Laura N. Gitlin, PhD, director of the Jefferson Center for Applied Research on Aging and Health (CARAH) at Thomas Jefferson University, Philadelphia, recently spotlighted the results of Care of Persons with Dementia in their Environment (COPE) trial before the Senate Special Committee on Aging.
The presentation detailed how occupational therapy improves functional dependence of dementia patients and home caregiving.
During COPE, researchers documented that antidementia medications showed few—if any—benefits for physical function or caregiver burden and may have substantial adverse effects.
After 4 months of COPE intervention, Gitlin’s team observed improvement in functional dependence for patients, most notably for such activities as using the phone, shopping, preparing meals, and doing housework. A slight increase was also noted for self-care activities such as bathing, dressing, and grooming. Caregivers who were also undergoing COPE treatment reported improvement in well-being and confidence.
“This study requires a new way of thinking about dementia care by physicians and practitioners, and highlights the important role of occupational therapists and nurses as part of the dementia care team,” Gitlin said. "It reinforces other recent findings that nonpharmacological, biopsychosocial-environmental interventions may positively contribute to disease management of patients with dementia who live at home and their caregivers. More research is needed to examine effects of underlying medical conditions, ways to boost treatment effects, cost-effectiveness, and other issues, but this is an indication that nonpharmacologic approaches should be integrated into the standard of care of patients with dementia."
More than five million people in the United States suffer from dementia; that number is estimated to reach 13.5 million by 2050. Most live at home and are cared for by family members. With disease progression, families increasingly provide hands-on physical assistance with the activities of daily living.
