Being Dementia Friendly

Being Dementia Friendly
By C. Angela Burrow, CDP CADDCT
“Using the expertise of professionals
to better serve those living with dementia”

C. Angela Burrow recently met with Alison Starkey, PT, MBA, MHA, CAPS, CFPS, CDP of Gaitway of Charlotte to ask an important question. “How can Physical Therapy, Occupational Therapy and Speech Therapy help persons with dementia?’

The role of rehabilitation in persons with dementia has grown in recent years. For many years persons with dementia were considered unable to learn a physical therapy program and so thought not to benefit.
At Gaitway of Charlotte – we feel that anyone can benefit from a rehab program – it’s all about how you frame an activity and integrate it into normal life.
When we work with clients, we take a detailed life history – what do you like for fun, what activities annoy you, what are you fearful of, what kind of work did you do etc.
We also complete evidence based cognitive tests that allow us to see what cognitive function remains. Armed with this information, we are then able to devise a program that is cognitively appropriate for an individual that has meaning and interest to the client.
As an example – consider an older accountant, who is out to eat, but is not very good at waiting – in fact, he gets a little agitated when he has to wait to eat, and this has been hard for the family to manage. Seeing as he is an accountant – I would bring a spreadsheet for him to review, give him a calculator and ask him to check the math. A 15-minute activity that can be pleasurable and familiar for the client that helps with that waiting time.
Fall prevention is the cornerstone for any rehab program in the dementia population. Using our baseline of information, empowers us to come up with creative solutions for strengthening, balance and endurance activities. Keeping persons with dementia healthy and mobile is a priority for all families. All too often, we see clients that sit in front of TV all day and do not interact with their environment. Some families are concerned for safety and so take away the jobs that they have done all their lives. We advocate for clients continuing to do household activities that keep them as mobile as possible. Instead of arms exercises – how about you reach into the washer and take out clothes and put them in the dryer – with supervision and assistance as needed to perform the task safely. Instead of leg exercises, consider folding the laundry on the kitchen countertop standing up. For gait training, how about a trip to your favorite store and browse – if a client has low endurance or some pre-existing balance deficits – how about using a shopping cart instead of a walker? We base all of our programs in a customized way. Using their “like to do activities” and avoiding the “hate that” activity, we can challenge the client physically just by asking them to join us in a familiar activity. All of this activity blends well to preventing falls.
In the early stages of dementia, speech therapy can be very helpful for practicing functional speech and language tasks – such as reading a menu or following a recipe. Speech therapists can also work on naming objects and using signs and labels in the home.
As our clients proceed along their dementia journey we can also address, custom seating systems that are usually covered by Medicare, as well as monitor swallow function and introduce special diets to prevent aspiration. Speech therapists are the experts on swallow function and can help families navigate dealing with swallowing deficits. The speech therapists can also help with food preferences and head positioning recommendations.
At Gaitway of Charlotte, (see ad in Rehabilitation section), we provide all of these services in a seamless manner, in our clients’ homes. Every client has different challenges; we create customized programs. We also educate families and caregivers on how to implement some of our home programs, prepare for the future and plan for any eventuality that may occur.