may experience specific age-related changes. For instance, age-related declines in semantic memory (memory for concepts and general knowledge) have been observed. In contrast, other factors, such as stress or health issues, may have a greater impact on episodic memory (memory for specific events and experiences).
It is significant to note that there are many things people can do to support and maintain their cognitive function as they age and that these changes in memory are not unavoidable. These might include doing mentally challenging things, working out frequently, eating well, and getting enough sleep.
What are cognitive impairment and dementia?
A decline in cognitive function—the mental operations necessary for learning and using knowledge, such as thinking, remembering, and learning—is referred to as cognitive impairment. A person's capacity to carry out routine tasks and activities is affected by cognitive impairment, which can range in severity from mild to severe.
A decline in cognitive function that is severe enough to affect a person's daily life and activities is referred to as dementia. Memory, language, problem-solving, and other cognitive abilities can all be impacted by dementia. Dementia is a term used to describe a collection of symptoms that may be brought on by a number of conditions, such as:
The most frequent cause of dementia, accounting for 60 to 80% of cases (more information below), is Alzheimer's disease. It is a chronic condition that damages brain cells and eventually renders a person incapable of performing daily tasks due to a decline in cognitive function.
The second most frequent type of dementia is vascular dementia, which is brought on by decreased blood flow to the brain, frequently as a result of numerous minor strokes.
Dementia caused by Lewy bodies: These abnormal protein deposits in the brain are what cause Lewy body dementia. It can result in a variety of symptoms, such as changes in cognition, movement, and behaviour.
A person's quality of life and capacity for independent functioning can be significantly affected by dementia, a serious and progressive condition. Although dementia cannot be cured, there are drugs and other treatments that can help manage the symptoms and enhance quality of life.
56% of Canadians are concerned about being affected by Alzheimer’s disease, and 46% of Canadians admit they would feel ashamed or embarrassed if they had dementia. - Azheimer Society
Alzheimer's disease is a neurological condition that worsens over time and affects brain cells, impairing cognitive function. It accounts for 60 to 80 percent of dementia cases, making it the most prevalent cause.
Alzheimer's disease is characterized by memory loss and a decline in cognitive ability. Usually, these symptoms start out mildly and get worse over time. The following are some additional typical symptoms:
Difficulty with language and communication
Difficulty with problem-solving and decision-making
Changes in mood and behaviour
Difficulty with coordination and movement
Although the precise cause of Alzheimer's disease is unknown, it is thought to be a result of a confluence of genetic, environmental, and lifestyle factors. The greatest risk factor for Alzheimer's disease development is age, and the risk rises with age. A family history of the condition, head injuries, high blood pressure, and unhealthy lifestyle choices like smoking and a poor diet may also be risk factors.
Despite the fact that there is no known cure for Alzheimer's, there are drugs and other treatments that can help manage the symptoms and enhance quality of life. These might include non-pharmacological treatments like cognitive-behavioural therapy and occupational therapy as well as drugs that improve memory and cognitive function. If you or a loved one is exhibiting symptoms of Alzheimer's disease, it is critical to seek medical evaluation and treatment as soon as possible..
What are some risks factors for dementia?
There are several risk factors for dementia, including:
Age: The risk of developing dementia increases, which is more common in people over 65.
Family history: A history of dementia increases the risk, particularly for a parent or sibling with the condition.
Head injury: Severe or repeated head injuries, especially those that result in a loss of consciousness, increase the risk of developing dementia later in life.
Cardiovascular risk factors: Certain cardiovascular risk factors, such as high blood pressure, high cholesterol, diabetes, and obesity, may increase the risk of developing vascular dementia, the second most common cause of dementia.
Smoking and alcohol use: Smoking and heavy alcohol have been linked to an increased risk of dementia.
Lack of mental and physical activity: Engaging in mentally and physically stimulating activities may help protect against the development of dementia.
Poor diet: A diet high in saturated fats and sugar and low in fruits, vegetables, and whole grains has been linked to an increased risk of developing dementia.
How to prevent cognitive decline and dementia?
While it is not possible to completely prevent cognitive decline or dementia, there are many things that people can do to help maintain their cognitive function as they age. These may include:
Engaging in mentally stimulating activities: Engaging in activities that challenge the brain, such as reading, puzzles, or learning a new skill, may help to maintain cognitive function.
Getting regular exercise: Regular physical activity has been shown to positively affect cognitive function and reduce the risk of cognitive decline and dementia.
Eating a healthy diet: A diet rich in fruits, vegetables, whole grains and low in saturated fat and sugar has been linked to a lower risk of cognitive decline and dementia.
Getting enough sleep: Adequate sleep is vital for maintaining overall health and well-being, including cognitive function.
How is dementia diagnosed?
Dementia is typically identified through a combination of cognitive and medical tests, as well as a review of the patient's medical history and symptoms. Dementia cannot be diagnosed with a single test, so a healthcare professional will typically make the determination after conducting a thorough examination.
The process of diagnosing dementia usually involves the following:
Medical evaluation: To rule out other conditions that could be the source of the symptoms, a healthcare professional will conduct a physical examination and may order laboratory tests and imaging studies, such as a brain scan.
Cognitive evaluation: To evaluate the patient's memory, language, problem-solving, and other cognitive abilities, the healthcare provider may administer a variety of cognitive tests.
Interviews with the patient and their family or caregivers: During these interviews, the healthcare provider may inquire about the patient's symptoms, medical history, and daily functioning.
Consider other conditions that might be causing the symptoms, such as depression, drug side effects, or an underlying medical condition, in order to rule out other conditions.
When dementia is identified, a treatment plan that may involve medication, therapy, and other support services will be created in collaboration with the patient and their family. If you or a loved one is exhibiting symptoms of dementia, it is critical to seek medical attention as soon as possible because early diagnosis and treatment can enhance the person's quality of life.
How is dementia treated?
Dementia has no known cure, so managing the symptoms and enhancing the patient's quality of life are the main goals of treatment. Depending on the underlying cause of dementia and the patient's unique needs, a treatment strategy will be chosen.
Alzheimer's disease, the most prevalent cause of dementia, can be treated with a number of medications to help patient's memory and cognitive abilities. These drugs, known as cholinesterase inhibitors, work by raising the levels of acetylcholine, which is important for memory and learning. Non-pharmacological treatments aim to better the patient's quality of life while managing their symptoms. They might consist of physical therapy, occupational therapy, and cognitive behavioural therapy. Help with daily chores like bathing and dressing, as well as emotional and social support for the patient and their caregivers, can all be considered supportive care.
What is the role of occupational therapy and people with dementia?
People with physical, mental, or developmental disabilities can lead independent and fruitful lives with the aid of occupational therapy. Occupational therapy can support people with dementia in maintaining their physical and cognitive abilities and carrying out meaningful activities.
Occupational therapy can assist those who have dementia in adapting to changes in their physical or cognitive abilities as well as improving their functional skills, such as bathing, dressing, and grooming. Occupational therapy can assist people with dementia in continuing to enjoy and derive meaning from their hobbies even as their abilities deteriorate.
By identifying and addressing safety hazards and offering advice on how to modify the home environment to meet their changing needs, safety can help people with dementia stay safe at home. In order to help caregivers of dementia patients better understand their loved one's needs and create strategies to support their independence and well-being, occupational therapy can educate and support them.
People with dementia may benefit greatly from occupational therapy as part of their care because it can help them maintain their skills, engage in worthwhile activities, and live safe, independent lives. They typically receive specialized training and encounters working with dementia patients from occupational therapists.
The annual cost of dementia to the Canadian economy and healthcare system is over $10.4 billion - Azheimer Society
How do occupational therapists improve functional skills?
To help people with dementia improve their functional skills, such as bathing, dressing, and grooming, occupational therapists employ a variety of techniques. The following are some specific techniques that an occupational therapist may employ to enhance functional skills:
A complex task is broken down into smaller, more manageable steps using task analysis, and each step is taught separately. By doing so, people with dementia may be better able to comprehend the task at hand and complete it on their own.
Adaptive equipment: To help people with dementia carry out daily tasks more effectively, occupational therapists may suggest and provide adaptive equipment, such as dressing aids or bathing aids.
Environmental changes: To help people with dementia perform tasks more safely and independently, the therapist may recommend making changes to the home environment, such as installing grab bars or making items more accessible.
Sensory integration: To help people with dementia process and react to their environment more effectively, occupational therapists may use sensory integration techniques, such as giving sensory input through touch or movement.
Cognitive rehabilitation: To help people with dementia improve their cognitive skills and carry out daily tasks, occupational therapists may use cognitive rehabilitation techniques, such as memory techniques and problem-solving exercises.
Occupational therapists are qualified to evaluate the functional abilities of dementia patients and create personalized treatment plans that take into account each patient's specific requirements and objectives. To help the person with dementia maintain their skills and independence, the therapist will work closely with them and their caregivers.
Dementia numbers in Canada. (n.d.). Alzheimer Society of Canada. https://alzheimer.ca/en/about-dementia/what-dementia/dementia-numbers-canada
Public Health Agency of Canada. (n.d.-a). Dementia: Overview - Canada.ca. https://www.canada.ca/en/public-health/services/diseases/dementia.html